Kosovo opposition parties have pledged to make substantial reforms in the healthcare system if they win the February 9 parliamentary elections, with emphasis on the expansion of the list of essential medicinal products, also considering adding hormone therapy for the LGBTI+ community.
Healthcare is one of the most poorly governed sectors in Kosovo. Ahead of the February 9 parliamentary elections, opposition parties are promising ambitious healthcare reforms as they seek to expand their support. Some of the promised changes include public health insurance, salary increases for healthcare workers, digitalisation of healthcare systems, and the expediting of surgeries waitlist.
Opposition parties also did not rule out the possibility of including hormone therapy in the list of essential medicinal products, a request made by the LGBTQ+ community.
Kosovo lacks a digital health management system, hospitals are outdated, cleanliness standards are inadequate, and renovation efforts have largely been unsuccessful. Meanwhile, medical students face long waits for employment opportunities, despite a shortage of doctors.
The ruling party, Vetëvendosje Movement, did not participate in the BIRN and Internews Kosova-moderated debates on plans for reforms in the healthcare system despite twenty non-governmental organisations strongly condemning the party’s decision to boycott these debates ahead of the 2025 parliamentary elections.
‘Debat Përnime’ that Vetëvendosje is boycotting is co-produced by the internationally recognized and award-winning civil society organizations, Balkan Network for Investigative Journalism, BIRN, and Internews Kosova.
Alliance for the Future of Kosovo, AAK
Salary increases for healthcare workers, digitalisation, and expansion of the Essential Medicinal Products List are the main points of focus for the Alliance for the Future of Kosovo’s, AAK, healthcare plan. AKK is campaigning in a coalition with the Social Democrat Initiative, NISMA.
Their promises include establishing 24-hour palliative care services, reducing patient waiting lists, creating an online platform for those diagnosed with chronic illnesses, increasing salaries for healthcare workers, and restructuring primary healthcare services.
Zarife Asllani, an MP candidate, shared her personal journey battling breast cancer to emphasise her determination to establish an accessible, online platform for individuals with chronic illnesses. In principle, this platform would connect the Kosovo University Clinical Centre, KUCC, and regional hospitals and contain a dedicated database for oncology patients so that records are more easily accessible across the country.
“A trained family member will use the platform. Additionally, any detailed updates about the patient will be added as comments. Appointments will also be managed through the platform, and major city hospitals and the Oncology department will have access to it,” she explained.
Asllani stated that her experience with illness motivated her candidacy, aiming to resolve healthcare issues.
Another candidate, Arbër Tolaj, promised 24-hour palliative care services in every municipality for patients suffering from severe chronic illnesses or those requiring transportation.
“These services will be provided to patients who have serious illnesses, chronic illnesses, are bedridden, and need transportation,” he said briefly.
Tolaj also explained that the inclusion of hormone therapy in the essential medicinal products list has not been planned specifically for the LGBTI+ community.
“If necessary, healthcare services must be provided, including medications, for all communities without distinction,” he emphasised.
Hormone therapy for individuals in the LGBTQ+ community, especially for transgender or non-binary individuals, is a process that involves the use of hormones to align a person’s physical characteristics with their gender identity. The goal is to provide a more congruent experience with the gender with which a person identifies, according to the World Professional Association for Transgender Health.
Additionally, Tolaj outlined a plan to revitalise the University Clinical Center of Kosovo’s, UCCK, infrastructure and provide professional training for healthcare staff, including mid-level staff, specialists, and new trainees.
Addressing the chaos surrounding the Essential Medicinal Products List, Tolaj attributed the problem to “complex procurement procedures.”
The supply of essential medicines in seven regional hospitals and the University Clinical Center of Kosovo in 2024 was 73.5 percent, as reported by Dardane Mehaj, Head of the Medicine Supply Sector at UCCK.
However, Kosovo patients lack access to 88 types of medicines from the Essential List, which the state is obligated to provide. These medicines cannot be imported into Kosovo because they lack the Marketing Authorization, MA, document, which ensures the product’s safety, quality, and effectiveness. Addressing this issue requires updating the Essential List and replacing the unavailable medicines with alternatives.
Shemsedin Dreshaj, another MP candidate, highlighted AAK’s commitment to ensuring the consistent availability of medications year-round.
“AAK is committed to ensuring that a medicine or drug is available 365 days a year,” he stated.
Establishing a Health Insurance Fund remains a priority, which, according to Dreshaj, would decentralise healthcare services and enhance patient care.
While acknowledging the time required for its implementation, Dreshaj and Tolaj assured its completion within the four-year governing term.
The Health Insurance Fund is one of the constant promises for reform in the healthcare system Kosovo political parties make during parliamentary election campaigns, however, Kosovo does not have public health insurance yet. The purpose of the Health Insurance Fund is to improve the health status and decrease the financial risk of citizens.
Dreshaj also proposed doubling the salaries of doctors and nurses to ensure their dedication to the profession without needing a second job.
Furthermore, the party plans to remove VAT on medical products and equipment.
The AAK-Nisma coalition’s electoral program also envisions assigning a family doctor to every family in Kosovo, ensuring a two-year budget for the Health Insurance Fund.
Democratic League of Kosovo, LDK
MP Candidates from the Democratic League of Kosovo, LDK, outlined their flagship project, to reform the healthcare sector if they come to power after the February 9 elections, is building a new hospital centre worth 500 million euros in Prishtina to replace CUUK. The exact location has not yet been determined.
“The construction of this Centre will take place in the first term and gradually. Until the new Hospital Center is built, the old Centre will function,” MP candidate Izet Sadiku declared.
Key pledges also include “increasing the healthcare budget to 5 percent of GDP from the current 3.3 percent,” and operationalising the Health Insurance Fund, Sadiku added.
The LDK believes that by increasing salaries, improving work conditions, and securing jobs, they can prevent doctors from leaving Kosovo for Western countries.
MP candidate Ekrem Hyseni explained that an important aspect is to “secure new doctors that after studies will start working the first six months.”
Operationalising the Health Insurance Fund, another long-standing promise, would start with drafting necessary documentation and legislation in the first year of governance.
Ardian Shala, another MP candidate explained that “the Fund would require contributions of 3.5 percent from both employers and employees, potentially generating 140 million annually euros,” adding that the payment of medical treatments abroad would be via this fund. He claimed that the private sector would need to step in if the costs exceed the means of the public sector.
Shala did not rule out the possibility of including hormone therapy in the essential medicinal products List, acknowledging that it has been a previous request from the LGBTQ+ community.
“Why not include many other categories you mentioned, such as hormone therapy? This has been a major discussion before, and we will do everything possible to ensure that those in extraordinary need receive the appropriate therapy, covered by the state,” Shala stated.
He also emphasised that the current issues, such as medication shortages, are a result of poor management.
Similarly, Sadiku criticised current Health Minister, Arben Vitia from Vetevendosje, for only being able to secure 70 percent of the products from the Essential Medicinal Products List. Sadiku highlighted discrepancies in medication availability and the resulting financial strain on citizens.
“In Prishtina, not even 50 percent has been covered in any year and we are forced (to pay) 500 thousand euros.”
Ekrem Hyseni advocated for regulating medical products’ prices based on reference rates instead of market demand, ensuring affordability.
“I am confident that the price of medicines will be regulated. They will cost less, and the availability of medicines will be higher,” he stated.
LDK pledged to increase staff capacity and invest in the healthcare workforce to address the issue of waiting lists for surgeries.
“It is painful if a family member of someone suffers something unexpected, and we are not able to reduce this waiting list by at least a week, or even eliminate it altogether,” Shala added.
Democratic Party of Kosovo, PDK
The Democratic Party of Kosovo, PDK, promises to digitise the healthcare system, increase doctors’ salaries by 50 percent, establish a Centre for Treating People Addicted to Drugs and Alcohol, and provide free medication for individuals with chronic illnesses.
“The Democratic Party of Kosovo aims to provide free medication to all patients suffering from various chronic illnesses,” Mimoza Ahmetaj, MP candidate declared.
Ahmetaj also underscored the importance of palliative care, stating that the program will assist long-term bedridden patients by providing specialised care to improve their quality of life.
The digitisation initiative through the Health Informative System, HIS, is expected to enhance medication accessibility.
Ahmetaj explained that “this system would enable accurate planning based on patient numbers and medication needs, facilitating the preparation of an essential medicine list.”
The Democratic Party of Kosovo does not have a concrete commitment regarding the inclusion of hormone therapy in the essential medicines list but does not rule out the possibility of doing so if it comes to power.
“The evaluation of the essential medicines list, whether in terms of services or medications, is based on medical performance and health needs or indications that must be addressed to preserve and advance overall health,” Fatbardh Rexha, MP candidate stated.
Additionally, the PDK plans to establish a National Medical Emergency System equipped with the necessary tools and helicopters “to respond effectively to crises or disasters.”
The party also aims to promote local pharmaceutical production to reduce dependence on imports, which currently contribute to higher medication costs.
“The primary pharmaceutical products in the Kosovo market come from imports, which significantly increases their price, making it understandably difficult for us to afford such products,” she stated.
Parliamentary candidate Fatbardh Rexha highlighted the need for operationalising health insurance and implementing medical protocols for professionals.
He mentioned a proposal to invest 1.5 billion euros in healthcare over the next four years.
“It is planned that approximately 1.5 billion euros will be invested in healthcare from Kosovo’s budget over the next four years, along with doubling the budget for medicine supply,” he stated.
Rexha also emphasised the importance of regulating medicine prices to ensure they align with Kosovo’s market conditions.
He stated that the “pharmaceutical market should reflect local economic realities rather than external references.”
To address surgical waiting lists, Pleurat Sejdiu identified factors such as insufficient professional staff, lack of regional services, and patient concentration in Prishtina.
He noted that Kosovo has approximately 600 unemployed doctors, whom the PDK plans to employ in regional hospitals or family health centers.
“These doctors will be employed either as specialists in clinics, regional departments, or in Family Medicine Centers,” he stated.
Meanwhile, Ahmetaj believes that increasing salaries is “crucial to prevent the emigration of healthcare professionals.”
Through the Health Insurance Fund, PDK aims to cover and reimburse healthcare services for specific categories.
Rexha emphasised that mandatory health insurance is essential for a functional healthcare system, noting that “while the legal framework exists, its implementation is a top priority.”
“It will be an extraordinary task to be carried out during the first year of governance, so that, complementarily, the Information System, Protocol, and Health Insurance System will begin to be implemented,” he said.
The draft law for mandatory health insurance was approved by the government on August 28, 2024, but its implementation is still pending.