The Republic of North Macedonia was a recipient of the Global Fund from 2004 – 2017, and to date has been disbursed over US$ 34 million for Tuberculosis and HIV programmes, including US$ 10 million for developing and supporting of programmes for the prevention of HIV and TB in key populations of MSM, PWUD, SW and PLHIV. In addition, it is part of the following Global Fund multicountry grants – Multicountry EECA ECOM, Multicountry HIV EECA APH.

With support of the Global Fund, the country has made significant progress in developing complementary services for HIV prevention among key populations which contributed to the timely detection of new cases of people living with HIV; timely inclusion of ARV therapy; and monitoring the health status of PLHIV. All of this has greatly contributed to maintaining the low HIV prevalence in the country, especially amongst the PWUD and SW community. 

It is important to note that the transition plan for Macedonia was successfully implemented with the support of the Global Fund, and from 2017, the Ministry of Health of Northern Macedonia took over the responsibility for financing all HIV prevention programmes among key populations that were established with financial support from the Global Fund. The Impact of Transition from Global Fund Support to Governmental Funding on the Sustainability of Harm Reduction Programs and Lost in Transition were developed by Eurasian Harm Reduction Network and Open Society Foundations respectively, which documents the withdrawal of the Global Fund in Macedonia.  

However, it is important to point out that although the state undertakes the obligation to finance these programmes, unfortunately, the financing is not institutionalised by law and bylaws, and depends – to a large extent – on the political will of the current government and/or minister. 

This year, as a result of the change of the Government, for the first three months of 2022, civil society organisations that are implementers of the National HIV Programme have been left without financial means from the budget of the Programme.