North Korea uses a sweeping public health campaign to reinforce state control over hospitals and medicine nearly one year after Kim Jong Un launched the initiative. The government presented the program as a national health revolution, yet officials have focused more on centralizing authority than expanding patient care. As a result, medical institutions now operate under stricter monitoring while ordinary citizens continue facing shortages of drugs and basic treatment.
Kim announced the public health revolution in February last year while claiming the state would assume full responsibility for citizens’ well-being. However, authorities immediately ordered a nationwide survey of hospitals, clinics, and pharmacies instead of expanding medical infrastructure. That survey required provincial health bureaus to report staffing levels, equipment inventories, and drug supplies, thereby allowing the government to measure how far reality diverged from official claims.
The sudden data collection revealed deep institutional decay across the medical system. Many hospitals could not account for their own equipment or personnel, while doctors admitted they personally purchased essential devices. Consequently, officials used those findings to justify stronger state control rather than broader investment, signaling that the campaign served political oversight more than healthcare reform.
The government promoted Kangdong County Hospital near Pyongyang as a flagship achievement of the campaign. Kim personally attended its opening ceremony, and authorities described the facility as a model for future regional hospitals. Moreover, the hospital received stable electricity, heating, and water, while patients paid lower consultation fees than at nearby clinics.
Yet Kangdong’s success relied on extraordinary privileges rather than sustainable systems. Officials transferred foreign-made equipment from Pyongyang hospitals, and they assigned elite doctors from the capital to support operations. In addition, the health ministry supplied medications directly, which allowed the hospital to operate more smoothly than most regional facilities.
That arrangement reflected political priorities rather than medical planning. Kangdong County hosts key military-linked industrial sites, which likely influenced the decision to concentrate resources there. Therefore, analysts view the hospital as a stability project rather than evidence of nationwide reform.
Meanwhile, most hospitals still lack essential drugs, forcing patients to purchase medicines from informal markets. Even after the campaign began, private acupuncture clinics and neighborhood doctors continued operating openly across the country. That reality highlights how state control has not replaced underground healthcare networks, despite aggressive government oversight.
At the same time, authorities have shifted healthcare toward a paid system. Model pharmacies now sell drugs at regulated prices, which fall slightly below market rates yet still burden low-income families. Officials designed this system to channel currency back into government hands, similar to recent reforms in food distribution.
However, those pharmacies carry limited selections, while imported medicines from China and Russia dominate informal markets. Patients often buy unfamiliar drugs without understanding their ingredients, reflecting widespread distrust in domestic supplies. That behavior shows how deeply confidence in state healthcare has eroded.
Looking ahead, the government plans to construct twenty additional hospitals next year. Still, experts warn that infrastructure alone will not restore public faith without consistent supplies, trained staff, and affordable treatment. Observers also caution that tighter oversight could worsen inequality as better-connected citizens secure access while others remain excluded.
Ultimately, North Korea’s public health campaign reveals a leadership more focused on governance than medicine. While officials speak of humanitarian reform, the system increasingly prioritizes revenue collection and political supervision. As a result, the campaign’s first year demonstrates that healthcare reform has become another mechanism for maintaining centralized authority rather than improving people’s lives.
