A man reads a newspaper in heavy fog and smog in Skopje, North Macedonia, one of the most polluted cities in the world.
A man reads a newspaper in heavy fog and smog in Skopje, North Macedonia, one of the most polluted cities in the world. Photo by Nake Batev/Anadolu Agency/Getty Images

This European Country Has Some of the World's Worst Air, and 'It's Too Expensive' to Fix

Skopje in North Macedonia is so polluted that the city stinks in winter. Residents blame decades of government corruption and inaction.
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Tipping Point covers environmental justice stories about and, where possible, written by people in the communities experiencing the stark reality of our changing planet.

Toni Nikushevski gazed sternly at the two old garbage trucks that wobbled up the hill to the Drisla landfill, one of the largest in Europe, ready to deposit their day’s load. A blanket of trash—from bottles and cans to plastic bags and dirty diapers—lined the road as they ascended.

Nikushevski was among about a hundred environmental activists who had gathered that morning in February 2019, to denounce the landfill’s dangerously low standards, its management’s lack of transparency, and the pollution it spews on the environs of Skopje, the capital of North Macedonia.


“We are demanding immediate change to the way waste is treated in this institution,” Nikushevski told reporters. “Drisla is one of the most critical polluters in this city and in this country.”

A garbage truck makes its way into Drisla, one of the largest landfills in Europe

A garbage truck makes its way into Drisla, one of the largest landfills in Europe. Photo courtesy of Jana Cholakovska

Two weeks prior, Skopje registered a hazardous air quality index that was 8.6 times higher than what global health officials consider safe, surpassing both New Delhi in India and Dhaka in Bangladesh as the most polluted city in the world.

This year, as air pollution levels fell dramatically across Europe due to strict measures meant to contain the COVID-19 pandemic, North Macedonia exceeded set limits on multiple occasions. The country’s air pollution crisis—which took the lives of 3,580 Macedonians in 2019—could prove even more lethal as researchers at Harvard University’s T.H. Chan School of Public Health have linked air pollution to higher coronavirus hospitalizations and deaths. North Macedonia’s coronavirus mortality rate—4.4 percent—is one of the highest in the region.

Over the past three decades, North Macedonia has not only fought its air pollution, but also the challenges that come with the slow and and sometimes painful process of democratization. After the collapse of the Soviet Union in 1991, a wave of political and economic liberalization washed over Southeastern Europe and North Macedonia emerged from Yugoslavia as an independent republic. While attempting to find its place in the world, North Macedonia’s government did not have the capacity or resources to ensure proper sustainable practices, thus leaving many public institutions, like Drisla, largely neglected.


The 190-acre landfill is the only officially regulated dump in all of North Macedonia—meaning that it is the only one of the country’s 3,000 dumps that operates with any safeguards.

Sasho Todorovski, Drisla’s executive manager, who has been with the landfill since its opening in 1994, is proud of its work. “You must remember that we are still the only landfill in North Macedonia that uses some kind of technological process,” he said.

Workers pile solid waste, compact it, and cover it in clay, to both isolate potential pollutants and mask the smell. Drisla collects, identifies, weighs, and processes most of the country’s hazardous materials, and collects and burns half of its medical waste.

The handling of hazardous waste at Drisla has triggered much of the public ire. Workers collect syringes, expired pills, discarded gloves, and the like and place them in large sealed bags that are then cut into the smallest possible pieces, and thrown into the landfill’s incinerator, a hand-me-down from the British government in 2001. The castoff, pegged as humanitarian aid, was highly polluting and outlawed under EU standards. Extra parts would have made the machine more sustainable, but the price tag was way out of North Macedonia’s range.

Whatever problems the incinerator brought to Skopje, they were better than what was in place before its arrival—the archaic practice of piling toxic waste in the middle of the landfill and setting it on fire. Dijana Veljanoska, Drisla’s chief of staff, acknowledged the landfill’s failings. “It was not in compliance with all environmental standards,” she said. “But, it was the best we could do.”


In the past 30 years, tight budgets have kept Drisla alive, but not properly functioning. When the incinerator first arrived, Drisla was under municipal control. But, the city quickly proved to be a terrible manager: not even one of the most basic processes of waste management—separating trash into categories like solid, organic, or recyclable—could be performed. Veljanovska describes those times as having “no standard whatsoever.”

In the years that followed, Drisla restructured multiple times. Between 2009 and 2010, the landfill was a successful self-financed private entity before a project sponsored by the World Bank suggested it transition into a private-public partnership: an international waste management company would own 80 percent of the shares and ensure steady investments, while the city would operate with the remaining 20 percent and retain institutional oversight.

What was supposed to be the beginning of a more streamlined and eco-friendly Drisla turned out to be the exact opposite. The company chosen to manage Drisla was FCL Ambiente, an unknown Italian company that was chosen over two of Europe’s leading waste management firms, the German Scholz AG and Austria’s Asa International Environmental Services. Balkan Insight later revealed that FCL Ambiente was set up only three days before the bidding deadline, even though interested companies were required to show both annual profits of at least $21.7 million and a minimum turnaround of $271 million for the previous five years. Concerns about irregularities and foul play during the bidding process spurred a lengthy legal battle. In the following decade, the ordeal served as an excuse for FCL Ambiente, which failed to invest the $86.1 million stipulated in the contract.


“We called it the smell of winter. We did not know that what that smoggy smell meant was enormous amounts of pollution.”

The months that followed Drisla’s legal troubles were a turning point for North Macedonia. The winter of 2014 brought on a wave of environmental protests that sparked a national conversation about air pollution. Gorjan Jovanovski, a software engineer and creator of the well-known air quality monitoring app AirCare, admitted that he was not aware of the severity of the pollution at the time. “We called it the smell of winter,” he said. “We did not know that what that smoggy smell meant was enormous amounts of pollution.”

Skopje’s distinctive smell of ash and chemicals is in fact the presence of particulate matter, hazardous microscopic solid or liquid particles suspended in the air. Although small, particulate matter is heavy. In the winter months, warmer air presses the heavier, colder air further into the valley, trapping the particulate matter and creating a thick quilt of fog and pollution.

The steep mountains guarding much of North Macedonia’s cities provide the perfect conditions—they make valleys virtually impenetrable to gusts of wind that might otherwise expel these heavy polluting particles. The only remedy is warmer, rainier spring days.

According to the European Environmental Agency, air pollution is the largest environmental health risk as particulate matter decreases the proper functioning of the immune system and exacerbates existing conditions like asthma and high blood pressure.


Petre Nikolovski is one of the many locals whose health has been permanently affected by North Macedonia’s dirty air. Now a retired electrical engineer, Nikolovski spent most of his career working for or near heavily polluting and largely unregulated industrial complexes. And in the late 1990s, Nikolovski and his family accidentally drove through a cloud of toxic chlorine gas after a plumbing installation exploded near his house. The accident significantly reduced Nikolovski’s already feeble lung function.

“My breathing is really heavy now. It sometimes feels like I am going to explode. The feeling creates not only pain but also panic.”

“My breathing is really heavy now,” he said. “It sometimes feels like I am going to explode. It is as if someone is sitting on my chest. The feeling creates not only pain, but also panic.”

Nikolovski now lives on the outskirts of Skopje. He had hoped that the concentration of particulate matter would be considerably lower outside the city’s limits. In the past two years, however, he has noticed the familiar gray smog inching ever so slightly closer to his refuge in the suburbs.

Both the EU and the WHO have set legal limits for particulate matter. But North Macedonia’s decrepit 18 official monitoring stations handily exceeded those standards in the past few years.

Deputy minister of the Ministry for the Environment and Physical Planning, Jani Makraduli, stands by the government’s plan to invest primarily in identifying and eliminating possible polluters, rather than in a new monitoring system. “We are focused on the sources of pollution,” Makraduli said. “And according to our information that is household heating. That is where we need to look for a solution.”


Household heating and vehicle exhausts are some of the leading causes of dangerous air pollution levels, since sustainable heating and a new car are simply not a possibility for many in a country where the average monthly salary hovers around $450.

Spotty air pollution data is one of North Macedonia’s thorniest issues. While the country received its first air monitoring system in 1998, some of these instruments are still in use today. The old technology is difficult to maintain and repair and is often only used for a few months at a time. Without replacing the monitoring system and letting it operate constantly, North Macedonia cannot be sure that it is properly and accurately tracking its air pollution levels.

Plus, the ministry is still the only accredited body so its data is what the EEA and the WHO use in their own reports.

“Ignoring the real air pollution contributors is the real issue here.”

Even Jovanovski relies on the government’s data for his app. “Even if the pollution is from household heating and old cars, they cannot be contributing to that extent,” Jovanovski said. “Ignoring the real air pollution contributors is the real issue here. They are living in a world without data.”

Makraduli acknowledged concerns and said that monitoring stations are mended whenever and as fast as possible. He also noted that a complete systematic overhaul, what the environmental activists are calling for, will require much more money. “The demands from activists already exist in some form or another across the ministry’s documents,” he said. “No one is saying that this type of project should not exist. But it is just too expensive.”


Much like the national system, Drisla’s own monitoring instrument works part-time. Veljanoska, Drisla’s chief of staff, said that it would be impossible to run the device constantly. “That would be too expensive; let’s not kid ourselves,” she said.

Costs kept coming up as a barrier for addressing air pollution. “In poor countries like North Macedonia it is really difficult to lead the fight for the environment,” Makraduli said. “What we need to do as a country is get together and ask: how will North Macedonia sustain itself energetically in the future? How are we going to balance economic development and environmental protection?”

This balance is incredibly difficult to maintain. But, the Paris Agreement stipulates that governments of developing countries must express commitment to a “Just Transition.” For Makraduli this is one of the most crucial aspects of his job. As transition to more sustainable ways of life brings about job loss it is his view that change must be strategic.

At present, Drisla does not have the capacity to transform its waste into energy. But Markraduli and Nikushevski are convinced that this is the path forward. A complete overhaul would require much more transparency, investments, and commitment from state institutions, activists, and citizens.

Both Drisla and North Macedonia have made substantial progress in the past few months. In January, Drisla finally broke the contract with its Italian partner and in June, got rid of its incinerator. Instead, it procured a new sterilizer that would streamline the way medical waste is treated. And in March, after three decades of uncertainty, the country officially became NATO’s 30th member and received an invitation for accession talks to the EU.

“Entry into the EU would really help us,” Makraduli said. “That is something that would push us more, the higher standards. No one is saying that we do not know what needs to be done. Or that we do not want to. But that costs money. I am optimistic that entry into the EU will completely change our society. Then there will be no excuses. No alibi. Only work.”

All interviews were conducted in Macedonian and translated into English.

Jana Cholakovska is a freelance reporter based in New York City, specializing in climate, politics, and Eastern Europe. She is a contributing writer for The Interlude and a former intern at City & State. Follow her on Twitter.

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