Sanctions undermine global health security

Sanctions undermine global health security
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The novel coronavirus that caused the outbreak in Wuhan, China, has spread throughout Asia, North America, and Europe. The alarming rate of new cases suggests the virus is more contagious than SARS.

Drastic measures, such as locking-down the entire city of Wuhan to prevent the spread, are being imposed in China. More and more countries are restricting the entry of Chinese travelers into their country. These draconian measures are not foolproof. People carrying the virus may still get through international borders. Of particular concern is the relatively long incubation period of two weeks during which people carrying the virus display no outward symptoms such as fever.

The global health community has consistently maintained that fighting these global threats effectively requires strong health systems — in all the countries. We are only as safe as the weakest link. It is in the interest of the world to ensure adequate health systems and pandemic readiness are in place in every country — including in North Korea. 

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While building robust health systems in the developing world is a complex and slow process, 

Countries must take swift action in bolstering their readiness capabilities in response to a new and sudden regional epidemic threat.

Recognizing the potential catastrophic consequences of an epidemic, the Democratic People’s Republic of Korea (DPRK) quickly implemented progressive measures to prevent the entry of the new virus into their country. Further, the Ministry of Public Health is working with the World Health Organization (WHO) country office to educate the public and prepare for a possible epidemic. Medical supplies such as diagnostic tests, IV fluids, antibiotics, and isolation equipment should be procured quickly, right?

Sadly, in practice, the current global sanctions regime on North Korea, although not intended to harm the ordinary people of North Korea or hinder humanitarian aid, results in unnecessary and even deadly delays.

Every aid organization intending to send humanitarian goods to North Korea must seek exemptions on a case by case basis. Perhaps even more concerning is the absence of a banking channel for aid organizations to go through when purchasing and sending humanitarian goods, including medical supplies. 

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On Jan. 30th, the UPI reported that the virus had reached Tumen, directly across the North Korean border. The DPRK Ministry of Public Health (MoPH) has now essentially sealed its borders to non-essential travel and requires mandatory quarantine for those who are entering from China.

The prospect of an outbreak within North Korea, with its limited capacity for diagnosis, treatment, and containment, is frightening. Preventing an outbreak is a matter of national security for the DPRK government. 

It is also in the interest of its neighbors and the world to help the DPRK and work with them. The sooner the virus is contained, the safer the world will be. 

In times of a pandemic threat, countries, friend and foe alike, must work together in fighting a common enemy. We must put aside our differences and find ways to cooperate in a spirit of global solidarity.

We recommend the following actions:

  1. Issuance of a general waiver to allow humanitarian organizations to send supplies and experts to help bolster the DPRK’s readiness in case of an epidemic.
  2. Immediate establishment of a banking channel to facilitate procurement of supplies.
  3. General travel permits for humanitarian workers who currently need to apply for exemptions.
  4. Full, up-to-date, and transparent reporting by the DPRK MoPH on the suspected and confirmed cases and their outcomes within the country.

These actions will minimize any unnecessary delays and thereby facilitate international cooperation and support for the DPRK government in preparing for a potentially catastrophic epidemic. The health security of the region and the world will be strengthened in the process. 

Kee B. Park, M.D., MPH, is a lecturer on Global Health and Social Medicine at Harvard Medical School. As the Director of the DPRK Program for the Korean American Medical Association, he has traveled over 20 times to work alongside North Korean doctors since 2007.

Nagi M. Shafik, M.D., is a public health specialist and former project manager and consultant at the WHO and UNICEF offices in Pyongyang, DPRK.