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  • Author: Leonard S. Rubenstein
  • Publication Date: 01-2011
  • Content Type: Policy Brief
  • Institution: United States Institute of Peace
  • Abstract: During the 1990s, economic mismanagement, political oppression, natural disaster, and loss of external subsidies after the end of communism led to a calamitous decrease in food production in the Democratic People's Republic of Korea (DPRK). The public health infrastructure, including water and sanitation systems, drug distribution and supply chains, and local clinics and hospitals, also deteriorated. At least half a million people died of starvation and millions more suffered acute or chronic malnutrition. Malnutrition increased vulnerability to disease at a time when the health system was incapable of effective response. Fifeen years later, neither health nor the food systems have recovered as the economy persistently stagnates. Health continues to be a low priority for the government. The availability of food is insufficient to meet population needs, hospitals and clinics are significantly ill-equipped, the medical workforce lacks appropriate training, and corruption in drug distribution is pervasive. Malnutrition and anemia, as well as diseases associated with poor sanitation, remain widespread. Over the last few years, DPRK has begun to accept international assistance to address health system needs, most notably to vaccinate children. Although these initiatives address some infrastructure needs, the continued centralized control of health and the lack of open discussion about key issues renders the possibility of reforms sufficient to meet the health needs of the people of North Korea dim. During the economic crisis, tens of thousands of North Koreans migrated to China despite harsh measures imposed by both governments to restrict border crossing and a refusal by China to give legal status to the migrants. To a limited extent, migration ameliorated the health impact of the crisis by stimulating illicit cross-border trade and informal markets that increased some North Koreans' access to food. Even after a disastrous effort by the DPRK government to shut the markets down in 2009, they are re-emerging. China's encouragement of these markets, along with regularizing the status of migrants in China, could advance its own economic interests as well as contributing to improving the health of North Koreans.
  • Topic: Communism, Economics, Health, Markets, Financial Crisis
  • Political Geography: China, Israel, North Korea
  • Author: Scott Snyder, Bonnie Glaser, John S. Park
  • Publication Date: 01-2008
  • Content Type: Working Paper
  • Institution: United States Institute of Peace
  • Abstract: This report is based on discussions with Chinese specialists on the Democratic People's Republic of Korea (DPRK) during a visit to Beijing, Changchun, and Yanji, June 25-30, 2007.1 Discussions followed on a similar round of interviews conducted in April 2006. Several of our interlocutors recently returned from extended stays in Pyongyang and many others regularly visit the DPRK, commonly referred to as North Korea. Topics discussed included trends in North Korea's economy and prospects for reform; current trends in Sino-DPRK economic relations; China's policy toward North Korea in the wake of the nuclear test; Chinese debates on North Korea; Chinese assessments of North Korea's political stability; and potential Chinese responses to instability.
  • Topic: Economics, Nuclear Weapons, Regional Cooperation
  • Political Geography: China, Beijing, Asia, North Korea, Changchun
  • Author: Scott Snyder, Joel Wit
  • Publication Date: 02-2007
  • Content Type: Working Paper
  • Institution: United States Institute of Peace
  • Abstract: The second North Korean nuclear crisis, which climaxed with the test of a nuclear device on October 9, 2006, has influenced the views of Chinese specialists. By revealing the status of North Korean nuclear development, Pyongyang's nuclear test was a poke in the eye of Chinese leaders, who had tried privately and publicly to dissuade North Korean leaders from conducting a test. As a result, China has taken stronger measures to get Pyongyang's attention, including a temporary crackdown on North Korea's illicit financial activities. These changes spotlight an ongoing debate within the Chinese academic community over whether North Korea (DPRK) could become a strategic liability rather than a strategic asset. This debate centers on whether it is necessary to set aside China's loyalty to the current North Korean regime in order to maintain good U.S.-China relations and achieve China's objectives of developing its economy and consolidating its regional and global economic and political influence. Or is maintaining North Korea as a strategic buffer still critical to preserving China's influence on the Korean peninsula? An increasingly vocal minority of Chinese specialists is urging starkly tougher measures in response to North Korea's “brazen” act, including reining in the Kim Jong Il regime or promoting alternative leadership in Pyongyang. Although their sympathy and ideological identification with North Korea has waned, many Chinese policy analysts clearly prefer North Korea's peaceful reform to a U.S.- endorsed path of confrontation or regime change. China's policymakers have sought to forestall North Korean nuclear weapons development, but they continue to blame U.S. inflexibility for contributing to heightened regional tensions over North Korea's nuclear program. Chinese analysts fret that economic and political instability inside North Korea could negatively affect China itself. They have shown more concern about the North Korean regime's stability in recent months than at any time since the food crisis in the late 1990s. Chinese policymakers ask how to encourage North Korea's leaders to embark on economic reform without increasing political instability. Discussions with Chinese experts reveal considerable uncertainty about the future of North Korean reform. The possibilities of military confrontation on the Korean peninsula, involving the United States and either a violent regime change or destabilization through North Korea's failure to maintain political control, are equally threatening to China's fundamental objective of promoting regional stability. These prospects have increased following North Korea's nuclear test and the strong reaction from the international community, as shown by UN Security Council Resolution 1718. China's economic rise has given it new financial tools for promoting stability of weak states on its periphery. Expanded financial capacity to provide aid or new investment in North Korea might help it achieve political and economic stabilization. The Chinese might prefer to use the resumption of benefits temporarily withheld as a way of enhancing their leverage by reminding the North of its dependence on Beijing's largesse. Managing the ongoing six-party talks will pose an increasingly difficult diplomatic challenge for China. Chinese diplomats take credit for mediation and shuttle diplomacy, but their accomplishments thus far have been modest. Talks have been fairly useful in stabilizing the situation, but they have also revealed the limits of China's diplomatic influence on both the United States and North Korea. U.S. intransigence is as much an object of frustration to the Chinese as North Korean stubbornness. Chinese analysts clearly have given thought to potential consequences of regime instability. For example, the Chinese military's contingency plans for preventing the spillover of chaos into China and for seizing loose nukes and fissile material imply that Chinese forces would move into North Korean territory. Without effective coordination, simultaneous interventions in the event of unforeseen crisis inside North Korea could lead to direct military conflict among U.S., Chinese, and South Korean military forces. Rather than accept South Korean intervention backed by the United States as a prelude to reunification, Chinese analysts repeatedly emphasize that “the will of the North Korean people must be considered” in the event of instability. If intervention were necessary, China clearly would prefer insertion of an international peacekeeping force under UN auspices. Such a force would establish a representative government, which would then decide whether to negotiate reunification with South Korea.
  • Topic: International Relations, Economics
  • Political Geography: United States, China, Beijing, Asia, South Korea, North Korea, Korea