Dr. Nikolov on the smuggling of cytostatics to Kosovo: A stain on the entire healthcare system of North Macedonia

Associate Professor at the Faculty of Medicine in Skopje and doctor at the Nephrology Clinic, Igor Nikolov, assessed that the health scandal involving the smuggling of cytostatics to Kosovo, which was rocking North Macedonia, should be clarified as soon as possible so that the entire health system in that country would not be stained.

The oncology clinic of the "Mother Teresa" University Clinical Center in Skopje found itself at the center of a scandal due to claims that the staff of that hospital gave patients cytostatics diluted with saline solution and that the cytostatics were resold and ended up in Kosovo. The Basic Public Prosecutor's Office in Skopje and the Ministry of Internal Affairs of North Macedonia launched a preliminary investigation a few days ago. Nikolov, who is also the current President of the VMRO - DPMNE health committee, also wondered why it had taken so long to react.

"Unfortunately, this dysfunctionality of institutions and systems stains the healthcare system. The healthcare system consists of healthcare workers, for whom we cannot generalize that they are all in the same basket with what is happening and announced, because if we generalize, we stain the entire healthcare system, and the entire healthcare system is not a part of this situation that institutions fail to solve. Failure to implement a solution or provide a real investigation creates even greater distrust among citizens and once again casts a shadow, mainly on health workers," Nikolov says.

He believes that the largest percentage of health workers should not be put in the same basket and that therefore it is necessary to take measures and solutions as soon as possible and to reveal those anomalies that led to the situation that gave birth to this affair.

"The dysfunctionality that has been created in recent years should be removed as soon as possible, even more so that it does not leave a mark on the entire health system, which is complex and very important for citizens. We must demand that the whole case be clarified as soon as possible. Procrastination stains the entire health system, and unfortunately, the healthcare workers, who are not to blame for the dysfunctionality of the healthcare system, are not to blame because someone did not take corrective measures or abolished the control system for monitoring the dose of cytostatics. It is not the healthcare professionals' fault that someone did not implement these corrective measures and did not eliminate the dysfunction. Of course, whoever is guilty or has taken criminogenic measures should be held accountable and punished most severely," Nikolov says.

Nikolov added that the institutions should take measures because he assumed that it was not just about the dysfunctionality of the Oncology Clinic, but also the dysfunctionality of the entire healthcare system.

"Citizens are witnessing dysfunctionality in other branches of the health sector, and if it is not removed, it will create additional dissatisfaction. Let's open the issue of waiting lists, do we have information on how long waiting lists are and are we taking measures to reduce them? Do we have a list of citizens who are waiting a long time for medical interventions? All of this should be available to the public because before this Government came to power, they announced that they would be transparent, which should have resulted in the correction of all the anomalies we are witnessing today," Nikolov says.

According to him, the scandal with cytostatics will certainly greatly affect the trust of the citizens of North Macedonia in the health system. He adds that restoring that trust will be a long-term process.

"Every postponement of measures increases mistrust. In recent years, we have not had the outcome of some cases that have been opened in the health system, which measures have been implemented in several affairs that have been opened in the health system, and all this, when put together, creates a great dissatisfaction that does not cover only the health workers, but creators of the health system, and political responsibility should be at a higher level," Nikolov said.

He added that for more detailed comments on the case, we should wait for the investigation to be completed as to where and how the cytostatics had been diverted, whether the channel had only gone to Kosovo or to other destinations.

"Without confirmation, we cannot generalize; it is very important to determine who diverted them, how they were diverted, and who all the participants in that diversion are. I am convinced that the health system does not divert all medicines and all devices or instruments for the treatment of all patients from neighboring countries. Of course, there are open questions, especially in the field of oncology. Since 2017, we have had an accelerator in the Military Hospital in Skopje, which is not working, and it has been promoted three times that it will be opened. We have oncology departments in the hospital in Shtip, which are not working, and there is an accelerator that doesn't work. We also have an accelerator in the hospital in Bitola that doesn't work. The question arises, is there political or organizational responsibility for all these anomalies? When they accumulate, they create one big deformity. A big deformity has consequences for the health of citizens. This must be prevented and put an end to it. The sooner we put an end to deformations in the health care system, the better for the health of our citizens," Nikolov said.