An estimated 11 million people in North Korea — over 43 per cent of the population — are undernourished and "chronic food insecurity and malnutrition is widespread," according to a UN report issued today.
The report by Tapan Mishra, the head of the UN office in North Korea, said that "widespread undernutrition threatens an entire generation of children, with one in five children stunted due to chronic undernutrition."
With only limited health care and a lack of access to clean water and sanitation, "children are also at risk of dying from curable diseases," the report added.
Mishra said that last year's UN appeal for US$111 million ($164m) to help 6 million of North Korea's most vulnerable people was only 24 per cent funded, one of the lowest levels in the world.
UN spokesman Stephane Dujarric told reporters that the UN humanitarian team in the country is calling for US$120 million "to urgently provide life-saving aid to 3.8 million people."
Without adequate funding this year, some agencies providing desperately needed help to North Koreans will be forced to close down, he said.
Dujarric said North Korea's government asked last month for help from international humanitarian groups to combat food shortages.
He said food production figures provided by North Korea showed "there is a food gap of about 1.4 million tons expected for 2019, and that's crops including rice, wheat, potato and soybeans."
Mishra's report said North Korea faces annual shortfalls in agricultural production because of a shortage of arable land, lack of access to modern agricultural equipment and fertilisers, and recurrent natural disasters.
Last year, it said, there was a severe heat wave in provinces considered to be the country's "food basket," and the food situation was further aggravated by Typhoon Soulik in late August.
Many North Koreans don't eat an adequately diverse diet, which reinforces their poor nutrition, Mishra said.
Although the national rate of stunting has dropped significantly from 28 per cent in 2012 to 19 per cent in 2017, Mishra cited major regional differences varying from 10 per cent in the capital area of Pyongyang Province to 32 per cent in Ryanggang Province in the northwest bordering China.
He said an estimated 3 per cent of children under age 5 — approximately 140,000 — "suffer from wasting or acute malnutrition" and "have a higher risk of mortality".
"The main underlying causes of wasting are poor household food security, inadequate feeding and care practices, as well as poor access to health, water, hygiene and sanitation services," Mishra said.
The report was issued days after a summit between North Korean leader Kim Jong Un and US President Donald Trump ended without any agreement on the North's nuclear programme.
While UN Security Council sanctions imposed on North Korea over its nuclear and missile programmes are supposed to exempt humanitarian activities, "humanitarian agencies continue to face serious unintended consequences on their programmes," Mishra said.
He cited "lack of funding, the absence of a banking channel for humanitarian transfers and challenges to the delivery of humanitarian supplies."
North Korea's banking channel has been suspended since September 2017 and attempts to find a replacement have been unsuccessful, Mishra said.
He welcomed new procedures approved by the Security Council committee monitoring sanctions against North Korea last August to streamline and expedite requests for exemptions from sanctions for humanitarian programmes.
However, Mishra said, "the continued risk-averse approach taken by suppliers and some authorities in transit countries ... continues to cause significant delays in the delivery of life-saving humanitarian assistance."
Meanwhile North Korea's state TV has aired a documentary glorifying Kim's recent visit to Vietnam that omitted the failed nuclear negotiations with Trump.
The footage's release today came amid reports that North Korea is restoring some facilities at its long-range rocket launch site that it dismantled last year as part of disarmament steps.
The documentary shows a smiling Kim talking with Trump while walking together inside a Hanoi hotel last week.
It shows Kim's black limousine passing through a Hanoi street lined with residents waving flags.
The footage also shows Kim visiting the North Korean Embassy where some skipped and wept with emotions before they took a group photo with the backdrop of a huge picture of Kim's late father and grandfather.
The documentary cited Kim as saying North Korea and the US must put an end to their decades-long animosity and confrontation. But it didn't mention about the lack of an agreement following the Kim-Trump summit.
The Hanoi summit broke down due to disputes over US-led sanctions on North Korea. Washington and Pyongyang blame each other for the talks' breakdown, but both sides still leave the door open for future negotiations.
North Korean documentaries are typically propaganda venerating Kim, the subject of a strong personality cult among the North's 25 million people.
Some observers say omitting the status of the nuclear talks also shows the North hopes to continue negotiations, while also not letting North Korean people know of any diplomatic failures that could damage his leadership.
Earlier Tuesday, two US-based websites specialising in North Korea studies cited commercial satellite imagery as indicating that North Korea is rebuilding some structures at its northwestern rocket launch facility.
South Korea's spy service gave a similar assessment to lawmakers in Seoul in a closed-door briefing on Tuesday.
"I would be very, very disappointed in Chairman Kim," Trump said when reporters asked him about reports of new work at the North's launch site.
"I don't think I will be" disappointed, Trump said, "but we'll see what happens."