The public health impacts of climate change in Macedonia

Abstract

The public health impacts of climate change in Macedonia Vladimir Kendrovski1, Margarita Spasenovska2, Maria Kisman2, Allison Thorpe3, Bettina Menne4 1Medical faculty, Skopje, FYR Macedonia 2WHO-CO, Skopje, FYR Macedonia 3Brunel University, London 4WHO, ECEH, Bonn, Germany Background. Scenarios for Macedonia anticipate an average increase of 3.8 °? by 2100, more frequent and more intense heatwaves, droughts and flood events.Climate change adaption has been established as a priority within existing international and national policy instruments. Aims. The aims were to assess the health effects of climate change and to develop a national adaptation strategy and action plan. Methods.A variety of qualitative and quantitative methodologies were used: Literature reviews, interviews, focus group, time series and regression analysis, damage and adaptation cost estimation, scenario based assessment, and stakeholder engagement. The development of a national adaptation strategy followed a public health strategy process developed by the WHO Europe. Results. Climate change poses a significant threat to population health in the Former Yugoslav Republic of Macedonia. An increase in average monthly temperatures of only 1ºC compared to the period 1996–2000 significantly influences the monthly distribution of total mortality. Climate change-attributed costs of approximately € 2.6 million were calculated. Projected direct health impacts include 5-10% higher salmonellosis notifications for each degree increase in weekly temperature, an increase in pollen distribution in early spring (March), and a change in the presence of vectors. Conclusions. The generation of a robust evidence base, a coordinated and systematic approach to climate change research and the development of robust stakeholder engagement can be used to support the formulation and implementation of sustainable, multisectoral strategies and promote adaptive capacity.