The World Health Organization (WHO) reports that there are several measurable improvements in healthcare for the DPRK including increased immunization rates. The percentage of one-year-old children immunized against measles is high (99.1%); as is the figure for DPT-3 (93.1%); OPV-3 (99.0%); BCG (98.1%); and TT2+, tetanus toxoid (98.9%). The under-five mortality rate has decreased but still remains high with respiratory and diarrheal diseases, combined with malnutrition, as the major causes. Maternal mortality also remains high with major causes being post-partum hemorrhages and puerperal infection.[i]
There have been substantial improvements in the control of communicable diseases. Treatment success rates for TB have been brought into line with global targets and the number of malaria cases has decreased significantly. However, both malaria and TB remain major problems. An increasing burden to morbidity and mortality are non-communicable diseases (NCDs). These include cardiovascular and cerebrovascular diseases, cancer, and respiratory illnesses. A major contributing factor to the increase in NCDs is the high percentage of tobacco smokers (54.5% among adult males).1
Despite significant improvement in some areas, the DPRK still faces numerous healthcare challenges. Suboptimal quality of patient care, lack of modern medical education standards, and limited supply of basic medicines and medical equipment remain significant problems. Persistent health issues include maternal mortality, unsafe abortion, high prevalence of low birth-weight, child malnutrition, TB, malaria, and hepatitis B.1 The main causes of death include stroke (19.4%), COPD (11.8%), IHD (11.4%), lung cancer (12.8%), lower respiratory infections (5.5%), self-harm (4.3%), liver cirrhosis (2.7%), liver cancer (2.1%), kidney disease (1.9%), and hypertensive heart disease (1.8%).[ii]
DPRK National Health Needs
The DPRK Ministry of Health in collaboration with WHO has listed the following national health priorities: Decrease the burden of communicable diseases; Delivery of quality medical services; Strengthen the Household Doctor system; Protect and promote mother, child and elderly health; Prevention and control of NCDs; Provide sufficient medicines; Intensify international cooperation and partnerships.[iii]
Opportunities to Transform Healthcare in the DPRK.
Among the 17 WHO Sustainable Development Goals (SDGs) 2016-2030; Goal 3 is Good Health and Well-being, Goal 4 is Quality Education, and Goal 17 is Developing Global Partnerships.[iv] PUST DMS has the opportunity to partner with the DPRK Ministry of Health, DPRK Medical Institutions, WHO, and other agencies to help achieve these goals and address the National Health Priorities in the DPRK. Through the provision of quality medical education and clinical training, PUST DMS has an opportunity to make a significant impact on the improvement of the health of the people of the DPRK.
WHO Country Cooperation Strategy: Democratic People’s Republic of Korea, 2015.
WHO Global Health Observatory, April, 2014.
Medium Term Strategic Plan for the Development of the Health Sector in the DPRK 2010-2015.
WHO Sustainable Development Goals: https://sustainable development.un.org/?menu=1300