Legal opinion

Osteocentre said that lawyers consulted before the visit had said that there were no legal obstacles to the two foundations paying Bulgarian officials’ expenses arising from the trip.

Bulgarian law focuses on personal benefit for the civil servant when examining possible conflict of interest. Nanev said that neither he, nor any associate of his, had received such benefits.

The US Foreign Corrupt Practices Act forbids "an offer or payment of anything of value to any person", but makes an exception for "reasonable and bona fide expenditure, such as travel and lodging expenses, incurred by or on behalf of a foreign official, party, party official, or candidate and was directly related to … the promotion, demonstration, or explanation of products or services," according to the legal opinion of a law firm contacted by Hichev, made public by Osteocentre.

The same opinion said that "if the payment of expenses is being done for the purpose of attempting to get the Minister of Health to use his influence to direct business to our client, then there may be a concern."

Albeit there is no direct contractual relationship between Osteotech and the Bulgarian Health Ministry, the ministry oversees all state-run hospitals, from which tissue is harvested and exported abroad by Osteocentre, one of the five tissue banks registered in Bulgaria.

Given the sensitivity of the Bulgarian public to any activity that implies the potential for corruption and Osteocentre’s history of negative media coverage, the suspicion with which Nanev’s visit was treated in Bulgaria is not surprising.

The lack of official statistics on tissue harvesting further fuels suspicion. According to the Transplants Agency, as quoted by Dnevnik daily, Bulgarian hospitals have received 317 allografts, which cost between $7000 and $50 000. About 1800 samples were provided to Pirogov hospital’s tissue bank, while tissue that was "surplus to requirements" was exported, according to a Hichev statement in April 2008.