HIV is Spreading in North Korea, Despite the Country Claiming to Be an ‘AIDS Free Zone’

Last year, on annual World AIDS Day, December 1, North Korean government officials declared the nation an “AIDS free zone”.

“There is not a single AIDS patient in our country," announced an editorial in the state-controlled newspaper Minju Choson. Exactly four years earlier, North Korea had made exactly the same claim. The East Asian country had, it seemed—against all odds and with the help of “the most superior socialist healthcare system” in the world—inoculated itself against the global spread of HIV. But unfortunately, none of these assertions were true.

In reality North Korea was, and still is, facing an explosive and largely unmitigated HIV outbreak. According to a team of researchers from both North Korea and the United States, the first confirmed infection of a local citizen came in January 1999. In recent years the number of infections has mushroomed, and in 2018 there were as many as 8,362 HIV-positive individuals in North Korea, the American Association for the Advancement of Science reports. Zunyou Wu, chief epidemiologist at China’s Center for Disease Control and Prevention in Beijing, noted that the country’s HIV prevalence was “much higher than I expected.” And the way things are going, the situation looks set to spiral further out of control.

North Korean researchers reached out to US nonprofit DoDaum in 2013 in the hope of investigating the spread of HIV throughout North Korea. DoDaum had run health and education projects in the country, and agreed to help. A few years later, they found that in 2015, North Korea’s Centres for Disease Control had documented a steady rise in HIV infections over the previous decade. Towards the end of last year, North Korea’s National AIDS Commission finished a nationwide survey indicating the spread of infections was increasing, with the virus being most common among blood donors and people who inject drugs. And while HIV prevalence is still relatively low compared to many other countries—0.069 percent, according to the research teams’ estimates, compared to the double digit figures of many African nations—North Korea is struggling to deal with the issue effectively.

There are just three labs in the whole country that use modern medical procedures to screen for HIV. Further to that, tight international sanctions mean only 30 to 40 percent of medicinal drugs used to treat the virus make it past the China-North Korea border, according to Taehoon Kim, co-founder of DoDaum. And then there’s the issue of censorship. Science magazine reports that North Korean officials initially insisted DoDaum keep the results of their findings to themselves. But as the situation worsened, researchers decided it was their obligation to tell the truth.

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general,” Kim Mun Song, a physician at the North Korean Ministry of Public Health in Pyongyang, and DoDaum’s liaison in North Korea, told Science. “On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

There is another, more chilling concern relating to the North Korean government’s attitudes towards HIV. Taehoon Kim and his team worry that authorities could impose “austere measures to contain the disease… at all costs”—by criminalizing the HIV status, potentially, and detaining or deporting people with the virus. The researchers are now calling on the international community to do more to help North Korea fight HIV, including providing a supply of antiretrovirals to treat those infected, and assisting in rebuilding the country’s health system.

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