North Korea has spent the past year expanding state control through a public health campaign announced by Kim Jong Un. The public health initiative began in February 2025 with promises to modernize hospitals and improve access to medical services. However, officials instead focused on gathering information and strengthening state control over medical institutions and supply networks nationwide. The government framed the campaign as a revolution, yet many hospitals still struggle with shortages and declining service quality.
Authorities first launched nationwide inspections that recorded staff numbers, equipment inventories, and drug stockpiles across medical facilities. Yet these inspections revealed that many hospitals relied on privately sourced equipment rather than official government medical deliveries. Officials then used these findings to justify expanding state control rather than addressing long standing shortages and infrastructure failures. As a result, ministries gained detailed data that helped tighten oversight across every public medical institution.
The government highlighted Kangdong County Hospital as proof that the public health campaign delivered tangible medical improvements. However, that hospital operates under special privileges that reflect state control rather than nationwide medical system reform. Foreign medical equipment and transferred doctors from Pyongyang keep the hospital functioning at levels unavailable to ordinary provincial facilities. Moreover, central authorities directly supply medicines to Kangdong, while many regional hospitals still lack basic pharmaceuticals and diagnostic tools.
Despite official claims, residents still rely on unofficial clinics and private practitioners to receive effective medical treatment across the country. Doctors frequently tell patients to purchase their own medicines because hospitals remain unable to provide even essential drugs. This dependence highlights how state control has failed to restore public trust in North Korea’s formal health system. Instead, the black market continues to fill gaps left by chronic shortages and inconsistent government supply programs.
Meanwhile, authorities have gradually shifted the medical system toward paid services under expanding state control across hospitals and pharmacies. Model pharmacies now set prices slightly below market rates to draw patients back into the government controlled distribution network. However, these facilities offer limited medicines while charging higher prices for treatments not included in state approved supply lists. Consequently, citizens still purchase many drugs from private sellers who provide broader options and faster access.
Analysts say the health campaign mirrors earlier efforts to restore state control over food sales through government run distribution shops. In both cases, the state uses pricing and licensing systems to reassert financial and administrative authority over essential commodities. Therefore, officials now apply the same strategy to medicine, clinics, and professional healthcare services nationwide. This shift allows the government to collect fees while limiting the influence of private medical providers.
Data show that public hospitals still lack enough equipment, medicine, and trained staff to meet national healthcare demand. Even in Pyongyang, patients often wait weeks for basic procedures unless they secure unofficial payments or personal connections. Such conditions reflect widening inequality despite the government’s emphasis on state control over medical service access. Experts warn these trends could further marginalize poorer citizens and rural communities without alternative healthcare options.
International observers say the campaign shows political priorities rather than humanitarian improvement across North Korea’s healthcare sector. Officials focus on centralization and revenue instead of improving drug quality, hospital staffing, and diagnostic capacity. Therefore, many experts doubt whether new hospitals planned for 2026 will meaningfully improve healthcare outcomes nationwide. They argue sustainable reform requires investment in supplies and personnel rather than deeper state control over service delivery.
Ultimately, the first year of the campaign reveals how the regime values administrative authority over actual health improvements. The government acknowledges healthcare’s importance but still avoids full responsibility for providing free and reliable medical treatment. As a result, citizens face rising costs while officials strengthen state control across hospitals, pharmacies, and professional services. Future outcomes will depend on whether leadership prioritizes people’s health or continues using healthcare primarily as a political management tool.
