# North Macedonia health reform and ethnic representation > Live situation record from CLSTR: https://clstr.news/situations/north-macedonia-health-reform-initiatives > Updated: 2026-08-25T11:34:10.000Z. Sources: 38. Developments: 18. In May 2026, Health Minister Azir Aliu launched a €205 million hospital modernisation programme targeting facilities in Štip, Kërčovë, and Tetovo, while also addressing debt at the Strumica hospital. Aliu promoted a National Digital Health Strategy 2026–2030, emphasizing telemedicine and digital care pathways. On 24 June, North Macedonia officially joined the EU’s €4.4 billion EU4Health programme, facilitating access to grants and expertise for digital health, oncology, and workforce strengthening. Despite these advancements, the ministry faced challenges. Aliu noted that private specialists often skip mandatory public hospital shifts due to low, irregular state pay. Furthermore, critics argued that digital reforms had stalled, with many platforms remaining in planning stages. Political instability also emerged; Aliu warned against early elections, and the ministry experienced rapid turnover, with Aliu leaving office after approximately one year amid government reconstruction. Following Aliu, Sasho Klekovski assumed the health portfolio. He announced a 26% increase in the public health budget and a 22% rise in medical staff salaries. To address personnel shortages, the ministry lifted a hold on hiring 300 specialists, aiming to complete a total recruitment target of 600 by the end of 2026, with priority given to regional hospitals outside Skopje. However, ethnic tensions resurfaced in July when Klekovski established a Professional Commission for malignant diseases that included no Albanian doctors, drawing criticism over representation. The government continues to pursue long-term salary increases, projecting a total rise of over 40% by the end of the mandate to stabilize the workforce. ## Timeline ### 2026-08-25: North Macedonia government announces healthcare staffing and salary increases The Macedonian government plans to hire 300 additional medical specialists by 2026 and implement salary increases exceeding 40% for healthcare workers by the end of the mandate. 2 sources. https://clstr.news/cluster/north-macedonia-government-announces-healthcare-staffing-and-salary-increases ### 2026-07-29: North Macedonia Health Ministry to hire 300 specialists by year‑end North Macedonia will hire the remaining 300 health specialists by end‑2026 after a government decision lifted a hiring pause, announced by Health Minister Sasho Klekovski. 3 sources. https://clstr.news/cluster/north-macedonia-health-ministry-to-hire-300-specialists-by-yearend ### 2026-07-22: Macedonia Health Minister Forms New Cancer Committee Without Albanian Doctors Macedonia's health minister Sasho Klekovski created a ten‑member cancer commission in Skopje, excluding Albanian doctors, sparking criticism over ethnic representation in health policy. 4 sources. https://clstr.news/cluster/macedonia-health-minister-forms-new-cancer-committee-without-albanian-doctors ### 2026-07-14: Macedonia's new health minister Sasho Klekovski outlines reforms Sasho Klekovski became Macedonia's health minister, inheriting Azir Aliu's agenda and pledging budget boosts, salary hikes, expanded services and pending electronic prescription and child insurance projects. 2 sources. https://clstr.news/cluster/macedonias-new-health-minister-sasho-klekovski-outlines-reforms ### 2026-07-13: Macedonian parliament turmoil amid government reconstruction Macedonian MPs quit a session on government reconstruction after a ministerial candidate verbally attacked SDSM deputies; the premier apologised while opposition calls the reshuffle a political market for early 15 sources. https://clstr.news/cluster/macedonian-mp-borisav-krmov-says-government-reshuffle-is-a-political-market-ahead-of-early-elections ### 2026-07-02: North Macedonia health ministry faces rapid turnover of ministers North Macedonia has had 20 health ministers since 1991, with recent rapid changes—including Azir Aliu’s brief tenure—sparking calls for a stable, long‑term health policy. 2 sources. https://clstr.news/cluster/north-macedonia-health-ministry-faces-rapid-turnover-of-ministers ### 2026-06-26: North Macedonia joins EU4Health programme, securing €4.4 billion funding North Macedonia signed the EU4Health agreement, gaining access to the EU’s €4.4 billion health programme to fund digital health, disease prevention, and workforce projects. 2 sources. https://clstr.news/cluster/north-macedonia-joins-eu4health-programme-securing-44-billion-funding ### 2026-06-26: Health Minister Azir Aliu Says He May Remain in Government Amid Reshuffle North Macedonia’s Health Minister Azir Aliu said he may stay in office after the announced government reshuffle, stressing his work is about serving citizens, not the title, and presented the EU4Health program. 6 sources. https://clstr.news/cluster/health-minister-azir-aliu-uncertain-about-staying-after-cabinet-reshuffle ### 2026-06-24: North Macedonia joins EU4Health program with €4.4 billion funding North Macedonia signed the EU4Health agreement, securing access to €4.4 billion EU health funding for reforms in digital health, prevention, and workforce. 9 sources. https://clstr.news/cluster/north-macedonia-signs-eu4health-agreement-to-boost-healthcare-reforms ### 2026-06-22: Macedonian Health Minister Azir Aliu argues early election would render government reshuffle illogical Macedonian Health Minister Azir Aliu says a government reshuffle is illogical if early elections are planned, urging focus on current term priorities. 3 sources. https://clstr.news/cluster/macedonian-health-minister-azir-aliu-argues-early-election-would-render-government-reshuffle-illogic ### 2026-06-18: Macedonia Health Minister Azir Aliu says private specialists skip state duties over low pay Macedonia's health minister says private specialists skip mandatory state duties due to low, delayed pay and administrative hurdles, pledging reforms to address the issue. 2 sources. https://clstr.news/cluster/macedonia-health-minister-azir-aliu-says-private-specialists-skip-state-duties-over-low-pay ### 2026-06-17: Health Minister Azir Aliu Advocates Digital Health at SEEHN Plenary in Skopje At the 49th SEEHN plenary in Skopje, Health Minister Azir Aliu pushed digital health, nursing leadership and system resilience, and announced a September regional health ministers conference under the World Bus 2 sources. https://clstr.news/cluster/health-minister-azir-aliu-advocates-digital-health-at-seehn-plenary-in-skopje ### 2026-06-15: Macedonian Prime Minister Christian Mitzkowski Announces Major Health‑Sector Investments Macedonia’s PM Christian Mitzkowski pledged continued health‑sector spending, highlighting modern equipment, transplant medicine and the soon‑to‑open Strumica hospital, while outlining other ongoing hospital,‑c 3 sources. https://clstr.news/cluster/macedonian-prime-minister-christian-mitzkowski-announces-major-healthsector-investments ### 2026-06-11: Health Minister Azir Aliu Announces Year‑One Reforms in North Macedonia North Macedonia’s Health Minister Azir Aliu outlines a year‑long reform drive: digital health records, telemedicine, regional hospital upgrades, new ambulances and anti‑tobacco legislation. 2 sources. https://clstr.news/cluster/health-minister-azir-aliu-announces-yearone-reforms-in-north-macedonia ### 2026-06-11: North Macedonia joins EU4Health, gaining access to €4.4bn EU health programme North Macedonia will join the EU4Health programme on June 24, securing access to €4.4 bn for health projects such as digital health, data space, prevention, mental health and workforce strengthening, saidHealth 3 sources. https://clstr.news/cluster/north-macedonia-joins-eu4health-gaining-access-to-44bn-eu-health-programme ### 2026-06-11: Macedonia's Health Minister Azir Aliu reports a year of reforms and EU health programme entry Macedonia's Health Minister Azir Aliu highlighted a year of reforms, digital upgrades, regional hospital investments and the country's 24 June entry into the EU4Health programme. 2 sources. https://clstr.news/cluster/macedonias-health-minister-azir-aliu-reports-a-year-of-reforms-and-eu-health-programme-entry ### 2026-06-05: Health Minister Azir Aliu promotes digital health strategy at WHO meeting in Riga Macedonia’s Health Minister Azir Aliu outlined the 2026‑2030 digital health strategy at a WHO Small Countries meeting in Riga, stressing AI support, teledermatology pilots, and a new health‑records law. 2 sources. https://clstr.news/cluster/health-minister-azir-aliu-promotes-digital-health-strategy-at-who-meeting-in-riga ### 2026-05-29: Macedonia Health Minister Azir Aliu Announces €205 M Hospital Investment and Debt Cut Macedonia's health minister Azir Aliu announced a €205 M hospital upgrade programme, a CT scanner for Strumica, a 20 M‑denar debt cut at its hospital, and a new digital health strategy. 2 sources. https://clstr.news/cluster/macedonia-health-minister-azir-aliu-announces-205-m-hospital-investment-and-debt-cut --- Cite as: North Macedonia health reform and ethnic representation. CLSTR, https://clstr.news/situations/north-macedonia-health-reform-initiatives