The establishment of the National Patients’ Organization is the result of a long and challenging evolutionary process of the patient movement in Bulgaria. The attempts to unite the patient organizations date back to the late 90’s of the past century. The convergence between the interest of various patient organizations and their leaders takes years. The first patient organizations were registered in 2005. 

The lack of management expertise and international experience have often led to conflicts and difficult periods in the history of the patient movement in Bulgaria. The interpersonal and internal struggles have often compromised the patients’ interests which on the other hand, has given chance to people beyond the patient advocacy sphere to reclaim the role and functions of patient organizations. The private interests have led to renouncement of groups of patients and their organizations which have been operating in contradiction with the democratic principles and the right to free cooperation. At times, patient advocates have been elected for various committees, national institutions and even management positions in the absence of democratic, public and transparent election process - people without the necessary competency and experience to defend the rights of all patients.

In 2009, several patient organizations who considered the situation quite disturbing and unfavourable for the Bulgarian patients took the initiative to democratize and modernize the patient movement. The initiative was rapidly endorsed by a number of national and regional patient organizations and in early 2010, the biggest patient alliance in Bulgaria was founded – the National Patients’ Organization.

The establishment of NPO lays the foundations of the modern patient movement in Bulgaria. Having learned a lesson, NPO took the necessary actions to ensure ethical conduct and adopted a Code of Ethics of the patient organizations aiming to affirm internationally recognized standards of ethics.