Newly published materials linked to U.S. court releases in the Jeffrey Epstein case have drawn attention in North Macedonia after references emerged to brain tissue samples originating from the country and later used in U.S. scientific research.
The documents describe how human brain samples were transported from Macedonia to the United States in the 1990s and early 2000s, including references to specimens being carried in suitcases on commercial flights. The descriptions have prompted public questions over whether the transfers were conducted transparently and in line with all legal and ethical procedures.
According to project reports published in the U.S. National Library of Medicine, scientific cooperation began in 1996 between the Institute of Forensic Medicine at the Medical Faculty in Skopje and Columbia University in New York. The collaboration focused on neuropathological research into psychiatric disorders, including studies of suicide victims.
Some of the renewed attention stems from a 2001 study led by U.S. researchers John Mann and Victoria Arango on the brains of people who died by suicide. Recently released U.S. Justice Department documents note that the research relied on brain tissue collected internationally, including samples obtained from Macedonia through an academic intermediary of Macedonian origin affiliated with Columbia University.
A text circulating as part of the newly disclosed materials states that researchers assembled a collection of around 1,000 human brains—some from suicide victims and others used as control samples—stored in ultra-low temperature freezers in the United States. The text describes Macedonia as a contributor of “newly collected brains,” noting that the tissue was frozen immediately after removal and transported under supervision to the United States.
The former director of Macedonia’s Institute of Forensic Medicine, Professor Aleksej Duma, confirmed that brain tissue samples from Macedonia were used in U.S. research but rejected claims of large-scale transfers.
“Yes, the research was legal and conducted under established protocols,” Duma told Vecher newspaper. “But it was not about a thousand samples. We are talking about several dozen tissues that were transferred in full compliance with procedures.”
Scientific cooperation dating back to 1996
According to the U.S. medical library report, Macedonia was selected as a partner due to its high autopsy rates and availability of trained forensic specialists, while U.S. institutions had stronger research infrastructure but limited access to psychiatric autopsy material.
The project involved staff training, academic exchanges, and the development of protocols for collecting and processing brain tissue. The report notes that exporting tissue from Macedonia was administratively sensitive and required approvals from the Ministry of Health, as well as formal export procedures, with samples often transported as checked luggage on commercial flights.
“Administrative obstacles in Macedonia were the main challenge,” the report states, adding that export approvals were more complex than obtaining permission to import the samples into the United States.
Duma said that family consent was required for the use and transfer of tissue at the time and stressed that Macedonia benefited from the cooperation through equipment donations and specialist training in the United States.
Public questions over transparency
Descriptions of tissue being transported in suitcases, combined with the renewed public interest generated by the Epstein-related document releases, have raised concerns among some members of the public over transparency and oversight.
However, the same project documentation emphasises that obtaining export permits from Macedonian authorities was difficult, suggesting that the process involved formal institutional controls rather than informal transfers.
Duma said that the figure of around 1,000 brain samples referred to the overall U.S. research collection and not to Macedonia’s contribution. He added that during the period in question, Macedonia conducted around 300–350 autopsies annually, with suicide cases numbering only in the dozens.
According to the project report, the broader Macedonia–U.S. collaboration later collected between 25 and 75 brain samples per year, with tissue and clinical data used in 39 funded research projects in the United States, Canada, and Macedonia.
While available documents and statements from those involved point to an established scientific framework, questions remain in the public debate over the exact number of samples transferred, the years involved, the documentation used, and the level of domestic oversight—particularly given the sensitivity of the subject and the renewed scrutiny linked to the Epstein case disclosures.