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.

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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.”

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

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

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

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

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

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

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

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

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

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

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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