The Lancet: Open Letter to The Global Fund About its Decision to End DPRK Grants

by Kee B Park, Uzma Khan, Kwonjune Seung


Dear Peter Sands and Aida Kurtović,


On Feb 21, 2018, The Global Fund quietly announced its intention to close down its malaria and tuberculosis (TB) projects in the Democratic People's Republic of Korea (DPRK, North Korea). The decision will have profound negative effects on the health of millions of North Koreans and the populations of other countries in the northeast Asia region.


Since 2010, The Global Fund has disbursed over US$100 million to support malaria and TB control programmes in North Korea. UNICEF and WHO implemented these programmes in collaboration with the DPRK Ministry of Public Health. This has been the largest foreign investment in health in North Korea in history, and a remarkably effective one.


The Global Fund's decision will cripple the efforts to control both diseases, and the effects on TB control will be particularly profound. The DPRK Ministry of Public Health recognises TB as the most important public health issue in the country. North Korea has a TB prevalence that is similar to sub-Saharan Africa despite being a country where HIV is assumed to be non-existent, and drug-resistant TB strains pose a serious problem. These strains were likely created in the late 1990s before spreading unchecked due to a scarcity of resources for diagnosis and treatment. In 2017, North Korea was put on the WHO high-burden country lists for both TB and multi-drug-resistant TB (MDR–TB)....


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