The teachings of juche, or self-reliance, has guided North Korea’s ruling Kim Dynasty for over seven decades as it kept people isolated from the outside world.
But Kim Jong-un must decide whether to accept offers of international assistance to overcome the unprecedented health threat from the coronavirus. The choice of the 37-year-old dictator will affect the international community’s struggle to end the global pandemic, with fears that Kim’s security concerns could hinder efforts to overcome the 25 million people under his rule.
“The nuclear and missile developments of recent years have shown how willing they are to sacrifice the well-being and prosperity of their own people for their own safety,” said Peter Ward, a Seoul-based North Korea expert at the University. from Vienna.
North Korea has expressed interest in participating in the Covax program, which strives for fair access to vaccines around the world, according to people familiar with the issue.
International medical experts who have worked in North Korea see this as a positive sign that Pyongyang could be willing to accept help from Gavi, the UN-backed vaccine alliance that has nearly 20 years of experience working in the country. The organization leads the Covax initiative along with the World Health Organization and the Coalition for Epidemic Preparedness Innovations.
A critical question depends on the level of foreign aid needed to facilitate a vaccination program.
International personnel should enter North Korea to conduct initial assessments and support the logistical challenges posed by the distribution of the vaccine in one of the poorest and least developed countries in the world. They should also train local staff and then, according to Gavi rules, follow the vaccination program.
North Korea introduced a sweeping blocking of cross-border and internal traffic in January. While it has not publicly confirmed cases of coronavirus, the measures have also resulted in most foreigners previously residing in the country – including diplomats and aid workers – leaving.
Ramon Pacheco Pardo, a North Korean expert at King’s College London, said that “ monitoring could be a problem ” given the low number of foreigners in the country, despite Pyongyang’s long-standing working relationship with WHO, Gavi and other NGOs.
“If North Korea is not willing to allow WHO or Gavi to monitor the distribution of the vaccine, it would likely be back in line as all countries around the world want to receive the vaccine as well,” he said .
Kee Park, a teacher at Harvard Medical School who has worked in North Korea, was convinced Pyongyang could institute a conservative quarantine period with additional testing. This would mean that international aid workers could enter the country “in a way that does not pose a significant risk to the population”.
“I think they can find a path to partially reopen so that the vaccination project can at least continue,” he said.
Analysts say the North Korean health system is relatively well prepared to support vaccine storage and distribution, despite being underfunded and poorly funded in many other areas.
This is a legacy of small-scale international efforts to combat diseases such as tuberculosis and hepatitis, as well as infant immunization programs.
Nagi Shafik, a former manager of the WHO office in Pyongyang, said North Korea can handle the Oxford / AstraZeneca vaccine, which can be stored between 2 ° C and 8 ° C.
“The cold chain storage system has been working for a long time. . . I can tell you with confidence that they have a high funding ratio, and they maintain it, ”said Mr Shafik, who last worked in Pyongyang in mid-2019, noting that Gavi data supported his claims.
But the extra cold temperatures required to store the Moderna and BioNTech / Pfizer vaccines would not be appropriate.
Dr. Harvard Park added that risk-averse North Korean health officials are unlikely to trust vaccines produced in Russia or China until there is more transparency about the success rates of the shots.
The border closures have battered trade between North Korea and China, strained the economy and slowed the supply of medical equipment and supplies. The economic crisis has pressured Mr Kim to take action.
But a resurgence in cases in the neighboring Chinese provinces of Liaoning and Jilin has renewed the risk of North Korea’s easing of entry restrictions. Tens of millions of people have been incarcerated in China in recent weeks and massive testing has been enforced to eradicate infections. Authorities in Jilin underlined the speed at which the virus could spread and said more than 100 cases had been linked to a traveling salesman.
The North Korean leader’s dire situation has come as richer countries face harsh criticism for not supporting poorer countries in gaining access to Covid-19 vaccines.
Health experts have also called for a relaxation of sanctions against Pyongyang, imposed in response to the nuclear weapons program. They say the measures threaten to slow the rollout of vaccines, and fears of hoarding drugs for the benefit of the military or elites close to the Kim regime have been exaggerated.
“We must separate the political question from the scientific one; science says no one will be immune until everyone is vaccinated. . . this is a human thing, we cannot punish people, ”said Mr. Shafik.