The Ministry of Health announced today that treatment for cystic fibrosis with CFTR modulators has been significantly expanded. Currently, 126 patients are receiving the therapy, compared with just three in 2021.

According to the Ministry of Health, all patients who meet the medical criteria are eligible, including children from the age of two and people with rare genetic mutations. Macedonia is among the countries in the region where the therapy is available from the age of two.

The ministry said that increased funding from the state budget and the Health Insurance Fund, together with successful negotiations with manufacturer Vertex, made it possible to expand the treatment.

An important step in early diagnosis was newborn screening. It began as a pilot project in 2018 and, since April 2019, has been implemented as a national program. This makes it possible to identify the disease at the earliest stages of life.

The fund enabled the first three patients to begin treatment with Kalydeco in 2021. Trikafta was subsequently made available, initially for patients with advanced lung damage. At the end of 2023, 12 people were receiving the therapy, and the National Guidelines for the Treatment of Cystic Fibrosis were published. During 2024, treatment was expanded to all eligible patients over the age of 12, and children aged 6 to 11 began to be included.

The Minister of Health said that the number of patients receiving therapy had risen from three in 2021 to 126 today. He stressed that behind each of these numbers are a child, a family and a new hope, attributing the achievement to continued institutional support and the goal of ensuring modern, targeted treatment for all patients who meet the medical criteria.

Macedonia’s cystic fibrosis centers are participating in the twinning project of the European Cystic Fibrosis Society (ECFS). The pediatric service is cooperating with Charité University Hospital in Berlin, while Papworth Hospital in Cambridge is supporting the development of care for adult patients.

Dr. Charles Haworth, an adult pulmonologist at Papworth Hospital, said that the new CFTR modulators had improved patients’ condition and life expectancy. According to him, the number of adults with cystic fibrosis is growing, which represents a major success. He said that on every visit to Skopje he observes clear progress in treatment conditions, doctors’ skills and health outcomes.

Dr. Miriam Stahl, a pediatric pulmonologist at Charité, explained that the teams hold monthly online meetings and consult on patients who experience difficulties with treatment. She said that care for people with cystic fibrosis in Skopje had made good progress.

Patient Fiki Gaspar is evidence of the change following treatment. Before receiving the therapy, he needed oxygen and spent almost half the year in hospital. Now, he says, he no longer requires oxygen support, and his lung function has increased from 15% to more than 55%. He has a family and a son, works full time and plays sports.

The Ministry of Health said that a total of 138 patients with cystic fibrosis have been registered in Macedonia. The country is part of the European Cystic Fibrosis Patient Registry, through which results are monitored and compared with European standards.

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From January 1, 2021, to April 30 of this year, the “My Appointment” platform remained without maintenance contracts for a total of 738 days, accounting for 37.9 percent of the period under review. Maintenance agreements were signed annually, without continuity of service being guaranteed.

During the same period, 333.3 million denars (€5.42 million) were spent on maintaining “My Appointment” and related systems at the PHI. Of this amount, only 9 percent was allocated to the national health information system, while 91 percent went to other public health systems.

These findings come from the final report of the State Audit Office, which focused on information systems under the title “My Appointment: Optimizing healthcare processes and improving the quality of healthcare”.

The analysis did not include the costs of the application software or its maintenance by primary care physicians or private healthcare institutions. It also found that 48 percent of total investments in other information systems at the PHI were concentrated among three software companies, signaling a high concentration risk and limited competition.

Because no functional analysis of staffing needs was conducted at the Electronic Health Administration, only 29 percent of the planned number of employees has been filled. Some of the needs are covered through employment contracts that are renewed annually.

Regarding institutional management, the audit found that the Electronic Health Administration, although responsible for developing and advancing the integrated health information system, does not have the legal authority to conduct public procurements related to “My Appointment”.

Another problem identified is that the name “My Appointment” was not registered and protected by state institutions, but by a private economic operator with which the Ministry of Health signs maintenance contracts. This means that the Ministry does not own the copyright to the name, while a private entity controls it, creating a risk of disputes over the intellectual property of “My Appointment”, the report states.

The central system for electronically recording working hours and the national system for material, financial and accounting operations in public healthcare institutions have not yet been created. Meanwhile, the system for registering medical equipment is not operating at full capacity because of incomplete data, while the lack of functional national systems is directly linked to the shortage of healthcare staff.

The Electronic Health Authority and the Ministry of Health have not established standards for certifying and approving software solutions in public healthcare, nor mechanisms for verifying and controlling the data entered into the system. During an on-site inspection, it was found that several public healthcare institutions lacked lists of scheduled examinations.

These practices create a risk that people without a scheduled appointment, by using priority referrals without an appointment or emergency referrals, could be seen before patients who have properly booked an appointment and waited for a longer period of time.

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Long waits for check-ups and delays in receiving medical results continue to concern citizens. In many cases, the waiting time is extended even after patients have undergone the examination, because the results are not reviewed in time. Health Minister Sasho Klekovski stressed that the shortage of appointments is a challenge faced around the world.

“The shortage of doctors, nurses and appointments is not a problem only for our country, but a global issue,” Health Minister Sasho Klekovski said.

According to Klekovski, the delays are mainly caused by an insufficient number of staff. He said consideration was being given to the possibility that some basic check-ups could be carried out not only by doctors, but also by other healthcare workers.

“In Zhirovnica, for example, there is a pharmacy, but no doctor. We need to consider whether blood pressure could be measured there or blood sugar levels checked, but these services must first be authorized by law. This proposal has been set aside and forgotten for more than two years. My aim is that in every place where there is a trained healthcare worker — a nurse, doctor or pharmacist — simple check-ups can be carried out, such as measuring blood pressure and blood glucose, as well as similar services,” Klekovski said.

North Macedonia ranks first in the region for mortality from cardiovascular diseases. Data for 2025 show that 6888 people lost their lives to these diseases. The mortality rate is 37.4% per 1000 inhabitants. Cardiovascular diseases and undiagnosed diabetes remain among the most serious risks, although they can be detected through simple check-ups.

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A 70-year-old man from Skopje has died from West Nile virus, becoming the tenth victim in Macedonia.

The patient died over the weekend at the Clinic for Infectious Diseases, where medical staff had tried to keep him alive for more than a month. The clinic’s director, Fadil Cana, announced the news at a press conference today.

A total of 70 cases of infection with the virus have been reported in the country so far.

Of the ten patients who have died, nine were from Skopje and one from Kumanovo. Most were elderly and suffered from several underlying conditions.

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Applications for the Ministry of Health’s call to employ 300 specialist trainees in public healthcare institutions through the end of 2026 have closed. Minister Sasho Klekovski said that candidates’ interests are currently being matched with hospitals’ needs.

According to Klekovski, hospitals outside Skopje will be given priority, based on their requests and their shortage of specialized staff.

“Applications have closed, and we are now in the process of aligning the interest expressed by the specialist trainees with the needs of the hospitals. We do not intend to force anyone to accept a position simply because there is interest from specialist trainees; there must be a genuine need at the relevant hospital. All hospitals outside Skopje have priority. Once the matching process is completed, which is expected soon, we will make the results known to the public and provide the hospitals with instructions to begin the employment procedures, including announcements, calls and testing,” Klekovski said.

The minister stressed that healthcare staffing needs should be assessed at the regional level, rather than only within each institution.

“We must understand that the shortage of doctors and nurses is a problem not only in Macedonia or Europe, but throughout the world. It is expected to deepen, not diminish, due to many factors. For this reason, in the future we must consider the institutions as a whole: public health centers, health centers, general hospitals and specialized hospitals. The workload at one institution may indicate unused capacity at another, which is why healthcare workers must also show greater flexibility in terms of availability,” the minister said.

Klekovski acknowledged that there is a general shortage of nurses, instrument technicians and other similar staff, adding that active efforts are under way to resolve the problem.

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In Macedonia, West Nile fever infections continued to be detected during the second half of September. According to data from the Institute of Public Health, as of September 22, 70 cases had been recorded, of which 65 were confirmed and five were probable. In the week from September 16 to 22 alone, five new cases were reported: three in Skopje, one in Veles and one in Tetova. Of all those infected, 63 are residents of Skopje, while the rest come from Veles, Kumanovo, Sveti Nikole, Kavadarci and Tetova.

The new geographical distribution once again highlights the Skopje region. According to the possible municipality of exposure, the largest number of cases is linked to Kisela Voda, with 15, and Gazi Baba, with 14. They are followed by Butel with seven cases, Aerodrom with five and Ilinden with four. Zelenikovo and Studenicani have three cases each, while infections have also been recorded in Centar, Petrovec, Sopishte, Saraj, Aracinovo and Chair. Outside the Skopje region, the areas mentioned are Veles, Chaska, Kavadarci, Sveti Nikole, Kumanovo, Dolneni and, in the latest report, Tetova.

However, these locations should not be interpreted as exact addresses where patients were infected. The Institute of Public Health stresses that this refers to a “possible municipality of exposure”, determined through an epidemiological survey, the incubation period and the patient’s movements. This is an indirect indicator of possible local circulation of the virus, not a laboratory-confirmed place of infection.

Of the 70 registered patients, 57 are over 60 years old. The average age of all patients is 66.5, while 52 of them are men.

So far, nine patients have died. All were men with the neuroinvasive form of the disease, aged between 62 and 83, with an average age of 71.1. Eight of the nine had underlying health conditions. Eight of the deceased were from Skopje and one from Kumanovo.

Of the 70 recorded cases, 68 developed the neuroinvasive form and were hospitalized. Of these, 50 patients have been discharged, nine remain under treatment and nine have died.

However, this percentage does not mean that almost all people infected with West Nile virus develop severe neurological disease. European and US health authorities estimate that around 80 percent of infections are asymptomatic, around 20 percent cause mild West Nile fever, and fewer than one percent progress to the neuroinvasive form.

The high proportion of severe cases in Macedonian statistics is likely also linked to the way patients are detected. The Institute of Public Health recommends laboratory testing especially for suspected cases of encephalitis, aseptic meningitis, acute flaccid paralysis or fever of unknown origin. This means that the system more readily records patients who are hospitalized, while a large proportion of mild and asymptomatic infections never appears in the official figures.

The ECDC described the situation in Macedonia as an unprecedented West Nile virus season at the beginning of September, particularly in the Skopje region. At the European level, by September 17, 1,482 locally acquired infections had been reported in 16 countries, and Macedonia had 66 cases in that European region. Five days later, the national total had already reached 70.

The Institute of Public Health says that the strongest spread in Macedonia occurred in July and August, but cases continue to emerge in September. On August 11, the institute had reported an outbreak in Kisela Voda, Gazi Baba, Aerodrom and Butel, while it now assesses that the concentration of cases in the Skopje region indicates active local circulation of the virus.

An additional signal comes from animal surveillance. So far, the virus has been laboratory-confirmed in two dead crows found in Skopje and one in Resen. The Food and Veterinary Agency has intensified bird surveillance throughout the country since the end of August.

West Nile virus is most commonly transmitted to humans through the bite of an infected mosquito. The Institute of Public Health recommends removing standing water around homes, installing window screens, wearing clothing that covers most of the body and using repellents according to the product instructions. Mosquitoes are particularly active at dawn and dusk.

Some infected people may experience fever, headaches, muscle and joint pain, fatigue, vomiting or a rash. The Institute of Public Health recommends seeking medical help if symptoms appear, especially if neurological signs develop.

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North Macedonia’s capital continues to bear the heaviest burden of West Nile fever infection, as the disease has now been confirmed in several other areas of the country. According to statistics published by the Institute of Public Health, as of September 22 the total number of cases has reached 70.

Of the total reported, 65 have been definitively confirmed, while 5 others are treated as suspected, based on official case definitions.

Skopje remains the epicenter, accounting for 63 of those affected. Three cases have been identified in Veles, while Kumanovo, Sveti Nikole and Kavadarci have one case each. In the same period, authorities also report the first confirmed infection in Tetovo.

In addition, data from health institutions show that nine deaths have been recorded so far as a result of West Nile fever.

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Health Minister Sasho Klekovski announced this evening that the main target of the operation carried out in the morning was products intended to enhance male performance. The operation targeted a criminal group accused of trafficking and illegally trading medicines, medications and medical supplements.

During the extensive operation, at least six people were arrested, while simultaneous searches were conducted at more than ten different addresses in the cities of Skopje, Tetovo and Gevgelija.

Explaining the nature of the case in an interview with “Telma,” Klekovski stressed that the investigation did not concern medical preparations, but supplements. He linked the crackdown to a previous operation that did not focus on Botox, and emphasized that all these measures aim to dismantle schemes involving the smuggling and illegal sale of these products. According to him, these illegal activities have been allowed to continue for far too long and carry a high risk of unforeseeable consequences.

The minister warned that the harm caused by these products is not merely economic, but poses a serious threat to public health, since the supplements in question have no kind of authorization.

Providing further details, Klekovski explained that the products contain various herbal combinations and are marketed with claims that they support male vitality and improve the function of certain organs. He added that these substances do not have the registration required in the country for the purposes claimed, making them entirely illegal.

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A 66-year-old man from Kumanovo has died as a result of West Nile fever, marking the ninth fatal case in the country. The patient also suffered from comorbidities.

According to Fadil Cana, director of the Infectious Diseases Clinic in Skopje, the 66-year-old man remained hospitalized for 28 days, during which time he developed a severe clinical condition.

Since the virus began spreading, 66 patients have been treated at the Infectious Diseases Clinic. Currently, 11 people are receiving treatment at the clinic, while one of them is in more serious condition.

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For the first time in more than a decade, health authorities have approved a new version of the essential medicines list. The updated document includes 372 pharmaceutical products, 193 of them new additions, while 12 medications on the previous list have been removed. The changes include grouping medicines into 28 therapeutic categories and, for the first time, adding contraceptives and nicotine replacement therapy.

The Ministry of Health explained that the list was drafted based on the latest scientific evidence and the current needs of healthcare. However, for patients, the question that remains is what concrete difference they will see in their pockets and on pharmacy shelves. Will the new therapies actually be accessible and affordable?

Citizens’ views reflect a mixed reality. Some view the modernization effort positively. One citizen said it was necessary for the list to be updated periodically with new medicines and that he considered the prices average, adding that the main medicines are covered by the Health Fund. “The list has now been updated,” he concluded.

Others, meanwhile, describe a less optimistic side of their everyday lives. One citizen who has been taking medication for nearly three decades said he regularly spends between 1,000 and 2,000 denars a month. Although he obtains most of his medicines by prescription, he buys two privately and noted that blood pressure medications have become significantly more expensive.

Another patient raised concerns about the physical availability of medicines. He said that for nearly two months he had been unable to find his blood pressure medication, adding that pharmacies had been out of stock and that he had been forced to wait for weeks. These accounts highlight that beyond being included on a list, patients need their therapy to be available in pharmacies and covered by health insurance.

Under the newly approved legislation, the essential medicines list will undergo a review every two years. It is important to distinguish this list from the Positive List, which determines which medicines are reimbursed by the Health Insurance Fund. Data from the Fund show that 27.3 million prescriptions for medicines were processed in 2025 alone, while new pharmaceutical brands have also been introduced into circulation this year.

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