A m e r i c a n C h a m b e r o f C o m m e r c e i n B u l g a r i a

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Is There a CureIs There a Cure for the Healthcare?for the Healthcare?

A m e r i c a n C h a m b e r o f C o m m e r c e i n B u l g a r

AmCham Established a CommitteeAmCham Established a Committee

Analyses:Analyses:The ShadowThe Shadow Business GrowthBusiness GrowthU.S. Depar tment of StateU.S. Depar tment of State on Human Rightson Human Rights

Events:Events:AmCham Awarded T wiceAmCham Awarded T wice at Eventexat EventexSki Tournament 2014Ski Tournament 2014

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Nobody likes to be chastised. Aversion to criticism is equally common among grumpy teenagers, successful middle-aged professionals, mega-rich rock stars and espe-cially well practiced by entire countries. As individuals and as members of a group, we all can suffer from a degree of willful blindness, self-imposed leniency towards our own faults and failures. We all want to protect our dignity and look our best. We may even go to some length to suppress or divert information that casts us in nega-tive light. Call this part of the human condition.

Little surprise then, that the most recent installment of the U.S. Department of State’s (www.state.gov) annual report on human rights practices around the world received little attention in the Bulgarian media when it was released on Feb. 27, 2014. For the 38th time U.S. top diplomats have prepared a country-by-country overview, enumer-ating problems and difficulties. Bulgaria is not the worst offender, by far. But it receives its share of reproach – and I recommend that this analysis be considered in all seriousness.

“The marginalization of the Romani minority remained the country’s most pressing human rights problem,” says the report in its second paragraph. And continues, “The continued deterioration of the media environment and increase in media self-censorship due to corporate and political pressure were also problematic.” It goes on to discuss concerns such as corruption, inadequate prisons, ill-functioning judicial system, abuses of wiretapping, harsh conditions in refu-gee centers, increasing online anti-Semitism, discrimination against LGBT persons, among others.

Put your hand on your heart and tell yourself, in all honesty: Is that not true? Are you living in a peachy country that respects all its minorities and enjoys perfectly functioning media, social and political systems? I doubt it (and need I remind you about the harsh evaluation from Reporters Without Border, which put Bulgaria at the unenviable 87th place according to press freedoms in 2013?)

But if you were to argue with me publicly (and Facebook recently has become the arena of the fiercest verbal battles I have ever seen), you would probably give me an earful about how the United States has no right to criticize Bulgaria because a) NSA, b) Iraq, Afghanistan, c) treatment of Native Americans, Black slaves, d) Middle East…. The list may go on and on and on. I’ve heard it all, and actually many of these arguments are valid and worthy.

Still, truth be told – at least as far as Bulgaria is concerned, the U.S. Department of State’s report is a fair assessment of our troubles with human rights practices. Any professional arbitrator will tell you that acknowledging and agreeing on the problems are the first steps toward their solution. Then you need the desire to resolve them instead of wallowing in misery for misery’s sake. Blaming others for pointing out you own shortcomings is the worst imaginable defense.

But I will have none of this defensiveness and I hope that you, too, as thinking and active people, will accept no less than Bulgaria’s fessing up to its issues – and swiftly acting to correct them. This magazine will remain a venue for analytical conversions and self reflection but the real change will come from the efforts of AmCham members who pos-sess tremendous collective force to demand better governance where it is lacking, less intrusion from the state, respect for privacy and stronger protections for the vulnerable groups.

The job is yours for taking.

Sincerely,

Christopher KaradjovDeputy Editor-in-Chief

AmCham Magazine

Dear Reader,

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Publisher American Chamber of Commerce in BulgariaBusiness Park Sofia, Mladost 4 AreaBuilding 2, Floor 6, Sofia 1766, BulgariaTel.: +359 (2) 9742 743Fax: +359 (2) 9742 741e-mail: amcham@amcham.bgwww.amcham.bg

Editor-in-ChiefMilen Marchev

Deputy Editor-in-ChiefChristopher Karadjov

Senior Editor:Irina Bacheva

ISSN 1312-935X

Writers:Boyko Vassilev, Marina Tzvetkova, Mina Georgieva, Panayot Angarev, Yuliana Boncheva

AdvertisingAmCham Bulgaria: Nadejda Vakareeva, nadia@amcham.bg

AmCham Bulgaria Magazine:Milen Marchev, milen@milenmarchev.com

The AmCham Bulgaria Magazine reaches a broad audi-ence of AmCham members, leading US, Bulgarian and international companies, US and Bulgarian decision-mak-ers, all AmChams around the world.Subscription is free of charge. If you would like to sub-scribe to AmCham Bulgaria publications, please contact the AmCham Bulgaria office.

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AmCham Bulgaria Magazine is a primary forum for political and economic analyses, news, viewpoints as well as for the presentation of new business opportunities. The articles in the AmCham Bulgaria Magazine express the opinions of the authors and do not necessarily reflect the position of the American Chamber of Commerce in Bulgaria.

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Contentsc o v e r s t o r y

Cure for Healthcare? . . . . . . . . . . . . . . . . . . . . . 4

By Marina Tsvetkova

Healthcare Committee Established . . . . . . . . . . . . 8

Strong Reform with Clear Objectives is Crucial for Resolving Issues in Healthcare Sector. . . . . . . . . . . . . . . . . . . . . .10By Irina Bacheva

Over-regulation of Pharmaceutical Market is a Problem, says Valentin Dimitrov, Medical Director, Actavis Bulgaria . . . . . . . . . . . . .11

Lack of Financing Remains a Problem, says Kiril Nikolchev, MD, MBA Country Manager, AbbVie . . . . . . . . . . . . . . .11

Bulgarian Healthcare Needs Consistent Strategy and We Have to Unite Over It, says Dimitar Dimitrov, CEO, Sopharma Trading . . . .12

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Deeper Shades of Gray in Bulgaria’s Economy . . . .14By Marina Tsvetkova

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AmCham Awarded Twice at Eventex . . . . . . . . . . .18

Sovereign Order of Malta and Bulgaria Celebrate 20th Anniversary of Bilateral Relations . . . . . . . . . . . . . . . . . . . . .18

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Diplomats, Businesses Compete on the Slopes. . . . . . . . . . . . . . . . . . . .20

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“Healthy Lifestyle” Program for Aurubis Bulgaria Employees . . . . . . . . . . . . . . . .22

q u a l i t y m a n a g e m e n t

Road Traffic Safety: Is Your Company Concerned? . . . . . . . . . . . . . . .24

n e w m e m b e r s . . . . . . . . . . . . . . . . . . . . .26

BNP Paribas S.A.Carat BulgariaEOS MatrixTelelink EADActavis

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Cruise Destination Saint Petersburg . . . . . . . . . . . . . . . . . . . . . . . .28

3M Bulgaria EOOD . 5W Communications . AA KRES EOOD . Abbott Products EOOD . AbbVie . ACO Building Elements Ltd. . Actavis . Adecco Bulgaria ltd. . Advance International Transport (Balkan) EAD . AES Corporation . AFA OOD . AGORA-IN Ltd. . AHNtech . AIG Europe Limited . AIMS Human Capital . Air Berlin PLC & Co. Luftverkehrs KG . Albena AD . Alfred C. Toepfer International Bulgaria EOOD . ALICO Bulgaria ZhZD EAD, a MetLife Inc. Company . All Channels Communication . Alliance One Tobacco Bulgaria . Allied Pickfords Bulgaria . Alpha Bank Bulgaria . Amarant Bulgaria Ltd. . America for Bulgaria Foundation . American College of Sofia . American English Academy . American Research Center in Sofia . American University in Bulgaria (AUBG) . Amgen Bulgaria EOOD . Anglo-American School of Sofia . AON Bulgaria . APOLO Ltd. . Arco Capital Management LLC . Arexim Engineering . Ashtrom International Ltd. . Astra Zeneca Bulgaria EOOD . AT Engineering 2000 Ltd. . Atlantic Club Bulgaria . Atos IT Solutions and Services EOOD . Attica Media Bulgaria Ltd. . Aurubis Bulgaria AD . AVON Cosmetics Bulgaria . Axway Bulgaria EOOD . Baker Tilly Bulgaria . Balkan Star Automotive EOOD . Ballistic Cell Ltd. . Baxter Bulgaria EOOD . Bayer Bulgaria EOOD . BC Serdon . BCD Travel Bulgaria . Bene Sofia EOOD . Berlitz Schools of Languages . BG Radio . BICA International Ltd. . BLD Asset Management . BMG Ltd. . BMW Vertiebs GmbH - Branch Bulgaria . BNP Paribas S.A. . BOYANOV & Co. . Braykov's Legal Office . British American Tobacco Bulgaria . Brown Forman Beverages Worldwide Sofia Branch LLC . bTV Media Group . Bulgarian American Enterprise Fund . Bulgarian Charities Aid Foundation (BCAF) . Bulgarian Development Bank . Bulgarian Executive Search Association . Bulgarian Property Developments EOOD . Bulgarian VIP Travel Ltd. . BulPros Consulting JSC . Bulstrad Life Vienna Insurance Group . Business Intellect Ltd. . Business Park Sofia EOOD . CallPoint New Europe AD . Carat Bulgaria . Carlsberg Bulgaria AD . Cefin Bulgaria EOOD (IVECO dealer) . Center for the Study of Democracy . Cheque Dejeuner Bulgaria Ltd. . Chevrolet Central & Eastern Europe LLC . Chevron Bulgaria Exporation and Production EOOD . Cisco Systems Bulgaria . Citibank N.A. - Sofia Branch . Club 50 Plus . CMS Cameron McKenna LLP - Bulgaria Branch . Coca-Cola HBC Bulgaria AD . Coca-Cola Enterprises, Inc. . Coface Bulgaria Credit Management Services EOOD . COLLIERS International Bulgaria . Congress Engineering Ltd. . Construction Management Group . Contitrans M Ltd. . ContourGlobal Maritsa East 3 AD . Corstjens Worlwide Movers Group . Credit Agricole Bulgaria EAD . Curtis / Balkan Ltd. . Dalkia Bulgaria EAD . Danailov, Mihaleva, Nedelchev & Co. . Delchev & Partners Law Firm . Deloitte Bulgaria EOOD . Delta Mechanical Branch Bulgaria . Deutsche Bank AG . Devin AD . DHL Express Bulgaria Ltd. . Diamed Ltd. . Dimitrov, Petrov & Co. . Djingov, Gouginski, Kyutchukov, & Velichkov . Dobrev, Kinkin & Lyutskanov Law Firm . Dr. I.S. Greenberg Medical Center . Drujba Glassworks SA . Dundee Precious Metals Inc. . DuPont Bulgaria EOOD . E.ON Bulgaria EAD . EcoPack Bulgaria AD . Edenred Bulgaria . Ekotoi - Service Ltd. . Ekzotika EOOD . Electron Progress EAD . Elevat Ltd. Legal House . Eli Lilly and Company . Eltrak Bulgaria Ltd. . EMC Computer Systems Austria GmbH . Emerson Process Management . EnergoService AD . Engineeringservice Sofia Ltd. . EOS Matrix . ERATO HOLDING Plc . Ernst & Young Bulgaria EOOD . ESRI Bulgaria . Etap Adress . Eurobank Bulgaria . Eurohold Bulgaria . EurOmax Resources Ltd. . European Bank for Reconstruction and Development (EBRD) . European Trade Center EOOD . Expat Capital . Experian Bulgaria EAD . FairPlay International . Fama Consulting OOD . Flying Cargo Bulgaria Ltd. - Licensee of FedEx . Force Delta Ltd. . Forton International AD . GAEA - Green Alternative Energy Assets EAD . Gasstroymontaj Jsc . GEFCO Bulgaria EOOD . General Electric International . Geostroy AD . Geotechmin OOD . Geotrading Ltd. . GIFTA . GlaxoSmithKline . Grand Hotel Sofia . GTC Yuzhen Park EAD . Hewlett-Packard Bulgaria Ltd. . HILD Asset Bulgaria Jsc. . Hilton Sofia . Honeywell EOOD . Hotel Yastrebets Wellness & SPA . IBM Bulgaria . IBS Bulgaria Ltd. . ICAP Bulgaria JSC . Ideal Standard - Vidima AD . Incotex Group Ltd. . Industrial Holding Bulgaria . ING Bank N.V. Sofia Branch . Interallis Chemicals SA . InterConsult Bulgaria Ltd. . Interdean Relocation Services . Interlang Ltd. . Intertek - Moody . Investbank PLC . Investor BG AD . IP Consulting Ltd. . Iris Trade Consult Ltd. . ITT Exelis . Japan Tobacco International Bulgaria . Jobs.bg EOOD . JobTiger Ltd. . Johnson & Johnson Bulgaria . Johnson Controls Electronics Bulgaria . Junior Achievement Bulgaria . Kaliakra AD . Kamenitza AD . Kamor Auto Ltd. . Katilin Popov Enforcement Officers . Kempinski Hotel Grand Arena Bansko . Kempinski Hotel Zografski Sofia . KPMG Bulgaria OOD . LANDMARK Property Management EAD . Lesaffre Bulgaria Ltd. . Lexim Sofia Ltd. . Lindner Immobilien Management EOOD . Lirex BG Ltd. . M3 Communications Group, Inc. A Hill & Knowlton Associate . Maria Vranovska, MD, MBA . Mars Incorporated Bulgaria EOOD . Marsh EOOD . Maxi I AD . MB Communications . MBL| Part of the CBRE Affiliate Network . Megatron EAD . Mellon Bulgaria EAD . Merck Sharp & Dohme Bulgaria . Microsoft Bulgaria . Miltech Ltd. . Minstroy Holding Jsc . Mobiltel EAD . Monbat Plc. . Mondelez Bulgaria AD . Moten Sport . Moto-Pfohe Ltd. . Movex Relocations . Mr. David Hampson . Mr. Jean Talmon . Mr. Roman Vassilev . Mr. Stefan Ivanov . Ms. Kalinka Kovatcheva . Ms. Magdalena Nikolova . Ms. Margarita Radeva, CPA . Municipal Bank Plc . Musala Soft Ltd. . National DISTRIBUTORS . National Palace of Culture - Congress Centre Sofia . NATO Defense College Anciens' Association . Nemetschek Bulgaria . NEXTDOOR Ltd. . Nova Broadcasting Group AD . NOVACON . Novotel Sofia MHQ . NuBoyana . Office for Mining Industry and Metallurgy Ltd. . On Bulgaria Ltd. . OPlus EOOD . Oracle East Central Europe Limited - Branch Bulgaria . Orak Group Europe Ltd. . Orbit Ltd. . Orkikem Ltd. . OSG Records Management . PANDA - IP Ltd. . Pedersen & Partners . Penev LLP . Penkov, Markov & Partners . Pfizer Luxembourg SARL Branch Bulgaria . Philip Morris Bulgaria EOOD . Pioneer Semena Bulgaria EOOD . PMB EOOD . PPD Bulgaria EOOD . PPTL Ltd. . Premier Luxury Mountain Resort . Premier Tours Ltd. . Prestige 96 AD . Progress CAD R&D Centre Ltd. . Provident Financial Bulgaria . PSG Payroll Services Ltd. . PwC Bulgaria . Quadrant Beverages JSC . Radisson Blu Grand Hotel . Red Devil Catering Plc . Regus Bulgaria Ltd. . Renault Nissan Bulgaria SRL . Right Rental Ltd. . Royal Philips Electronics . RSM BX Ltd. . S&T Bulgaria . Sanofi - Aventis Bulgaria EOOD . Sb Accounting and Consulting . Schenker EOOD . Schneider Electric Bulgaria . SECTRON . Sensata Technologies . Shell Bulgaria EAD . Sheraton Sofia Hotel Balkan . Sherita M Ltd. . Siemens EOOD . SIENIT Holding . Sitel Bulgaria EOOD . Sodexo Pass Bulgaria EOOD . Sofia Bio . Sofia Princess Hotel AD . Sogelife Bulgaria IJSC . Sopharma AD . Sopharma Trading . St. Sofia Golf Club & SPA . Stanton Chase International Bulgaria . Steelcase International . Stefan Dimitrov, Norman Realestate Co. Ltd. . Stroy-Consult EOOD . Sunfoods Bulgaria EOOD - Development Licensee of McDonald’s in Bulgaria . Sutherland Global Services Bulgaria EOOD . TBI Bank EAD . TechnoLogica EAD . Telelink EAD . The City Media Group Bulgaria . The Coca-Cola Company Bulgaria . Tishman Management Company EOOD . Titan Zlatna Panega Cement . TMF . Totema Engineering JSC . UniCredit Bulbank . UniCredit Leasing AD . Unimasters Logistics Plc . Unique Estates . Unisys Bulgaria Branch . United Bulgarian Bank . VAPTECH Ltd. . Videolux Holding / Technopolis . VISA Europe . VIVACOM . VMware Bulgaria EOOD . VSK Kentavar - IZ Dinamika EOOD . VUZF University Higher School of Insurance and Finance . Walltopia . Welcome to Bulgaria . Westinghouse Energy Systems Bulgaria Branch . World Courier Bulgaria Ltd. . World Transport Overseas Bulgaria Ltd. . WorleyParsons Nuclear Services JSC . Wrigley Bulgaria EOOD . Wyser . Xerox Bulgaria Ltd. . Zlatina Ruseva-Savova, LL.M., MBA . Zobele Bulgaria EOOD .

Board of Directors of the American Chamber of Commerce in Bulgaria

President Mr. Peter Lithgow AES Corporation

Vice President Mr. Daniel Berg European Bank for Reconstruction and Development (EBRD)

Vice President Mr. Alex Nestor Individual Member

Treasurer Ms. Petya Dimitrova Eurobank Bulgaria

Members Mr. Levon Hampartzoumian UniCredit Bulbank

Mr. Borislav Dimitrov Cisco Systems Bulgaria

Mr. George Brashnarov Nemetscheck Bulgaria

Ms. Diana Pazaitova Fama Consulting

Ms. Krassimira Chemishanska Amgen Bulgaria

Mr. David Butts CMS Cameron McKenna EOOD

Mr. Sergey Koinov AG Capital

Mr. Solomon Passy Atlantic Club Bulgaria

Ex-Officio Member Mr. Thomas Bruns U.S. Commercial Officer

Executive Director Mr. Valentin Georgiev

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Until the end of 2013, one of the most often mentioned words in the Bulgarian healthcare sector was “reform.” The word was used mainly by politicians. In practice, however, there was no development strategy to be carried out steadi-ly and consistently and to lead to concrete positive results.

People in the sector admit what has been well known to patients for years: that there is a constant change of rules that makes them more like an experiment. Some of the failed initiatives are the short-sighted closure of municipal hospitals that made it impossible to provide medical aid in whole regions of the country; the structural changes in the health system that were conducted as an end in itself; the poor control, the unsuccessful attempt at uniting hi-tech hospitals with large capacity and potential to ensure bal-anced coverage of the territory of the country.

With time, especially in the past few years, the wrong politi-cal decisions worsened patients’ access to healthcare and triggered the development of negative practices. That disap-pointed the people, said Dr. Andrey Kehayov, chairman of

Bulgarian Medical Association and president of the Southeast European Medical Forum.

A new beginning

The National Health Strategy, which Plamen Oresharski’s government adopted two months ago, envisages increasing the healthcare budget to 5.5 percent of the GDP by 2020. The document will be the basis of a financing agreement to be closed with the European Commission, the Ministry of Health said. EU funds will be invested in electronic health-care, emergency medical service, as well as in doctor train-ing in specialties in shortage, e.g. anesthetists, pathologists, cardiologists.

The first steps towards the implementation of the strategy were announced by Health Minister Tanya Andreeva. In the future, health establishments will be obliged to admit emer-gency patients. In addition, hospitals will not have the right to choose which services in the list of clinical treatments to provide. New health establishments will only be opened with

Cure for Healthcare?Bulgaria adopted a development strategy until 2020 under insistence from the EU

By Marina Tsvetkova

Dr. Rumyana Todorova, chairman of the National Health Insurance Fund during negotiations with the Bulgarian Medical Association.

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the express permission of the minister. The changes will underlie the new version of the Health Insurance Act and are expected to become effective by this year’s end.

There will be changes in the medicine policy too. The Supervisory Board of the National Health Insurance Fund will be able to stop reimbursing cancer drugs if pharmaceu-tical companies refuse to give a discount on the medicines. According to the health authorities, however, that will not threaten patients’ treatment.

The strategy also reads that the Bulgarian health system in the 2020s will be oriented to patients, families and health-care providers, be transparent and have clearly set quality and result targets. Its implementation is expected to result in a substantial improvement in public health through pre-vention and early intervention, providing integration of health and social services for the older people, conducting

integrated programs for prevention of chronic non-communi-cable diseases, which are among the main factors for pre-mature death at present, etc.

The strategy outlines eight priority areas:Ensuring that each Bulgarian citizen has access to a reli-able health-insurance system, quality medical aid and health service; Implementing a single integrated system by developing electronic healthcare with the view of providing complete transparency and efficient use of the available resources; Streamlining the systems for financial management and control in healthcare;Strengthening and upgrading the emergency medical ser-vice system;A regional policy that puts a special focus on supporting the health establishments in the remote and small regions of the country; Efficient functioning of maternal, children’s and young people’s health; Sustainable development of human resources with an emphasis on medical staff specialization and continuous training; Reorientation of the health system towards prophylaxis and prevention of major diseases.

One of the goals that have to be achieved with the imple-mentation of the measures in the strategy is improving the health, safety and well-being of the people to the average EU levels: increasing life expectancy in good health by two years, reducing infant mortality by 30 percent and inequali-ties by 30 percent.

The other objectives are connected with the transformation of the health system to provide accessible and quality health service (restructuring hospitals; streamlining the manage-ment, financial and quality control in healthcare; providing long-term service to the vulnerable groups of the popula-tion), implementation of a single integrated system by devel-oping electronic and mobile health, ensuring the capacity of human resources to meet the growing health needs (easing the access to specialization, ensuring quality continuous training), development of research and innovation. The

Bulgaria among worst performers in Europe in healthcare service qualityBulgaria ranks 31st among 35 European countries in terms of healthcare quality, shows the latest Euro Health Consumer Index. The quality of healthcare is worse only in Poland, Latvia, Romania and Serbia, and the Netherlands again has the best performing health system in Europe (for a fourth consecutive year). Bulgaria is second to Romania in infant mortality and even Macedonia has better indicators in this respect. Another indicator places Bulgaria among the coun-tries with the highest abortion rates in EU: more than 400 per 1,000 live births – third after Estonia and Romania. Nevertheless, the data show that Bulgaria is still in the group of the relatively well performing countries like Germany, Lithuania and Sweden in terms of number of doctors per capita. On the other hand, Bulgaria is among the eight coun-tries that have not implemented electronic prescriptions, the other being Albania, Macedonia, Cyprus, Latvia, Malta, Serbia and Slovakia.

Dr. Tsvetan Raychinov (L), chairman of Bulgarian Medical Association and Dr.

Ivan Kokalov (R) at a meeting in the Parliament Healthcare Committee.

Dr. Tanya Lyubomirova Andreeva-Raynova, Minister of Health

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implementation of the strategy will be funded with national financing and resources provided under the operational programs.

The strategy is accompanied by an action plan that speci-fies the measures to be taken under the separate policies, the terms for implementation and the responsible institu-tions, as well as the sources of financing. The document reflects the recommendations of the European Commission, as well as the proposals made during the public consulta-tions, the Ministry of Health says.

Even the best of intentions can remain on paper only, health experts caution. People in the sector warn of a disturbing trend that threatens healthcare as a whole and looks irre-versible.

Bulgarian doctors work abroad

Some 80 percent of the graduating young doctors want to work abroad, a survey of the Bulgarian Medical Association shows. Students at the Medical University in Sofia are the most willing to emigrate, followed by students from the medical schools in Pleven and Plovdiv.

Besides the traditional anesthesiology, preferred specialties for specialization and work abroad now include psychiatrics, pathology, visual diagnostics and ophthalmology. Doctor migration is already creating shortages of medical staff in Bulgaria, especially in the smaller towns, the Bulgarian Medical Association warns. That results in deterioration of healthcare in Bulgaria and affects the early access to healthcare and medical specialists. The survey is based on the number of issued good medical practice certificates to doctors who want to work abroad.

Minister Andreeva said that no measures had been taken in previous years to stop the outflow of medical staff. In the next program period the focus in the healthcare sector will be on increasing the remuneration of the medical staff, as well as on the professional development of young doctors and post-graduate students. An emphasis will be put on programs for health promotion and prevention. Measures will be taken to improve the access to healthcare. The health system was not properly managed, Minister Andreeva said.

Beyond the good intentions

Bulgarians’ health is deteriorating, shows the 2012 annual report adopted by the parliamentary Healthcare Committee in late January. There is a persistent trend of high infant mortality rates, twice the average of Europe. The report also shows demographic decline, frequent hospitalizations and an increase in the number of vacant hospital beds at the same time. Hospital debts keep on rising too, the annual report reveals. There were 339 hospitals in 2012 and 28,643 doctors. Nearly 47 percent of doctors are younger than 60 years-of-age, a fifth is above 60, and a quarter is between 31 and 45.

For comparison, in 2009 the number of doctors was nearly

35,000. The report points out as a positive development the introduction in 2010 of pneumococcal meningitis vaccina-tion, as well as the decrease in abortions, despite the fact that one in ten abortions were performed on girls aged up to 19 years. Problems that stand to be addressed include the creation of hospital after-care centers.

Another survey focuses on statistics that the co-payment rate for medication in Bulgaria is the highest in Europe. Patients in Bulgaria cover 56 percent of the price of medi-cines, compared with an average of 18 percent in the European countries, an analysis conducted by IMS Health shows. Bulgaria has the smallest pharmaceutical market, the biggest share of co-payment for treatment and medica-tion, the lowest expenditure on original drugs and the lowest per-capita expenditure on medicines, IMS Health reveals. In terms of co-payment, Bulgaria is close to the Third-World countries. For comparison, the share is 40 percent in Romania, 13.6 percent in Greece, 7 percent in Germany and Spain.

The Bulgarian pharmaceutical market remains among the smallest in Europe, despite the fact that the population is larger than in countries such as Denmark, Finland, Ireland, etc., the analysis shows. Besides, the market of original medical products is among the smallest in Europe. Bulgaria steadily lags behind the European countries in terms of expenditure on original medicines as a share of the total healthcare expenditure: about 11 percent.

Bulgaria is at the bottom in Europe in terms of average per-capita expenditure on medicines.

The annual expenditure per capita in Bulgaria is 108 Euro. Expenditure is lower only in Romania and Latvia: 104 Euro and 99 Euro respectively. The figure for Greece is 316 Euro a year and the top performer is Switzerland with 523 Euro. The Association of the Research-Based Pharmaceutical Manufacturers in Bulgaria has repeatedly called on the state to increase state spending on medicines, so that the share of patients’ co-payment can fall and make treatment more efficient.

Directive to improve cooperation among EU states in healthcareThe Directive on Patients’ Rights in Cross-Border Healthcare entered into force in the EU at the beginning of 2014. By then all member states had to transpose the Directive that was adopted 30 months before into their national legislations. The new rules give patients rights such as a bigger choice of health services, more information and easier recognition of prescriptions abroad. The implementation of the Directive is good for the European health systems too, as it improves the cooperation among member states as concerns the interop-erability of electronic healthcare instruments, the use of health technology assessments and the pooling of special-ized knowledge.

At Amgen, we believe that the answers to medicine’s most pressing questions are written in the language of our DNA. As pioneers in biotechnology, we use our deep understanding of that language to create vital medicines that address the unmet needs of patients fighting serious illness—to dramatically improve their lives.

For more information about Amgen, our pioneering science and our vital medicines, visit www.amgen.com.

Transforming the language of life into vital medicines.

©2012 Amgen Inc. All rights reserved.AMG-BGR-AMG-074-2013- April-NP

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Healthcare Committee Established

The launch of the committee that took place in Radisson Blu Grand Hotel.

Krassimira Chemishanska, General Manager,

Amgen Bulgaria.

Dimitar Dimitrov, Executive Director, Sopharma

Trading. Kiril Nikolchev, Country Manager, AbbVie.

AmCham members in healthcare sector gathered to establish Healthcare Committee (HC) aiming to address health-care policy and legislative issues at AmCham level. The launch event was attended by more than 50 representatives of the AmCham members.

The rationale behind the Committee’s establishment is related to the following key points:

Importance of multi-stakeholder approach to healthcarePromotion of investment in health and innovationsRaising awareness about the role of education, training, and research and innovations for the healthcare sectorTransatlantic Trade and Investment Partnership agreement’s (TTIP) impacts on the healthcare sectorUntapped opportunities for cooperation, as well as exchange of information and best practices with counterpart organi-zations at national and international level.

At its first meeting on February 27th, 2014 the newly founded Healthcare Committee has elected Krassimira Chemishanska, general manager, Amgen Bulgaria as a chair of the committee.

Dimitar Dimitrov, executive director and Chairman of the Board of Directors, Sopharma Trading JSC, and Kiril Nikolchev, Country Manager, AbbVie EOOD, were elected as deputy co-chairs of the Healthcare Committee.

The Chair, Ms. Chemishanska is an industry leader with more than 20 years’ experience on the Bulgarian market. She has held senior sales and marketing posi-tions in several multinational R&D based pharmaceutical companies. Among her key priorities are to work with different stakeholders as government representa-tives, health professionals, and patient organizations, in order to ensure access to innovative medical products in the Bulgarian healthcare system and to improve patient care quality.

Mr. Dimitar Dimitrov, Executive Director, Sopharma Trading has 11 years of experience in the healthcare sector. Among his priorities is the introduction of the highest business standards in the pharmaceutical industry in a way that the Bulgarian citizens will receive better care for their health, have access to the most innovative therapies and have benefits equal to the patients in other EU member states.

The entire professional career of Kiril Nikolchev, Country Manager, AbbVie has been focused on the healthcare sector where he has more than 13 years of expe-rience in different sales, marketing and management positions at several innova-tive pharmaceutical companies. In his speech at the Committee’s launch event he underlined the fact that accelerated implementation of proven cost-effective innovative health technology solutions is a key requirement for improving the health status and well-being of Bulgarian popula-tion.

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-Being part of the healthcare sector in Bulgaria, what would you define as your major concern/issues?

As widely known, healthcare has not been among the highest priorities of none of our recent governments during the last decade or beyond. There is an increasing need for investment in multiple key healthcare relat-ed areas, in order to ensure economic growth and guarantee prosperity. The reform in this sector has been lagging behind, leaving Bulgaria far below other EU countries in terms of standards of healthcare. The necessity of long-term vision, consistent strategic approach and appropriate implementation of measures in the currently struggling healthcare reform, remains very obvious.

As a consequence of the above, the main concerns are related to the existing model of operation in the sector, in terms of: 1) financ-ing – low public expenditure for healthcare as a % of GDP, 2) monopoly of the NHIF, 3) low levels of utilization of EU funds, 4) lack of public debate for defining a long-term strategy, 5) declining number of healthcare professionals, due to immigration, 6) lack of electronic tracking system to ensure efficiency and control of and last but not least ,7) slow access to medical innovation.

-What kind of reforms is needed in order to attract invest-ments in the sector?

In my opinion, a strong reform with clear strategic objectives in terms of de-monopolization of the financial system will be crucial for resolving the above mentioned issues. In addition, adequate rewarding and motivation need to be addressed quickly, in order to stop the brain drain in the sector. The necessary reforms, including appropriate changes in the legislative system, support-ing R&D investments and access to innovation, are required as a priority.

-What kind of opportunities for exchange of information and best practices with other counterpart organizations at national and international level do you see on your part?

On one hand, the business and in particular innovative R&D based pharmaceutical companies, play a major role in bringing investments in R&D clinical trials, by making Bulgaria part of the global clinical trial programme for the approval of innovative therapies. This opportunity defines several key benefits for the

Bulgarian healthcare system – direct finan-cial investments, doctors’ education and knowledge transfer, saving costs for treat-ment from public funds and opportunities for patients to be treated according to most up to-date standards.

Most of the R&D companies in the sector are involved and are investing in educa-tional programs and activities, related to innovation in certain medicine areas, part-nering with universities and academics, encouraging scientific exchange and knowledge transfer on both national and cross-border level.

Amgen as a company, strongly dedicated to biotech innovation in medicine, is invest-ing a lot of resources in developing a wide

R&D clinical trial programme in Bulgaria, with practically all new pipeline molecules. In addition to that, last year Amgen Bulgaria launched its long-term educational project “Amgen Biotech Academy” directed towards specialists and students, in collabora-tion with the academic societies and Junior Achievement.

-How could AmCham be instrumental in initiating reforms in the sector?

During the past years, AmCham Bulgaria has been successfully addressing the need of reforms in different sectors of the econo-my, following its mission and attempting to ensure a more favor-able and predictable business environment. Following recent developments, the AmCham Board has identified the need to found a Healthcare Committee in order to address healthcare related issues, support the strategic changes and align with EU standards in the sector. In addition the HC committee is expected to promote access to innovation and investment in health, as key prerequisites for economic growth. In order to be successful, the newly founded HC committee should work towards ensuring a more transparent and predictable regulatory environment, multi-stakeholder approach and co-operation with the AmCham EU in the area of healthcare policy shaping. Support to life science education, scientific exchange and R&D should play a key role among the priorities of the HC committee. In the course of devel-opment, the AmCham HC committee should take the leadership in the Transatlantic Trade and Investment Partnership (TTIP) between the US and the European Union in the healthcare sec-tor.

-What is your opinion about the draft National Health

Strong Reform with Clear Objectives is Crucial for Resolving Issues in Healthcare SectorSays Dr. Krassimira Chemishanska, M.D., MBA Country Director Amgen Bulgaria EOOD

By Irina Bacheva

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Strategy 2014-2020 which has being discussed at the Parliament?

The draft of the National Health Strategy 2014-2020 provides a fair analysis of the current status of the healthcare system in the country, demographic changes and major issues and challenges for the next programme period. It outlines the key objectives and priorities for the sector, putting Bulgaria in the context of Europe 2020, where health is defined as wealth and investment in health is one of the obligatory conditions to fulfil 4 out of the 5 strategic

goals of Europe 2020.

What the draft National Health Strategy 2014-2020 has mostly been criticized for, is the lack of a clear action plan and defined timing for implementing the key strategic priorities and fulfilling the objectives set. Each of these strategic directions needs to be addressed separately, using the existing model and standards as a baseline for initiating future reforms. A forward-looking public debate should be initiated to address the defined keyobjectives and identify realistic tactical solutions.

-Being part of the healthcare sector in Bulgaria, what would you define as your major concern/issues?

-My major concern is the “over-regulation” of pharmaceutical market. For example: external and internal reference pricing system for medical products, constant changes of legislation (government fees, etc.) unstable political environment lead-ing to constantly changing rules.

-What kind of reforms are needed in order to attract investments in the sector?

-Transparency and de-monopolization of NHIF; clear policies regarding hospital healthcare; clear and firm state strategy for healthcare.

-What kind of opportunities for exchange of information and best practices with other counterpart orga-nizations at national and international level do you see on your part?

Close collaboration with ArPharma and BgPharma, communication and collabo-

ration with professional organizations in medical sector and patient organiza-tions.

-How could AmCham be instrumental in initiating reforms in the sector?

Initiating round tables related to given problems in healthcare with government structure. Initiating of proposal and dis-cussion of already made proposals at expert level.

-What is your opinion about the draft National Health Strategy 2014-2020 which has being discussed in the Parliament?

Very unclear and too many questions to be addressed.

-Being part of the healthcare sector in Bulgaria, what would you define as your major concern/issues?

Lack of sufficient financing of healthcare sector and lack of transparency for the reasons behind current prioritization/dis-tribution of the available resources.

-What kind of reforms are needed in order to attract investments in the sector?

To increase the significance of outpa-tient compared to inpatient sector, to be paid for result, not for activity, to be implemented DRG (diagnosis-related groups) in the hospital sector.

-What kind of opportunities for exchange of information and best practices with other counterpart

organizations at national and inter-national level do you see on your part?

Synergy with all appropriate health industry associations (pharma, hospi-tals, NGOs, etc) in order to align strate-gies and to increase the share of voice for the desired changes when communi-

cated with authorities/decision makers.

-How could AmCham be instrumental in initiating reforms in the sector?

AmCham high reputation in front of authorities could support the reason-able proposals especially through the partnership with the U.S. Embassy.

-What is your opinion about the draft National Health Strategy 2014-2020 which has being discussed at the Parliament?

Very sophisticated document with little practical significance and guidance how the proposed measures will be achieved especially within the extremely limited projected growth of the financing in the healthcare sector and unrealistic decrease of drugs’ expenditure.

Over-regulation of Pharmaceutical Market is a Problem

Lack of Financing Remains a Problem

Says Valentin Dimitrov, Medical Director, Actavis Bulgaria

Says Kiril Nikolchev, MD, MBA Country Manager, AbbVie

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-Being part of the healthcare sector in Bulgaria, what would you define as your major concern/issues?

Definitely the lack of transparency in the regulatory environment and correspond-ingly the lack of substantial dialog between the state authorities and the organizations representing the business are in the fundamental of all healthcare related issues. In the last years the overregulation of the state with regard to the prices of medicines, mark-up of wholesalers, licensing and other regula-tive regimes was conducted without the necessary consultations with the sector. As a main topic I would mention the need to have more transparency and better tools for controlling the spending of the public funds, including in the hos-pitals. Several governments do not take any efficient and long-term measures for solving the issues with the debts of the hospitals in the country. We observe only ad-hoc solutions.

Another main concern is the lack of vision for development of e-healthcare. Bulgaria does not have some basic structures for introducing e-health ser-vices in the near future like center for development of e-health, implementa-tion of electronic patient dossier, e-prescription, etc. The synchroniza-tion of the Bulgarian legislation to the EU regarding healthcare is far behind too.

-What kind of reforms are needed in order to attract investments in the sector?

I would stress on the need to reduce the restrictions and the bureaucracy in the sector. The governmental authorities should rely more on the principles of the free market and competition because this will guarantee for sure that the Bulgarian patient will get the best ser-vice and product at the best price. Of course, the state should have strong monitoring functions. If Bulgaria wants to attract investments to our relatively small market it should provide unique conditions for the business to operate.

On a second place, I would list the pre-dictability of the state regulations. Unfortunately, in the last decade there was no consistent strategy about the Bulgarian healthcare. The change of governments was changing each time the strategy. This way, in the healthcare sector we are observing some daily basis patched work.

-What kind of opportunities for exchange of information and best practices with other counterpart organizations at national and interna-tional level do you see on your part?

I would recommend keeping a close relationship with the European Association of Pharmaceutical Wholesalers (GIRP).

-How could AmCham be instrumental in initiating reforms in the sector?

I would recommend to AmCham to pro-voke regular discussions with the health-care related authorities – Ministry of Health, National Health Insurance Fund and the Bulgarian Drug Agency. AmCham has to be recognized by the state as one of its main partners on

healthcare related issues.

-What is your opinion about the draft National Health Strategy 2014-2020 which has being discussed at the Parliament?

As I have mentioned before having a strategy has proven not to be of main importance. More important is to have a strategy behind which the whole sector unites and thus to make sure it will be applied in practice no matter what will be the political situation in the country. Again the strategy has been made and accepted by the Parliament without any substantial discussions in the sector.

In a national healthcare strategy, I would like to see more particular and feasible goals as well as a detailed plan for its implementation together with a con-comitant financial frame. The strategy should give explicit answers to the patients how particularly the healthcare service will improve for them. Among its targets should be the adoption of EU funds, because the country has not applied for EU funds in the last program period nor will in the forthcoming 2014 – 2020.

Bulgarian Healthcare Needs Consistent Strategy and We Have to Unite Over ItSays Dimitar Dimitrov, CEO, Sopharma Trading

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The economy in all shades of gray is slowly killing the state and its public sys-tems that depend directly on budget rev-enue collection: healthcare, education, security.

The so-called “gray sector” is a strange economic beast that grows or shrinks depending on the conditions in which it operates. That is a very harmful phenom-enon for the economy, which diverts the investment flows, closes quality jobs, increases influence peddling and creates unfair competition, said Bozhidar Danev, executive chairman of the Bulgarian Industrial Association (BIA). He added that the share of the shadow business in Bulgaria is inversely proportional to tax revenue.

Unofficial accounts show that in 2007-2012 the gray economy increased by 32 percent, while gross domestic product (GDP) grew 29 percent. The gray econo-

my saw a particularly rapid surge in 2010: more than 5.1 percent. For the period, the amount of non-collected tax

receivables topped 12.4 billion leva and another 12.2 billion leva worth of pay-ments was hidden. BIA’s data, which use numerical methods for the first time, show the actual condition of the econo-my.

There will not be a change in tax revenue but only in VAT collection,

Danev said. In his words the govern-ment’s new system of VAT refund is an excellent way for the Ministry of Finance to bring the gray sector into the light, though it will not become entirely official.

According to BIA data, informal employ-ment in Bulgaria is about 22 to 30 per-cent and the share of informal workers is 13 percent. Some 15 percent of the ser-vices Bulgarians receive are not report-ed, with health services having the big-gest share. That makes Bulgaria second only to Greece, where the share is 30 percent.

At the same time tax revenue has increased just 11 percent for the past five

Deeper Shades of Gray in Bulgaria’s Economy“Shadow business” has grown by 32 percent in five years, overtaking GDP increase. Tax authorities have failed to collect nearly 12.4 billion Leva in revenue

By Marina Tsvetkova

Bozhidar Danev, Executive Chairman of the Bulgarian Industrial Association during a press conference about

Shadow Businesses in Bulgaria.

Bulgaria: The “gray champion” of EuropeThe size of the shadow economy in Bulgaria is the largest among European coun-tries: 31.2 percent of GDP, or 12.8 Billion euro, a survey of international consulting firm A.T. Kearney showed. The share of the gray economy in Romania in 2013 was about 28.4 percent of GDP, or 39.5 billion Euro – almost the size of the entire Bulgarian economy. The gray economy in Croatia is similar to Romania’s. The small-est gray economy is reported in Switzerland: 7.1 percent of GDP, or 36 billion Euro. The survey showed that countries encourage the official economy by reducing the size of social-security payments.

The gray economy is particularly small in the United States, the Organization for Economic Cooperation and Development (OECD) reports. In 2013 the experts assessed it at 6.2 percent of GDP. The reason for that is the almost unregulated labor market in the United States and the generally low level of taxes in the country. That is why people in the United States do not have a stimulus to work illegally, which is generally worthwhile only for undocumented immigrants.

Germany, in turn, tops the list of shadow economies among more than 20 OECD countries, despite the fact that undeclared incomes have declined considerably in recent years. France and Austria are a special case. The experts note that the gray economies in the two countries increase together with unemployment.

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years, despite the 29-percent GDP growth and the considerable improve-ment in some economic parameters that lead to higher direct and indirect taxation of people. The survey of the gray econo-my is based on statistical data of the National Statistical Institute and Eurostat and not on sociological data.

It turns out that the drop in tax revenue is not the result of the crisis alone but also of the short-sighted changes in the taxa-tion and social-security systems and the administration’s inability to cope with tax revenue collection.

The problem is that the legislature is conducting a

wrong policy of increasing direct and indirect taxation

to make up for the reduced tax revenue, rather than creating incentives to increase tax revenue collection, Danev said.

In terms of share of GDP, the most sub-stantial drop in revenue in 2012 as com-pared to 2007 was registered in profit tax, 48 percentage points, while the rate stood flat at 10 percent. That was fol-lowed by VAT revenue, which decreased 21 percentage points, regardless of the fact that the rate remained unchanged and GDP grew 29 percent.

The apparent stability in the volume of revenue from social-security contribu-tions, natural persons’ income taxes, excise and customs duties is false, because it does not reflect the above-mentioned changes in some economic parameters, BIA experts contended. For reducing the gray economy, the Chamber proposes some legislative and organiza-tional measures, including strengthening the analytical unit of the National Revenue Agency (NRA) for identification of hidden turnovers, incomes, social-security pay-ments and other violations.

The measures include a review of the results of NRA’s software for detection of tax frauds and building a digital-based library (data center) for storage, process-ing and analysis of companies’ account-ing information for the whole period. Creating a public register of the appealed, revoked and maintained tax assessment notices by sectors and regions and link-ing the incentive schemes for NRA’s offi-cers with the results of the completed liti-

Bulgarians largely work illegally Bulgarian workers are largely ignorant of the law and the risks of receiving unde-clared incomes. People younger than 24 years-of-age and those above 45 years are the most likely to enter the gray sector. Bulgaria does have a sustainably high level of gray economy. The smaller the risk of being caught and the worse the performance of the institutions, the more confident businesses are that they will get away with it, said economist Lachezar Bogdanov.

There is unofficial economy in all sectors. The low incomes of households as com-pared to their expenses and the high unemployment rates are the reasons why people agree to working without contracts or with contracts that specify smaller wages than they actually receive.

Besides easing the labor legislation and reconsidering the social-security income thresholds, economists recommend that tackling the unofficial economy should start with providing a legal definition of undeclared employment.

According to the experts the simplification of tax returns can also have a positive effect, as well as the introduction of more flexible contracts, e.g. for performing a specified job for a specified period. Globalization and the entry of large multinational companies have also started to gradually limit the practice of undeclared incomes.

GermanyFrance

United KingdomBelgiumSwedenNorway

NetherlandsSwitzerland

DenmarkFinlandAustriaIreland

ItalySpain

TurkeyGreece

Portugal

PolandRomania

Czech RepublicHungaryBulgariaCroatia

SlovakiaLithuaniaSlovenia

LatviaEstonia

Figure 1The shadow economy in relation to GDP

Notes: Data for EU-27 (excluding Cyprus, Lexemburg and Malta) plus Norway, Switzerland, Croatia and Turkey.The size of the shadow economy is calculated using the MIMIC method.

Source: Dr. Friedrich Schneider, Johannes Kepler University of Linz, Austria; Eurostat; A. T. Kearney analysis

Western Europe

Southern Europe

Eastern Europe

Shadow economy size (EUR billion)Official GDP (EUR billion)Shadow economy (% of GDP)

European average: 18.5%

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gation procedures are some of BIA’s proposals.

To bring the gray economy into the light, BIA’s experts consider it crucial to amend the Health Insurance Act and revise the procedure for restoration of health-insurance rights, as well as intro-duce financial norms for health servicing of the non-insured towards defining the financing source of the costs incurred by the health system.

In EU, the most efficient measures for fighting the gray economy

are the exchange of information between the institutions, registration of employ-ment contracts from the very first day and tightened control by the labor inspections. Administrative penalties are often used against offenders but they are not as efficient as the early detection of illegal employment.

A large part of Bulgarian companies have no respect for either the tax authorities or the labor inspectors and freely break the law to reduce their expenses and gain competitive advantage, the Bulgarian Industrial Capital Association says.

Nearly two-thirds of employers believe that the

gray sector provides opportunities for short-term economic gains

and one in two is convinced that the risk of penalty is too small and it is worth taking it. According to 50 percent of the respondents the gray economy can save a business from bankruptcy in a crisis. The prevailing opinion is that the state’s controlling bodies use a double standard. That is seen from the fact that

90 percent of the interviewed managers say that the laws in Bulgaria are not applied with the same vigor to all com-panies.

The gray economy is the most common in the sectors of tourism, milk process-ing, information technology and con-struction, a business survey among 11 industries shows. The official economy prevails in machine building, non-bank-ing financial services and postal servic-es. A survey of the scope of the informal business practices in each of the 28 regions of the country shows that the controlling bodies have to take the most stringent measures in Pernik, Razgrad, Blagoevgrad, Stara Zagora, Lovech and Silistra, where the gray economy is nearly 60 percent.

Bulgaria has the largest undeclared economy of all EU countries, calculated the European Foundation for the Improvement of Living and Working Conditions. The survey measured the gray economy as a share of GDP in each member state and shows the changes in its volume during the recession (2008-

2012). The data showed that the unde-clared economy in Bulgaria increased in 2009 and 2010 and remained virtually unchanged in the last two years. For the five-year period covered by the survey the shadow economy decreased only insignificantly: from 32 to 31.9 percent of GDP.

Compared with 2003 however the unof-ficial sector in Bulgaria has decreased some 4 percentage points. Besides Bulgaria, the top three countries with the largest undeclared economies are Romania and Lithuania.

The best-performing companies are in Austria, Luxembourg and the Netherlands. These are the only countries in the EU where the share of the grey sector is below 10 percent of the GDP. On the whole, the levels of the shadow economy are higher in Eastern, Central and Southern Europe and lower in Western and Northern Europe.

The general conclusion is that in 2008-2012 the EU has been gradually winning the fight with undeclared employment. For the five-year period, the shadow economy shrank from 22.3 to 18.4 per-cent.

One of the explanations for the positive trend is that gray employment decreases during a recession because, as a result of the growing unemployment, more and more people are ready to work legally even for less money and under flexible conditions. At the same time unofficial wages become smaller and people decide it is not worth working without social security.

According to the economist Lachezar Bogdanov, the more government institutions perform badly, the more

comfortable the shadow business feels.

700 million Leva lost through VAT fraudAt least 700 million Leva a year is lost in various VAT fraud schemes, a National Revenue Agency’s analyses showed. The amount equals 9.5 percent of the annual tax revenue, which stands at 7.366 billion Leva. VAT is the biggest revenue item in tax authorities’ portfolio. About 400 million Leva is brought “into the light” as a result of tax audits and check-ups. It turns out that there is still room for improvement in inspectors’ work.

The most revenue is lost in VAT schemes between Bulgarian companies and their partners in Greece and Romania. The risk sectors are trade in metals, fuels and grain, where VAT is siphoned off in fake wholesale deliveries.

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AmCham Bulgaria has been awarded with two certificates of appreciation in two categories at the Eventex Awards contest on March 5, 2014. The Chamber was ranked second in the category ”Social Event of 2013” for its Thanksgiving charity dinner that raised some 77,000 Leva for education projects of disadvantaged youth. The Chamber also received a second place as “Organizer of 2013” as well. Peter Lithgow, AmCham president, and Nadezhda Vakareeva, event manager, accepted the awards at the recep-tion.

Among other winners of the contest were: Microsoft Bulgaria, Kamenitza, Adi’s Cook&Book, Bulgarian National TV, bTV. The can-didates were assessed by prominent Bulgarian and international professionals in event, PR, marketing and advertising business.

The contest aimed at recognizing the professional achievement of teams and venues in their efforts to lead the events industry for-

ward. Eventex Awards International is a platform for showcasing contribution to the industry, excellence in working practices and innovative thinking.

AmCham Awarded Twice at Eventex

The Embassy of the Order of Malta in Bulgaria has launched a program of celebrations for the establishment of bilateral diplomatic relations on February 26th, 2014. A ceremony was held in Sofia with the presentation of "Travel journal about 7 cultural sites on the UNESCO World Heritage List" that collects drawings and comments from a group of orphans, assisted by the Association "Hug Me", of Bulgarian monuments declared UNESCO world heritage sites.

The exhibition of the drawings of the young artists will be open until 28th of March at the UniCredit STUDIO on 12

Kniaz Alexendar I, Str.

The book that collects the drawings and the memories of the children was made with the support of UniCredit Bulbank and under the patronage of the Ministries of Culture, Foreign Affairs and other institutions.

At the inauguration, which took place in the art gallery of UniCredit Bulbank, Ambassador Camillo Zuccoli, the Bank’s President Levon Hampartzoumian with the General Manager Andrea Casini, and the Director of "Hug Me" Milena Neyova welcomed 200 guests. Among the

guests were ambassadors and diplo-mats of Iraq, Italy, Kazakhstan, Kosovo, Lebanon, Morocco, Palestine, Monaco, Ukraine, Slovakia, the United States, Members of the National Assembly, Counsellors for Culture and Social Affairs of the President of the Republic, the Chief of Cabinet of the Minister of Foreign Affairs, the Director of the Institute of Culture of the Ministry of Foreign Affairs, chair-persons of the Chambers of Commerce, academics, journalists, artists and volunteers from the Group that collaborates with the Embassy in humanitarian activities promoted in Bulgaria.

Sovereign Order of Malta and Bulgaria Celebrate 20th Anniversary of Bilateral Relations

Orphan drawings of Bulgarian cultural monuments.

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Some 110 weekend racers gathered on the International Women’s Day for the 10th AmCham Ski Tournament at Pamporovo ski resort. The event was brimming with emotions, romance and perfect skiing mood. Ambassadors of several countries, business representatives of AmCham member com-panies and their children raced neck in neck for the cups and awards kindly provided by AmCham members. All of the guests enjoyed the beauty of Rhodopi Mountain, many pres-ents and after parties at Orlovets hotel.

The awards were given out in eight categories: 1. In the children category the first place was taken by Eleonora

Doseva, Nemetschek Bulgaria, followed by Mihail Angelov, Nemetschek Bulgaria, and Peter Kandilarov, Congress Engineering OP Ltd. in the third place.

2. In junior category Nikola Dosev, Nemetschek Bulgaria, placed first; he beat Elza Ekimova, EnergoService, and Alexander Brashnarov, Nemetschek Bulgaria.

3. In women’s category the first place was taken by Albena Koeva-Ekimova, EnergoService AD, followed by Ralitsa Ivanova, 3M Bulgaria, and Emilia Doseva, Nemetschek Bulgaria OOD.

4. In the category of diplomats the first place was taken by Ivaylo Dermendzhiev, Consulate of the Republic of Kenya,

followed by Pavel Vacek, ambassador of the Czech Republic, and Marian Jakubocy, Embassy of the Slovak Republic.

5. In the category of the senior executives first came Kamen Ilchev, Renault Nissan Bulgaria, followed by Plamen Stoichev, Eltrak Bulgaira Ltd., and Sasho Tchakalski, Municipal bank.

6. In men’s category the winner was Valentin Mitrin, Actavis; Boyan Angelov, Nemetschek Bulgaria, took the second place, and Ekim Ekimov, EnergoService AD, placed third.

7. In snowboard category the first place was taken by Filip Bukov, EnergoService AD; in the second came Nia Lisikova, Sunfoods Bulgaria, and Pavel Vacek, the Czech ambassa-dor, placed third.

8. The team award went to Nemetschek Bulgaria, followed by EnergoService AD and Municipal Bank.

On March 9 Arexim Engineering hosted a business luncheon for AmCham members at Bear’s House restaurant on Perelik Peak.

AmCham cordially thanks Pamporovo AD for the perfect orga-nization of the contest and the generous support of our spon-sors: Aurubis Bulgaria, Nissan, Adecco Bulgaria, McDonald's and Nemetschek Bulgaria.

Diplomats, Businesses Compete on the Slopes

At the final of Snezhanka II ski run in Pamporovo resort.

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Albena Koeva-Ekimova, EnergoService was first among women (middle).Stephan Reiter, General Manager of Hilton.

The first place in the category of team award went to Nemetschek Bulgaria, fol-

lowed by EnergoService AD, and Municipal Bank.Warming up for the contest.

In the children category the first place was taken by Eleonora Doseva, Nemetschek

Bulgaria.

In the category of the senior executives on the first place came Kamen Ilchev,

Renault Nissan Bulgaria.

In snowboard category the first place was taken by Filip Bukov, EnergoService. In men category the winner was Valentin Mitrin, Actavis.

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Aurubis Bulgaria launched a new employee program for active and healthy lifestyle in June 2013. The main idea of “Healthy Lifestyle” is that activities we do for implementing the pro-gramme are going to motivate us to lead a healthy lifestyle. This could happen with a few simple changes in our life – a new healthy diet, participation in many activities, overcoming

bad habits, etc.

For the launch of the project every single employee received a pocket book “Healthy Lifestyle Guide” which inform and advise us to think about our daily menu and how to be more active in leisure time.

A part of events were seminars and individual consultations focused on Occupational Health Service. The seminars were led by experts in healthy nutrition, psychology and methods to overcome smoking. Our guest psychologist shared a very interesting and instructive way to deal with human habits and addictive behavior. Dr. Ipokratis Papadimitrakos had an attrac-tive presentation on topic “Normal lifestyle – normal eating. What IS and what ISN’T the food”. Being an experienced con-sultant to families, adults, children and adolescents, Ms Papadimitrakos was admired by the visitors.

Free telephone line for all employees and their family members was open as part of the program where to receive advises on how to overcome various topics associated with bad habits, stress and others.

Changes in the canteens of the company were part of the pro-gram and we organized an independent choice of food, des-serts and fresh juice, as well as very popular already self-ser-vice salad bar – where everyone could make a variety of sal-ads at a fixed value to weight.

The events are going to become a tradition in the company. The employees already appreciate the positive changes in canteens and the organization of various seminars. There were new ideas for this year and organizing of similar events.

“Healthy Lifest yle” Program for Aurubis Bulgaria Employees

The healthy diet program applied in the canteens of Aurubis.

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q u a l i t y m a n a g e m e n t

If we think for a minute about the factors that determine wheth-er a new initiative or the overall company performance will be a success, most of us will probably come to the following list:

Costs; Productivity; Innovation capabilities; Use of technologies; Competitors’ activity; People; Marketing and sales efforts;

When we refer to managing people contribution to the comple-tion of the objectives of our company, we focus our efforts mostly on maintaining and encouraging their competence, motivation, quality of work, loyalty, skills and productivity. And all these are important.

But when we think of productivity and the impact that our teams have on it, what will happen if key team member par-ticipating in a project for a major customer is not available for some time due to a sudden sick leave?

It will certainly cause problems with the customer. In case the leave is due to an injury caused by a road traffic incident during working time, there will probably be claims to employer too.

“People availability” should be added to the list of key suc-cess factors above, but this requires a detailed review of your company’s current road traffic safety performance and actions to improve it by adopting a systematic approach to road traffic safety management. And this process has to start today because it is about our responsibility for human lives.

According to the official statistics, 75% of the people that lost their lives in road traffic accidents in 2012 were in working age (18-64 years) and most of the accidents have occurred in day-light.

The safety status of road traffic is a global concern. According to the Global Status Report of the World Health Organization (WHO) on Road Safety, 1.24 million people are killed on world’s roads each year and 20-50 mln people sustain non-fatal injuries. The concern of many international organizations regarding road traffic safety resulted from the UN General Assembly announcing the “Decade of Action for Road Safety 2011-2020”. Among the main objectives of the published Global Plan for the Decade of Action for Road Safety 2011-2020, is the focus on global prevention of road traffic injuries aiming to reduce fatalities by 2020.

The Global Plan for Action envisages adoption at a national level of strategies for action which should include promotion and support of initiatives aimed at road traffic safety manage-ment, such as the international standard ISO 39001:2012 – Road Traffic Safety (RTS) Management Systems - Requirements with Guidance for Use.

The implementation of a Road Traffic Safety management system framework, based on ISO 39001:2012, allows improve-ment of results and contribution to prevention of risks of seri-ous injuries and fatalities caused by road traffic incidents.

This framework is applicable to all organizations dealing with a road traffic system, including:

Road users (haulage companies, couriers, organizations with employees travelling or operating their own fleet);

Organizations that plan, construct or maintain road infra-structure (local government bodies, private companies);

Organizations that generate demand for the road (retail stores, trade and sport centers, schools, etc.)

Companies worldwide have already taken steps towards improvement of their road traffic safety performance by pre-planning the routes that their employees follow during imple-mentation of their daily travels, implementing systems that allow them to control online the speed of the vehicles they operate and by implementing the best practices of road traffic safety as set by ISO 39001:2012.

AmCham member companies that interact with road traffic system have also implemented measures to ensure the safety of their staff during performing their duties. For example, Allied Pickfords operates an online vehicle tracking system to control the speed and drivers obligatory time breaks. Online Traffic Management routes the trucks and vans away from traffic and controls if vehicles follow the programmed route.

Due to the importance of the subject and the interest of AmCham members, Road Traffic Safety was the topic of the AmCham Quality Management Working Group in March 2014.

Approaches to road traffic safety based on ISO 39001:2012, as well as related experience and success stories of AmCham member companies - Intertek, Shell, WorleyParsons - were presented during the meeting. If you would like to share your experience and best practices, please contact the Chairs of AmCham Quality Management Working Group.

Road Traffic Safet y: Is Your Company Concerned?

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In Bulgaria, BNP Paribas S.A. – Sofia Branch employs

teams with in-depth knowledge, exercising their profession with the highest ethical standards. Fully integrated within the BNP Paribas Group, relying on professionals all around the world, we provide efficient coordination and cooperation with the in-house experts throughout Europe. Our focus is to develop partner-like relationships with large corporates, financial and public institutions with which we identify mutually beneficial business opportunities. We offer our clients efficient and competitive services to the Bulgarian market via our central main office in Sofia and regional

office in Varna. We offer the varied activities of corporate invest-ment banking through implementation of “one-stop shopping” concept. It provides corporate clients with a full range of commer-cial and investment banking products including cash manage-ment, trade finance, working capital solutions, FX hedging & conversion, e-banking, commodity hedging.

Contacts:Hans Broucke

Tel: (+359) 2 9218 528Address: 2, Tzar Osvoboditel Blvd.

1000 Sofia

Carat Bulgaria was established in 2012 and for a short peri-od of time the com-pany achieved con-

siderable success on a local marketplace managing to position itself as an innovative and highly efficient communication agency. Agency operations are focused on Strategic Communications planning, media planning and buying, and media research. Some of the main clients serviced are: Mondelez, Mtel, General Motors, Adidas, Mattel etc. The agency’s mission is to create better busi-ness value through specific command of media convergence. Its

communication planning approach is supported by a unique tool: CCS Planner – a system of research, insights and planning tools based on the most in-depth single source of media, marketing and consumer targeting data in the world. The team consists of highly motivated professionals who apply all International Industry standards.

Contacts:Maria Milanova

Managing PartnerTel.: +359 2 981 9917http://www.carat.com

Telelink EAD is a leading system inte-gration company in South-East Europe

with proven experience, professional skills and in-depth knowl-edge in the areas of Network Infrastructures, System Integration and Security & Automation. The team consists of more than 500 employees and manages about 2000 subcontracted workforce, which makes it one of the largest pool of certified experts on the Balkans. Nowadays Telelink operates in Bulgaria, Romania,

Serbia, Montenegro, Bosnia and Herzegovina, Macedonia, Ukraine and Hungary. Having proven successful track record in several of the biggest ICT projects in the region, Telelink is gradu-ally expanding its activities, expertise and presence.

Contacts:Tsvetan Mutafchiev

CEOTel: +359 2 970 40 40

www.telelink.com

EOS Matrix was established in Bulgaria in 2002 and today it is one of the leading and most active players in the field of receivables man-agement. The company is focused on providing security through tailor-madesolutions for leading

companies in the financial, utilities, telecommunications and B2B sectors.EOS stands for high standards in debt management and for the consistent protection of the interests of creditors and con-sumers. We offer full range of services covering the each aspect of the receivables management process. EOS Matrix is part of EOS Group - a leading international provider of customized finan-

cial services focused on debt management. With its workforce of more than 9,500, EOS serves approximately 20,000 customers in over 25 countries worldwide through 50 subsidiaries. Together with an international network of partner companies, we offer our customers resources in 140 countries on all continents.

Contacts:Rayna Mitkova-Todorova

Managing DirectorTel;: + 359 2 976 08 00

http://bg.eos-solutions.com

Actavis is the third largest generic phar-maceutical company

worldwide and the biggest American pharmaceutical company in Bulgaria. Actavis has the broadest product portfolio on the local market. The company has two production sites in Bulgaria spe-cialized in separate production technologies- solid oral forms (Dupnitza) and cream, liquid forms (Troyan). Our plants cover the

highest international standard connected to the quality of the phar-maceutical production- GMP (Good Manufacturing Practice).

Contacts:Iliya Pashov, Executive Director

http://www.actavis.bgAddress: 29, Atanas Dukov Str.

1407 Sofia

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Founded by Peter the Great in 1703 as a symbol of upcoming new era for the Russian state, the city passed through dramatic ups and downs during its his-tory of more than 300 years. Nowadays St. Petersburg is a home of countless cultural, historical, architectural and reli-gious treasures and became one of the most desirable destination among cruise-lovers in the Baltic region.

Unlike other ports of call where average stay lasts a few hours, cruise lines usu-ally provide two-day stay in this magnifi-cent city so guests can explore and enjoy more sights in their visit there. A great variety of day and evening shore excursions are available for passengers. Take a tour from the cruise company and you can get ashore without having a Russian visa! Second major advan-tage of visiting St. Petersburg by cruise ship is quick access to some key tourist sites where ordinary people wait in a line for hours to get in.

What to see in St. Petersburg?

You will have to choose what to see among hundreds tourist attractions located in and nearby the city. Here are short descriptions of some MUST SEE sites:

Tsar’s Village in Pushkin

Catherine’s Palace in the Tsar’s Village ranks as one of the masterpieces of world art. Peter the Great presented the estate to his wife Catherine in 1710 and the architect Braunstein built a small palace here. From this time until the time of the last Russian Tsar, Pushkin was used as the summer resi-dence of the Royal Family. In 1756, Bartolommeo Rastrelli expanded the palace in Baroque style. Its grandiose, white and gold facade stretches 978 feet. The palace tour takes you through the series of magnificent rooms, includ-ing the famous Picture Gallery, the Great Hall and the world famous Amber Room.

Peterhof

Peterhof was built by Peter the Great to rival Versailles. It lies on the southern shore of the Gulf of Finland, 22 miles west of St. Petersburg. Built in the beginning of the 18th century, Peterhof is known as the most brilliant of all the summer residences of the Russian Tsars. The estate construction spanned two centuries, and upon its completion it encompassed seven parks and more than 20 smaller palaces and pavilions. Peter himself designed the layout of the 300-acre park and spectacular foun-tains. Nowadays you can admire the full variety of forms and the different func-tions played by the fountains, which make Peterhof an open air museum unlike any other in the world.

Yusupov Palace

If you’d like to look at the city from a dif-ferent perspective you can visit Yusupov Palace. There you will learn about the tragic death of one of the most mysteri-ous figures in Russian history – Grigory Rasputin.

Hermitage

The State Hermitage is a museum of art and culture, one of the largest and old-

est in the world. It was founded by Catherine the Great in 1764 when she started her art collection by purchasing paintings. Her collection consisted of Rembrandt, Rubens, Titian, Antoine van Dyck, Rafael and many others.

When to visit St. Petersburg and how to travel best in the Baltics?

Baltic cruise programs begin in May and end in September. If you wish however to be there during so called White Nights you need to book your trip for May or June.

The variety of products is enormous - you can choose among free-style, con-temporary, premium and luxury cruises. Duration of cruises vary from 7 to 14 days. All itineraries in the Baltic Sea as a rule include St. Petersburg. Besides this magical city, for the time of your voyage you will enjoy some other great ports of call as Copenhagen, Stockholm, Helsinki, Tallinn, Oslo and Hamburg.

You can book Baltic cruises and shore excursions in St. Petersburg &Baltic capitals at Cruise AgencyCONTITRANS M Ltd.

Please Call at 0700 10575 or visit www.contitrans-m.com

Cruise Destination Saint Petersburg

The Church of Our Savior on the Spilled Blood.