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Since the outbreak of the war in Ukraine on 24th February 2022, humanitarian needs have been increasing by the hour. Millions of people across Ukraine are fighting for their lives. As of 6th April 2022, around 11.4 million people have been forcibly displaced, with 7.1 million internally displaced persons (IDPs) and nearly 4.3 million who have fled the country, seeking a safe haven in neighbouring countries. The majority of displaced people and refugees are women and children. The EU must put SRHR and protection from sexual and gender-based violence at the heart of its response to the crisis, in order to respond to the SRHR needs of Ukrainian people, especially of all women, girls and vulnerable and marginalized populations fleeing the war, whether they are in third countries or in EU Member States. Our brief includes recommendations that the EU can adopt within external and internal action in order to deliver on the sexual and reproductive health and rights of refugees and displaced persons. Credit photo: Fine Acts

COVID-19 created the largest health and socio-economic crisis of our generation. Many health systems were pushed to the brink by restrictive measures rushed in to respond to the pandemic, resulting in the deprioritisation of some existing healthcare services. In almost all European countries, COVID-19 had a negative impact on the delivery of vital sexual and reproductive healthcare, including maternal health and family planning, for women and groups that face barriers to accessing care, including young people. The pandemic also uncovered weaknesses within our systems and exposed the fact that countries are not adequately prepared to deal with health emergencies. To help bring about positive change for young people, IPPF European Network is working to strengthen healthcare systems through the project Youth Voices, Youth Choices, and to remove all kinds of barriers preventing youth from accessing essential care in five Balkan countries: Albania; Bosnia & Herzegovina; Bulgaria, Kosovo and North Macedonia. We are focusing particularly on the needs of those living in remote areas, as well as those from communities that face challenging social conditions, such as the Roma. POLICY RECOMMENDATIONS In October 2022, IPPF EN launched a set of regional policy recommendations that call on decision-makers to listen to young people and uphold their SRHR as they build back health and social systems in the wake of the pandemic. Presented at the European Parliament on 26 October by youth advocates and experts, with the support of MEP Fred Matić, the recommendations were developed by a group of specialists who came together to develop a blueprint for designing systems that prioritise access to youth-friendly SRH care, and better support of young people’s health and well-being. The policy recommendations are available for download below. RESEARCH REPORT  As a basis for this work, in 2021 and early 2022, we conducted a study to provide us with a clearer picture of the impact of the pandemic on young people’s SRHR. The data was published in a series of reports presenting the findings of the study, carried out by and among youth in five Balkan countries. The reports, available for download below, document young people’s SRH needs and experiences and the perspectives of healthcare providers and other relevant stakeholders on these needs. They also capture the latter’s needs as they deliver services, information and education to young people, building on their experience of COVID-19. YOUTH VOICES Young people are at the heart of this work. They were part of the teams that carried out the research presented in the reports below. They participated in the expert groups that developed our regional recommendations for policy change (below) at national and regional level, and they are being supported and empowered to advocate for these changes. Youth were also in the lead at our 'Healthy Youth – Healthy Future' multi-stakeholder meeting in Tirana in spring 2023, where together with staff from our partner organisations they held discussions with decision-makers and experts from the field, concluding with the signing of a joint declaration on protecting the health and social wellbeing of young people during and beyond moments of crisis - available for download below.     Young people also carried out a series of interviews among their peers to share stories of how the pandemic affected their access to SRHR, and what their vision is for a more youth-friendly future that listens to the younger generations and upholds their SRHR.

Since the outbreak of the war in Ukraine on 24th February 2022, humanitarian needs have been increasing by the hour. Millions of people across Ukraine are fighting for their lives. Anyone who has been forced to flee or who lives in an area of active fighting is particularly vulnerable, even more so women and girls. People’s access to health services may be suspended or the quality may be low, and they will not have access to lifesaving reproductive health care. They are in a dire state of emergency and further exposed to risk of sexual violence, sexually transmitted infections including HIV and unintended pregnancies. Amid the terrifying devastation experienced through a humanitarian crisis, people need first and foremost safety and protection. Sexual and reproductive health (SRH) services can save lives and prevent further suffering. Read below about the urgent actions to be taken by European humanitarian donors and actors.

This article was written in September 2017. Since then, thanks to the work of NGOs including our member HERA, Macedonia’s government has committed to providing long-term funding for all HIV programmes for marginalised people. Although HIV prevalence is low in Macedonia, with only 151 people registered as living with HIV, these small numbers mask a complex picture, and one that is rapidly changing. In 2016, there were 40 new HIV diagnoses, the majority of them among men who have sex with men.  Macedonia is not alone in facing a rise in HIV cases. In many parts of Central and Eastern Europe, the rate of new infections is growing. Between 2010 and 2015, the region saw a 50 per cent rise in new HIV infections annually. Another looming problem that threatens to send Macedonian HIV rates spiralling upwards is a funding crisis precipitated by donor cutbacks and political uncertainty. Between 2004 and 2016, Macedonian HIV programmes received almost $25 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Much of this money was channelled into HIV prevention, funding NGOs that target those deemed most vulnerable to infection – sex workers, people who inject drugs, men who have sex with men and prisoners. But in 2016 this funding was phased out and NGOs on the frontline are left hoping that the new government will deliver fully on a recent commitment to step in with similar levels of funding in 2018. In the chasm left by the country’s public healthcare system, Macedonia’s sexual health and rights NGOs work tirelessly to plug the gap, often on a shoestring and in an increasingly uncertain funding landscape. HERA, IPPF's member in Macedonia, is a leading NGO providing free HIV testing services, sexual health support and advocacy. It works closely with smaller organisations around the country to ensure support for young people, sex workers, people who inject drugs and men who have sex with men. These NGOs are many people’s first port of call for HIV tests and other vital health care.