The reclusive communist state has suffered from a chronic shortage of food and energy due to years of isolation over its nuclear program, mismanagement and natural disasters. North Korea has relied on international handouts since 1995 to help feed its more than 20 million people.

According to Nesirsky, some 16 million people in North Korea suffer from hunger, malnutrition and economic losses.

A murderous famine gripped North Korea in mid 1990s after unprecedented floods. The official death toll released by the North Korean Food Damage Rehabilitation Committee in 1999 stands at 220,000, while various sources, estimate that from two to three million people died between 1995 and 1998.