The institution with overall responsibility for implementing the Heat-Health Action Plan is the Ministry of Health. Within the Ministry of Health, the Commission for Monitoring Heat-Health Consequences has been operational since July 2007, while the Climate Change and Health Commission was established in June 2009. This latter participates in the carrying out, and surveillance of, a wide range of activities connected to climate change and health. Both commissions have participated in the preparation of the National Heat-Health Action Plan and they cooperate in the execution, surveillance and evaluation of the Plan. The Climate Change and Health Commission functions as coordinating body and is responsible for the coordination of the involvement of institutions during the implementation of the activities outlined in the Plan, as well as promoting multi-sectoral cooperation. The Commission for Monitoring Heat-Health Consequences oversees practical implementation of the activities, especially those connected with the provision of timely information to the public and health workers. It is responsible for implementing actions and activating the Plan. It is recommended that when necessary, people from other relevant institutions are included in this Commission and in the Plan implementation, as: Public Health Institute and Public Health Centres, the Occupational Health Institute - WHO Collaborating Centre, Crisis Management Centre, Hydrometeorological Institute, Directorate for Protection and Rescue, Departments for improving the living environment within the municipalities (in the ﬁrst phase, active participation of the City of Skopje), Ministry of Transport and Communications, Ministry of Labour and Social Policy, Ministry of Education and Science, Macedonian Red Cross, Media, Non-governmental sector.
For the preparation of this plan the World Health Organization in collaboration with the Ministry of Health organized two workshops: (i) First workshop for preparing the health action plan for hot weather, 21-22 May, 2009, Skopje; (ii) Second workshop for revising and supplementing the work version of the plan, 21 October, 2009, Skopje.
In the current implementation phase this collaborative approach has proven to work well. For instance, in order to strengthen preparedness for crisis situations and climate change related emergencies, a simulation exercise took place on 22 May 2013, in Strumica Region in the country. The key stakeholders were Ministry of Health, Strumica General Hospital (an important regional hospital centre), Emergency Medical Services, Crisis Management Centre, the Red Cross, fire-rescue units, the Ministry of the Interior, the Ministry of Defence and WHO. Prior to the simulation exercise some preparatory meetings were held to establish the parameters of the exercise such as expected casualties, trigger indicators for activating the emergency response plan, triage and patient traffic flow as well as the responsibilities of hospital and emergency medical services staff. The simulation allowed the authorities to test general preparedness and also the implementation of the National Heat-Health Action Plan.