Balkan region maintaining record high air pollution, doesn’t tackle main sources

Photo: HEAL


February 8, 2019






February 8, 2019





Author: Vlatka Matković Puljić, Senior Policy Officer, Health and Energy, Health & Environment Alliance (HEAL)

Yet another year, this winter, air pollution hits countries in the Balkan region hard – most of them for many consecutive days struggle with air pollution that is unhealthy to breathe. New World Health Organization (WHO) data[1] shows that Macedonia has the highest premature death rate associated with air pollution in EU and Balkans combined, followed by Bosnia and Herzegovina, Montenegro and Serbia.

Concretely, these numbers mean that in 2016 air pollution led to 4,388 premature deaths in Serbia, 2,793 in Bosnia and Herzegovina, 1,702 in Macedonia and 489 in Montenegro.

Citizens raise their voices

Peak smog events in the Western Balkans can last for days. This winter, Belgrade, the Serbian capital, has on some days had the worst air quality worldwide. The air in Skopje, Macedonia, was not much better either.

Citizens in the Balkans are raising their voices against health harming air pollution. In 2018, thousands of citizens in Tuzla, Bosnia and Herzegovina, took to the streets to demand that authorities find long-term solutions to persistent bad air quality in the city. The same happened in other cities across the region: in Pljevlja in Montenegro, Bitola, Skopje and Tetovo in Macedonia, and Pristina in Kosovo*

National and local authorities are doing little to nothing to tackle air pollution

Already in 2015, Serbian doctors have called to end coal powered energy production to improve air quality, to reduce the incidence of respiratory, cardiovascular and other diseases related to air pollution, and to reduce long-term economic costs for the health system.

But the situation has not improved – national and local authorities are doing little to nothing to tackle air pollution.

Sporadically, there are some good examples and attempts to implement concrete actions on improving air quality. For example, Sarajevo issues warnings asking residents to adopt non-polluting means of transportation and to reduce their outdoor activity, particularly during morning and evening hours when smog pollution is at its worst. While some cities like Jagodina, Serbia, offer free public transport.

The economic repercussion are ignored

But there is such a lack of structural changes and decisions for long term implementation that the overall air quality problem remains very bad year after year. The economic repercussion are ignored by the region’s governments.

According to WHO figures, the South East Europe region is losing the equivalent of 19% of its GDP to costs associated with premature deaths caused by air pollution.

In Serbia, health costs associated with air pollution total 33.5%of GDP, in Bosnia and Herzegovina 21.5%, in Macedonia 19.9% and in Montenegro 14.5%. These percentages are much lower in Western Europe [2]. In Germany it totals to 4.5%, while in neighboring Croatia 10.8%

Artificially low prices hide the true cost of fossil fuel powered energy

Main contributors to poor air quality in the region are the burning of coal in thermal power plants (TPPs), for electricity production, household burning of fossil fuels or biomass, and transport.

The Western Balkans countries are home to the most polluting plants in the whole of Europe

Artificially low prices hide the true cost of fossil fuel powered energy – they do not take into account the attached environmental and health costs. All of us pay twice for fossil fuel subsidies – once when scarce public funds are used to subsidise outdated fossil fuel energy and secondly when society deals with the health costs associated with burning fossil fuels.

Despite the nearly a decade-old commitment to end such financial support a recent Health and Environment Alliance (HEAL) report reveals that on average the health costs associated with fossil fuels are over six times higher than the subsidies [3].

Coal phase out should have been underway for years, but at the latest as of 2018, the countries of the Western Balkans need to start reducing their emissions for large combustion plants and align national laws and rules with EU ones[4].

Today, the Western Balkans countries are home to the most polluting plants in the whole of Europe.  Annual emissions from the 16 coal power plants (16 GW) in the Western Balkans are almost as high as from the 296 existing coal plants (156 GW) in the EU-28 [5].

Controlling air pollution from coal power plants is a huge opportunity to save 6,460 lives and EUR 2,724 million in healthcare costs in the next decade.

In order to seize the huge health savings, Western Balkans governments need to start setting up pollution control measures and the rapid phase out of coal should be advanced, by closing all old coal plants and not building new ones, and ending all public financing for coal.

[1] World health statistics 2018: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2018.
[2] WHO Regional Office for Europe, OECD. Economic cost of the health impact of air pollution in Europe: Clean air, health and wealth. Copenhagen: WHO Regional Office for Europe; 2015.
[3] https://www.env-health.org/wp-content/uploads/2018/08/hidden_price_tags.pdf
[4] These rules are as a matter of fact not even in line with the latest EU rules for large combustion plants – the so-called LCP “BREF” that entered force in the EU in August 2017” but are instead more lax
[5] https://www.env-health.org/wp-content/uploads/2018/06/Boosting-health-by-improving-air-quality-in-the-Balkans.pdf
* This designation is without prejudice to positions on status and is in line with UNSCR 1244/99 and the ICJ Opinion on the Kosovo declaration of independence.
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