Human rights group Amnesty International says North Korea is failing to meet even the most basic health needs of its people.
The group's report was based on interviews with North Korean defectors and health professionals who work with North Koreans, the BBC says.
It describes barely functioning hospitals, poor hygiene and epidemics made worse by widespread malnutrition. Many people were also too poor to pay for treatment.
North Korea spends less than $US1 per person per year on healthcare, World Health Organization figures show.