Breaking down barriers to treatment access in the Republic of North Macedonia

Every year on 30 May the world marks World MS Day – a time to raise awareness and support for people living with MS. In 2025, the National Association for MS joined this global movement with a powerful message: People with MS deserve diagnosis and treatment without barriers.

Fighting for access to treatment

One of the biggest challenges for people with MS in the Republic of North Macedonia is getting the right treatment at the right time. Many newly diagnosed patients, or those who need to switch to a more effective disease modifying therapy (DMT), face delays or limited options.

The National Association for MS has been working hard to change that. Thanks to their efforts, and support from the National Health Insurance Fund and the University Neurology Clinic in Skopje, there has been a significant increase in the clinic’s budget for MS treatments this year. This means more patients than ever before can now receive the treatment they need.

How the Association helped make change happen

The recent improvement in access to MS treatment didn’t happen by chance. It was the result of careful planning, teamwork, and effective advocacy.

Step 1: Understanding the need

The first step was to work closely with neurologists at the University Neurology Clinic in Skopje. Together, they created a clear picture of the situation: who was already receiving treatment, who was still on a waiting list, and which DMTs were needed. This helped everyone understand the real number of patients and the gaps in care.

Step 2: Building support

Next, the Association reached out to the clinic’s leadership. They asked for their support in pushing for more resources – not just for current patients, but also for those still waiting. This step was key before taking the issue to the national level.

Step 3: Making the case

With the clinic’s backing, the Association arranged a meeting with the Head of the Health Insurance Fund and his team. They came prepared with facts, figures, and a clear request for the essential treatment needed by people with MS in the country.

Step 4: Staying persistent

After that meeting, the work didn’t stop. The team followed up with formal letters, ongoing discussions, and repeated negotiations. Their message stayed consistent, and their efforts paid off. The budget was increased to cover the treatment costs for people with MS on the waiting list.

‘Our key learnings from this process are the importance of a constant, gentle push, maintaining good relationships, thoroughly understanding the situation, having solid facts and data, and persistent negotiation. These elements combined truly made the change possible.’

Ana Karajanova, President of the National Association for MS

Real impact for people with MS

There are around 2,300 people living with MS in the Republic of North Macedonia. Each year, about 100 to 120 new cases are diagnosed. Until recently, only about 700 patients were receiving therapy, with others either in clinical trials or using alternative treatments. Now, with the expanded budget, hundreds more families have hope.

‘This isn’t just a number on paper – it’s a chance to stop the disease from getting worse. It’s a chance for a more normal life.’ Ana Karajanova. 

A team effort

During the World MS Day event, the Association also thanked the doctors and nurses who care for people with MS every day. Their expertise, dedication, and compassion are key to helping patients manage this lifelong condition.

The success of this year’s World MS Day shows what can happen when patients, health professionals, and institutions work together. The National Association for MS continues to push for better access, better care, and a better future for everyone affected by MS.