Photo Gallery: Rising HIV numbers and funding cutbacks - Macedonia at the crossroads

Although HIV prevalence is low in Macedonia, with only 151 people registered as living with HIV, these small numbers mask a complex picture, and one that is rapidly changing. In 2016, there were 40 new HIV diagnoses, the majority of them among men who have sex with men. 

Macedonia is not alone in facing a rise in HIV cases. In many parts of Central and Eastern Europe, the rate of new infections is growing. Between 2010 and 2015, the region saw a 50 per cent rise in new HIV infections annually.

Another looming problem that threatens to send Macedonian HIV rates spiralling upwards is a funding crisis precipitated by donor cutbacks and political uncertainty. Between 2004 and 2016, Macedonian HIV programmes received almost $25 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Much of this money was channelled into HIV prevention, funding NGOs that target those deemed most vulnerable to infection – sex workers, people who inject drugs, men who have sex with men and prisoners. But in 2016 this funding was phased out and NGOs on the frontline are left hoping that the new government will deliver fully on a recent commitment to step in with similar levels of funding in 2018.

In the chasm left by the country’s public healthcare system, Macedonia’s sexual health and rights NGOs work tirelessly to plug the gap, often on a shoestring and in an increasingly uncertain funding landscape. HERA, IPPF's member in Macedonia, is a leading NGO providing free HIV testing services, sexual health support and advocacy. It works closely with smaller organisations around the country to ensure support for young people, sex workers, people who inject drugs and men who have sex with men. These NGOs are many people’s first port of call for HIV tests and other vital health care.

Photos: IPPF EN/Jon Spaull

 

  • A street in Šuto Orizari (Šutka), a large Roma neighbourhood in northern Skopje.
    A street in Šuto Orizari (Šutka), a large Roma neighbourhood in northern Skopje.
  • Rumena Gjerdovska, the only social worker in Macedonia specialising in HIV, works at the state-run Clinic for Infectious Diseases. She was previously a volunteer for IPPF member HERA, running their SOS hotline for people concerned about HIV.
    Rumena Gjerdovska, the only social worker in Macedonia specialising in HIV, works at the state-run Clinic for Infectious Diseases. She was previously a volunteer for IPPF member HERA, running their SOS hotline for people concerned about HIV.
  • NGOs and some clinics in Skopje provide free condoms, lubricants, HIV and STI testing.
    NGOs and some clinics in Skopje provide free condoms, lubricants, HIV and STI testing.
  • Ljupco Popov is assistant coordinator at STAR-STAR, a sexual rights NGO in central Skopje that is a partner of HERA. He says the way the media in Macedonia portrays transgender people and sex workers is "catastrophic".
    Ljupco Popov is assistant coordinator at STAR-STAR, a sexual rights NGO in central Skopje that is a partner of HERA. He says the way the media in Macedonia portrays transgender people and sex workers is "catastrophic".
  • Lila (not her real name) is a transgender sex worker in Skopje. She says she could never tell her family about her real life.
    Lila (not her real name) is a transgender sex worker in Skopje. She says she could never tell her family about her real life.
  • "Mirror, mirror on the wall who's the most affected of them all?" Bojan holds up a mirror as part of an HIV campaign, photographed at the Clinic for Infectious Diseases, Skopje.
    "Mirror, mirror on the wall who's the most affected of them all?" Bojan holds up a mirror as part of an HIV campaign, photographed at the Clinic for Infectious Diseases, Skopje.
  • A drug den opposite the main hospital in Skopje. Up to 70% of drug users in Macedonia have hepatitis C.
    A drug den opposite the main hospital in Skopje. Up to 70% of drug users in Macedonia have hepatitis C.
  • Medical assistant Katerina Gogova treats people who inject drugs at Health Options Project Skopje drug support clinic, an NGO providing needle exchange, condoms and health check-up services.
    Medical assistant Katerina Gogova treats people who inject drugs at Health Options Project Skopje drug support clinic, an NGO providing needle exchange, condoms and health check-up services.
  • Drug paraphernalia is scattered on the floor in a drug den directly opposite Skopje's Central Hospital. Methadone is often sold on the black market by people on methadone programmes.
    Drug paraphernalia is scattered on the floor in a drug den directly opposite Skopje's Central Hospital. Methadone is often sold on the black market by people on methadone programmes.
  • HERA Project Coordinator Vojo Ivanof talks to a client in HERA's mobile HIV and STI testing clinic, Skopje.
    HERA Project Coordinator Vojo Ivanof talks to a client in HERA's mobile HIV and STI testing clinic, Skopje.
  • Sex worker Mihaela (not her real name) looks out over the Roma neighbourhood of Šuto Orizari (Šutka). Mihaela is a mother of five and has been a sex worker since she was 16.
    Sex worker Mihaela (not her real name) looks out over the Roma neighbourhood of Šuto Orizari (Šutka). Mihaela is a mother of five and has been a sex worker since she was 16.
  • Testing for HIV in HERA's mobile testing clinic in Skopje.
    Testing for HIV in HERA's mobile testing clinic in Skopje.
  • A sex worker waits for clients in Skopje's main red light distict, on the north bank of the Vardar river.
    A sex worker waits for clients in Skopje's main red light distict, on the north bank of the Vardar river.