Archive for the ‘Disease prevention’ Category

Tuberculosis in North Korea

Wednesday, April 11th, 2018

Benjamin Katzeff Silberstein

Some interesting (and disturbing) numbers and facts in this article by Bloomberg. One wonders just how many TB treatments one of Kim Jong-un’s yachts could pay for…

While the rogue state’s nuclear ambitions have long inspired angst—and led to economic sanctions—the threat of TB, the planet’s biggest infectious killer, has garnered less attention. With more than 100,000 cases in 2016, North Korea is on the World Health Organization’s list of nations with the greatest incidence of the deadly lung disease, and doctors warn that an explosion in multidrug-resistant strains could be coming.

In February, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the biggest financial contributor to TB control in the Democratic People’s Republic of Korea since 2010, announced that it will close its programs there in June, citing challenges working in the country. The closure of programs is likely to lead to “massive stock outs of quality-assured TB drugs nationwide,” wrote Harvard Medical School doctors in an open letter to the Global Fund, published on March 14 in the British medical journal the Lancet. Such privation in the past has “led to the rapid creation of drug-resistant TB strains, as doctors ration pills and patients take incomplete regimens,” they wrote.

Infections that can’t be cured with standard drugs are already rife in the country. No nationally representative survey has been conducted to measure the incidence among North Korea’s 25 million people, but according to WHO estimates, 5,700 of the country’s 130,000 TB infections in 2016 were caused by bacteria resistant to the antibiotic rifampicin or at least two other key TB medications.

That may be a gross underestimate, according to a study published last year in the Journal of Korean Medical Science that analyzed hundreds of patient sputum samples. More than three-quarters of those that tested positive for TB contained multidrug-resistant strains, and two samples contained extremely drug-resistant strains—a form almost impossible to treat in resource-poor countries such as North Korea. Treatment for patients with multidrug-resistant TB, or MDR-TB, commonly lasts two years or longer and typically involves six months of daily injections and a regimen of about 14,000 pills, including some that are toxic.

Treatment regimens that are too short or rely on inferior or inappropriate medicines are the fastest route to drug resistance, says Jennifer Furin, a Harvard-trained doctor and researcher, who’s cared for TB patients for 23 years. Cutting funding to programs in North Korea, she says, will undermine disease-control efforts beyond North Korea.

“This will be a disaster that the global health community will pay for later,” Furin says. “This is a politically created problem that will turn into a health catastrophe, not just for the people living in the DPRK, but for everybody in the region.”

Chinese authorities are on alert for cases among migrant workers from North Korea. Still, many people who’ve been exposed to TB develop a latent infection with no symptoms, making it difficult to stop at borders.

Dandong, a city in China’s northeastern Liaoning province and separated from North Korea by a river, is a main entry point for migrant workers. Quarantine officials identified 33 TB cases among 9,500 North Koreans screened from 2012 to 2014, according to a government report published in 2014 that recommended heightened surveillance in the Dandong area. Local authorities pledged in December to beef up border screening and epidemic management.

Just as HIV has helped spread TB in sub-Saharan Africa, chronic malnutrition is fueling the epidemic in North Korea, according to Kwonjune Seung, who was among the authors of the open letter to the Global Fund published in the Lancet. Seung visits a dozen TB centers in North Korea twice a year as medical director of the Eugene Bell Foundation, a Christian charity focusing on treating North Korean patients. A spillover of MDR-TB from North Korea “would take decades to clean up and could detrimentally affect the public health of bordering countries like China and South Korea,” Seung and his colleagues wrote in their letter.

More than 38 countries contribute to the Global Fund, including South Korea and the U.S.; in late March, Congress approved $1.35 billion in funding for the 2018 financial year. The Global Fund defended its decision to suspend its programs in North Korea, saying in an email that it was fully aware of the risks that might arise from disorderly closure of its grants and that it’s working with Unicef to accommodate mitigating actions. The decision to withdraw from the country wasn’t taken in response to pressure but rather influenced by concerns about the “unique operating environment” in North Korea, it said. The closed environment prevents donors from properly assuring effective use of grants and resources and managing risks. As of last August, the Global Fund’s internal performance reviewers gave the North Korea program a B1, or “adequate,” rating.

In an open letter to the Geneva-based organization published on March 13 by the Korean Central News Agency, North Korea’s official news agency, Kim Hyong Hun, the country’s vice minister of public health, accused the Global Fund of bowing to the “pressure of some hostile forces.” President Trump has been trying to enlist other nations in a campaign of sanctions against North Korea.

“The decision to suspend the Global Fund projects in North Korea, with almost no transparency or publicity, runs counter to the ethical aspiration of the global health community, which is to prevent death and suffering due to disease, irrespective of the government under which people live,” Seung and his colleagues wrote in the Lancet.

Furin sees it as another dimension of the tensions between Trump and North Korean leader Kim Jong Un, whom the U.S. president nicknamed “Little Rocket Man” after the nation tested its missile capabilities in September. The two nations are slated to meet in an historic summit as early as May. “You can’t help but think global powers are very concerned about North Korea’s erratic behavior, and this is a way to punish the country,” she says. “But this is a weapon of destruction in and of itself. TB is an airborne disease. It doesn’t stay within borders.”

Article source:
North Korea’s Other ‘Weapon’ Is Poised to Explode
Fiona Li, Peter Martin and Dandan Li
Bloomberg News
2018-04-11

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Eugene Bell expands TB work in DPRK

Tuesday, November 11th, 2014

According to Yonhap:

A U.S. charity group said Tuesday it has agreed with North Korea to expand its medical aid program in the impoverished nation.

Under the deal, the Washington-based Eugene Bell Foundation will construct three new wards at tuberculosis (TB) treatment centers in Pyongyang.

It is the fruit of a three-week trip to the communist nation by a group of 13 officials from the foundation.

“The number of patients at those treatment centers has grown as the activity of our foundation is increasingly known,” a foundation official said. “Every treatment center suffers a severe lack of wards.”

The foundation has long provided medical humanitarian assistance to North Korea, especially for multidrug-resistant tuberculosis.

In a new program, it is sending 770 million won (US$750,000) worth of TB medication to the North.

Read the full story here:
U.S. charity group to expand medical aid program in N. Korea
Yonhap
2014-11-11

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German Government offers TB assistance to DPRK

Tuesday, August 26th, 2014

According to Yonhap:

The German government has provided North Korea with US$600,000 in medical aid via [Caritas International], a U.S. media reported Tuesday.

The Roman Catholic group Caritas International, which was launched in Germany in 1897, has been campaigning to help the needy in the impoverished communist nation, especially those infected with tuberculosis (TB) and hepatitis.

“The German government is providing 450,000 euros [$600,000] to be used for the TB patients in the DPRK,” Reinhard A. Wurkner, a Caritas official in charge of Asia, was quoted as telling the Voice of America. DPRK is the acronym for the Democratic People’s Republic of Korea, North Korea’s official name.

Caritas began its North Korea project in 1996. It has since offered medical and nutritional assistance to TB and hepatitis patients in the country.

Read the full story here:
German gov’t offers US$600,000 in N. Korea aid
Yonhap
2014-8-26

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Eugene Bell offers TB assistance to the DPRK

Monday, July 28th, 2014

According to Yonhap:

The Eugene Bell Foundation, which provides medical assistance to the impoverished North, will send 770 million won (US$750,000) worth of TB medication to the communist country, ministry officials said.

In February, the foundation shipped 720 million won worth of TB drugs to the North in an attempt to tackle the growing issue of multidrug-resistant TB in the country.

So far this year, the South has approved 11 shipments of civilian aid worth a combined 2.82 billion won to North Korea.

The latest approval comes after Seoul announced on July 15 that it will provide Pyongyang with humanitarian aid worth 3 billion won through civilian organizations.

It marks Seoul’s first state-funded aid to North Korea since the North torpedoed the South Korean warship Cheonan in the Yellow Sea in 2010, killing 46 sailors. Following the incident, Seoul imposed a blanket ban on cross-border economic and other exchanges.

Read the full story here:
Gov’t OKs civilian medical aid to N. Korea
Yonhap
2014-7-28

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Wellspring assistance in drilling water wells

Friday, March 14th, 2014

According to Wellspring’s website:

Wellspring has had the privilege to partner with several Non-Government Organizations (NGO’s) in our work in North Korea. Partnering with other groups allows Wellspring to work efficiently and effectively by focusing on our specialty – drilling water wells in North Korea. We have provided wells for our partners in several areas of the country and desire to work with new partners who are currently working in North Korea.

According to Yonhap:

Private agencies in the United States have provided North Korea with aid to help its people have access to clean water and medicine, media reports said Friday.

According to the Washington-based Radio Free Asia (RFA), Wellspring, a non-governmental organization in the U.S., sent a large truck to the North earlier this week to support its groundwater development project.

The aid was provided at the request of the North’s underground water development research institute, and the lorry was purchased in China, according to the RFA.

Under the vision of “Bringing living water to the people of North Korea,” James Linton, who leads the organization, has visited the communist country every year since 2007 to provide training, equipment, and expertise in the field and has drilled some 200 wells across the country.

The Connecticut-based private agency AmeriCares also recently sent medicine, medical devices and food for children worth $370,000, according to the Voice of America.

They are expected to arrive in the North next month to be delivered to hospitals and local clinics in Pyongyang and North Hwanghae, it added.

North Korea has regularly suffered from acute food and medical shortages caused mainly by isolation and natural disasters.

Read the full story here:
U.S. NGOs offer humanitarian aid to N. Korea
Yonhap
2014-3-14

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UN WFP report claims DPRK citizens undernourished

Tuesday, May 7th, 2013

According to Yonhap:

Eight out of every 10 North Korean families are suffering malnutrition with little access to protein foods, a U.S. media report said Tuesday.

In its survey of 87 North Korean families from January to March, the World Food Program (WFP) found that 80 percent of them were undernourished mainly due to a lack of protein intake, the Washington-based Voice of America (VOA) said.

About 38 percent of those surveyed were not able to eat high-protein foods during the one week before the survey, such as meat, fish, eggs or beans, said the report, monitored in Seoul.

Quoting the WFP report, the VOA said the North Korean families, on average, eat meat 1.3 days a week or beans 1.2 days per week.

The report also said about 14 percent of the 86 hospitalized North Korean children under age 5 whom its aid workers visited during the January-March period were in serious malnutrition conditions.

Meanwhile, AmeriCares, a U.S. non-profit aid group, is about to send 10.5 tons of drugs in humanitarian assistance to the North this week, another U.S. media report said.

The aid package, which includes antibiotics, stomach medicines and dermatology drugs, will be shipped later this week to six hospitals in Pyongyang and other areas, the Washington-based Radio Free Asia reported. The shipment will also include personal hygiene items like toothbrushes and soaps, it said.

The RFA said the latest aid has no political consideration and is solely for humanitarian purposes.

AmeriCares began its aid to the North in 1997 as the first American private group to do so. Last year, it sent US$7 million worth of medicine for flood victims in the impoverished country.

Read the full story here:
Eight out of 10 N. Korean families undernourished: report
Yonhap
2013-5-7

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Eugene Bell sends medical aid to DPRK

Friday, April 19th, 2013

According to the Hankyoreh:

While North Korea prohibited members of the Corporate Association of Kaesong Industrial Complex (CAKIC) from entering the North, it granted access to representatives of the Eugene Bell Foundation. The foundation has been providing humanitarian and medical aid to North Korea for some time.

On Apr. 18, the Eugene Bell Foundation announced that a group of nine people who had been staying in Beijing waiting for their North Korean visas, including Chairman Stephen Linton and a group of donors to the foundation, finally received their visas that afternoon and boarded a plane bound for Pyongyang.

“Even this morning, it was unclear whether they would be allowed to enter the country, but fortunately the visas were issued in the afternoon,” a representative of the foundation said.

This is being seen as showing that North Korea is linking the Kaesong Industrial Complex issue with the current political situation on the Korean peninsula, but that it is willing to receive humanitarian support. Particularly noteworthy is the fact that the group visiting North Korea includes eight Americans and one French person, but no South Korean nationals.

The Eugene Bell Foundation, which operates tuberculosis clinics in eight areas in North Korea, including Pyongyang and Nampo, has sent representatives to North Korea twice each year in order to assess whether the tuberculosis medicine that it provides is being used properly. These visits continued to take place during the Lee Myung-bak administration (2008-Feb. 2013).

On Mar. 22, the foundation sent North Korea 678 million won (USD$604,267) worth of tuberculosis medicine in keeping with the principles of Park Geun-hye’s trust-building process for the Korean peninsula, which does not link humanitarian aid with the North Korean nuclear weapons issue. This medication left Pyeongtaek harbor and arrived at Nampo harbor on Apr. 4 by way of Dalian, China.

Meanwhile, the owners of the businesses at the Kaesong complex that were prohibited from entering the North on Apr. 17 have decided to try once again to visit the North on Apr. 20 via the CIQ (customs, immigration, and quarantine) office in Paju, Gyeonggi Province.

The Ministry of Unification announced on Apr. 18 that eight more employees who had been staying in Kaesong had returned to South Korea through the CIQ office. This brought the number of South Korean employees still remaining in the complex two weeks after North Korea blocked traffic from entering to 197, less than one fourth of the original total.

Read the full story here:

N. Korea allows entrance to foreign aid group
Hankyoreh
Gil Yun-hyung
2013-4-19

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RoK approves private aid to DPRK

Friday, March 22nd, 2013

According to Yonhap:

Under the approval, Eugene Bell, a South Korean charity group, will ship tuberculosis medicine worth 678 million won (US$606,500 to eight tuberculosis clinics run by the South Korean group in North Korea. The shipment is expected to be delivered in April, the official said.

This marks the first aid package approved by the ministry since Park took office on Feb. 25. The last aid request was granted in November last year under President Lee Myung-bak.

“The approval is strictly for humanitarian purposes and should not be read as a message to condone North Korea’s recent provocations,” Kim said.

“The planned medicine aid can help cure about 500 multidrug-resistant tuberculosis patients in the North whose lives would be at serious risk without the medicine,” the spokesman said. It is difficult for North Korea to produce quality medicine to cure the difficult type of tuberculosis, he added.

President Park has repeatedly said despite relations with the North, she will continue to allow humanitarian aid to less-privileged North Koreans as part of her signature North Korean policy to build trust with the country. She, however, pledged to sternly respond to any provocations by the North.

“The spread of multidrug-resistant tuberculosis is so serious that North Korea is judged to have missed the crucial ‘golden time’ to root out the tuberculosis,” Stephen Linton, the chairman of Eugene Bell, said in a news conference in November following a two-week visit to the country.

The charity foundation has been running a medical service program for tuberculosis patients in the North since 2000 and sends drugs on a regular basis to the impoverished country.

Read the full story here:
Seoul approves first private-level aid provision to N. Korea under new administration
Yonhap
2013-3-22

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North Korean products in department stores on the rise

Friday, February 22nd, 2013

Institute for Far Eastern Studies (IFES)
2013-2-22

The number of North Korean made products is increasingly on the rise at North Korean department stores. Reportedly, 70 percent of the merchandise on the shelves in North Korea’s largest department store, Pyongyang Department Store No. 1, is North Korean made.

Japan-based pro-North Korean newspaper Choson Sinbo reported on February 13 that the bestselling item is apple juice made from the Taedong River Combined Fruit Farm, sold from the kiosk located on the first floor of Pyongyang Department Store No. 1. Sonhung Food Factory products, especially bread and confectionaries, are also said to be very popular.

The newspaper commented that the regularly held product exhibition shows at the department store have created competitive environment for local factories and companies and contributed to the production of high-quality products. They also emphasized that exhibition of products began on account of recommendations of the former North Korean leader, Kim Jong Il.

It further added, “The product exhibition invites participation from light industry factories and enterprises and its affiliated units from central and regional areas as well as department stores in Pyongyang and general stores that sell industrial products.” It commended the expos to be well received by the local people for filling the shelves with local products.

The first exhibition began in December 2010, and the second and third exhibitions were held in July 2011 and January 2012, respectively. Selling of Taedong River Combined Fruit Farm products began from the third exhibition.

In an interview with Choson Sinbo, Kim Miyoung, commerce director of Pyongyang Department Store No. 1, said the following: “Employees of the department stores and our patrons never imagined a day like this would come where our department store shelves are filled with North Korea made products, especially when we were going through the difficult economic times.”

The news also reported the opening of North Korea’s first 24-hour pharmacy. Pyongsu Pharmaceutical, a joint venture company between North Korea and Switzerland, has claimed to have opened North Korea’s first 24-hour pharmacy, called Taedongmun Pharmacy, in Pyongyang last August. Pyongsu pharmaceutical joint venture company was established from September 2004 between InterPacific Group of Switzerland and Pyongyang Pharmaceutical Factory under the Ministry of Health of the DPRK. They both produce and sell pharmaceutical products in Pyongyang. Its homepage introduces nine operating pharmacies in Pyongyang. (See Pyongsu’s website for details: www.pyongsu.com.)

The first pharmacy by Pyongsu was built near the Pyongyang’s Arch of Triumph in 2006 and expanded the number of pharmacy to nine, including the Taedongmun Pharmacy. In addition, Kangan Pharmacy was highlighted in its website, boasting that all the pharmacists working at this pharmacy are graduates of Kim Il Sung University. It also boasts that it is the first pharmacy to have been equipped with blood testing equipment.

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Lee Myung-bak administration sets the lowest record for assistance to North Korea

Thursday, January 31st, 2013

Institute for Far Eastern studies (IFES)
2013-1-31

The total amount of assistance provided to North Korea by the South Korean government and private organizations in 2012 decreased by 28 percent against 2011, which marks six years of continuous decline.

The Ministry of Unification revealed on January 27 that the total amount of South Korean assistance to North Korea tallied 14.1 billion KRW (13 million USD), with 2.3 billion KRW (2.12 million USD) of government aid for vaccines and medical trainings and 11.8 billion KRW (10.89 million USD) from the private sector for medical supplies. This is a 28.1 percent drop from the previous year’s total of 1.96 billion KRW (18.09 million USD).

The South Korean government sent about 6.5 billion KRW (6 million USD) of medical supplies to North Korea via UNICEF and the private sector sent about 13.1 billion KRW (12.1 million USD) of malaria prevention supplies, powdered milk, soy milk, and flour.

Last year was the lowest record for humanitarian assistance to North Korea in sixteen years. Prior to this low was 1996, which recorded 3.6 billion KRW (3.3 million USD).

Lee Myung-bak administration’s aid to North Korea for the last five years reached a total of 257.5 billion KRW (236.2 million USD), with 102.4 billion KRW (93.94 million USD) in government funds and 155.1 billion KRW (142.3 million USD) from the private sector. This is equal to only 20 percent of the Roh Moo-hyun administration’s 1.275 trillion KRW (1.17 billion USD), and 44 percent of the Kim Dae-jung administration’s 582.9 billion KRW (534.8 million USD) of total aid to North Korea.

The highest record for South Korean humanitarian aid to North Korea was in 2006 at 298 billion KRW (273.4 million USD), in both government and private sector aid and continued to remain at a high level in 2007 with 289 billion KRW (265.1 million USD) in 2007. However, with the launch of the Lee Myung-bak government in 2008, it dropped to 116 billion KRW (106 million USD), and continued the downward slide recording 67.1 billion KRW (61.6 million USD) in 2009; 40.4 billion KRW (37.06 million USD) in 2010; 19.1 billion KRW in 2011 (17.5 million USD); and 14.1 billion KRW (12.9 million USD) in 2012.

The source of the drop in humanitarian assistance can be attributed to deadlocked inter-Korean relations followed by the shooting death of a Mount Kumgang tourist in 2008; long-range rocket launch and second nuclear test in 2009; and Cheonan and Yeonpyeong Island incidents in 2010.

From 1995 to 2012, the total amount of humanitarian aid to North Korea from the South Korean government was 1.48 trillion KRW (1.36 billion USD) and from the private sector was 871 billion KRW (799.1 million USD), equating to about 2.347 trillion KRW (2.15 billion USD) in total.

Meanwhile, international humanitarian aid to North Korea increased 30 percent in 2012 against the previous year. According to the United Nation’s Office for the Coordination of Humanitarian Affairs (OCHA), total aid to North Korea in 2012 was 113 million USD while the previous year reached 89.2 million USD. It quadrupled to the total amount, 24.4 million USD of 2010.

Nineteen countries joined in the effort to provide humanitarian aid to North Korea such as South Korea, Norway, Switzerland, Canada, Russia, Brazil, and Sweden. In 2010, there were only six countries, and it later increased to seventeen countries in 2011. The OCHA announced that the humanitarian aid provided in 2012 focused mainly on improving the food supply and nutrition, and provided agricultural support.

UPDATE: Here is a similar report in Yonhap (2013-1-27):

South Korea’s humanitarian aid to North Korea dropped 28 percent to a record 16-year low last year, the unification ministry said Sunday, as the cross-border relations remained chilled under Seoul’s outgoing government of President Lee Myung-bak.

Seoul’s humanitarian aid to the impoverished North totaled 14.1 billion won (US$13.1 million), compared with 19.6 billion won a year earlier. Last year’s amount is the lowest since 1996 when only 3.6 billion won was provided to the North in humanitarian aid.

The sharp drop came as relations between the two Koreas remained frozen since the North sank a South Korean warship near their Yellow Sea border in March 2010 and then shelled a border island in November that year. Pyongyang’s nuclear test and rocket launches also affected their ties.

The total amount of assistance the South provided the North during the five years of President Lee was 257.5 billion won, including 155.1 billion won of civilian aid. The total amount is only 20 percent of the aid sent during the presidency of Lee’s predecessor, the former late President Roh Moo-hyun.

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An affiliate of 38 North