Air pollution is a significant problemin cities and urban centers in the Republic of NorthMacedonia. This report is one in a series of three reportson air quality management (AQM) in Bosnia and Herzegovina,Kosovo, and North Macedonia. It examines the nature andmagnitude of ambient air pollution (AAP) in North Macedonia.It provides estimates of the health burden, and economiccost associated with the health impacts, of AAP, that is,particulate matter with a diameter of 2.5 micrometers orless (PM2.5) in North Macedonia. It also analyzes the rolesof various sources of PM2.5 emissions on ambient air qualityin North Macedonia at the national level. The institutionaland policy framework for AQM in the country is examined,including contributions of other development institutions insupporting North Macedonia’s efforts to address airpollution. Furthermore, the report presents experiences ofselected countries that have applied different policy,investment, and technical interventions for air pollution,prevention, reduction, and abatement. Finally, it providesrecommendations for reducing air pollution in NorthMacedonia. People in North Macedonia and living in theBalkans and Eastern Europe are typically breathing moretoxic particulate air pollution than their neighbors inWestern Europe. This is due to fewer air pollution reductionpolicies and more solid fuel heating and cooking (meaningmany more residential wood and coal stoves) in EasternEuropean and Balkan countries compared to the rest ofEurope. Western Europe has mostly moved away from coal-firedpower plants (or at least has pledged to reduce coalconsumption to meet climate goals), but in the Balkans andin Eastern Europe they are still widely in use. In fact, theBalkan region is home to many coal and lignite-fired unitsand to 7 of the 10 most polluting coal-fired power stationsin Europe.
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