The U.N. World Food Program (WFP) has not distributed food aid to vulnerable women, children and patients in North Korea since March 2021, the agency said in a new report published Wednesday, as pandemic restrictions have prevented the organization from providing assistance to cover apparent food shortages.

The DPRK has limited almost all cross-border transportation to prevent the spread of COVID-19 since Jan. 2020, and there have been no international aid workers on the ground there for almost a year, with WFP’s country director the last U.N. staff to leave Pyongyang.