Representatives of the UN family, health workers and representatives and of many national partners involved gathered to discuss lessons learned from the Joint Programme, which was implemented by three UN agencies, UNFPA, UNICEF and WHO, in coordination with the UN Resident Coordinator’s Office, and funded by the UN COVID-19 Response and Recovery Fund., Participants of the event also discussed how to reach groups that may have been left behind in health services, improve preventive care in remote and underserved areas, how to strengthen immunisation, utilize digitalisation to ensure accessibility of the health services for all. “This programme was established to enable fast and innovative response to emerging needs stemming out of COVID-19 and we are happy to be among very few in the world that managed to get funding from the UN COVID-19 Response and Recovery Fund”, says Patrizia DiGiovanni, UN Resident Coordinator ad interim. “The program enabled free life-saving services for the people, particularly women and girls, living in underserved areas to whom provision of such services was disrupted or postponed due to COVID 19 pandemic and it should serve as a model for many future activities and investments in the health sector, aiming not only to save life, but to increase quality of life and improve outcomes for all people in the country.” “Safe and Innovative Health Services in Times of COVID-19 in North Macedonia” is a joint programme that helped the government improve essential health services within the context of COVID-19 by building on the significant investments already made to strengthen the national health and social systems, contain disease outbreaks, and ensure health responses to various emergencies. The programme has introduced several innovative health services, such as the mobile gynaecological clinics visits to remote areas, including e-immunisation registry that aims to improve data collection and the calculation of immunization coverage rates, and risk communication to immunization-sceptic populations as well as awareness raising among women and girls of sexual and reproductive health and gender-based violence. These improved services address the significant decrease in their provision since the outbreak of COVID-19 and enable more efficient real time collection of policy relevant data on immunization while also contributing to greater professional and public support for vaccination. The programme targets vulnerable women, adolescent girls and children, particularly those living in remote areas of the country, who would benefit from sexual and reproductive health services, immunization and psycho-social support. The implementation of the programme started in January 2021 and ends now at the end of March 2022, with a budget of $850,000. The programme is jointly implemented by three UN agencies in close partnership with key national partners including the Ministry of Health, Ministry of Labour and Social Policy, e-Health Directorate, Association of Gynaecologists and Obstetricians, Committee on Safe Motherhood and Healthy New-borns, Macedonian Medical Association, Macedonian Association of Nurses and Midwives, University Clinic of Psychiatry and civil society organizations. This joint programme is made possible thanks to the contributions to the UN COVID-19 Response and Recovery Fund by the governments of Norway, Netherlands, Switzerland, Denmark, Sweden, Republic of Korea, Finland, Austria, United Kingdom, Spain, New Zealand, United States of America, Iceland, Croatia, Portugal, Thailand, Slovak Republic, Romania, Cambodia, Cyprus and Philippines. More info at: https://northmacedonia.un.org/en/170196-safe-and-innovative-health-services-times-covid-19

Supply chain and logistical disruptions on Ukrainian and Russian grain and oilseed production and restrictions on Russia’s exports will have significant food security repercussions. This is especially true for some fifty countries that depend on Russia and Ukraine for 30% or more of their wheat supply. Many of them are least developed countries or low-income, food-deficit countries in Northern Africa, Asia and the Near East. Many European and Central Asian countries rely on Russia for over 50% of their fertilizer supply, and shortages there could extend to next year.

Food prices, already on the rise since the second half of 2020, reached an all-time high in February 2022 due to high demand, input and transportation costs, and port disruptions. Global prices of wheat and barley, for example, rose 31% over the course of 2021. Rapeseed oil and sunflower oil prices rose more than 60%. High demand and volatile natural gas prices have also driven up fertilizer costs. For instance, the price of urea, a key nitrogen fertilizer, has increased more than threefold in the past 12 months.

The conflict’s intensity and duration remain uncertain. The likely disruptions to agricultural activities of these two major exporters of staple commodities could seriously escalate food insecurity globally, when international food and input prices are already high and volatile. The conflict could also constrain agricultural production and purchasing power in Ukraine, leading to increased food insecurity locally.

Core Risk Factors Identified

Cereal crops will be ready for harvest in June. Whether farmers in Ukraine would be able to harvest them and deliver to the market is unclear. Massive population displacement has reduced the number of agricultural laborers and workers. Accessing agricultural fields would be difficult. Rearing livestock and poultry and producing fruits and vegetables would be constrained as well.

The Ukrainian ports on the Black Sea have shuttered. Even if inland transportation infrastructure remains intact, shipping grain by rail would be impossible because of a lack of an operational railway system. Vessels can still transit through the Turkish Straits, a critical trade juncture through which a large amount of wheat and maize shipments pass. Rising insurance premiums for the Black Sea region would exacerbate the already high costs of shipping, compounding the costs of food imports. And, whether storage and processing facilities would remain intact and staffed is also still unclear.

The Russian ports on the Black Sea are open for now, and no major disruption to agricultural production is expected in the short term. However, the financial sanctions against Russia have caused an important depreciation which, if continued, could undermine productivity and growth and ultimately further elevate agricultural production costs.

Russia is a major player in the global energy market, accounting for 18% of global coal exports, 11% of oil, and 10% of gas. Agriculture requires energy through fuel, gas, electricity use, as well as fertilizers, pesticides, and lubricants. Manufacturing feed ingredients and feedstuffs also require energy. The current conflict has caused energy prices to surge, with negative consequences on the agriculture sector.

Wheat is a staple food for over 35% of the world's population, and the current conflict could result in a sudden and steep reduction in wheat exports from both Russia and Ukraine. It is still unclear whether other exporters would be able to fill this gap. Wheat inventories are already running low in Canada, and exports from the United States, Argentina and other countries are likely to be limited as government will try to ensure domestic supply.

Countries reliant on wheat imports are likely to ramp up levels, adding further pressure on global supplies. Egypt, Turkey, Bangladesh, and Iran are the top global wheat importers, buying more than 60% of their wheat from Russia and Ukraine, and all of them have outstanding imports. Lebanon, Tunisia, Yemen, Libya, and Pakistan also rely heavily on the two countries for their wheat supply. Global maize trade is likely to shrink due to expectations that the export loss from Ukraine will not be filled by other exporters and because of high prices.

Export prospects for sunflower oil and other alternative oils also remain uncertain. Major sunflower oil importers, including India, the European Union, China, Iran, and Turkey, must find other suppliers or other vegetable oils, which could have a spill-over effect on palm, soy, and rapeseed oils, for example.

Policy Recommendations

1. Keep global food and fertilizer trade open. Every effort should be made to protect the production and marketing activities needed to meet domestic and global demands. Supply chains should keep moving, which means protecting standing crops, livestock, food processing infrastructure, and all logistical systems.

2. Find new and more diverse food suppliers. Countries dependent on food imports from Russia and Ukraine should look for alternative suppliers to absorb the shock. They should also rely on existing food stocks and diversify their domestic production to ensure people’s access to healthy diets.

3. Support vulnerable groups, including internally displaced people. Governments must expand social safety nets to protect vulnerable people. In Ukraine, international organizations must step in to help reach people in need. Across the globe, many more people would be pushed into poverty and hunger because of the conflict, and we must provide timely and well-targeted social protection programs to them.

4. Avoid ad hoc policy reactions. Before enacting any measures to secure food supply, governments must consider their potential effects on international markets. Reductions in import tariffs or the use of export restrictions could help to resolve individual country food security challenges in the short term, but they would drive up prices on global markets.

5. Strengthen market transparency and dialogue. More transparency and information on global market conditions can help governments and investors make informed decisions when agricultural commodity markets are volatile. Initiatives like the G-20’s Agricultural Market Information System (AMIS) increases such transparency by providing objective and timely market assessments.

  Representatives of national human rights institutions, persons with disabilities and their representative organizations, civil society representatives from the Western Balkan region, along with their peers from other European countries, and other organizations participated in the regional conference organized by the Ombudsman and the United Nations family in North Macedonia, yesterday. The participants of the conference “Strengthening National Human Rights Institutions as independent monitoring mechanisms for the implementation of the UN Convention of the Rights of Persons with Disabilities (CRPD)” had a unique chance to share experiences, good practices, challenges, opportunities, and initiatives on the existing monitoring frameworks. “Societies can never achieve the Sustainable Development Goals without the full participation of everyone, including people with disabilities. Recognizing their rights and ensuring their engagement is critical.  Progress has been made in the countries in the region, but a lot remains to be done to accelerate disability inclusive development,” says Rossana Dudziak, UN Resident Coordinator in North Macedonia. “Only through a dialogue and by working together – across governments, international and regional organizations, civil society, and the private sector – can we effectively fulfil the CRPD and Agenda 2030 commitments.” The goal of this conference is to encourage a constructive, action-oriented dialogue on accelerating inclusive, equitable, sustainable development in the Western Balkans, guided by the international human rights standards and the 2030 Agenda’s promise to leave no one behind. “We have a long way with a lot of challenges on it, before we can talk about full inclusion and integration of persons with disabilities, as per the Convention, which is a tool that can help us in achieving these goals. In that sense, I strongly believe that the conference will open up a lot of discussions and initiatives how to achieve the desired progress,” says Naser Ziberi, Ombudsman. Focusing on strengthening the role and the collaboration among national human rights institutions in the region, the conference seeks to inspire and guide future action to be pursued by NHRIs, disability movements and other partners across the region. In addition to further enhancing regional exchange, participants of the conference agreed to ensure that the good practices and lessons learned on including civil society in the monitoring process from the conference will be included into their work and future activities, and that they will continue to support the independent monitoring, and leverage on human rights agenda across the region.

SKOPJE| 24 February 2022 - The Minister of Health, Bekim Sali, representatives of the UN family and representatives of the diplomatic corps visited Cheshinovo- Obleshevo to see the implementation of the mobile gynaecological clinic established to enhance access to gynaecological services, particularly for the most vulnerable women and girls in hard-to-reach areas who have been most impacted by the COVID-19 pandemic.  ”The Joint Programme “Safe and Innovative Health Services in Times of COVID-19” in North Macedonia turned out to be a very successful activity towards improving access to sexual and reproductive health, immunization and services to support victims of gender-based violence, as well adolescents, children and people from vulnerable groups and from underserved areas”, says Bekim Sali, Minister of Health. “This would not have been possible without the support of UNFPA, UNICEF and WHO, in coordination with the UN Resident Coordinator’s Office, the contributions of the Government within the UN COVID-19 Response and Recovery Fund and the national partners. For this, I am sincerely grateful!" For the past three months, the mobile gynaecological clinics have carried out examinations in in several municipalities so far - Sveti Nikole, Vrapchishte, Gradsko, Lozovo, Chashka and Chesihovo Obleshevo. The implementation of the mobile gynaecological services is supported through the project “Safe and Innovative Health Services in Times of COVID-19” in North Macedonia, funded by the UN COVID-19 Response and Recovery Fund. "One of the greatest values of this programme was the ability to quickly respond to a set of health-related needs, often directly at those at greatest risk and in underserved areas”, says Rossana Dudziak, UN Resident Coordinator in North Macedonia. “Even more importantly, the activities and services introduced through this joint programme are an investment for the future, for increased quality of health services for all, beyond the COVID-19 pandemic.” “Safe and Innovative Health Services in Times of COVID-19 in North Macedonia” is a joint programme that helped the government improve essential health services within the context of COVID-19 by building on the significant investments already made to strengthen the national health and social systems, contain disease outbreaks, and assure health responses to various emergencies. The programme has introduced several innovative health services, such as the mobile gynaecological clinics visits to remote areas, including e-immunisation registry that aims to improve data collection and the calculation of immunization coverage rates, and risk communication to immunization-sceptic populations as well as awareness raising among women and girls of sexual and reproductive health and gender-based violence. These improved services address the significant decrease in their provision since the outbreak of COVID-19 and enable more efficient real time collection of policy relevant data on immunization while also contributing to greater professional and public support for vaccination. The programme targets vulnerable women, adolescent girls and children, particularly those living in remote areas of the country, who have benefit from sexual and reproductive health services, immunization and psycho-social support. The implementation of the programme started in January 2021 and will last through March 2022, with a budget of $850,000 funded by the UN COVID-19 Response and Recovery Fund. The programme is jointly implemented by three UN agencies - United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), and World Health Organization (WHO), under the coordination of the Office of the United Nations Resident Coordinator and in close partnership with key national partners including the Ministry of Health, Ministry of Labour and Social Policy, e-Health Directorate, Association of Gynaecologists and Obstetricians, Committee on Safe Motherhood and Healthy New-borns, Macedonian Medical Association, Macedonian Association of Nurses and Midwives, University Clinic of Psychiatry and civil society organizations. This joint programme is made possible thanks to the contributions to the UN COVID-19 Response and Recovery Fund by the governments of Norway, Netherlands, Switzerland, Denmark, Sweden, Republic of Korea, Finland, Austria, United Kingdom, Spain, New Zealand, United States of America, Iceland, Croatia, Portugal, Thailand, Slovak Republic, Romania, Cambodia, Cyprus and Philippines. More info on: https://northmacedonia.un.org/en/170196-safe-and-innovative-health-services-times-covid-19