AGP Executive Report

Antibiotic Stewardship: Bulgaria reports a sustained drop in antibiotic use in human medicine, linked to tighter 2024 controls and mandatory digital prescriptions, with authorities citing at least a one-third fall from two years ago and further declines in 2025–2026. Rural Healthcare Workforce: A 90-year-old GP in Bulgaria’s mountain village continues seeing 1,500+ patients across multiple communities, highlighting the strain of an ageing workforce and the lack of younger doctors willing to work in rural areas. Patient Safety & Privacy Tech: A European network under COST Action GoodBrother discusses how smart cameras and microphones could help older people live independently—while stressing the need to protect privacy and prevent “surveillance” fears. Cross-Border Medical Access: North Macedonia’s President Iliana Iotova raised the case of injured citizen Iva Mihaylova, saying she needs medical treatment in spite of legal proceedings in Bulgaria, and sought Council of Europe attention. Public Health Integrity: Swiss prosecutors are investigating Granit Xhaka over alleged use of a forged COVID-19 vaccination certificate, as he publicly admitted the decision was a mistake.

Rural Health Access: A 90-year-old GP in Bulgaria’s mountain village of Skrat is still treating 1,500+ patients across nearby communities, highlighting how ageing medical staff and doctor shortages keep care going in border rural areas, including near North Macedonia. Patient Rights in Cross-Border Care: Council of Europe President Iliana Iotova raised the case of Iva Mihaylova, a North Macedonian/Bulgarian citizen reportedly denied needed medical treatment in Bulgaria due to legal proceedings, urging access to care and possible review at the Council of Europe. Digital Safety for Children: UNICEF reports that 20 million children aged 12–17 across 21 countries faced technology-facilitated sexual exploitation or abuse, with most cases linked to social media—fueling calls for stronger protection and reporting pathways. Privacy-Aware Tech for Seniors: A European network (GoodBrother) discussed how cameras and microphones could help older people live independently while protecting privacy and limiting surveillance fears—an issue relevant to future care models in the region. Healthcare Workforce Pressure (Local Context): North Macedonia’s school “optimization” closures in rural areas show how shrinking populations and unsafe facilities can disrupt access to services for families—an indirect pressure point for broader community health and wellbeing.

Cross-border healthcare access: North Macedonia’s President Iliana Iotova raised the case of Iva Mihaylova, a young woman with North Macedonian and Bulgarian citizenship, saying Bulgaria has denied her needed medical treatment while legal proceedings continue in Kočani—calling it a human-rights precedent and asking the Council of Europe to review it. Rural health workforce pressure: A report highlights how an ageing doctor in a mountain village near the North Macedonia border still treats 1,500+ patients across communities, underscoring the wider challenge of too few younger doctors willing to work in rural areas. Patient safety & privacy tech: On World Patient Safety Day, coverage focuses on smart home monitoring for older people—like cameras and microphones that can detect falls or distress—while stressing the privacy and control concerns that come with surveillance-like systems. Public health integrity: Swiss prosecutors opened an investigation into Granit Xhaka over alleged use of a forged COVID-19 vaccination certificate, with Xhaka admitting it was a mistake and apologising. School closures affecting families: North Macedonia’s education “optimization” is closing 26 rural schools due to low enrolment and unsafe buildings, raising worries about children’s safety and longer commutes.

Patient Access & Rights: North Macedonia’s President Iliana Iotova raised the case of Iva Mihaylova, a young woman denied medical treatment in Bulgaria due to legal proceedings, urging the Council of Europe to look at the human-rights impact. Digital Health & Privacy: A European network (GoodBrother) discussed how smart home cameras and microphones can help older people live independently, while warning that privacy and data access concerns can quickly turn care into surveillance. Public Health Integrity: Swiss prosecutors opened an investigation into footballer Granit Xhaka over alleged use of a forged COVID-19 vaccination certificate, after he admitted the decision was a mistake and apologized. Child Safety Online: UNICEF reported that tens of millions of children were affected by technology-facilitated sexual exploitation and abuse, with social media platforms playing a major role. Healthcare System Context: North Macedonia’s education “optimization” is closing 26 schools due to low enrollment and unsafe buildings, a shift that can affect families’ access to safe local services and routines.

Patient Access & Rights: North Macedonia’s President Iliana Iotova raised the case of Iva Mihaylova, a young woman denied medical treatment in Bulgaria due to legal proceedings, telling the Council of Europe that her injuries are being turned into a political issue and urging access to needed care. Healthcare Tech & Privacy: A European COST Action GoodBrother discussion on World Patient Safety Day focused on how cameras and microphones can help older people live independently, while stressing the privacy and control concerns that come with in-home monitoring. Child Safety Online: UNICEF reports that technology-facilitated sexual exploitation and abuse affects over 20 million children across 21 countries, with social media platforms driving a large share of cases and many victims underreporting. Health System & Community Impact: North Macedonia’s education “optimization” is closing 26 primary schools due to low enrollment and unsafe buildings, including protests by parents worried about children’s safety and longer commutes—an indirect pressure on family health and access to local services.

Patient Care & Rights: North Macedonia’s President Iliana Iotova raised the case of Iva Mihaylova at the Council of Europe, saying Bulgaria has denied her needed medical treatment while legal proceedings continue in Kočani—calling it a human-rights precedent. Elder Safety Tech: On World Patient Safety Day, a European COST Action GoodBrother report highlights how privacy-aware cameras and microphones could help older people live independently, while warning that monitoring can quickly feel like surveillance. Digital Child Protection: UNICEF reports that about 20 million children aged 12–17 across 21 countries faced technology-facilitated sexual exploitation or abuse, with most cases occurring on social media—pushing calls for stronger online safeguards and support routes. Public Health Misinformation: A journalism lecture warns that “industrialised falsehood” is accelerating with generative AI, citing fake medical advice circulating online that can mislead people about health and “immune resets.” Health & Society: OSCE states, including the UK, urged Belarus to release all political prisoners—an issue that also affects access to healthcare and freedom for people under detention.

Patient Safety & Privacy Tech: On World Patient Safety Day (17 Sept), a COST Action GoodBrother discussion highlights how cameras and microphones could help older people live independently—detecting falls and alerting carers—while raising hard questions about who can access recordings and how to balance safety with privacy and dignity. Cross-Border Care Access: North Macedonia’s President Iliana Iotova says Bulgaria must allow injured citizen Iva Mihaylova access to needed medical treatment despite ongoing legal proceedings, warning the case risks turning a personal tragedy into a human-rights issue. Health Misinformation Online: A journalism lecture by Craig Silverman warns that AI-driven scams can spread dangerous medical advice, citing a fake “Dr John Valentine” supplement pitch that claimed to “reset” the immune system. Public Health & Travel Risks: A British tourist sought a hotel refund after mosquito bites in Crete, requesting inspection by a certified health company—an example of how travel health concerns can quickly become disputes. Child Safety Online: UNICEF reports that technology-facilitated sexual exploitation and abuse affects over 20 million children (ages 12–17) across studied countries, with most cases occurring on social media.

Cross-border medical access: North Macedonia’s President Iliana Iotova raised the case of Iva Mihaylova, a young woman with North Macedonian and Bulgarian citizenship, after she was denied medical treatment in Bulgaria due to legal proceedings in Kočani; Iotova told the Council of Europe Secretary General Alain Berset that the situation risks turning a personal injury into a political issue, noting Bulgaria offered either treatment in Bulgaria or a Bulgarian medical team consultation. Privacy-aware elder care tech: On World Patient Safety Day, a COST Action GoodBrother discussion highlighted how cameras and microphones could help older people live independently and get help after falls or trouble, while stressing the key concern of who can access recordings and how to avoid turning support into surveillance. Public health travel risk: A British tourist in Crete reportedly sought a hotel refund after mosquito bites, saying the bites “ruined” the holiday; local reports say an inspection did not find issues, and the adviser said the goal is to address visitor concerns without damaging the destination’s reputation. Digital child protection: UNICEF reported that in 21 countries, about 20 million children aged 12–17 faced technology-facilitated sexual exploitation or abuse in a year, with most cases occurring on social media platforms.

Patient Rights in Focus: North Macedonia’s President Iliana Iotova raised the case of Iva Mihaylova with the Council of Europe, saying Bulgaria has denied her access to needed medical treatment due to legal proceedings, after she was seriously injured in a road accident; Iotova called it a human-rights precedent and said Bulgaria offered either treatment in Bulgaria or a Bulgarian medical team for consultation, which Skopje did not accept. Elder Care & Privacy: On World Patient Safety Day, a European COST Action GoodBrother discussion highlighted how cameras, microphones and AI could help older people live independently, while also warning about the fear of surveillance and concerns over who can access recordings and data ownership. Child Safety Online: UNICEF reported that more than 20 million children aged 12–17 across 21 countries experienced technology-facilitated sexual exploitation or abuse, with many cases occurring on social media and underreporting likely masking the true scale. Digital Health Misinformation: A journalism lecture on online disinformation pointed to AI-made medical advice scams, including a fake “doctor” avatar promoting unsafe hydrogen peroxide claims, showing how false health content spreads online.

Privacy-Aware Elder Care: A European COST Action network (GoodBrother) is examining how cameras and microphones can help older people live independently after falls or other emergencies—while tackling the big question of who can access recordings and how to avoid turning support into surveillance. Patient Safety Focus: The discussion ties into World Patient Safety Day, stressing that “safety” at home also means fast help without losing dignity and control. Cross-Border Medical Access: North Macedonia’s President Iliana Iotova says Bulgaria has denied medical treatment to Iva Mihaylova due to legal proceedings, and has briefed the Council of Europe’s secretary general—calling it a human-rights precedent. Child Protection Online: UNICEF reports that about 20 million children (12–17) across 21 countries faced technology-facilitated sexual exploitation or abuse in one year, with most cases occurring on social media. School Health & Wellbeing: Across the Balkans, education and health authorities are pushing measures to lighten pupils’ schoolbags—lockers and digital textbooks included—after concerns about heavy loads.

Patient Rights in Focus: North Macedonia’s President Iliana Iotova briefed the Council of Europe Secretary General about Iva Mihaylova, a young woman with North Macedonian and Bulgarian citizenship who says she’s been denied needed medical treatment in Bulgaria due to legal proceedings in Kočani. Digital Safety & Abuse: UNICEF reports that about 20 million children aged 12–17 across 21 countries faced technology-facilitated sexual exploitation and abuse in a year, with most cases linked to social media. Privacy-Aware Care for Seniors: A European COST Action network (GoodBrother) discussed how cameras and microphones could help older people live independently, while raising concerns about who can access recordings and whether it becomes surveillance. Public Health Misinformation: A journalism lecture highlighted how “industrialised falsehood” spreads online, including health scams amplified by generative AI—pointing to how fake medical advice can reach large audiences quickly. School Health & Burden: Across the Balkans, education and health authorities are pushing measures to lighten pupils’ schoolbags (lockers, split textbooks, digital materials), noting parents in North Macedonia report bags can still weigh 5–7 kg in early grades.

Cross-border patient care dispute: North Macedonia’s President Iliana Iotova raised the case of Iva Mihaylova with the Council of Europe, saying she has been denied needed medical treatment in Bulgaria due to legal proceedings in Kočani, and urging access to care or a Bulgarian medical consultation. Privacy-aware elder support: On World Patient Safety Day, a European COST Action network (GoodBrother) discussed how cameras and microphones could help older people live independently while protecting privacy, data access, and dignity. Child safety online: UNICEF warned that technology-facilitated sexual exploitation and abuse affects an estimated 20 million children across 21 countries, with social media driving many cases and underreporting likely masking the true scale. School health and wellbeing: Across the Balkans, education and health authorities are pushing measures like lockers, lighter schoolbags, and digital textbooks to reduce the physical strain on pupils, including reported bag-weight concerns in North Macedonia.

AI & Misinformation in Health: Investigative journalist Craig Silverman warned that generative AI is accelerating “the industrialisation of falsehood,” pointing to fake medical advice accounts (including an AI “doctor” promoting hydrogen peroxide foot soaks) used to sell supplements and drive clicks. Patient Safety & Privacy at Home: On World Patient Safety Day, a European COST Action network (GoodBrother) highlighted how fall-detection cameras and microphones for older people can help independence, but also raise hard questions about who watches, who stores data, and whether care becomes surveillance. Cross-Border Care & Rights: North Macedonia’s President Iliana Iotova briefed the Council of Europe on Iva Mihaylova, a young woman denied medical treatment in Bulgaria due to legal proceedings, arguing her injuries should not be trapped in politics. Child Safety Online: UNICEF reported that about 20 million children aged 12–17 across 21 countries faced technology-facilitated sexual exploitation or abuse, with most cases occurring on social media and underreporting likely masking the true scale.

Human Rights & Access to Care: President Iliana Iotova briefed Council of Europe Secretary General Alain Berset on the case of Iva Mihaylova, a young woman with North Macedonian and Bulgarian citizenship who says she has been denied needed medical treatment in Bulgaria due to legal proceedings in Kočani; Iotova called it a precedent for human-rights violations and said Bulgaria offered either treatment in Bulgaria or a Bulgarian medical consultation team, but Skopje did not agree. Child Safety Online: UNICEF reports that about 20 million children aged 12–17 across 21 countries were subjected to technology-facilitated sexual exploitation and abuse in a single year, with nearly 60% of cases occurring on social media platforms; the report warns of underreporting and urges stronger help pathways. School Health & Burden Relief: Across the Balkans, education and health authorities are pushing measures to lighten pupils’ schoolbags, including lockers, splitting textbooks into smaller volumes, and more digital textbooks; in North Macedonia, parent groups report bags can still weigh 5–7 kg for early grades.

Child Safety & Digital Abuse: UNICEF estimates about 20 million children aged 12–17 across 21 countries faced technology-facilitated sexual exploitation and abuse in one year, with nearly 60% of cases happening on social media. Education & Health at School: Across the Balkans, authorities are trying to ease heavy schoolbags using lockers, digital textbooks, and splitting materials into smaller volumes; in North Macedonia, parent groups say bags can still reach 5–7 kg for early grades. Public Health & Emergency Response: EU crisis management commissioner Hadja Lahbib highlighted Romania’s emergency response capacity and Civil Protection Mechanism support, stressing faster help when countries are overwhelmed. Health Tech & Access: Apple is expanding iCloud+ in 100+ countries by bundling Apple TV, Apple Arcade, and Apple Music Select at no extra charge, while some major regions are excluded.

West Nile Update (Skopje): North Macedonia’s Infectious Diseases Clinic reports 8 hospitalized confirmed neuroinvasive West Nile virus cases in Skopje, with 2 in intensive care on ventilators; a new death was also reported over the weekend (a 70-year-old man from Dracevo), while no new admissions came in recent days. Public Health Response: With 58 infections and 8 deaths reported as of September 2026, health and veterinary authorities have intensified emergency measures, including mosquito spraying (aerial and ground) and updated guidance urging extra caution for people over 60 and those on immunosuppressive therapy. Sports Cardiac Care (Scotland/Napoli): Napoli says Scotland midfielder Scott McTominay’s heart ablation for a mild benign arrhythmia was a complete success; he’ll rest for two weeks and miss upcoming Nations League matches that include North Macedonia. Labour Safety Cooperation (Skopje): Qatar and North Macedonia signed an MoU to strengthen labour-market cooperation, including occupational safety and health, labour inspection, and preventive measures for safer working conditions.