The case concerned an extradition request by North Macedonia for the prosecution of a Macedonian national accused of aggravated extortion committed in Prilep in March 2025. The Court of Appeal of Milan declared that the conditions for extradition were met. The requested person challenged the decision before the Italian Supreme Court, arguing that his medical condition, identified as transverse myelitis, was incompatible with detention in North Macedonia; that the Macedonian prison system presented risks of inhuman or degrading treatment; and that his subsequent application for international protection in Italy should suspend the extradition proceedings or prevent surrender pending the administrative asylum procedure. The Supreme Court declared the appeal inadmissible. As to health conditions, it held that the Court of Appeal had reasonably relied on the assessment of Italian prison doctors, according to which the previous condition was resolved and only residual thoraco-lumbar pain remained, manageable through physiotherapy and ordinary physical activity. The defence objections were considered repetitive and generic, including the opinion from a Macedonian prison doctor, which did not address the specific evolution of the illness. As to detention conditions, the Court held that the Court of Appeal had properly considered the 2024 CPT report and the supplementary information provided by North Macedonia. The critical findings in that report concerned Idrizovo prison, whereas the requested person would be detained in Bitola prison, for which individualized information had been obtained. The Court therefore found no concrete risk of inhuman or degrading treatment. Finally, the Supreme Court held that there is no preliminary or suspensive relationship between extradition proceedings and an international protection procedure. A request for international protection submitted by the requested person does not, by itself, justify suspension of the extradition proceedings or refusal of surrender pending its determination. The appeal was declared inadmissible.

The case concerned a request by North Macedonia for extradition from Italy for the execution of a six-month prison sentence imposed for assault or bodily harm. The requested person did not consent to extradition and argued that surrender should be refused because the bilateral additional agreement between Italy and North Macedonia allowed execution extradition only for certain categories of offences and only where the sentence imposed reached a minimum threshold. The Court of Appeal of Bologna rejected that argument. It held that the limitations contained in the bilateral additional agreement concerned only the extradition of each State’s own nationals: Italian nationals to North Macedonia and North Macedonian nationals to Italy. They did not bar the extradition of the requested person in the case before the Court. The Court further found that the judgment was final, that the required documentation had been transmitted, that double criminality was satisfied, and that no statutory grounds for refusal under Article 705 of the Italian Code of Criminal Procedure were present. It therefore declared that the conditions for extradition to North Macedonia were met.

In extradition proceedings, the acquisition of specific and individualised information is necessary where information—emanating from official sources—reveals structural deficiencies in the prison system of North Macedonia, and thus a risk that detained persons may be subjected to inhuman or degrading treatment. The Court of Cassation considered, among the relevant assessment parameters, the findings of a report issued by the European Committee for the Prevention of Torture of the Council of Europe, published in 2017, whose conclusions were substantially confirmed during a subsequent visit by the same Committee in 2019. With specific reference to the present case, it should be noted that the existence of information from official sources regarding structural shortcomings in the North Macedonian penitentiary system is even more up to date, as evidenced by a report of the Council of Europe’s Committee against Torture dated June 2024, which—broadly speaking—highlighted that, compared to previous CPT inspections in 2016 and 2019, no improvements have been made in the treatment of persons deprived of their liberty.

In assessing whether pre-trial measures have lost their effectiveness under the law of the requesting State, the Italian court cannot review the merits of the powers exercised by the Macedonian judicial authority. Therefore, where it does not appear that the precautionary measure has been revoked, the judicial authority of the requested State cannot challenge its validity.