The South Korea-based TB aid organization Eugene Bell Foundation reported that North Korea has “at least 5,000” cases of multidrug-resistant TB (MDR TB) every year. Incidence actually could be much higher because North Korea restricts foreign doctors’ access and the country does not have the means to test for MDR TB.
MDR TB treatment requires an intense course of “second-line” antibiotics that costs approximately $2,000 per patient per year—an amount beyond the means of most North Koreans. Although the Eugene Bell Foundation sent more than $600,000 worth of TB medicines to North Korea in March, that amount helps only 500 North Korean patients a year, according to foundation chairperson Stephen Linton.
Western nations’ sanctions and poverty have resulted in “chronic shortages of medicine” in North Korea. The sanctions make it hard to produce pharmaceuticals in North Korea because companies cannot import dual-use products—items for military and civilian use—including chemicals necessary to ensure drug quality. TB flourishes in cold, damp, crowded conditions, among malnourished people, as many are in North Korea. The emergence of MDR TB strains in North Korea could threaten neighboring countries China and South Korea.
Reports about North Korea’s healthcare system are conflicting. Although a World Health Organization director stated that North Korea’s free system was “the envy of the developing world,” Amnesty International reported that doctors had to perform surgery by candlelight and amputations without anesthesia.
Positive indicators include the 2010 collaboration between scientists from a US nonprofit organization and the North Korea health ministry on a TB prevention and treatment training center for North Korean doctors. In addition, some Chinese and European companies have set up pharmaceutical companies in Pyongyang, a more affluent area where many can afford medicines.