North Korea relies on China for more than 90% of its trade. Researchers admit that while health indicators have improved in the two decades since the countryʼs 1990s famine, during which hundreds of thousands of people starved to death,48 but there are still major problems. In the 1990s, Amnesty International (London, UK) detailed a crumbling health care system in North Korea, a nation unable to feed its population, and, in violation of international law. North Korea refused to cooperate with the international community to receive food. Levels of malnutrition, maternal health, and tuberculosis (TB) are chronic problems, but a lack of accurate data on HIV/AIDS and hepatitis B present cause for alarm. Health indicators have improved in the two decades since the countryʼs 1990s famine, but major problems still exist. Whereas communicable diseases account for a large proportion of the disease burden, there are very few opportunities to better understand and control them.49 While health infrastructure has improved, capacity is low and the health system is chronically under-resourced. North Korea has allowed for United Nation (UN) interventions, primarily focused on sustainable development, but this has been on North Koreaʼs terms, a demand not unusual for autocratic regimes.50