CINDI PROGRAM IN BULGARIA - RESULTS AGAINST REALITY

For several decades, worldwide health systems efforts have focused on the control of the epidemic of chronic noncommunicable diseases and, to date, success in many developed countries has been reported, with a reduction in risk factors.The article does not criticize the CINDI program, which has been shown to play a positive role in reducing the impact of risk factors for chronic noncommunicable diseases, but its writing is provoked by the lack of the ultimate goal of the program - improving the health of the nation. The issue "CINDI results against reality" is discussed, presenting the discrepancy between the results reported in the implementation of the CINDI program in Bulgaria and the actual statistics on the health of the nation over a five-year period. A special emphasis is placed on the nature of the WHO CINDI program.The main causes of the problem are the non-implementation of the principles of the CINDI program, due to economic reasons, organization of the health system, the deepening process of social inequality among the population - a reason for limiting access to medical care in all aspects: medical services, medicines, preventive activities . Disregarding the "cybernetic nature of the system", in this case the health care - its emergent course.The failure to achieve the long-term health goals of the nation through the implementation of the CINDI - Improvement of Health Indicators Program is due to its subsidiary nature, applying a universal approach to all countries, without taking into account certain activities in the organization of healthcare, in the country-specific economic and social environment; and the "insufficiency" of policies to support the control of chronic non-specific diseasesThe CINDI program can be considered as a standard, with universal criteria for measuring the quality of prevention activities, but applied under different socio-economic conditions in different countries. The consequence is a discrepancy between optimal CINDI indicators and morbidity and mortality statistics.To reduce the CINDI reality gap, the program needs to be enriched with new criteria drawn from the country's economic and social environment to support national health policies for the control of chronic non-specific diseases