KEY TAKEAWAYS
KEY TAKEAWAYS
This essay is part of a series, Pursuing Peaceful Coexistence with North Korea, that explores how the United States and South Korea can peacefully coexist with a nuclear North Korea.
For any peaceful coexistence between the United States and North Korea to take root, there will need to be multiple levels of dialogue, engagement and cooperation. Given the historic distrust between the two countries, this is easier said than done. But “people-focused” engagement — that is, engagement that centers North Korean people’s wellbeing — could allow Americans to establish working relationships with North Korean counterparts while also demonstrating U.S. commitment to improving the lives of ordinary North Koreans.
People-focused engagement with North Korea encompasses any transnational cooperation that aims to improve the wellbeing of North Korean people. It includes areas such as health care, food security, water and sanitation, disaster response and prevention, and climate change.
Sometimes this work is referred to as humanitarian aid. However, it’s important to note that aid and engagement are not synonymous. People-focused engagement is much larger and reciprocal in scope. And while aid can certainly be one component of that engagement, there is growing recognition that even in acute, rapid-onset emergencies — a category to which North Korea does not currently belong — simply injecting what is perceived as “needed” can still be insufficient and ineffective.
So, rather than relying exclusively on the one-way delivery or the passive reception of aid, people-focused engagement is about collaborating with partners to achieve beneficial, mutually agreed upon outcomes. Non-governmental organizations (NGOs) are important actors in this endeavor. And in the context of North Korea, many NGO workers can attest to the intelligence and commitment to community held by their North Korean counterparts.
Additionally, people-focused engagement is not exclusively reactive, emergency-oriented work. It can encompass preventative work and research in crucial fields, such as drought-resistance crops, as well as policy and practice in areas impacting daily life, such as the rights of people with disabilities. While engagement with North Korea currently faces significant obstacles, it is important to remember that the country actively engaged in these different areas in the past.
In the mid-1990s, North Korea invited international humanitarian organizations to work with North Koreans on responding to an acute famine. Although some people-to-people engagement predated these invitations — for example, an American Friends Service Committee delegation first arrived in North Korea in 1980 — the famine response marked the beginning of large-scale international humanitarian engagement.
Key actors working on the ground alongside North Korean stakeholders included U.N. bodies, such as the World Food Program, and various NGOs (many of which were American). North Korean stakeholders included liaison bodies such as the Flood Damage Rehabilitation Committee and the Korean American Private Exchange Society, but also directors and staff at institutions such as hospitals, schools and orphanages.
As North Korean society segued out of the acute famine era, concerns remained about systemic issues in key areas of human wellbeing such as health care, food security and disaster response. While many organizations had long incorporated sustainability concerns into their programming, people-focused engagement in North Korea also evolved away from acute emergency response in the mid-2000s to instead address these other areas of wellbeing.
Since the 1990s, people-focused engagement … [has] contributed to important improvement in North Korean people’s wellbeing.
Since the 1990s, people-focused engagement by U.S. NGOs and other organizations have contributed to important improvement in North Korean people’s wellbeing. On a broad level, there have been marked improvements in health indicators such as wasting and malaria incidence.
While it is unfair to attribute these improvements solely to the work of international organizations, such achievements in nutrition and health have been bolstered by people-focused engagement. American NGOs achieved notable contributions in areas such as multi-drug resistant tuberculosis (MDR-TB) and clean water. In 2019, the Eugene Bell Foundation had a cure rate of nearly 75 percent for its MDR-TB patients — a significant increase from the world average of 55 percent. That same year, Christian Friends of Korea brought cutting-edge hepatitis diagnostic capabilities to North Korea, running the first Hepatitis B diagnostic tests in the country and training lab doctors in three North Korean cities how to interpret the test results.
However, starting in 2017, people-focused engagement was severely curtailed due to several factors:
Poor U.S.-North Korea official relations stemming from the nuclear issue have hindered people-focused engagement and introduced additional roadblocks. U.S. efforts to maximize pressure against North Korea in 2017 to compel denuclearization contributed to a ban on U.S. travel to North Korea following the tragic death of U.S. citizen Otto Warmbier. Although the ban included exceptions related to humanitarian considerations, it added another layer of administration, cost and time burdens to U.S. NGOs active in people-focused engagement.
As of now, North Korean denuclearization remains a central policy for the United States and other key allies such as the European Union. However, North Korea refuses to engage as long as denuclearization stays on the agenda. But there are growing voices calling for Washington to reconsider this goal as well as encouraging the EU to break with Washington and reconsider denuclearization on its own terms.
There has been no firm indication that President Trump will consider adjusting the denuclearization goal — though sources have claimed this is on the table, and Trump did refer to North Korea as a “nuclear power” on the first day of his second term. Additionally, speculation on Trump personnel choices suggests the potential for renewed diplomacy efforts with North Korea. However, uncertainties remain on Trump’s approach to North Korea and how it will impact the environment for engagement.
In January 2020, North Korea closed its border in response to COVID-19. Foreign presence inside the country — including U.S. NGOs — greatly reduced, with the last international humanitarian workers leaving in March 2021. In January 2023, only nine countries had diplomatic staff in Pyongyang. Today, the border is no longer closed and diplomatic staff from several countries and Russian tourists have returned to the country.
However, travel and international residency remains limited in comparison to pre-COVID and most U.S. citizens and NGOs remain locked out. With a few exceptions, international organizations engaged in people-focused work that had previously made regular trips to North Korea or had foreign staff living in the country have not been able to resume these activities.
Unilateral and multilateral sanctions against North Korea — despite being aimed at halting its military and ballistic weapons program — have also impacted average North Korean citizens. While it is difficult to get data on the daily impact of sanctions on ordinary North Koreans, there is consensus that sanctions have had an unintentional negative impact on livelihoods for workers in sanctioned industries, as well as in health care and agriculture, due to shortages of fuel, equipment and medical supplies.
Additionally, evidence suggests that sanctions have made people-focused engagement more difficult and less agile. Organizations face further challenges in importing equipment for water and sanitation programs. And delays caused by the hard-to-navigate sanctions exemption process have rendered time-sensitive agricultural equipment less effective. At least one NGO, the Finnish group Fida, ended their North Korea work due to the challenges of secondary sanctions.
Primary and secondary sanctions have also resulted in issues with banking. A Russian intermediary bank, Bank Sputnik, previously provided a banking channel for humanitarian work, but this channel collapsed in 2017 and there has been no sustainable solution since. In 2021, Bank Sputnik facilitated a test to reopen the channel, but said its North Korean partner, the Foreign Trade Bank, reneged on the agreement and demanded sanctions against them be lifted. The banking channel problem is not unique to North Korea, but in this particular context, a solution remains elusive.
At the time of writing, North Korean troops fighting alongside Russia in the war against Ukraine is a massive geopolitical hurdle. North Korean on-the-ground involvement in the war may have greatly reduced possibilities for engagement organized by or coordinated through states allied with Ukraine, including NATO member states. However, NATO member states can still consider how their policies inhibit or enable non-state actors who are engaged in people-focused work in North Korea.
Another geopolitical issue is the perception that people-focused engagement may provide support to the North Korean regime. However, it is clear that people-focused engagement does not play such a role. If it did, the severe reduction in such engagement since 2017 would have demonstrated a detrimental impact on the regime. By its very definition, people-focused engagement is centered on the wellbeing of ordinary North Koreans, not on the regime. The reality of the North Korean system means that people-focused engagement requires working with government entities. But, as humanitarian workers can attest, this does not preclude being able to impact ordinary North Koreans.
Transnational efforts that work with North Korean people and support their wellbeing will require action from Pyongyang. But other stakeholders, such as the U.S. government, can be proactive in creating optimal conditions for engagement.
Of course, a restart of official engagement with North Korea would provide the most far-reaching benefits for humanitarian cooperation. In the absence of renewed diplomacy, smaller, intermediate actions — such as changes to sanction regulations similar to those made by the U.S. Office of Foreign Assets Control in February 2024 — can help pave the way for more engagement by NGOs as well as signal sincere U.S. interest in improved relations. These amendments broadened the range of activities that could fall under general licenses, including peacebuilding and disarmament engagement by NGOs. Further revisiting of sanctions legislation, including secondary sanctions that impact even non-U.S. NGOs, with a people-focused lens could also help respond to the unintended consequences of sanctions.
To take advantage of improved sanctions regulations and opportunities presented by North Korean partners, U.S. NGOs require consistent, agile funding. Multiyear, flexible funding is becoming the gold standard in global humanitarian responses. As has been previously argued in this essay series, short-term funding does not communicate adequate levels of trust and commitment, either to North Korean audiences or to U.S. NGOs themselves.
Surveys suggests there is popular support among Americans for engagement with North Korea, particularly in areas such as the repatriation of U.S. service members’ remains from the Korean War and meetings between the president and Kim Jong Un. There is also support for revisiting sanctions that harm ordinary North Koreans.
As the North Korean human rights organization LiNK writes, “North Korea is more than Kim Jong-un and nuclear weapons. It's home to 25 million people.” People-focused engagement that is centered on the wellbeing of those 25 million ordinary North Koreans can help create ties between U.S. NGOs and North Korean counterparts, support better health outcomes for North Koreans, and lay the foundations for the peaceful, secure futures that both Americans and North Koreans deserve.
Dr. Nazanin Zadeh-Cummings is an assistant professor for international relations and humanitarian action at the University of Groningen in the Netherlands.