Non-governmental organizations (NGOs) have been active in North Korea since the 1990s. Their work has raised debates about what role NGOs should play in countries ruled by repressive regimes like North Korea's. NGOs and other providers of aid face an ethical dilemma in such countries: How does one provide assistance to a population without inadvertently supplying aid to groups such as the North Korean military or others who will try to profit from it? In the North Korean case, NGOs have been viewed by many as providing aid, technical advice, and resources at little or no cost to a despotic regime. Many NGOs as well as other relief and development providers believe that aid should go to those in the greatest need and should be non-political. At the same time, the NGOs insisted on transparent delivery of aid. North Korean officials have failed to comply with requirements for transparency and have diverted significant amounts of humanitarian aid. On the other hand, there is evidence that several NGOs have had successes, albeit limited, in a wide range of activities, from providing food aid to sponsoring informal diplomacy. By the late 1990s, several NGOs had set up programs geared toward enhancing capacity and boosting agricultural production in North Korea. Relief agencies offered projects that ranged from alternative types of farming including wider use of greenhouses and hydroponics, hospital renovations, mobile diagnostic clinics, water and sanitation projects, to disaster management training. In food assistance programs, according to several sources, in spite of initial North Korean efforts to hamper NGOs by limiting movements by their staff and refusing to allow Korean speakers to accompany them, over time some NGOs have obtained as good or better access and monitoring than much larger international organizations. Many NGOs felt this gave them some assurance that aid was reaching the right recipients. Congress may wish to consider the role of NGOs in North Korea as part of its oversight of the U.S.-North Korean relationship, and also because of their potential role in delivering humanitarian assistance. Recently, the Obama Administration has been considering whether to restart an earlier aid program begun under the Bush Administration in 2008. The South Korean and U.S. governments have received several requests from North Korea for large-scale food aid since late 2010. In February 2011, the spokesperson for the Department of State stated that future food aid would depend on a needs assessment, and whether the U.S. government could ensure that the program would be effectively managed to ensure that no aid would be diverted from its targets. In March, the U.S. Special Envoy for North Korea Policy, Ambassador Stephen Bosworth, also noted that the United States would "provide food aid when we see a perceived need and in a situation in which we can monitor." It is possible that the Administration could use NGOs for aid delivery, as the Bush Administration did from 2008 to 2009. Some have argued that through the implementation of their work NGOs may have promoted at least some degree of transparency and a measure of accountability for the aid recipients. It is, however, difficult to assess such effects, given North Korea's isolation. As of 2010, a few NGOs have remained active in North Korea, most from European aid agencies. Other active but non-resident NGOs include the Mennonite Central Committee (Canada), First Steps (Canada), the Eugene Bell Foundation (United States/South Korea), Christian Friends of Korea (United States), the Canadian Food Grains Bank, and the Hanns Seidel and the Friedrich Naumann Foundations (Germany). Several European NGOs can expect consular protection from embassies based in Pyongyang, except for Canada, France, and Ireland which have embassies in Seoul. U.S. NGOs rely on the Swedish Embassy in Pyongyang. South Korea has cut off nearly all bilateral food and fertilizer aid and curbed South Korean NGO contacts with North Korea since the election of President Lee Myung-bak in December 2007. The South Korean government imposed especially tight restrictions after sinking of the South Korean naval corvette Cheonan in March 2010 and North Korea's shelling of a South Korean island in November 2010. Both incidents resulted in the loss of South Korean lives. Many South Korean NGOs criticized the Lee government's restrictions. Several NGOs, among them the Korean Sharing Movement and Good Friends, asked the government to allow them send food to North Korea. These offers were rejected. In 2010, the South Korean and U.S. governments made small donations of aid, some of which NGOs distributed. In January 2010, South Korea donated 10,000 tons of food through the South Korean Red Cross. In March 2010, South Korea sent 20 tons of milk powder. In September 2010, U.S. Agency for International Development (USAID) made $600,000 available to fund flood assistance via Samaritan's Purse, Global Resource Services and Mercy Corps. The North Korean government has tightly controlled and monitored NGO activities. Its officials have frequently resisted NGO demands to monitor the distribution of aid. North Korean officials initially blocked NGO efforts to visit the northeast provinces of Chagang, South Hamgyong, North Hamgyong, and Ryanggang, as well as portions of Kangwon, South Hwanghae, and North and South Pyongan (see map at Figure 1 ). Officials also tried to curb NGOs' ability to monitor by excluding Korean speakers from their groups. International organizations and NGOs were not permitted to conduct random site visits. Finally, DPRK officials insisted that NGOs use the government's Public Distribution System to transmit aid. The Public Distribution System is the primary means by which the state allocates food according to the social importance of groups. Between 1998-2000, citing these restrictions on monitoring, some NGOs, notably Doctors without Borders and Oxfam, withdrew from North Korea. Two U.S.-based NGOs, CARE and Catholic Relief Services, left for similar reasons. By 2005, restrictions on NGO travel had dropped substantially but still included smaller portions of the northeast provinces, North and South Pyongan, and Kangwon. North Korean officials ruled out visits to these areas citing security reasons. The North Korean government has assigned government contacts to NGOs, to serve as a conduit for their aid and provide the regime with buffers between the organizations and the public. These were assigned on the basis of national origin or residency, and have shifted frequently over the years that NGOs have worked in the country. Some NGOs have sought to strengthen their hand by coordinating their own work through these North Korean government entities, with varying degrees of success. Beginning in 1995, U.S. NGOs, some European NGOs, and international groups such as the World Food Programme fell under North Korea's Flood Damage Rehabilitation Committee's (FDRC) purview. A few U.S. NGOs, the American Friends Service Committee and World Vision International, as well as all South Korean NGOs were assigned to the Asia-Pacific Peace Committee (APPC). In 2005, North Korean officials reassigned the U.S. NGOs to the Korean American Private Exchange Society (KAPES). One European NGO noted that the new North Korean arrangements under KAPES effectively reduced the number of NGOs on the ground and reassigned them with new contacts. The FDRC/KAPES staff are drawn from the North Korean Foreign Ministry or local authorities. The APPC reports to the central committee of the Korean Worker's Party. The APPC also has responsibility for Asian-Pacific states that lack diplomatic relations with North Korea. Generally speaking, North Korean officials refused to grant U.S. or South Korean NGOs residency in order to limit their range of movement in North Korea. In 1996, InterAction, a U.S. NGO consortium comprising more than 150 U.S. NGOs, initiated a process of facilitating and coordinating humanitarian relief with its members in North Korea. Participating NGOs in InterAction also formed the North Korea Working Group to advocate for assistance to North Korea. To facilitate work further, InterAction recommended the establishment of the Food Aid Liaison Unit (FALU), which operated from WFP's office in Pyongyang. WFP and NGOs worked within the system of national food rationing mentioned earlier, referred to as the Public Distribution System. A year later, other non-resident NGOs created the Private Voluntary Organization Consortium (PVOC), which included Amigos Internacionales, CARE, Catholic Relief Services, Mercy Corps, and World Vision. The aim of PVOC was to monitor distribution of over 150,000 MT of U.S. government food aid and ensure delivery to workers in cities where factories were closed or idle. Analysts describe the formation of the PVOC as a period of close cooperation between U.S. agencies and NGOs. USAID and United States Department of Agriculture funded the PVOC group's food assistance programs. This permitted some NGOs to move beyond the original food assistance programs and towards development-oriented programs. In 2000, the General Accounting Office (now the Government Accountability Office) reported that the initiative yielded "mixed results." The Consortium reported that the North Korean government's restrictions made it difficult to adequately monitor the distribution of the food. The PVOC withdrew from North Korea shortly after June 2000 after difficulties in its seed potato project. North Korean officials also began granting several European NGOs residency, among them Doctors Without Borders. European NGOs negotiated residency in North Korea as a condition for their assistance. Some argue that this newly formed community of active and inquiring resident NGOs promoted a new dynamic in North Korean society. North Korean officials encountered NGO representatives who operated on the basis of transparency, and had diverse experiences operating in other countries. As a result, North Korean officials and aid recipients had to adapt to each other. Responding to the U.N. World Food Programme and the U.N. Food and Agricultural Organization's (FAO) calls for aid to North Korea in 2008, the United States pledged to donate 500,000 MT of food aid to North Korea for one year. The Bush Administration declared at the time that North Korea had made substantial concessions in monitoring and access which would permit confirmation of aid to the intended targets. The U.S. government arranged to send a portion of that aid, 100,000 MT, through five U.S. NGOs. The U.S. Department of State selected World Vision, Mercy Corps, Samaritan's Purse, Global Resource Services, and Christian Friends of Korea to distribute this aid. The NGO aid consortium operated in two northwest provinces until the North Korea government ordered them to leave the country in March 2009. North Korea offered no explanation for the dismissal. Many South Korean NGOs participating in North Korean assistance programs are faith-based, privately run charities. They emphasize confidence-building through frequent contacts. Feelings of patriotism and a desire for national reconciliation motivate many of them. Prominent among these NGOs are Good Friends South Korea/Peace Foundation and the Korean Sharing Movement. Until 1999, the South Korean government had South Korean NGOs contribute through its Red Cross organization. South Koreans also had to obtain the approval of the Ministry of Unification to travel to North Korea. To expedite deliveries, some South Korean NGOs delivered aid through their affiliates. The NGO World Vision Korea, for instance, shipped rice via World Vision International. The U.S. NGO Eugene Bell Foundation shipped aid on behalf of several South Korean Christian NGOs. Other NGOs took advantage of the porous North Korea-China border. Some NGOs ran small cooperative farms in Chinese border states to deliver food to their recipients. Under the "sunshine" policy of engaging North Korea, the administrations of President Kim Dae Jung (1998-2003) and President Roh Moo-hyun (2003-2007) lifted many of these restrictions on NGOs. After the June 2000 inter-Korean summit, the South Korean government's aid programs grew substantially. While other NGOs pressed for strict monitoring to minimize the possibility of diversion of aid, the South Korean government delivered large quantities of aid, with less stringent monitoring and fewer follow-up reporting requirements. With the election of President Lee Myung-bak, the South Korean government withheld most bilateral aid and restricted private visits to North Korea. During the "sunshine policy era," South Korean NGOs set up a variety of food security programs to plant high-yield corn, provide fertilizer, propagate seed potatoes, develop goat milk production, and sponsor greater use of greenhouses and alternative growing techniques. These programs were introduced to offer sustainable food sources. Some NGOs also began programs to supplement nutrition or curb disease, such as providing vitamins, tuberculosis controls, pest control, and developing pharmaceutical firms. By 2000, the South Korean Ministry of Unification supported NGOs whose programs included aid to flood survivors, children, and the elderly. NGOs also initiated programs in medicine and hygiene programs, and aid in natural disaster prevention. NGOs have offered programs oriented to build capacity in agriculture and health, sponsoring projects on water and sanitation, seed improvement, animal husbandry, and land management. Other NGOs have promoted programs for study abroad, and courses in English language, banking, and trade. Specific examples include founding a digital library at a North Korean university; establishing of a U.S.-DPRK Scientific Engagement Consortium; creating a privately run foreign university in Pyongyang, sponsoring exchange programs on economics, urban development, and technology; and establishing a reference laboratory for the diagnosis and treatment of multidrug resistant tuberculosis. Members of Syracuse University, the Korea Society, and North Korea's Permanent Mission to the United Nations discussed the prospect of a digital library in spring 2001. Syracuse University and the Korea Society sought to improve the opportunities of North Korea students and promote science education. The Permanent Mission selected Kim Chaek University as the project partner. Researchers at Syracuse and Kim Chaek Universities identified the necessary standards to catalog information and develop software from open sources. The sponsors' contact in North Korea was the FDRC. The program relied on private grants from the Korea Society, the Henry Luce Foundation, the Ford Foundation, and Syracuse University. Kim Chaek University bore the cost of constructing the library facility. The digital library opened in 2006. In 2008, journalists accompanying the New York Philharmonic Orchestra on its visit to Pyongyang said they visited the digital library and had accessed their Facebook accounts there. In 2005, as an offshoot of the digital library project, the partners agreed to develop twin integrated information technology laboratories ("the Twin Labs project") as well as support exchanges of Syracuse and Kim Chaek Universities' junior faculty. This program has met delays; no North Korean faculty members have enrolled at Syracuse yet. The U.S.-North Korea Science Engagement Consortium (officially known as the U.S.-DPRK Science Engagement Consortium) represents an effort to foster science cooperation between the U.S. and North Korean scientific communities, primarily between academic institutions. The U.S. consortium core members (the American Association for the Advancement of Science (AAAS), the Civilian Research & Development Foundation Global (CRDF Global), the Pacific Century Institute and Syracuse University) were inspired by the example of the bilateral collaboration between Syracuse University and Kim Chaek University of Technology in the development of the latter's digital library. The digital library project has been ongoing for almost ten years. In May 2007, several university and NGO representatives met to examine participants' experiences with respect to scientific collaboration with North Korea. This resulted in the formation of the Consortium, which has since sent a Nobel Laureate science delegation to Pyongyang in 2009 and hosted a DPRK State Academy of Sciences (SAOS) delegation in Atlanta in February 2011 where scientists from Emory, Georgia Institute of Technology, the University of Georgia, Stanford, Johns Hopkins, Syracuse University, and the University of Missouri attended. The Consortium, which maintains a secretariat at CRDF Global, has signed two agreements with the SAOS and plans to implement a few initiatives including English language training for scientists in 2011 and 2012 contingent upon receiving funding and securing legal approvals. In late October 2010, an American educator of South Korean origin, James Kim (Kim Chin-kyung), and a South Korean NGO, the Northeast Asia Foundation for Education and Culture (NAFEC), opened North Korea's first and only private university, the Pyongyang University of Science and Technology (PUST). PUST began as a North Korean proposal in 2000: North Korean officials approached James Kim eight years after he had founded one of China's first foreign university in Jilin province. PUST offers masters and doctorate degree programs in computing, electronics, and agricultural engineering, as well as a masters degree program in Business Administration. Construction on the campus began in March 2001. North Korean education officials accepted Kim as PUST president, and acknowledged his right to hire faculty of any nationality. PUST intends to create an industrial park on the campus. Kim and NAFEC have raised funds from private and public sources. The South Korean Ministry of Unification contributed close to $1 million. NAFEC raised nearly $32 million, mostly from South Korean churches and foreign donors. Kim and NAFEC also obtained the advice of business investors and a former president of Rice University. PUST expects to spend about $4 million in its first year of operation. North Korea's education ministry selects the students. Since the university's opening,160 graduate students have enrolled. James Kim and the PUST faculty hope to add undergraduate programs later, and eventually enlarge the university to 250 faculty members, 600 graduate students, and 2,000 undergraduates. Several NGOs, in response to North Korean requests, have provided specific technical assistance, offering courses to candidates selected by the North Korean government in economics, agriculture, and capacity building. Some have advised North Koreans on water, sanitation, seed improvement, and soil erosion prevention projects. Others have offered North Koreans officials study-abroad opportunities, and/or classes in English language. The Hanns-Seidel-Foundation Korea (HSS), for example, a German NGO associated with the Christian Social Union, a political party, promotes political dialogue, education, management training, and institution building. HSS is notable because, among other reasons, it is among the few Europeans involved in business/economic training. In 2006, HSS partnered with the Pyongyang International Information Center for New Technology and Economy and the EU-Korea Industrial Cooperation Agency. They sponsored the EU-NK Trade Capacity Project to introduce mid-level North Korean officials to business and trade practices. Its interlocutor was the Korean European Cooperation Coordinating Agency, created by the North Korean Ministry of Foreign Affairs to serve as its point of contact with European NGOs. Participants attended seminars on international business and trade, and on establishing chambers of commerce, food safety standards, textile associations, customs procedures, and export strategies. In 2008, HSS also offered courses in agriculture and forestry management. The North Korean government ended its participation in the EU-North Korea Trade Capacity Project in 2009. HSS Director Bernhard Seliger suggested that North Korea's decision to withdraw stemmed from an unwillingness to accept the notion of trade. In addition, North Korean officials selected participants; and those participants were rotated frequently so that in most cases, they were in their posts no longer than six months, which enfeebled the project as well. The Friedrich Naumann Foundation (FNF), like HSS, is a non-profit organization with links to a political party, the German Free Democratic Party (FDP). The Naumann Foundation's goals include the promotion of democratic institutions, human rights, the rule of law and economic freedom. FNF provides policy consultation, educational programs working with local NGOs, civic organizations, and educational institutions. As recently as July 2010, FNF hosted a small delegation of North Korean senior officials of the ruling Worker's Party, as well as some senior bureaucrats to tour Munich, Dresden, and Berlin, to introduce them to German engineering practices and sustainable development. The U.S.-North Korean Tuberculosis (TB) Project established a national reference laboratory in North Korea for the identification of multi-drug resistant strains of tuberculosis. It seeks to improve North Korea's diagnostic capacity and thereby enhance the health security of the region. Successful treatment in North Korea would lower the risks of TB exposure to the populations of neighboring states. North Korea's rate of infection is high: 345 per 100,000 individuals. For comparison, the United States rate of infection in 2009 was 3.8 per 100,000. The U.S.-North Korean TB project began with meetings between Stanford University faculty and officials of North Korea's Ministry of Public Health (MoPH) in 2008. The Bay Area TB Consortium, and the Nuclear Threat Initiative (NTI), a Washington-based nonprofit organization devoted to strengthening global security, were the initial funders. In April 2008, NTI committed $300,000 to cover equipment and training for the national laboratory. Later in 2008, Christian Friends of Korea, an NGO based in North Carolina, joined the project. The project partners made three trips to Pyongyang from 2009-2010 to renovate a public health facility designated as the TB reference laboratory. They shipped laboratory materials and equipment via Beijing to Pyongyang to complete the laboratory's installation. According to Christian Friends, the cost of the equipment and supplies came to approximately $1.7 million. By fall 2010, they had completed laboratory renovations, including checks of the building facilities and equipment, and had held two workshops to train staff in TB culturing methods and laboratory practices. The TB reference laboratory is set to receive some support from funds administered by UNICEF. The Global Fund to Fight AIDS, Tuberculosis and Malaria is a public-private partnership created to respond to HIV/AIDS, tuberculosis (TB), and malaria. The Global Fund agreed to provide aid for medication supply and basic testing for multi-drug resistant TB for a two-year period (June 2010-2012) in North Korea. One of the fundamental problems in dealing with the North Korean regime is its deep isolation, which makes traditional diplomatic exchanges difficult. Some NGOs have sought to organize Track II exchanges—that is, sponsoring informal communications between North Korean scientists, academics, military officers and private citizens, and their counterparts in the United States or overseas. The creation of the U.S.-North Korean TB project, the Kim Chaek-Syracuse digital library project and the U.S.-DPRK Scientific Engagement Consortium owe much to Track II diplomacy. Other NGOs seek to address political issues of the Korean Peninsula directly. Some NGOs that have sponsored Track II exchanges include the Korea Society, Stanford University, Syracuse University, the National Committee for American Foreign Policy, the University of California (the Northeast Asia Cooperation Dialogue (NEACD)), and the Asia Society. Track II dialogues often rely on the participation and reputation of retired diplomats or government officials. For example, the Korea Society, the National Committee on American Foreign Policy, and the Asia Society played roles in engaging North Korean diplomats during moments when the Six-Party Talks appeared to be deadlocked. The Center for International Security and Cooperation at Stanford University and the University of California's Northeast Asia Conflict Dialogue (NEACD) have also held meetings with officials participating in Six-Party Talks. North Korean diplomats last attended a NEACD session in 2009. Diplomats from both the North Korean Permanent Mission to the United Nations and the Ministry of Foreign Affairs in Pyongyang, rather than academics or scientists, have attended. By virtue of their experience as either past negotiators with North Korea or their expertise, some U.S. representatives have also opened doors for diplomacy, for example former President Jimmy Carter, former New Mexico Governor Bill Richardson, and retired Director of Los Alamos National Laboratory Dr. Siegfried Hecker. Some observers oppose public exchanges that involve prominent figures, because the North Korean regime frequently uses such events for its own propaganda purposes. Others believe they are relatively "low-cost" tools of diplomacy, in which the North Korean regime sometimes is encouraged to make concessions in exchange for the opportunity to publicize a visit. Within the last decade, South Korean activists and North Koreans who successfully defected to South Korea have developed independent radio broadcast organizations. Some of these organizations have managed to smuggle cell phones to North Korean citizens as a means to gain information. NGOs have received some funding from the National Endowment for Democracy, as well as the U.S. Department of State. South Korean and North Korean defectors have been broadcasting via short- and medium-wave radio since 2004. The broadcasts include news briefs, particularly about the Korean Peninsula, interviews with North Korean defectors, and international commentary on events occurring in North Korea. Defectors interviewed in South Korea confirmed that they were able to listen to these broadcasts after doctoring radios that are locked onto official frequencies by North Korean authorities. The U.S. Broadcasting Board of Governors cited a recent survey in which defectors interviewed in China and South Korea indicated that they had listened to foreign media. One representative of Radio Free Chosun suggested that the transmissions offered hope, saying: "Radios must let North Korean people know that, if personal farming, market[s] are legalized, [the] economy opened and cooperation with South Korea, China, and the United States start, the North Korean economy can revive, and their hunger can end." CRS Report R40095, Foreign Assistance to North Korea , by [author name scrubbed] and Mary Beth Nikitin CRS Report R41259, North Korea: U.S. Relations, Nuclear Diplomacy, and Internal Situation , by [author name scrubbed] and [author name scrubbed] CRS Report RS22973, Congress and U.S. Policy on North Korean Human Rights and Refugees: Recent Legislation and Implementation , by [author name scrubbed] CRS Report R41438, North Korea: Legislative Basis for U.S. Economic Sanctions , by [author name scrubbed] CRS Report R41481, U.S.-South Korea Relations , coordinated by [author name scrubbed] CRS Report R41363, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: U.S. Contributions and Issues for Congress , by [author name scrubbed]

Summary: A number of non-governmental organizations (NGOs)—non-profit, charitable institutions—have been active in North Korea since the mid-1990s. Although their work is relatively limited in scope, it is of interest to U.S. policy-makers because of the deep isolation of the regime in Pyongyang. Several American and international NGOs have provided assistance to North Korea in humanitarian relief, development, health, informal diplomacy, science, communication and education. A relatively recent trend is that a growing number of NGOs, particularly in South Korea, are run by or have North Korean defectors on staff. Non-governmental organizations' activities in North Korea have stirred some controversy. Some observers believe that NGOs' projects represent one of the few ways to improve the lives of ordinary North Koreans, and that their work provides first-hand accounts about social conditions in North Korea. Some NGOs have a comparative advantage in dealing with North Korea, with over a decade's experience working with North Korean officials and institutions. However, others argue that NGOs' programs aid North Korea's regime, and that given the lack of transparency and tight restrictions imposed on them by the regime, their funds are vulnerable to diversion by North Korean officials. Two issues bear consideration: Have NGOs contributed to improving the lives of ordinary North Korean citizens in sustainable ways? Can NGOs evaluate the impact of their operations and take steps to minimize diversion of the resources they deliver to North Koreans? In short, are they effective, and should the United States welcome their work in spite of the North Korean regime's treatment of its citizens? This paper will address some of the publicly disclosed activities that NGOs have undertaken in North Korea. The role of NGOs in North Korea may re-emerge as a congressional interest, as the Obama Administration has expressed interest in restarting humanitarian assistance to North Korea. During the Bush Administration, five large U.S. NGOs were part of a food delivery program that enjoyed some success. Some believed they were more effective than international organizations at navigating the North Korean system to get aid where it was needed. But some organizations opted to cease their operations when North Korean restrictions became too onerous.