Famine, drug shortage lead to TB problem in North Korea

Famine and a shortage of tuberculosis drugs are two factors that contribute to an increase in TB incidents North Korea, according to a recent visit from a Science editor.

Richard Stone, the journal's international news editor, traveled to urban and rural parts of North Korea in March to investigate efforts being made in the battle against TB. According to a 2012 World Health Organization report, the incidence of TB in North Korea was 380 cases per 100,000 people in 2011, up from 50 cases per 100,000 people in 1994.

"This was my fifth trip to DPRK, and my first opportunity to experience the bleakness of life in the countryside," Stone said. "The TB epidemic only adds to the hardship of villagers who depend on government food rations for survival."

A four-year famine that began in 1994 left the malnourished survivors highly susceptible to TB. A shortage of TB drugs at the time and a lack of patient compliance increased the incident of multi-drug-resistant TB, which is difficult to treat even at top-tier health programs.

Stone visited the country with members of the Christian Friends of Korea, a humanitarian organization. The visitors examined the National Tuberculosis Reference Laboratory, the only facility in the country capable of detecting MDR-TB strains.

The visit came during a delicate time, when the U.S. and South Korea were conducting annual military exercises.

"Our visit took place during heightened tensions with the West. It didn't escape our attention that the seven of us were the largest group of Americans there at the time," Stone said. "Our hosts with the Ministry of Public Health seemed genuinely concerned about our welfare. I came away with the feeling that the scientists we encountered have good hearts and a real desire to help their countrymen."

While progress has been made with the NTRL in the fight against TB, the visitors said much needs to be done to enable the facility to fight the growing MDR-TB problem.