Activity Report January – December 2024
Summary
BOLD Foundation pursued its purpose during 2024 of promoting democracy and human rights in Bulgaria. The following activities were implemented:
1 Campaigns and Positions
In the report period, BOLD conducted four online meetings of regular members at which it made decisions on campaigns, events, and positions on key issues of Bulgarian democracy. Highlights:
19 May 2024: In 2022-2023, BOLD worked on the issue of disinformation in the context of a project that included a series of events on the impact of the war in Ukraine on Bulgarian democracy. In December 2023, together with the Access to Information Programme (AIP), BOLD organized a conference on “Disinformation: challenges and solutions in search of truth” at which a commitment was made by BOLD and AIP joined by the Bulgarian Helsinki Committee (BHC) to develop recommendations on guaranteeing freedom of expression in virtual settings while taking measures against hate speech and disinformation. The document, entitled Recommendations on Freedom of Expression and Its Restrictions in Virtual Settings, was drafted, discussed and adopted under BOLD coordination in January-April, and publicised in May. The recommendations are based on the laws, policies and best practices adopted, or in the process of being adopted, by the European Union.
9 August 2024: BOLD publicised a position in which it strongly condemned the adoption by the National Assembly of a bill to amend the Preschool and School Education Act, in order to ban “propaganda, promotion or incitement” of “non-traditional sexual orientation” and “defining gender identity other than biological” in Bulgarian schools. BOLD’s Position against the Ban of LGBT Propaganda in Schools presented an analysis on how the new provisions contradict a number of norms of the Bulgarian and international legal order, including the Constitution, the Law on Protection against Discrimination, the Charter of Fundamental Rights that binds EU member states, the European Convention on Human Rights, and several UN treaties to which Bulgaria is a party. BOLD expressed concern that by voting the bill, the Bulgarian Parliament demonstrated a lack of clear and consistent representation of liberal democratic ideas and human rights values.
20 September 2024: Starting in September, in the second half of 2024, BOLD participated in the campaign of the European Citizens’ Initiative (ECI) entitled My Voice My Choice, aimed at ensuring the right to safe and accessible abortion in the European Union. BOLD spread several appeals asking people to sign the ECI so that one million signatures would give rise to mandatory consideration by the European Parliament of the proposed legislation. The ECI is an instrument of direct democracy in the EU through which citizens can participate in the adoption of legislation in the EU. The ECI was successfully registered and is awaiting adoption.
2 Project “Strategic Litigation for Vaccination Justice”
This project ended on November 30 2024. In this project, with Dimitrina Petrova, Executive Director of BOLD as project leader, BOLD partnered with the Bulgarian Helsinki Committee.
The main accomplishment of this project is that it created a possibility for people to seek justice in realising their rights in the context of the distribution of scarce healthcare resources. Before the start of this project, there was no awareness in Bulgaria of the political, social, medical and ethical issues surrounding health rationing. The pre-existing discourse on health justice was entirely ignorant of the globally advancing area of heath rationing, including the evolving approaches around the criteria and process of distribution of scarce health resources. The unjust national policy of Covid vaccinations put forward in late 2020 that disadvantaged those who were most in need of such vaccinations (the elderly and people with certain medical conditions that put them at greater risk of death from Covid) motivated BOLD and the Bulgarian Helsinki Committee to undertake strategic litigation, research and advocacy in an attempt to tackle human rights in conditions of rationing and develop awareness in the country of this complex area of health justice. On the whole, the project opened avenues for pursuing more just health rationing practices in the future, and its innovative character consists in making the difficult first steps in that direction.
Below are details on the activities that produced the project results:
Litigation: Starting in December 2021, several cases were filed complaining against the national vaccination policy that had failed to protect from death the most vulnerable categories of persons – the elderly and those with certain underlying health conditions, in the first half of 2021 when Covid vaccines were scarce. Each case pursued a different strategy, under a different type of legal process, but all had the general purpose to establish that the Bulgarian authorities have violated the rights to life, health and non-discrimination of over 10,000 persons who have died from Covid-19 in the period between February and July 2021.
In the first case, an individual complaint on behalf of relatives of Covid victims was filed against the government under administrative law procedure, contesting the lawfulness of the National Vaccination Plan. (A separate case was also filed later on behalf of the same individual victim’s relatives in civil courts.) Challenging the lawfulness of the National Vaccination Plan was decided as the goal of the initial phase of litigation under this pathway in order to then be able to file cases under the Liability of the State and Local Authorities for Torts Act (Zakon za otgovornostta na durzhavata i obshtinite za vredi – ZODOV) providing for damages to persons harmed by unlawful state action or inaction. It was thought that, in case the Supreme Administrative Court declares the respective portions of the National Vaccination Plan unlawful, the gate would be open to action under ZODOV. In case the request is dismissed, the victims’ relatives will have demonstrated that no effective remedy exists for them in Bulgaria. The cases were filed directly at the Supreme Administration Court because it is the court of first instance when the lawfulness of a normative provision is contested. The deceased persons whose relatives filed the complaint were in group 4 that comprised persons over 65 and persons who, by reason of an underlying medical condition, have a much higher risk of death or severe illness in case of Covid infection. The claimants argued that their deceased relatives should have been assigned a much higher priority and showed that the three groups that preceded group 4 consisted of millions of individuals who were not at a comparable risk of death. They argued that by failing to vaccinate their family members as a matter of priority, the state has violated their rights to life, health and non-discrimination. In the subsequent series of court decisions, various issues became a subject of dispute, including whether the National Vaccination Plan was a normative act, and whether the claimants had legal interest, both consequential regarding the admissibility of the claim. Next, issues of jurisdiction and procedure were argued by both sides, and at the time of this report, the case is still pending.
Another case was launched in the public interest represented by BHC under civil law procedure, alleging a violation of national anti-discrimination legislation. It was decided that a complaint against the government could be filed by the Bulgarian Helsinki Committee acting on its own behalf (i.e., with no individual plaintiffs) in a civil court. As an NGO working in the public interest, the BHC has standing to sue under Article 71.3 of this Act without individual clients, on behalf of the public interest. The essence of the claim would be that the government, through its vaccination plan and subsequent vaccination policy, has discriminated against persons on the basis of age and disability, by not treating them equally, which in this case, on account of their higher risk of death, would have required preferential treatment, i.e., a priority position in the vaccination queue. A positive outcome would consist in a finding that discrimination has occurred and a ruling that no similar violation can be allowed in the future. The government and the health minister at the relevant time who are the defendants in this case rejected the claim and raised objections regarding, inter alia, the comparator in finding discrimination.
Additionally, under this project a collective complaint against Bulgaria was submitted to the European Committee of Social Rights of the Council of Europe by Open Society European Policy Institute (OSEPI), with assistance from the BHC and BOLD, alleging violations of several articles of the Revised European Social Charter – Article 11 (right to protection of health) and Article E (non-discrimination) of the European Social Charter (Revised). A positive decision of the ESC will be binding on the Bulgarian government. As at May 21, 2024, the case is pending.
Research: For the purposes of supporting litigation as well as for advocacy and communications, the project included several studies. (i) Legal analysis of the Bulgarian normative framework on health policy regarding Covid vaccinations – examining the lawfulness of the December 2020 vaccination plan, in both substantive and procedural terms, and assessing the regulations and policies implementing it from the point of view of human rights as enshrined in Bulgarian and international law. Two legal teams – one coordinated by BHC Legal Director Adela Kachaunova responsible for the civil law pathway and the other by partner BOLD responsible for the administrative law pathway (see above) carried out detailed legal research that was fed into the case submissions under all three pathways described above. (ii) Comparative epidemiological research – aimed at comparing data between Bulgaria and other countries, focusing on vaccination and death statistics disaggregated by age and by accompanying medical conditions, analyzed in terms of their dynamics over time. Under terms of reference elaborated by the project team, Dr Hristiana Batselova, an experienced epidemiologist, completed the study. Central to the study is an expert assessment of the situation of vaccines’ allocation in the country during the first months of the vaccination process, i.e., from late December 2020 to late May 2021, and the subsequent effects of the vaccine distribution on public health. (iii) Comparative global legal research – analyzing law and case law from various jurisdictions, in respect of: (a) claims of violations of the rights to life and health consisting in authorities’ failure to fulfil their positive obligations in respect to these rights, by failing to take steps to protect people from preventable death, through unfair or unreasonable distribution of scarce health resources; (b) claims of age and/or disability discrimination in the area of health in situations comparable with the one tackled by this project. The OSJI led on this activity, in consultation with the Bulgarian project team. Prof John Harrington of the Cardiff University was appointed to carry out the study and completed the report, with assistance from his academic team.
The results of the above studies have been used, and will continue to be used, to: (i) build further legal argument in strategic litigation cases; (ii) drawn upon in future as amicus curie briefs; (iii) develop advocacy positions and other advocacy materials.
In the post-pandemic environment, we recalibrated and re-focused the project, from the topic of vaccination justice to the broader conceptual framework of just allocation of scarce health resources, concerned that the discourse of “health rationing” was still non-existent in Bulgaria. In 2024, scoping research was carried out which resulted in a study entitled Mechanisms for the Distribution of Scarce Resources in the Healthcare System of Bulgaria that was published in November 2024. The research was a first of this sort. It explores the mechanisms of distribution of scarce health resources, aiming to identify what criteria are being applied, who decides, who has oversight of decision making, how the mechanism of resource allocation evolved over the last decade, and the impacts on health results. The study is expected to serve as a key instrument for human rights policy advocacy. The research included an analysis of the normative framework; a study of good practice; monitoring of national practice; and field research through focus groups and interviews with stakeholders.
Advocacy and communications: In early 2022, the project team prepared and sent out information letters to the Health Ministry and the Justice Ministry letting them know that complaints were being filed in national courts and the European Committee of Social Rights in respect to the vaccination plan of December 2020, its implementation and communication on the vaccination process. There has been informal acknowledgement from both ministers that the letters had been taken into account in improving pro-vaccination policy. In March 2022, the project team sent an advocacy letter to the President of the European Committee of Social Rights, endorsed by numerous national non-governmental organizations whose regular activities and mandates are relevant to the project’s objectives. Throughout the project period, the team monitored Ministry of Health policies related to Covid and vaccines. On 21 March, the ministry launched its campaign to increase confidence in vaccines, entitled “Plus Me”. However, a review of the media in Bulgaria shows that the campaign is limited and is its message is not broadly disseminated. Starting in February 2022, the war in Ukraine, Ukrainian refugees’ arrival in Bulgaria and the escalation of the social and economic crisis caused by the war shifted public attention from all issues around Covid vaccines. Meanwhile, the last anti-epidemic measures in the country were dropped in May 2022.
At various points during the project lifetime, press releases were issued on the filing of the legal cases seeking responsibility from the Bulgarian state for poor vaccination of the most vulnerable to Covid-19. The response was moderate, given the diminished significance of Covid and the general tendency to reduce anti-epidemic measures, including vaccination. Several interview requests were received and interviews with project team members were broadcast.
At the end of the project, an event open to stakeholders and media was organized to present the study Mechanisms for the Distribution of Scarce Resources in the Healthcare System of Bulgaria. Two short videos based on the study were also publicized. The study had a very good initial uptake among key actors and decision makers, including medical associations, patient rights groups, lawyers and civil society organizations. Interviews and other materials were published in the media.
3 Communications
We have maintained the organizational website, https://boldbg.net, placing materials related to positions, events, etc.
A variety of content was disseminated via an e-bulletin sent to over 2000 subscribers.
BOLD regularly published materials on its Facebook page.
Regular communication with the BOLD members has been maintained and four general meetings of the members were held online.
Media outreach: we have published several articles in Bulgaria and abroad, e.g., on discrimination in emergencies authored by Dimitrina Petrova and there have been several interviews with BOLD leaders during the report period, e.g. on disinformation and hate speech, and abortion rights.
