Greater health engagement and commitment needed to clean up the air in Serbia

Author: Srđan Kukolj, Health and Energy Adviser for the Balkan Region, Health & Environment Alliance (HEAL)

The launch of the first ever national Air protection Program in the Republic of Serbia with an Action Plan is a unique opportunity to bring down high rates of disease.

Air pollution is the biggest environmental challenge that threatens the public health of the Republic of Serbia for decades. Air pollution has been associated with multiple diseases, such as cardiovascular and respiratory diseases, and diminished life expectancy. The World Health Organization estimated that exposure to ambient air pollution accounted for 6 592 deaths and 131 183 years of life lost in the Republic of Serbia in 2016.

Air pollution in this country remains one of the highest in Europe and has a direct impact on citizens’ health. The very high concentrations of air pollutants are mainly due to emissions from industrial installations, energy sector (such as coal power plants), domestic heating (dominantly wood and coal fired stoves) and transport (older vehicles). In order to reduce the harmful effects of air pollution on the health of European citizens, the Republic of Serbia should set more ambitious actions to go hand in hand with other European Union member states.

Scientific evidence should be the backbone of policy-making

In 2018, the Government of the Republic of Serbia has adopted a Public Health Strategy 2018-2026 that addresses the overall protection of the environment and human health. The strategy calls for reducing the impact of environmental risks on public health, specifically mentioning the implementation of international environmental legal obligations, improving the state of the environment, responding to climate change, and reducing the emissions of harmful gases from industrial installations, domestic heating and transport compared to 2015 by 20%. To support these actions, there is the Law on Public Health which addresses actions in the protection of public health of the Republic of Serbia, including the implementation of risk assessment for the health of the population based on the register (cadaster) of sources of pollution, monitoring and evaluation of the health status of citizens, and assessment of health risks related to environmental impacts.

Although these health milestones have been set, Serbian citizens still suffer from acute and chronic diseases due to exposure to high levels of air pollution. The country lacks intersectoral cooperation that will strengthen the response to reducing air pollution, health experts do not participate equally in the development of environmental policies. A multisectoral approach, engaging such relevant sectors as health, environment, finance, energy production, industry and transport, is needed to develop policies that reduce the risks of air pollution to health.

In addition, the national public health institution in the Republic of Serbia that does the analysis of the concentration of pollutants in the air is the Institute of Public Health of Serbia “Dr Milan Jovanović Batut”. Every year, the Institute publishes data on air quality through the Health Statistics Yearbook of the Republic of Serbia, highlighting cities where air pollution has exceeded limits. These reports have been published for years now, and decision makers have not taken into account the importance of this data in order to create a rapid health response aimed at reducing the harmful impact of air pollution on public health. In 2020, this Institute acknowledged the importance of air quality monitoring to assess the impact of polluted air on the citizens of this country, and the conclusions confirm that the trend of low representation of particulate matter pollution monitoring with PM10 and PM2.5 has continued, which can have serious public health impacts.

Serbia is halfway to launching its first national Air protection Programme

The country has made efforts to develop a legal framework to boost environmental mitigation, including energy transition laws, climate change law and expects to launch of the first ever national Air protection Program in the Republic of Serbia with an Action Plan by the end of this year, but air pollution still exceeds the limits set by the World Health Organization Air Quality Guidelines. In order to demonstrate its readiness to mitigate environmental impacts, the government needs to involve health experts and science in all stages of the process, including in the evaluation of the draft of the national Air protection Program in the Republic of Serbia with an Action Plan. This scientific exercise will give the health community a chance to integrate public health measures into the Strategy which will lead to timely prevention of diseases and premature deaths in the future. Development of the Air Protection Program in the Republic of Serbia with an Action Plan is supported by the European Union through the IPA 2014 Project “EU for a Better Environment – Developing a Framework for Alignment with EU Legislation on Air, Chemicals and Horizontal Issues“.

On its path to joining the European Union, the Republic of Serbia has taken responsibility for strengthening the response to air pollution, which will improve the health of Europe’s citizens. The Ministry of Health of the Republic of Serbia must take the lead in implementing public health policies that will lead to a reduction in health and economic losses.

Environmental health impacts can be most cost-effectively addressed through strategies that simultaneously consider multiple pollutants from multiple source sectors, as well as factors such as future population and economic growth.

In order to move forward, the Republic of Serbia needs to take the following steps:

1. Conduct a health impact assessment for all industrial installations, energy sector, domestic heating and transport deliberations and decisions. This means that every project is assessed for its potential effects, damages and benefits for the health of a population, both in the country concerned and beyond.
2. Identify and prioritise measures that will provide for the greatest health benefit. Air pollution is a public threat and should be addressed through strategic measures aimed at a healthier future and economic growth.
3. The country needs to increase the participation of health experts in decision-making processes to ensure that the timely integration of public health measures into environmental policies are in place.
4. Scientific evidence should be the backbone of policy-making. The country needs to make decisions based on scientific evidence, using the knowledge of the international and national scientific community.
5. The country should encourage the public interest in decision-making processes using the legal mechanisms which will ensure a higher level of transparency in the work of public institutions. Efficiency in the implementation of laws and decisions in the field of industrial installations, energy sector, domestic heating and transport should be increased in order to achieve greater health and economic benefits for all citizens.