Welcome back!

Welcome to this first new edition of the advocacy newsletter.

This new format puts the spotlight on the work of our national cardiac societies’ advocacy efforts, and the volunteers behind them. 

Each addition will draw attention to the work of our different national societies on their experiences and learnings as we push to ensure that cardiovascular health receives policy attention and funding, proportional to the challenges we all know it represents.

- Donna Fitzsimons and Francesco Cosentino, Co-Chairs of the ESC Advocacy Committee

This month's spotlight: the Bulgarian Society of Cardiology

We recently caught up with Vassil Traykov, current president of the Bulgarian Society of Cardiology, which celebrated its 50th anniversary earlier this year.

He was fresh off of participating at a conference on cardiovascular health in Sofia, hosted by Mariya Gabriel, former deputy prime minister and former European Commissioner, and by Frederique Meurice, Ambassador of Belgium to Bulgaria and attended by European Commissioner for Health Stella Kyriakides, among others.

The ever-rotating cast of politicians poses a challenge — “a bit of a limitation,” Dr. Traykov admits — but one that can and must be overcome. Along with the European elections in June, Bulgaria also had its own elections that same month for government and parliament.

“Politicians change, but we have to work with each one of them,” he says. “It’s a step-by-step process, with each step we take we advance a bit, until we reach where we want to go.”

Despite the challenges, Dr. Traykov is hopeful. Among those present at the conference was Hungarian Ambassador to Bulgaria Miklós Boros, who assured attendees cardiovascular health will be among the top of the priorities list during his country’s turn at the helm of the rotating presidency of the Council of the EU, which kicked off this week.

“We do believe it will be the next breakthrough,” Dr. Traykov said of cardiovascular care, “as it happened with oncology and cancer.”

Premature deaths in Bulgaria are more than two times higher compared to the ESC and EU median. According to our Atlas data, CVD accounts for 65% of female deaths and 55% male. Its overall economic burden stands at almost €2 million. 

On the bright side, there has been a steady development in cardiovascular care in the country, “comparable” to other countries of similar size, says Dr. Traykov. Reimbursement of cardiovascular care is growing but there is still a substantial need for improvement, he explains. Some of the biggest areas needing improvement as well are patient rehabilitation, raising awareness of the various causes of CVD (such as smoking, excessive alcohol consumption and eating habits) and, above all, prevention.

Bulgaria has developed a lot in the past 20-15 years in terms of cardiology, with new labs around the country. While mortality is lower than it used to be, the number of patients is not. As the population itself is decreasing as well, this aspect is concerning, and the changes the country is implementing nowadays “will only show results 10 years from now.”

The overarching goal for this year? “Advance with the document,” he says, referring to the National Plan for Cardiovascular Health that the society has been working on for a while. “It won’t be an easy task,” he says. 

Dr. Traykov is happy to see the rise in attention from the EU institutions, he says, towards putting cardiovascular health at the top of the political agenda.

In Bulgaria, younger people are becoming more aware of the impact smoking, alcohol consumption and eating habits have on their cardiovascular health. “They’re showing promise that things will change,” he says, they exercise more and eat better. “This makes me very, very happy.”

Bulgaria will be hosting its biannual National Congress of Cardiology in October, during which it will welcome ESC volunteers and other prominent experts.

Moving towards the future, through research

Research is crucial for the advancement of treatment against Europe’s biggest killer. But difficulties in sharing health data across borders within the European Union are creating a roadblock in the path to innovation.

Right now, sharing health data across borders in Europe easily is nearly impossible: because computer systems do not “speak” the same language, translation protocols would be needed in order to transfer the data. To transfer this data across borders, computers today would need to translate across about 351 different languages for the 27 EU member states — and that’s a modest estimate. 

This technological obstacle, plus a few regulatory hurdles, prevent us from using health data to its full potential — both in terms of treating patients, and for secondary uses such as research.

Earlier this year, the European Parliament approved a new regulation that will improve the sharing and use of health data across the European Union.

Through the European Health Data Space, Europe will be able to use its data to its full potential — both improving healthcare delivery and facilitating innovation and policy decisions. Once a common system is in place, computers in all member states would all speak in one common language. 

For its part, the ESC welcomes this change. Its Regulatory Affairs Committee has been at the forefront of discussions since the European Commission published this proposal back in 2022. The framework “holds promise for improving cardiovascular healthcare outcomes,” committee chair Piotr Szymański said. 

He also warned the battle is not yet over: “It is important to ensure that the new regulation is implemented in a harmonised way to achieve its ambition.”

The EHDS, in a nutshell: As a regulation, the EHDS will be applicable in all member states. It will be implemented starting in 2026, and will create a common data language through which EU citizens would have access to their health data in all member states (Someone living in Romania but needing an emergency hospital visit while on vacation in Italy, for instance, would benefit from 

How we got here: From its inception, the ESC has engaged with this file and worked towards strengthening stakeholder involvement. Our Regulatory Affairs Committee developed a position paper, held meetings with a wide cast of EU officials as well as with representatives of our national societies, who were asked to send in recommendations.

We will be back next month with a spotlight on the Hungarian Society of Cardiology and a look into the EU's new pharma reform legislation.