Position of the Ministry of Foreign Affairs
21 August 2026 News
On 20 August, the Court of Appeal in Štip upheld the decision of the Basic Court in Kočani denying Iva Mihailova the opportunity to undergo the medical treatment she requires outside the Republic of North Macedonia.
It is particularly concerning that, in reaching its decision, the Court evidently failed to give due consideration to the conclusions of the competent local health authority regarding the severity of Iva’s condition. Nor does it appear to have given due consideration to the treatment prescribed to her and the fact that this treatment cannot be provided in North Macedonia.
The required medical intervention is not an optional treatment or a procedure undertaken at the patient’s request. Specialists in both Bulgaria and North Macedonia have determined that it constitutes a necessary part of the treatment of Iva’s serious condition. It should be carried out in order to prevent any further deterioration in the health of the young Macedonian Bulgarian, including the occurrence of irreversible consequences.
Particularly difficult to comprehend is an inhumane approach whereby the need for treatment is called into question on the grounds that there is no evidence that the most severe possible consequences have already occurred.
We recall that the very purpose of timely treatment is to prevent such consequences from occurring, rather than to wait until they materialise before a court can recognise the existence of a medical necessity.
The continuing delay is all the more serious given the nature of Iva’s condition and the risk that, as time passes, the prospects of successful treatment and recovery may become increasingly limited.
The Ministry of Foreign Affairs has already taken urgent measures within the scope of its competence to protect the rights of Iva Mihailova and will continue to make use of all available diplomatic and legal mechanisms with a view to ensuring that she is able to receive the necessary treatment in a timely manner.