North Korea is well into its second decade of chronic food shortages. With plausible policy adjustments – such as maintaining food imports on commercial terms or aggressively seeking multilateral assistance – the government could have avoided the famine and the shortages that continue to plague the country. Instead, the regime blocked humanitarian aid to the hardest hit parts of the country during the peak of the famine and curtailed commercial imports of food once humanitarian assistance began. The DPRK stopped importing food and gradually reduced the purchase of grain to as low as one-tenth of the needed amount. After over one decade of humanitarian missions on the ground in North Korea, such programs are far from living up to international standards. We have no guarantee that aid is reaching the truly needy, and the communist regime consistently spoils any attempts to control its distribution. The report concludes that we have therefore to pose the question whether the ultimate result of humanitarian aid is the reinforcement of the North Korean regime.