Cancer patients stood in front of the Health Ministry yesterday. They weren't asking for privileges - that was their message too. They were asking for therapy to arrive on time and not be interrupted. In a country with functioning procurement, that's a demand that should never have to reach the street.

The drugs most frequently missing were fulvestrant and Zoladex, therapies for breast cancer patients. This time some of the cytostatics from the positive list were missing too. The "Hema-Onko" association says the problem has now been resolved - part of the therapy has arrived, the rest is expected within two days.

But here comes the sentence that explains everything. The tender was completed in May. The interruptions ran all summer. So the procurement formally existed while patients waited. Between a signed tender and a drug in a patient's hand sits an entire administration that spent the summer on a break.

The one scanner

In parallel, the country's only public PET/CT scanner is out of order again. Patients wait two to three months for a scan that is essential to see whether the therapy is working at all. Those who can, pay around 1,300 euros privately or travel abroad. Those who can't - wait.

Macedonia's entire public health network depends on one machine. Average capacity is around 180 scans a month, a maximum of 13 patients a day. Annual maintenance costs around 1.2 million euros. When that one machine stops, diagnostics stop for the whole country.

The University Institute for Positron Emission Tomography provided no information on the cause of the fault, on the service provider, or on a deadline for getting it working again. The clinic maintains that continuity of treatment was not disrupted. Patient testimony describes delays of a month at a time.

Those two statements cannot both be true

Either the therapy wasn't late, or the patients aren't lying. An institution insisting everything was fine while the people who use that institution say the opposite isn't solving a problem - it's closing it.

"Hema-Onko" points to another layer: inadequate prevention and weak screening programmes. Without early detection the number of patients grows, and with it the cost of treatment. That's a bill that gets bigger every year, and gets postponed every year.

The patients announced that if the problem recurs without transparency about accountability, they will be back out. The question for the institutions isn't how to prevent the protest. The question is why someone undergoing therapy has to organise a protest to get a drug that has already been paid for.