North Korea has, at the time of writing, reported no confirmed cases of COVID-19. Pyongyang was quick to enforce strict measures to control the outbreak, closing its borders as early as January 2020, quarantining foreign nationals, and shutting down schools and public sites. However, sources suggest that the reality of the COVID-19 caseload is quite different with reports that infected North Koreans have died, although these accounts are not yet verified.
North Korea is located between South Korea and China, two countries that have suffered significant numbers of COVID-19 cases. North Korea’s very limited health infrastructure (particularly outside Pyongyang) and underlying vulnerabilities related to food security, malnutrition and chronic disease mean that any COVID-19 outbreak could have a devastating impact on the population. In February 2020, the DPRK Humanitarian Country Team identified 8.7 million North Koreans as in need of humanitarian health intervention in 2020 due to a lack of essential medicines and equipment.
COVID-19 presents particular challenges to an already weak healthcare system. The UN’s Global Humanitarian Response Plan: COVID-19 explains, “While the scope of and testing capacity [in North Korea] is unclear, the increased COVID-19 screening and hospitalisation may strain the already overburdened system and come at the expense of other vulnerable groups – including pregnant and lactating mothers, children, older people and those suffering from pre-existing conditions.”
While the provision of humanitarian exemptions to the sanctions and the speed with which they were granted in this instance are entirely appropriate, it does demonstrate that the exemption process can in fact be much faster and more effective.
The limited presence of international aid organisations and the effect of sanctions will impact the success of a potential response. As discussed more fully in Humanitarian Aid in North Korea: Needs, Sanctions and Future Challenges, humanitarian agencies navigating the sanctions environment in North Korea have generally found that sanctions negatively impact the quality and reach of programming, and that the process of being granted a humanitarian exemption to the sanctions is onerous, inconsistent and slow.
In response to COVID-19, however, some humanitarian agencies such as the World Health Organisation, the International Federation of the Red Cross and Médecins Sans Frontières have been granted six-month waivers, including the provision of medical and personal protective equipment. The International Federation of Red Cross and Red Crescent Societies (IFRC) has been granted exemption from UN sanctions to provide humanitarian aid in DPRK, and stated that its volunteers will be working closely with healthcare providers to support COVID-19 screening and promote effective hygiene practices. Given the underlying weakness of the healthcare system and vulnerability of the population, it remains to be seen whether the scale of support available will be sufficient to tangibly reduce the potential impact of COVID-19.
The long-term impacts to North Korea’s economy will also be significant. With the formal economy already weakened by the impact of international sanctions, the informal economy may be hit hard by the impact of efforts to contain the virus. US President Donald Trump has reportedly written to North Korea’s President Kim Jong Un to offer assistance in dealing with COVID-19, although this does not appear to have amounted to any concrete strategy or progress in the relationship. There are currently no indications that support with a COVID-19 outbreak will offer the US leverage in the stalled denuclearisation negotiations, thought the overriding consideration should be humanitarian need rather that political implications.
While the provision of humanitarian exemptions to the sanctions and the speed with which they were granted in this instance are entirely appropriate, it does demonstrate that the exemption process can in fact be much faster and more effective. And while the spectre of COVID-19 may have galvanised recent efforts, the severe and persistent humanitarian need that has long existed in North Korea also requires urgent and effective response.