North Korea struggles to feed itself due to a mixture of geography and economic policy.
Photographs which depict a lush, rural environment are misleading. The country needs an average of 1m metric tonnes in food aid a year.
"North Korea is not an agrarian country," said Kathi Zellweger, a frequent visitor to the country with aid organisation Caritas. It is mostly rugged mountain terrain, and only about 18% is arable.
It is dependent on fertilizer and machinery to make that land productive, both of which are expensive.
Politics compounds topography. Agriculture in North Korea was collectivised in the 1950s, in line with its Stalinist philosophy of self-reliance.
This means farmers have a low incentive to work hard, said Paul French, a writer on North Korea.
"If their farm produces five times as much, they don't get five times as much food," he said. Instead, they concentrate on their own private plots, which they use to feed themselves and to produce food for the markets.
Spiralling prices :
The problem with this system is that market reforms, instituted in 2002, have sent prices soaring at a higher rate than wages. "Who can afford this stuff in the markets?" asked Mr French.
The answer: only the elite. Government officials, senior managers of state enterprises, security forces, and the leadership of the army are all unlikely to go hungry.
But a typical urban family can now only afford to buy 4kg of maize - the cheapest commodity - a month.
Market prices are too expensive for the average North Korean The UN's World Food Programme estimates that an average urban North Korean's guaranteed diet is around 280g of cereals a day.
However, spokesman Gerald Bourke points out that North Koreans are very adept at foraging for wild food, and may also be given gifts from relatives.
The internationally recommended minimum is 550-590g a day, provided this is nutritionally balanced. But dietary balance is difficult to achieve in North Korea, where foodstuffs such as oil are prohibitively expensive.
The urban diet is partly made up of a ration provided by the government, but this has dropped from 300-250g of cereals per person per day. North Korean officials have told the WFP they expect it to slump to 200g a day.
"The rural folk have already learned how to cope," said Tim Peters, director of aid agency Helping Hands Korea. "But the urban people are so dependent on the government for distribution."
As a result, foreign donations that have helped to prop North Korea up in previous years are doubly important this year.
To date, only 270,000 of the 500,000 tonnes of food needed for 2005 has arrived, the WFP says.
And there is always the risk of natural disaster.
Floods exacerbated the extreme food shortages 10 years ago, and North Korea's ability to cope with them "is now probably worse", said Mr French.
Ongoing land clearance has destroyed natural water breaks, "so it all just comes flooding down".
Mr Bourke was reluctant to paint a worst-case scenario.
"I'm not in the business of predicting numbers that are going to die," he said. "North Koreans are very tough people. They are very accustomed to deprivation. But that doesn't take away the urgent need for food aid."