AGP Executive Report

West Nile alert: Europe’s West Nile virus keeps spreading, with the ECDC reporting 241 human cases this season and noting 13 in North Macedonia; WHO says there’s no vaccine or specific treatment, so prevention matters most (repellent, cover up at dawn/dusk, and mosquito control). Local risk context: Bulgaria’s infectious-disease chief warns the peak is expected from August to mid-September and says cases may already be circulating even if none are confirmed yet. Cross-border care dispute: In Kočani, court decisions have again blocked Iva Mihaylova from leaving North Macedonia for medical treatment in Bulgaria; Bulgaria’s Foreign Ministry says the delay risks permanent, irreversible harm and cites the need for timely care. Wildfire and health pressure: North Macedonia is battling wildfire outbreaks amid a heatwave and drought, with 14 open-air fires recorded by Aug 4, raising concerns for smoke-related health impacts. Public health travel angle: Spain reported its first West Nile death of the year, underscoring why summer visitors should take mosquito-bite precautions.

Medical Rights Dispute: Bulgaria’s Foreign Ministry says Kočani court again refused Iva Mihaylova permission to get timely, adequate treatment abroad, warning of a “real risk” of permanent, irreversible harm tied to her severe neurological condition. Cross-Border Pressure: Bulgaria urges North Macedonia to allow the treatment, citing a local health authority opinion that the prescribed care can’t be provided in North Macedonia. Parliamentary Scrutiny: Mihaylova’s case is set for an extraordinary hearing by Bulgaria’s parliamentary committee for Bulgarians abroad, where her mother testified that she could be left with permanent disabilities if care doesn’t start soon. Public Health Alert: West Nile virus is accelerating in Europe; Spain reported its first death this year, and Greece’s outbreak has surged with multiple deaths, prompting mosquito-bite prevention reminders. Local Health Context: Bulgaria’s infectious disease chief says West Nile fever’s peak is expected in August–mid September and that cases may already be circulating, with no vaccine and prevention as the main tool.

West Nile Risk: Greece’s West Nile outbreak is accelerating fast, with 65 locally acquired cases and six deaths reported by Aug 5; all fatalities involved people over 65, and there’s no vaccine or specific antiviral—so prevention (repellent, long sleeves at dusk, removing standing water) and prompt medical contact after symptoms are key. Local Health & Safety: North Macedonia is battling wildfire spread amid a heatwave and drought, with 14 open-air fires registered by Aug 4 and major response efforts in the Kavadarci area. Patient Access & Justice: The case of Bulgarian citizen Iva Mihaylova—injured in a road crash and barred from leaving Kočani for 10 months to get treatment—was heard by Bulgaria’s Parliament committee, with her mother warning delays could cause permanent disability; hearings in Kočani continue amid disputes over testimony and medical needs. Public Health Outlook: Bulgaria’s infectious disease chief says West Nile fever’s peak is expected Aug to mid-September and that cases may already be circulating, while North Macedonia is listed among countries with confirmed activity in the wider region. Community Action: A global beach clean effort logged 10+ tonnes of litter removed across countries, including volunteers in North Macedonia recovering items like a fridge.

West Nile alert: Greece’s locally acquired West Nile cases have surged to 65 (as of Aug 5), with 6 deaths and rising hospitalizations—ECDC notes the virus is spreading across Europe, and Bulgaria has warned the peak may be in August to mid-September, with no vaccine or specific antiviral. Heatwave health risks: The EU health agency (ECDC) says longer, warmer summers are boosting threats like foodborne illness and mosquito- and tick-borne infections, urging hygiene, insect protection, and removing standing water. Wildfires and water safety: North Macedonia is battling wildfire spread amid extreme heat and drought, with the Crisis Management Center reporting multiple open-air fires and ongoing response efforts. Medical access case: In Kočani, the Iva Mihaylova case continues as Bulgarian MPs hear her mother, with the key issue still whether she can leave for medical treatment in Bulgaria after months of restrictions. Women’s health policy: Montenegro has introduced paid “menstrual leave” for people with severe menstrual cramps, drawing mixed reactions in the region and renewed calls for similar steps.

Medical Access & Humanitarian Case: Bulgarian citizen Iva Mihaylova’s fight to leave Kočani for treatment in Bulgaria is back in focus as the Bulgarian Parliament’s Committee on Policies for Bulgarians Abroad holds an extraordinary hearing with her mother, Hristina Mihaylova, describing the risk of permanent disability after 10 months without care. Courtroom Developments: In Kočani, the trial continues amid disputed accounts and alleged procedural problems, including claims that a police officer involved in measurements lacked required qualifications and that witness statements don’t support the prosecution’s version of events. Public Health & Climate Pressure: North Macedonia is also dealing with health risks tied to extreme heat, with wildfires reported after drought conditions, while Europe’s health agency warns longer warm summers can raise the spread of infections. Vector-Borne Alert: West Nile fever is expected to peak in Bulgaria in August and early September, with North Macedonia mentioned among countries where cases have been reported.

Wildfires & drought pressure: North Macedonia is battling a surge in open-air fires as a prolonged heatwave and dry conditions follow Europe’s worsening drought. The Crisis Management Center reported 14 open fires by Aug 4 (one still active, four under control, nine extinguished), with Kavadarci hit hardest and air support deployed. Infectious disease watch: The ECDC warns that longer, warmer summers are raising risks for foodborne illness and mosquito- and tick-borne diseases across Europe, urging stronger cross-border cooperation and prevention steps. West Nile fever update: Bulgaria’s infectious disease chief says West Nile fever’s peak is expected from August to mid-September and that cases may already be circulating, with North Macedonia listed among countries that have reported cases. Local health access in court: In Kočani, the case of Iva Mihaylova continues as her defense argues she needs medical treatment in Bulgaria and that North Macedonia lacks the required conditions; a decision on whether she can travel is expected soon. Community cleanup (health-linked): A global beach clean effort logged 10+ tonnes of litter removed, including a reported haul in North Macedonia (a fridge), highlighting ongoing environmental health risks. Women’s health policy signal: Montenegro’s new paid menstrual leave for severe cramps is being watched by regional women’s rights groups as a potential model.

Wildfires & water safety: North Macedonia is battling fast-moving wildfires as a severe drought and heatwave push temperatures to around 37°C in Skopje, with the Crisis Management Center reporting 14 open-air fires by Aug. 4 and ongoing firefighting near Kavadarci. Infectious disease watch: The ECDC warns that longer, warmer summers across Europe raise risks for foodborne illness and mosquito- and tick-borne diseases, including West Nile virus; in Bulgaria, officials say the West Nile fever peak is expected from August into mid-September, with North Macedonia already among countries reporting cases. Health access in court: A Kočani court hearing continues in the case of Iva Mihaylova, injured in a crash and barred from leaving her hometown since October; the next decision is expected on whether she can receive treatment in Bulgaria. Public health context: Eurostat data highlights obesity as a growing challenge in Europe, while Albania remains among the lowest-obesity countries (12.6% obese adults).

Conference League Health & Travel: Scottish side Hibs say they must take a first-leg lead when they host North Macedonia’s FC Shkendija, warning of very different conditions in Skopje next week and stressing a clinical start at home. Infectious Disease Watch: Bulgaria’s infectious-disease chief says West Nile fever’s peak is expected in August into mid-September, with the virus likely already circulating; North Macedonia is among countries reporting cases in Europe-wide monitoring. Heat-Driven Risk Alert: The EU health agency ECDC warns longer, warmer summers are expanding the spread of multiple infections, with focus on foodborne illness and mosquito- and tick-borne diseases—plus practical prevention steps. Local Court & Medical Access: In Kočani, the trial of Iva Mihaylova continues as her defense argues she must receive treatment in Bulgaria and that key prosecution material and witness accounts contain major contradictions; a decision on whether she can travel for care is expected soon. Public Health Context (Obesity): Albania’s obesity rate is reported as among the lowest in Europe, while the wider region—including North Macedonia—faces higher levels, tied to sedentary habits and diet shifts.

West Nile Fever Watch: Bulgaria’s infectious disease chief says the West Nile fever peak is expected in August and the first half of September, with the virus likely already circulating there even if no cases are confirmed yet; ECDC data show cases reported across Europe, including North Macedonia, and experts stress prevention since there’s no specific treatment. Heat-Driven Infection Risks: The ECDC warns that longer, warmer summers are boosting multiple infections across Europe—especially foodborne illness, mosquito-borne diseases (including West Nile), and tick-borne threats—urging hygiene, insect protection, and tick checks. Court & Access to Care: In Kočani, the trial of Iva Mihaylova continues as her defence argues she should be allowed to receive medical treatment in Bulgaria after a crash; hearings highlight disputed documents and witness contradictions, with a decision expected soon. Health Projects Abroad: TIKA says it will run health-related development projects in North Macedonia as part of its 2026 Development Ambassadors Program, bringing students from Türkiye to partner countries.

Water Safety Update: Gostivar’s tap water is now safe for personal hygiene after a suspected coliform contamination triggered an outbreak of stomach problems, but it’s still not safe to drink or cook; bottled water continues while authorities address system modernization delays and investigate utility managers. Infectious Disease Watch: The ECDC warns longer, warmer summers are boosting risks for foodborne illness and mosquito- and tick-borne infections across Europe, with West Nile virus cases rising and North Macedonia among countries reporting infections. Health & Policy: Serbia’s women’s rights groups are reacting to Montenegro’s new paid menstrual leave law, calling it progressive while noting mixed public views. Reproductive Health: A Skopje hospital reports a successful complex IVF case resulting in the first-time parenthood of a 61-year-old woman and her 71-year husband, with both mother and newborn in good health. Court & Care Access: In Kočani, the case of Iva Mihaylova continues as she seeks permission to travel to Bulgaria for medical treatment after a crash, with court hearings focused on contradictions and whether required expertise is available in North Macedonia.

Infectious Disease Alert: Europe’s longer, warmer summers are driving higher risks for multiple infections, with the ECDC warning on foodborne illness, mosquito- and tick-borne diseases, and vibriosis—plus guidance like safer food handling and stronger bite protection. West Nile Virus Update: WHO reports rising West Nile virus activity across Europe, including locally acquired cases in North Macedonia, urging travelers to use repellents and protective measures. Water Safety in Gostivar: After a stomach-illness outbreak linked to suspected coliform contamination, Gostivar tap water is now safe for hygiene but still not for drinking or cooking; bottled water continues while authorities investigate and push water-system fixes. Court & Access to Care: In Kočani, the case of Iva Mihaylova continues as the court weighs whether she can travel to Bulgaria for medical treatment after a crash; the hearing highlights disputes over police documentation and witness statements. Maternal Health Milestone: A Skopje hospital reports a successful IVF birth for a 61-year-old woman, describing it as an exceptional medical outcome. Air Pollution Health Impact: Eurostat data ranks the Western Balkans among Europe’s hardest hit for premature deaths tied to fine particulate matter, underscoring ongoing respiratory and heart risks.

Water Safety Update: In Gostivar, North Macedonia, tap water is now safe for personal hygiene but still not for drinking or cooking after a coliform contamination scare that triggered an emergency response and widespread stomach illness complaints; authorities report hyperchlorination has reduced contaminants, with bottled water continuing while officials and investigators scrutinize delays and alleged causes tied to the city’s water modernization project. Court & Access to Care: A Kočani court hearing continues in the case of Iva Mihaylova, injured in a crash between Kočani and Štip, as she remains barred from leaving her hometown to get treatment; the dispute centers on conflicting documents and witness accounts, including claims that a police officer involved in measurements lacked required qualifications, with a decision expected soon on whether she can receive the needed surgery in Bulgaria. Infectious Disease Watch: The ECDC warns that longer, warmer summers across Europe are increasing risks for multiple infections, including foodborne illness and mosquito- and tick-borne diseases, urging cross-border cooperation and stronger prevention measures. West Nile Virus Alert: WHO and ECDC report rising West Nile virus activity in Europe, with locally acquired cases including in North Macedonia, and stress mosquito protection as there’s no human vaccine or specific antiviral treatment. Reproductive Health Milestone: Skopje’s Dr. Organdziski Hospital reports a successful IVF birth to a 61-year-old woman using uterine reconstruction and donated eggs, describing it as an exceptional medical outcome. Air Pollution Impact: Eurostat data highlights the Western Balkans’ heavy health burden from fine particulate matter, with North Macedonia among the worst in Europe for premature deaths linked to PM2.5 exposure.

Court & Access to Care: In Kočani, the trial of Bulgarian citizen Iva Mihaylova continues as her defence argues she must be allowed to travel to Bulgaria for surgery she says North Macedonia cannot provide; the hearing has featured conflicting witness accounts and questions over whether a police officer who carried out measurements for the prosecution had the required qualifications. Water Safety in Focus: In Gostivar, tap water is now safe for hygiene but still not for drinking or cooking after an outbreak of stomach problems linked to coliform contamination; authorities say hyperchlorination reduced contaminants, while bottled water continues and managers of the local utility are in custody over alleged causes. Heat & Infection Alerts: The ECDC warns that longer, warmer summers across Europe are increasing risks for multiple infections, including foodborne illnesses and mosquito- and tick-borne diseases, urging cross-border and cross-sector cooperation. Mosquito-Borne Risk: West Nile virus cases are rising in Europe, with North Macedonia among countries reporting locally acquired infections; health agencies advise protection measures like repellents and nets. Maternal Health Milestone: A Skopje hospital reports a successful IVF birth for a 61-year-old woman using donated eggs and uterine reconstruction, with mother and newborn said to be in good health. Air Pollution & Premature Deaths: Eurostat data highlight severe PM2.5 health impacts across the Western Balkans, with North Macedonia among the worst in Europe for air pollution-related premature deaths.

Court & Access to Care: In Kočani, the trial of Bulgarian citizen Iva Mihaylova continues as her defence argues she must be allowed to travel to Bulgaria for treatment she says North Macedonia cannot provide; hearings have featured conflicting witness accounts and scrutiny of a prosecution expert report, including claims that the officer who carried out measurements lacked required qualifications. Heat & Infection Alerts: Europe’s health agencies warn that longer, warmer summers are raising the risk of infectious diseases, with ECDC highlighting foodborne illnesses and mosquito- and tick-borne threats. West Nile Virus Watch: WHO and ECDC report rising West Nile virus activity across parts of Europe, including locally acquired cases in North Macedonia, and urge mosquito protection. Water Safety in Gostivar: After a stomach-illness outbreak linked to suspected coliform contamination, Gostivar tap water is now safe for hygiene but not for drinking or cooking while authorities continue work and investigations into the utility company. Fertility Care in Skopje: A 61-year-old woman and her 71-year-old husband in North Macedonia reportedly became parents for the first time via complex IVF, with the hospital saying both mother and newborn are in good health. Air Pollution & Premature Deaths: Eurostat data place North Macedonia among the worst in Europe for air pollution-related premature deaths, underscoring ongoing cardiovascular and respiratory risks. Health Projects Abroad: TIKA says it is running health-related development projects including in North Macedonia as part of its 2026 student program.

Court & Care Access: In Kočani, the case against Bulgarian citizen Iva Mihaylova continues as prosecutors and witnesses face growing contradictions over the crash and whether she can leave North Macedonia for surgery in Bulgaria; a decision is expected tomorrow after her defence submitted medical reports saying North Macedonia lacks the needed conditions. Public Health—Heat & Infection Risk: Europe’s health agencies warn that longer, warmer summers are increasing infectious disease threats, with ECDC highlighting higher risks for foodborne illness and mosquito- and tick-borne diseases. West Nile Virus—Regional Spread: WHO and ECDC report rising West Nile virus activity across Europe, including locally acquired cases in North Macedonia, alongside major clusters in Greece and Italy; officials urge mosquito protection and vigilance. Water Safety—Gostivar Update: After a stomach-illness outbreak linked to suspected coliform contamination, Gostivar tap water is safe for hygiene but not for drinking or cooking; hyperchlorination reduced contaminants, while investigations continue into the modernization project. Reproductive Health: Skopje’s Dr. Organdziski Hospital reports a successful IVF birth for a 61-year-old woman using uterine reconstruction and donated eggs, with mother and newborn in good health. Health & Climate Data Point: Eurostat data ranks Albania among the worst in Europe for premature deaths tied to fine particle air pollution, underscoring the wider Western Balkans burden. Health Diplomacy: President Droupadi Murmu’s visit to North Macedonia included talks on healthcare and pharmaceuticals cooperation as India boosts bilateral ties.

Court & Care Access: In Kočani, the trial of Bulgarian citizen Iva Mihaylova continues as her defence challenges major contradictions in traffic documents and witness testimony after she was injured in a crash and barred from leaving her hometown for treatment; a decision is expected tomorrow on whether she can receive surgery in Bulgaria. Public Health—Heat & Infection Risk: The ECDC warns that longer, warmer summers across Europe are expanding the spread of infections, with key risks including foodborne illness and mosquito- and tick-borne diseases. Mosquito-Borne Alert (West Nile): WHO and European health agencies report rising West Nile virus activity in southern Europe, with locally acquired cases including in North Macedonia, and urge strict mosquito bite prevention and fast medical care for severe symptoms. Water Safety in Gostivar: After a stomach-illness outbreak linked to contaminated tap water, Gostivar’s water is now safe for hygiene but not drinking/cooking; officials say hyperchlorination reduced contaminants while bottled water continues and investigations target utility management. Fertility Care in Skopje: A 61-year-old woman and her 71-year-old husband became first-time parents in North Macedonia after a complex IVF procedure at a Skopje hospital, with both mother and newborn reported in good health. Health & Climate Context: Reports also highlight that air pollution remains a major health driver in the region, with Western Balkans countries among the hardest hit.