View all the contents provided on SDG 3.

Goal 3
"Ensure healthy lives and promote well-being for all at all ages"

Significant progress has been made, such as an increase in life expectancy for mankind and a decrease in mortality rates for infants, infants and pregnant women, but the fertility system needs to be improved to reduce the mortality rate of less than 70 per 100,000 by 2030.

In order to achieve the goal of reducing the early mortality rate from non-inflammatory diseases by one-third by 2030, we need to encourage efficient technology to use clean oil during cooking and education on the risk of tobacco.

It also takes a lot of effort to eradicate various diseases and solve continuous health problems. By focusing on effective funding for healthcare systems, improving hygiene, expanding access to healthcare services, and providing information on environmental pollution prevention, we can make great progress in saving millions of lives.

3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents

3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

SDG 3 and the UN Human Rights Mechanisms

      1st UPR Cycle

      2nd UPR Cycle

      3rd UPR Cycle

Recommending State
Strengthen cooperation with international organizations, particularly in the areas of health, education and food
Take immediate steps to allocate proper budgetary resources to ensure protection of the rights to food, health, water and sanitation
Consider further increase in state expenditures on the health sector with a view to meeting the demand for medical supplies, including essential drugs
Continue to ensure effective functioning of the telemedicine system
Venezuela (Bolivarian Republic of)
Take appropriate measures to effectively implement the Strategy for Health (2011-2015) and some other programmes on health
Iran (Islamic Republic of)
Strengthen health-care services for its citizens through better training of the medical personnel, particularly in remote rural areas
Carry out a reproductive health strategy and other programmes for women's health with a view to reducing the maternal mortality rate as set out in the MDG
Take concrete measures to improve health care for women to further decrease maternal mortality
Provide the necessary resources to the health system, in order to strengthen it, and especially in order to lower child and maternal mortality rates
Continue actions to ensure that children in the most disadvantaged areas enjoy the same benefits in education and health enjoyed in urban areas
Venezuela (Bolivarian Republic of)
Develop and implement more substantiated programmes and initiatives for the provision of enhanced level of the rights to education and health for all
Continue to make efforts to ensure that children with disabilities and those without parents fully enjoy their right to health, education and other social and cultural rights
Sri Lanka
Consider increasing budget allocations to the health, education and social sectors, within the Five-Year Strategy for National Economic Development, to ensure improved access to services in rural areas
Redirect its public spending in order to fulfil the right of all people in the Democratic People's Republic of Korea to a standard of living adequate for their health and well-being, in line with Sustainable Development Goals 1, 2 and 3 (Netherlands);
Remove the barriers to access to education and health and provide genuinely free education and health services for its entire population
Continue to make efforts to develop education and health care, to better protect people's right to education and right to health
Develop a strategy to ensure more equal access to the rights to health, education and an adequate standard of living in rural areas
Costa Rica
Take further measures to reduce inequalities in access to health care, at an affordable cost
Strengthen its positive actions to further reduce the infant mortality and malnutrition rates in the country
Continue the development of the health sector and achieve universal health care
Continue its initiatives to improve public health services, in line with the right to health
Continue modernizing the national health system in favour of the population
Venezuela (Bolivarian Republic of)
Adopt concrete measures to address the root causes of infant and child mortality, including social and economic deprivation and inequality, child malnutrition and child labour
Continue its efforts to provide persons with disabilities with equal access and rights to health care and education
Recommending State
Ensure that the rights of women, children and persons with disabilities are more effectively realized through the implementation of the strategy for the promotion of reproductive health, 2006- 2010, the national strategy for the prevention of AIDS, 2008-2012, the primary health care strategy, 2008-2012, the national action plan for the well-being for children, 2001-2010 and the comprehensive action plan for persons with disabilities, 2008-2012
Syrian Arab Republic
Take positive measures to further reduce infant mortality rates and maternal mortality rates
Syrian Arab Republic
Take measures to improve the quality of health services deteriorated due to lack of medical facilities and medicine
Iran (Islamic Republic of)
Work on the enhancement of the free health care programme and free primary education, obtaining the necessary assistance through international cooperation

SDG 3 and the North Korean Government

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Domestic legislation, including the DPRK Constitution, Public Health Law, and Medical Law, all stipulate that North Koreans have the right to enjoy universal and free healthcare. The DPRK government has always promoted its universal health coverage with frequent articles in the Rodong Sinmun highlighting that “under the popular mass-centered Korean socialist system, the health system is a complete and overall free medical treatment system that guarantees medical service to all regardless of gender, age, occupation and place of residence.” Universal health coverage has been reported in all of the state reports submitted to the UN through CEDAW, CRC, CRPD, and the UPR Mechanism with statements such as “the Socialist Constitution provides that ‘[c]itizens are entitled to medical care. This right is ensured by free medical care, an expanding network of hospitals, sanatoria and other medical institutions, State social insurance and other social security systems.’”

In particular, the DPRK promotes and emphasises the development of preventative medicine and telemedicine in the country. In its state report submitted to the UN Committee on the Rights of the Child, the DPRK stated that the telemedicine service “network is playing a vital role in decreasing child mortality rate.” As a result, the “child mortality rate significantly declined thanks to the public health policy of the DPRK and as a result of the hard work on the part of medical workers.” According to its 2021 VNR report, the DPRK government set the target of reducing the neonatal mortality rate per 1 000 live births to less than 6 and under 5 mortality rate to less than 12 by 2030. The DPRK government also emphasised that “There has been considerable progress in protection of maternal life and health,” stating the increased proportion of births attended by skilled health personnel from 97.3% in 2010 to 99.5% in 2017, and its target to reach 100% by 2030.

The DPRK gave an in-depth report to the CRC in 2017 about its fight against communicable diseases, stating that, “no HIV/AIDS case has been reported so far in the DPRK,” and that, “according to the Tuberculosis Control Strategic Plan, the TB cases and death rate are to be reduced by half of 2008 figures in 2015.” In regards to tuberculosis control, the DPRK stated that, “the number of laboratories for TB diagnosis at all levels increased to 359 and [the] recording and reporting system [was] strengthened. DOTS programme was implemented for TB treatment since 2007, resulting in high success rate of treatment and declined death rate.” 

In both of its State Reports to the CRC and CEDAW, the DPRK highlighted laws that promote mental health, stating, “the Law on the Protection of the Rights of Children provides that local power organs, as well as institutions, enterprises and organizations concerned shall provide sufficient conditions for families to bring up and educate their children to be physically and mentally healthy;” as well as “the Law on the Protection of the Elderly was adopted on April 26, 2007 with a view to ensuring them their rights and interests so that they could live a worthwhile and happy life in physical and mental health.”

With regards to the pledge to prevent and treat substance abuse, the North Korean government enacted the Narcotics Control Law in 2003, which includes several clauses for strict control and strong punitive measures against all who use drugs. North Korea’s Penal Code also includes 16 articles involving such crimes as smuggling and sale of narcotics, which are subject to capital punishment. 

Additionally, the DPRK reported to the CRC that the DPRK’s Traffic Law was in place “to prevent accidents involving children.”

The North Korean government adopted an anti-smoking law at the Supreme People’s Assembly in November 2020. State media reported that, “the Anti-Smoking Act, composed of 31 articles, strengthens legal and social controls on tobacco production and sales and smoking in accordance with the requirements of the national anti-smoking policy to protect people’s lives and health, and to create a more culturally hygienic living environment. In addition, the rules that citizens must follow are regulated in political and ideological education places, public places such as theaters, movie theaters, childcare and education institutions, educational institutions, medical and health facilities, commerce, convenience service facilities, public transport facilities, and other smoking prohibited places and units were established.”

SDG 3 and North Korean Escapees

“There are cases in which deformed infants die, but there are rarely any cases of death among infants without abnormalities. Infants with malformations cannot survive. They are left [without medical care] and they die after a while.”

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database)]

“There is a condition called atonic bleeding in which the woman starts bleeding right after childbirth. Some doctors say that the mothers die in 10% of the cases. There are one or two [such cases] a year.” 

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database)]

“Lectures are performed for health personnel only, saying that AIDS is the Black Death of the 21st century. I don’t know what the actual occurrence [of AIDS] is. I don’t know because no complete medical check-ups were made. Nobody in North Korea has ever said that there is AIDS. (What was the content of the lecture?) They told us that promiscuous capitalists may get AIDS. They told us that you can contract the disease overseas so you have to be careful and that we shouldn’t go to China or anywhere else.”

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database)]

“I don’t know why there are so many cases of tuberculosis. Tuberculosis had disappeared. It had disappeared at the time when anti-tubercular drugs from the United Nations were poured into Hoeryong for three years because it was the hometown of Kim Jong Suk, one of the Three Great Generals of Mount Baektu. I think it was from 2007 to 2010. Before I left North Korea, there were no tuberculosis drugs, so patients had relapses and suffered a lot. Cases of tuberculosis were rarely seen at the time when the medicine was largely distributed. Then in 2011, it suddenly started appearing again. All patients with respiratory diseases had tuberculosis. When examined, they all tested positive for tuberculosis.” 

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database

“Nowadays people use ice (meth) when they have a cold, backache, sinusitis, dental or nasal cavity disease. It has a similar effect to opium, so the number of people using ice increases every day.” 

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database)] 

“The more serious people (with serious addictions) are taken to a hospital, it’s called ‘Seong-dong’. So they would send patients like that to that kind of hospital. We called it a mental hospital. It was also known as Hospital No. 49. The form of treatment they would give isn’t anything special. They just lock people up and give them a drug called Aminazin, which is like a sedative. They would just lock them up. There are people who are treated for 40 days, some for 6 months.” 

[Interview by NKDB in 2017 (NKDB Unified Human Rights Database)]

“[In North Korea] if you get into a car accident, you end up either dead or seriously crippled. Car accidents are not that common, but the roads are one-lane roads and the safety installations are poor. People ride on top of trucks. You are not supposed to drive people [like this]. People here (in South Korea) fasten their seat belts in the car, while those in North Korea take bumpy rides on the roof of trucks.”

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database)]

“There are a lot of people who don’t go to the hospital to receive antenatal examinations. Hospitals are far and those who live hand to mouth find it tiresome to visit hospitals; they didn’t even want to have babies in the first place, but birth control is difficult for those without money. They can’t practice birth control since it’s expensive. They get pregnant when they should not have babies... If these people visit the hospital in the morning, many of them would be in a situation where they don’t have anything to eat the next day because they couldn’t earn money that day.” 

[Interview by NKDB in 2017 (NKDB Unified Human Rights Database)]

“Until 2011, reusing syringes was common. From 2012, patients’ awareness improved and they brought their own syringes. When patients are hospitalized, it is a rule to ask them to bring syringes, two for intravenous injections, another two syringes for intramuscular injections, and a drip line, one drip line with a needle. Lines were reused after disinfection by boiling. During my last months in North Korea I don’t think I (disinfected them by boiling) because people brought their own. There were many [supplies] coming from China and as long as you had money you could buy a lot. Before that, when we tried to find medical instruments but were unable to, we used rubber bands [instead of drip lines]. When I just started (working at the hospital), we used rubber bands. There were only about thirty [in the hospital]. When we had to do intravenous drips we did them on serious patients first, and gave oral liquid medication to the others.”

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database)]

“The water itself came out black as if it was river water. We didn’t boil the water as there was no electricity. Even in winter, we couldn’t light a fire. You could only boil water if you had firewood. We let the dirt sink, or just drank the water as it was.” 

[Interview by NKDB in 2019 (NKDB Unified Human Rights Database)] 

SDG 3 and the International Community

NKDB’s research on the right to health in North Korea has found that the universal free healthcare system in North Korea collapsed during the ‘Arduous March’ in the mid-1990s. During this period, the entire social system collapsed primarily due to food shortages. Despite the collapse, North Korea continues to propagate the superiority of the regime as well as its universal free health care, but this does not correspond to reality. In North Korea, the official supply of medicine is provided from the central medical warehouse to major treatment and prevention centres and provincial medical warehouses. Provincial medical warehouses supply municipal and district medical warehouses with medical supplies. Though it is standard to have a vertical supply of medicine, since the 1990s, however, the frequency and scale of medical supplies officially provided by hospitals and pharmaceutical management centres have gradually decreased. Eventually, it has become difficult to secure medicine and medical supplies, so the small amount of medicine supplied is given mainly to people living in Pyongyang and state officials, or some of the poorest inpatients who are unable to afford any alternative. In other cases, self-sufficient measures were implemented such as patients basically bringing their own medicine or medical supplies. In this process, people started to buy and sell the medicine at the Jangmadang, a private market.

In the 2017 annual report released by the UN Resident Coordinator for the DPRK, humanitarian partners found that “in recent years a number of public health gains have been achieved, including significant reductions in Maternal Mortality Rates.” However, in 2019, UNICEF reported that “maternal mortality (58/100,000 live births) and levels of malnutrition among pregnant women (28 percent) are still unacceptably high.” NKDB’s research on maternal mortality found that “most cases of maternal mortality occurred in the process of childbirth due to excessive bleeding. In North Korea, there is no proper management system for blood storage and transfusions nor electricity required for necessary devices to function.”

According to UNICEF “early childhood mortality rates are fairly low and continue to decrease” in North Korea. Meanwhile, NKDB’s research with former North Korean medical workers who worked in the department of obstetrics and gynecology found that “deformed infants were left alone without proper care until death upon parental consent. Although the North Korean authorities claim to have a comprehensive healthcare system that provides a full range of services for women, from pregnancy to delivery, birth defects are hardly detected before birth in North Korea due to lack of medical equipment such as ultrasound devices.

In regards to HIV, NKDB has found that opinions diverged amongst the health personnel interviewees on AIDS patients. Some state that AIDS is regarded as a disease of capitalism in which promiscuous sexual relations prevail, and it is strongly believed that such a vice does not exist in North Korea because the general public has not witnessed AIDS.

NKDB’s research on the problem of narcotic drugs in North Korea has shown that the Narcotic Control Law is only applied to lay down the law and control the socially weak, while those with power and wealth are able to easily evade punishment. The North Korean authorities seem to regard the use of drugs as an anti-socialist phenomenon that requires consistent crackdown and punishment. Any attempt to address the issue by means of comprehensive diagnosis and treatment is thus far absent.

In regards to North Korea’s progress toward target 3.7 to ensure universal access to sexual and reproductive health-care services, NKDB has found that there is a marginalization of low-income, vulnerable groups extended to the case of women especially in the rural areas in their access to sexual and reproductive health services.

According to the UN Country Team, more than half of the country’s population do not have access to a functional water supply. As a result, improving access to basic services including health, water, sanitation, and hygiene has remained one of the top three priorities for international aid organisations comprising the UN Country Team working in North Korea during the period under review. Due to the low quality and quantity of water, inappropriate use of pit latrines, use of fresh excreta as fertilizer and general poor hygiene practices, there are high risks to the health of the North Koreans. Diarrhoea and pneumonia are the two main causes of death amongst under-five children in North Korea, as it is mainly caused by the lack of safe potable water, poor sanitation and hygiene practices.

Tobacco use is one ofthe most preventable causes of death globally and in the Democratic People’s Republic of Korea. While there is no official data for tobacco use in the DPRK, NKDB’s research with 503 North Korean defectors showed that the rate of tobacco use among family members, who are over 15 years old, was 31.6%. Although the gender of smokers has not been taken into consideration in NKDB’s survey, if assumed that the male to female ratio in the household is 50- 50, it is possible to estimate that the prevalence rate of smoking among North Korean men is 63%. This is very much a result of the fact that North Korea is still a very patriarchal society, in which women rarely smoke.

Due to economic problems, the DPRK faces a critical shortage of pharmaceutical and medical supplies, and the overall quality of medical personnel has declined due to a lack of proper education. However, NKDB’s research has found that one of the most successful efforts from the DPRK government in regards to SDG Goal 3 has been attempts to re-establish a system of vaccination for new-borns and against infectious disease.

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