Project type                          Health adaptation national strategy

Partners                                European Climate and Health Observatory, Government of Macedonia

Beneficiaries                        Republic of North Macedonia municipalities

Dates                                      2012 (Approval date)

Website                                 Implementation of the Heat-Health Action Plan of North Macedonia

The HHAP aims to reduce current and future morbidity and mortality related to extreme temperatures and heat waves. In particular, the plan, and the related warning system, focus on the most vulnerable groups of the population: the elderly, infants and children up to five years old, chronically ill persons, people who are overweight, outdoor workers, and people whose socioeconomic status makes them more vulnerable to climate change effects (e.g. the homeless). The health care system in the country has an important role in developing and implementing adaptation, prevention, and response measures to address the health risks related to climate change, by:
• Strengthening existing public health capacities for early detection and adequate response.
• Anticipating the consequences of emerging diseases potentially related to climate change.
• Raising awareness among the population about the possible links between climate change and health.

The Heat Health Action Plan (HHAP) was finalized in 2011 and officially adopted by the Government of Macedonia in 2012. As part of its implementation, a heat health warning system was established, which continues to operate annually from May 1 to September 30. The system’s operations involve several key bodies:
• Cross-government coordination: A coordinating body composed of the Ministry of Health, the Institute of Public Health, the Institute of Occupational Medicine, and other relevant national stakeholders oversees the heatwave alert process. This body manages the activation of various alert levels—green (vigilance), yellow (alert/preparedness), orange (heatwave), and red (emergency)—and coordinates with local authorities to implement necessary measures.
• Meteorological agency: This agency is responsible for providing the Ministry of Health with warnings about impending heatwaves, including a 24 to 48-hour forecast of heatwave conditions.
• Public health agency: The agency evaluates the health impacts of heatwaves based on specific indicators outlined in the national heatwave plan (SCORCH, 2020).

• By actively monitoring and issuing heatwave warnings, the HHAP has helped to reduce health risks associated with extreme heat, particularly for vulnerable populations (elderly, children, those with chronic conditions, and outdoor workers).
• Through its communication strategy, the HHAP has increased awareness among citizens and health professionals about the dangers of heatwaves and the necessary precautions.
• The HHAP includes an ongoing monitoring and evaluation process, such as the 2020 survey with Université Catholique de Louvain (Belgium). These assessments have helped refine the plan over time, ensuring that it stays relevant and effective in mitigating health risks associated with climate change.