Humanitarian disasters in closed, authoritarian regimes pose particular challenges to the international community. Government actions can exacerbate or even create crises; this was certainly true of the great famine of the early 1990s. Yet the victims of the regime’s choices are innocents, including overstretched but dedicated doctors and health care workers. If the sanctions regime is impeding an outside humanitarian response, it needs to be adjusted–and quickly. There is evidence—outlined below—that sanctions exemptions are being granted to multilateral institutions and NGOS with greater speed. But by sheer proximity, China and South Korea are best positioned to play a role, and should exploit the discretion they are being given to act.