Update on WHO in DPR Korea November 2003 Facts about DPR Korea

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					                              Update on WHO in DPR Korea
                                    November 2003



                                                                   Facts about DPR Korea
                                                               ► Population:         22,2 millions
                                                               (2002 est.)
                                                               ► Area:        120,540 sq km
                                                               ► Arable land:        14.1%
                                                               ► Literacy rate:      99%
                                                               ►GDP per capita: US$ 480 (est.)




BACKGROUND

 WHO as been present in DPRK since                         in the health care system and thus
1997, initially as a WHO Emergency                         contribute to the improvement of the
and Humanitarian Action office. With                       health status of the population .
the establishment of a permanent
office in Pyongyang in 2001, WHO has                       Comparing the current humanitarian
consolidated its presence in the                           situation to that of the period between
country and is involved in all aspects                     1995-1999, there has been a verifiable
of health through its regular program                      improvement       with    reduction    in
and through projects funded under the                      malnutrition rates and a better outlook
United        Nation’s   Consolidated                      for the food security. In health, access
Interagency Appeal and other funding                       to basic health care for a large part of
mechanisms.                                                the population is still unsatisfactory
                                                           with critical shortages of essential
The Organization has made extensive                        medicines, inadequate resources to
assessments of the health situation                        handle complications related to child
and the health care system in the                          birth, severe infections and surgical
country. After years of isolation, and                     emergencies.       However        marked
following     the   major    economic                      progress in programs such as
difficulties, present policies and                         immunizations , tuberculosis and
practices, the infrastructure and the                      malaria has been noted.
services in the health sector in DPRK
are outdated and in urgent need of                         WHO REPORTS SIGNIFICANT REDUCTION
rehabilitation.                                            OF MALARIA CASES


The SARS outbreak in the region                            Changes in agricultural practices to
highlighted the vulnerability of the                       adapt to a difficult economic situation
health services in DPR Korea. The                          and dramatic energy problems (less
current shortcomings of the health                         pesticides available, different irrigation
delivery system will inevitably lead to                    system in the rice fields) are believed
increased morbidity and mortality. The                     to have contributed to the re-
present health situation and the critical                  emergence, in 1998, of the Vivax
stage of all health services do require                    malaria, eradicated in the 70s. The
more funding that could help us                            number of cases reached epidemic
alleviate some of the most critical gaps

  For further information, contact WHO Representative Dr. Eigil Sorensen, e-mail: sorensene@whosea.org WHO,
                  Munsudong, Pyongyang, DPR Korea. Phone: 850-23817914, Fax: 850-23817916
                              Update on WHO in DPR Korea
                                    November 2003


proportion in 2001            with     300,000             DOTS COVERING THE WHOLE COUNTRY!
reported cases.
                                                           With the increase in recent years in
Under the leadership of WHO and                            cases of tuberculosis , a phased
thanks to the generous contribution of                     approach to DOTS expansion was
South Korea, Sweden and Norway -                           introduced and it is expected that
around 2.5 million USD - international                     DOTS should cover the whole country
organizations were able to provide                         by the end of 2003. Despite the
substantial technical and material                         weaknesses in the DOTs program, the
support to the malaria control                             introduction and expansion of DOTS in
campaign since 2000. As of 15                              DPRK must be seen as one of the
September, there were 38,920 cases                         success stories of the international
reported as opposed to 185,420 cases                       engagement in the country. WHO has
at the same period last year. The vast                     provided technical assistance to the
improvement of the malaria situation                       national     TB    control    program.
can be attributed to the malaria control                   Substantial funding provided by WHO
efforts carried out in the past two-three                  through emergency and humanitarian
years.                                                     funding/multi-     country     funding
                                                           mechanisms with main donors being
                                                           Norway,     Sweden,      Canada and
Besides the supply of anti-malarial                        Australia, has facilitated the phased
drugs,     impregnated      bed    nets,                   rapid expansion.
microscopes and other laboratory, a
key factor of WHO’s support has been                       FIRST NATIONAL WORKSHOP ON
the technical assistance it has                            HIV/AIDS PREVENTION STRATEGIES
provided to the malaria control
program. WHO invites regularly WHO                         HAIV/AIDS is currently not a major
short-term consultants and experts to                      problem in the country. However
carry out trainings, capacity building                     several risk factors are now present.
and assessments. In spite of the                           The poor awareness of HIV/AIDS
SARS travel restrictions from April to                     prevention among the population ,
July this year, WHO was able to bring                      increasing travel in and out of the
in two international malaria experts to                    country, rapidly increasing HIV
assist the Ministry of Public Health this                  infections rates in neighbouring
year. The use of international WHO                         countries and unsafe blood and
experts has contributed to better                          injection practices are just some of the
understanding and documentation of                         risk factors. HIV/AIDS information and
the malaria problem in DPRK,                               blood safety programmes must now be
including knowledge of the vector and                      strengthened if a future explosion of
the reporting system. Further training                     HIV transmission, similar to that
aimed at laboratory technicians,                           experienced by other countries in the
entomologists and other key health                         region is to be avoided.
workers will be implemented in 2004 to
help building sustainable national                         As a first step towards the prevention
capacity in malaria control.                               of HIV/AIDS, the Ministry of Public
                                                           Health      organized the first national
                                                           HIV/AIDS workshop on 23rd and 24th
                                                           October 2003.. The WHO office in
                                                           Pyongyang supported this initiative

  For further information, contact WHO Representative Dr. Eigil Sorensen, e-mail: sorensene@whosea.org WHO,
                  Munsudong, Pyongyang, DPR Korea. Phone: 850-23817914, Fax: 850-23817916
                                Update on WHO in DPR Korea
                                      November 2003


financially and technically. The                             •    The current political climate is a
workshop, attended by some 50                                     limitation for attracting funds, in
people, had good representation from                              particular       for    development
various sectors. Participants came                                activities. DPR Korea does not
from the Ministry of Public Health at                             have access to international
central and provincial level, Ministry of                         financial institutions such as World
Education,      other      Government                             Bank and Asian Development
ministries, Medical Universities, the                             Bank.
Korean Red-Cross, the Korean Family
Planning     Association,      Women’s
League and residential international
organizations (, WHO, UNICEF,
UNFPA, UNDP and IFRC). The UN
Country Theme Group on HIV AIDS,
chaired by WHO, assisted in the
planning and preparation of the
national workshop.

The workshop focused on the global
HIV/AIDS situation, the epidemiology
of HIV/AIDS, the prevention strategies
in Asia, an analysis of the situation in
China, its control strategy and the
prevention and control plan in D.P.R.
Korea. It resulted in a better
awareness of all participants on the
HIV/AIDS. WHO is planning to provide
technical support in 2004 for
development of a national HIV work
plan based on the strategy document
being prepared by the Government.                                      This paper has been prepared by
                                                                       the WHO Country Office. The
CHALLENGES AND CONSTRAINTS                                             objective is to provide updated
                                                                       information and analysis on the
•     Higher priority to health and more                               health and humanitarian situation
      resources from the government                                    in DPR Korea for use within
      and donors are needed to improve                                 WHO, for development partners
      access to basic health services.                                 and donor agencies.
•     A recovery and revival of the
      health sector is closely linked to
      the ability in finding an acceptable
      solution to the country’s economic
      difficulties.
•     The limited access to and
      interaction        with      national
      counterparts are constraints for
      building capacity and technical
      skills.


    For further information, contact WHO Representative Dr. Eigil Sorensen, e-mail: sorensene@whosea.org WHO,
                    Munsudong, Pyongyang, DPR Korea. Phone: 850-23817914, Fax: 850-23817916