Summary Points

The health system in the Democratic People’s Republic of Korea (DPRK) is suitable for high public health program coverage, with a wide facility network and high staff-population ratios.
Economic difficulties, natural disasters, and poor resourcing of the health sector in the 1990s had catastrophic impacts on public health and system functioning, leading to sharp declines in vaccination coverage.
With considerable international support, diphtheria, tetanus, and pertussis (DTP) vaccine coverage has risen from 37% in 1997 to 96% in 2013. Major challenges related to immunization services and the health sector more generally have been reduced.
This recovery demonstrates the potential for international partners to support DPRK’s national health agencies and improve public health programming, notwithstanding tensions in international relations and challenging domestic conditions.
Sustained collaboration is required to improve population health and health services in DPRK. This has regional and global public health implications and may influence ongoing political tensions.