The first 1,000 days of a child’s life lay the foundation for their future health and development. Access to timely medical care, including essential medications, is critical in preventing complications and ensuring children thrive. Recognising this, Bulgaria’s National Assembly has taken a landmark step: from July 1, 2025, children up to 7 years old will receive free prescription drugs for acute infections, including antibiotics and corticosteroids, covered by the National Health Insurance Fund (NHIF). This historic change is the result of a decade-long advocacy effort led by the Trust for Social Achievement (TSA), co-leader of the First Years, First Priority campaign in Bulgaria, and a coalition of civil society organisations working to ensure equitable healthcare access for all children.
A smart investment in health
This decision isn’t just about easing financial strain on families—it’s a strategic investment in public health. By ensuring timely treatment, Bulgaria can reduce unnecessary hospitalizations, prevent complications, and cut long-term healthcare costs. Government estimates suggest the measure will require 10-20 million leva, but civil society organizations argue it will ultimately save money by reducing severe illness and hospital stays.
A decade-long advocacy victory led by TSA
This achievement is the result of persistent advocacy by civil society organisations, spearheaded by TSA. A decade ago, TSA launched the “Together – Healthy Baby, Healthy Future” program, which identified two major barriers to child health: limited access to prenatal care and unaffordable medications for children in poverty. As part of their pilot project, TSA covered these costs for families who could not afford them, gathering crucial data to advocate for systemic change. Since 2021, the “Colorful Tomorrow for Our Children” initiative, with TSA’s leadership, has driven forward policy reforms, working alongside a coalition of NGOs forming the We Care Network and funding partners. Through research, discussions, and collaboration with medical experts and policymakers, they built the case for reform, culminating in this milestone decision.
The data that made the difference
A 2025 report, initiated by TSA and its partner organizations, highlighted the urgent need for intervention. It found that half of Bulgarian parents struggle to afford their children’s medications, with 14.4% facing severe financial difficulty. Families spend an average of 562.32 leva per child on medicine annually, contributing to over 1 billion leva in total costs. In contrast, the NHIF spent over 126 million leva on hospital treatment for children in 2024, much of which could have been avoided with earlier outpatient care. The study estimated that free medications for all children under 7 could prevent at least 10% of pediatric hospitalizations.
A healthier future for all
Beyond financial savings, the initiative has profound long-term benefits. Early access to treatment reduces chronic illnesses, supports cognitive and physical development, and helps create a healthier generation. Civil society leaders, including TSA, emphasise that health policies should reflect core values—no child should suffer due to financial barriers.
Bulgaria’s decision marks a major step toward health equity, ensuring that every child, regardless of background, gets the care they deserve. Thanks to TSA and its coalition’s relentless advocacy, this policy shift will help build a stronger, healthier future for all, with lasting benefits that begin in the most crucial years of a child’s life. The early days are when a child’s development is most sensitive, and timely access to the right treatment can have lifelong implications, ensuring that every child has the opportunity to grow into a healthy, thriving adult.
