North Korea running low on TB meds, experts fear epidemic

The withdrawal of a major international aid organisation threatens to leave tens of thousands of tuberculosis patients in North Korea without the medication they need and could spiral into a severe crisis if it is not addressed soon, according to health experts familiar with the situation in the North.

The dwindling stockpile of crucial medications follows the abrupt departure of the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international aid organisation whose grants to North Korea supported the treatment of 120,000 TB patients last year.

Its support officially ended in June despite an outcry among health officials in North Korea and in the international community that it could spark a major epidemic.

Neurosurgeon Kee Park, of the Program in Global Surgery and Social Change at Harvard Medical School, said in an email to The Associated Press that the situation is extremely dire and likely to get dramatically worse in the years ahead if it is not properly dealt with.

The US-based nonprofit Eugene Bell Foundation, which works on the ground treating tuberculosis in North Korea, said Friday that the crisis is being compounded by US-led sanctions over Pyongyang's nuclear weapons and missile program.

North Korea has one of the world's highest rates of tuberculosis, a highly infectious disease that, while treatable, globally causes more than 1 million deaths each year.

According to the World Health Organisation, about 107,000 cases of tuberculosis were reported in North Korea in 2017.

Making matters worse, North Korea has estimated that 6-7 per cent of its tuberculosis population has the drug-resistant variety, known as MDR-TB, which is far more difficult and costly to cure.

"As a result of the loss of the Global Fund grants for the DPRK, we expect a 50-75 per cent reduction in treatment capacity for non-MDR-TB patients," Park said.

"Consequently, our model predicts between 155,000 to 210,000 more people will die from TB-related causes within five years. To be clear, these are new deaths that are expected on top of the current mortality rates. We have assumed that the treatment of MDR-TB will continue at current levels."
"Time is ticking," Park said. "I have heard from people who have been inside recently that the rationing has already started."