North Korea has yet to report a single case of COVID-19—a remarkable success that, if true, the nation achieved after severing links with the outside world. But that isolation could soon exact a steep toll in other areas of public health: Humanitarian groups warn the isolated country is facing eroding food security, and they are bracing for a rapid spread of tuberculosis (TB), as supplies of first-line drugs against more treatable strains are expected to run out this month.

North Korea watchers warn that the country’s aggressive measures to defend itself against COVID-19, the illness caused by the novel coronavirus, are hobbling efforts to combat tuberculosis (TB) and other infectious diseases.

A fuse is about to be lit on an infectious disease powderkeg in northeast Asia. On 30 June, The Global Fund to Fight AIDS, Tuberculosis and Malaria will pull the plug on its grants to North Korea, which has one of the highest rates of tuberculosis (TB) in the world. The pullout leaves the isolated nation with about 1 year to line up a new source of medicines and diagnostics to combat a deepening TB crisis.