The Director-General of the World Health Organization, Margaret Chan, says the North Korean government has made some notable achievements in public health, but still faces numerous challenges. The WHO chief has just returned from a three-day visit to North Korea where she had wide-ranging discussions with key officials and visited several health facilities.
Dr. Chan says North Korea has some advantages over other developing countries. She says there is no shortage of doctors and nurses in North Korea. She says the country does not suffer from a so-called brain drain because health professionals do not emigrate.
She notes North Korea has a very elaborate health infrastructure and has developed a network of primary health care physicians. Each one of these household doctors is responsible for the well being of 130 families.
Dr. Chan says the government has done a good job in areas such as immunization coverage, effective implementation of maternal, newborn and child health interventions, in providing effective tuberculosis treatment and in successfully reducing malaria cases.
"Despite these successes, there are challenges," she said. "The health system requires further strengthening in order to sustain the government policy of universal coverage and, of course, to improve the quality of services. More investments are required to upgrade infrastructure and equipment and to ensure adequate supplies of medicines and other commodities, and to address the correct skill mix of the health workforce."
Dr. Chan says greater emphasis is needed on nutrition and lifestyle-related disease like cancers, heart diseases and stroke, along with more efforts in tobacco control.
She says the government must pay particular attention to the nutritional status of infants and pregnant women. She says low weight among newborns is a problem as is anemia among pregnant women.
The WHO chief welcomes, what she calls, North Korea's increased flexibility in engaging with international partners.
She says the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI, the Global Alliance for Vaccines and Immunization have agreed to support health programs because of the government's willingness to accept their conditions.
"I can confirm, at least in the area of health, the government is receptive to engagement with international partners and they are receptive to the request for increasing transparency, have a better quality data and being held accountable for the resources flowing in to the country to improve health," Chan said. "So, I think this is, to me, very good signs and signal."
But, Chan says the international community also has a responsibility to try to engage the government to be a global actor if it wishes to engage North Korea to improve the health of its people.