The Mihajlova case: the minister says it is a matter of justice, while inspectors found violations in the health system

Health Minister Sašo Klekovski came back from Sofia with a signed Plan for Cooperation between the two ministries for 2026-2028 and an unusual diplomatic formula. With his Bulgarian counterpart Katya Ivkova, he says, they reached a "tacit agreement" that the Iva Mihajlova case is not a health issue but a matter of justice. "The person is a fugitive from justice wanted on an international warrant. Since that is a matter of justice and not a health issue, we did not discuss it," he said.

Tacit agreement. So at a meeting of two health ministers, the topic filling the headlines in both countries was never raised. Maybe that is wise. But it also means nobody has officially closed it.

From a car crash to an arrest warrant

On 7 October 2025, on the Kočani - Štip road, a 33-year-old man was killed in a head-on collision between two vehicles, and several people were injured. The prosecution accuses Mihajlova, then 23, of driving too fast and crossing into the opposite lane. She and her lawyers dispute this and claim the other vehicle came into her lane. She suffered serious spinal injuries in the crash.

The court seized her passports and banned her from leaving the country. Despite that, on 11 October this year Mihajlova, who holds Macedonian and Bulgarian citizenship, turned up in Sofia, where she already has a Bulgarian lawyer. The Interior Ministry issued a national and international arrest warrant, and the Basic Court in Kočani ordered 30 days of detention. She claims she crossed the border legally, through an official border crossing. If that is true, the question for the Interior Ministry is even more awkward: how does someone with seized passports and a travel ban get through an official border crossing?

The violations are in the domestic health system

While politics steers the dispute towards justice, the health side of the story stays at home. The State Sanitary and Health Inspectorate, on the initiative of the Neurology Clinic, carried out an inspection of how Mihajlova was treated by Professor Ivan Barbov, who recommended she be treated in Bulgaria. "Violations have already been established at this stage, and a professional review of the medical part of the report has been requested," Klekovski said. The minister asked for the inspection to cover her entire treatment path, including a private health facility.

Barbov said earlier that he did not know proceedings were being conducted against her, and that he recommended Bulgaria because she has Bulgarian citizenship and health insurance, and Bulgaria is the nearest country offering the treatment methods he recommended. The professional review now has to show whether the recommendation was medically justified and properly documented.

Prime Minister Hristijan Mickoski, for his part, called the Bulgarian reactions "showbiz" tied to the "folklore" of their presidential election, and said the Bulgarian interior minister's statement did not deserve a comment. Fine. But the questions at home do deserve answers: how does a defendant in a court case get a recommendation for treatment abroad from a doctor who doesn't know about the case, and how does she leave the country despite her passports being seized? Those answers are not in Sofia.