Can President Donald Trump pen a new chapter in his love story with North Korea’s Kim Jong Un? 

In Trump’s first term, the two leaders, in Trump’s words, “fell in love” after exchanging letters and held three historic meetings, but failed to make much progress toward the goal of denuclearizing the heavily armed hermit state. 

Now, Trump appears to be trying to recapture the magic, reportedly urging aides to set up a meeting with Kim as soon as this fall. This news comes soon after Trump’s Truth Social post on Sunday announcing he had ordered the US military to “substantially reduce” joint military exercises with ally South Korea in part because it would send “a signal that is totally inappropriate and hostile, to a Country that, as long as Donald J. Trump has been President, has been unthreatening and respectful” — North Korea. 

Trump has claimed, without elaborating, that Kim has responded to this overture, but there’s been no public response from Pyongyang yet. 

Trump’s outreach didn’t come entirely out of nowhere. Trump has made clear since the beginning of his term that he would like to meet with Kim again, and there was speculation that a meeting might happen when Trump traveled to South Korea for a summit last fall. North Korea’s UN Mission in New York has also rebuffed several attempts by US officials to deliver a personal letter from Trump seeking to restart dialogue. 

In the midst of an unpopular conflict with Iran that seems unlikely to end in anything resembling a victory, it makes sense that Trump might be reaching back to what he sees as one of the foreign policy high points of his first term. “Kim Jong ​Un has always treated me with great respect,” Trump told reporters on Monday. “I understand him. He understands me.”

Beyond reconnecting with an old friend, it’s not entirely clear what Trump actually wants out of North Korea. But if his goal is a new diplomatic breakthrough, that will be even harder than it was the first time: The country is a much different place than it was the last time the two leaders sat down and even if they were to meet again, Kim seems even less likely to make real concessions. 

Like it or not, North Korea is a nuclear power now

Analysts believe North Korea possesses around 50 nuclear weapons with enough fissile material to build 40 more. It has missiles that are theoretically capable of reaching the US mainland. There was a time when the North Koreans were willing to at least discuss giving up their program in exchange for sanctions relief and major concessions on US military support to South Korea, but that time is probably over, partly thanks to Trump’s own actions. 

“There is no chance that North Korea is going to denuclearize. Zero chance,” said Joseph Yun, a veteran US-North Korea negotiator who recently served as acting US ambassador to South Korea. “They have seen what happened to Iran. They have seen what happened to Ukraine. The way they see it, their nuclear weapons are what protects them.” Last year, the country’s official news agency dismissed denuclearization as an “unrealizable pipe dream.”

On top of that, North Korea is in a much stronger negotiating position than it was the last time these two leaders met for a photo op.

“It’s a very different North Korea now. It’s stronger geopolitically, and Kim is stronger domestically.”

Jung Pak, served as US special representative for North Korea in the Biden administration

In 2018, North Korea was heavily isolated and struggling under an international sanctions regime that was at least officially — if not always in practice — supported by China and Russia as well as the United States. For a young leader still looking to establish his internal legitimacy and international standing, a meeting with the sitting US president was a major coup. 

But things improved dramatically for North Korea after the pandemic. After it began lifting its Covid-era lockdown — one of the toughest in the world — North Korea has become what the Wall Street Journal has called “the world’s most unlikely growth story.”

The country’s economy has grown for three straight years, and while it’s still an impoverished country where nearly half the population is malnourished, Pyongyang is by all accounts booming, with thousands of new homes built along with a surge in Western-style restaurants and ride-hailing apps. 

“North Korea emerged from the pandemic stronger, despite the odds,” said Jung Pak, who served as US special representative for North Korea in the Biden administration. “It’s a very different North Korea now. It’s stronger geopolitically, and Kim is stronger domestically.”

North Korea has been one of the main beneficiaries of the war in Ukraine, sending thousands of soldiers and munitions to help the Russian war effort. While thousands of those troops have died, the North Korean regime has gained billions of dollars in revenue and military aid from Russia in response, as well as invaluable battlefield experience for its commanders and weapons systems.     

Russian President Vladimir Putin has come through for the North Koreans in other ways. In 2024, Russia vetoed the mandate of the UN body that monitored the enforcement of international sanctions on North Korea, effectively shredding the international sanctions regime. In 2025, trade between North Korea and China, its main economic partner, rose 25 percent.  

The regime has found other innovative ways of raising revenue, reportedly netting billions through cybercrime targeted at foreign banks and cryptocurrency exchanges. 

Kim is also less desperate for legitimacy these days. In September 2025, he stood alongside Xi Jinping and Vladimir Putin at a massive military parade in Beijing, a powerful demonstration of unity among three US adversaries. These days, Kim likely feels he’s the one being wooed. Xi’s high profile trip to Pyongyang in June was interpreted by many as a sign that China, warily eyeing the increasingly close relationship between Russia and North Korea, was looking to shore up its ties with its longtime ally. 

Domestically, when the world’s first millennial dictator took power after his father died in 2011, many wondered how long he would last. Today, he’s feeling secure enough to be thinking about long-term handoff plans, publicly positioning his 13-year-old daughter as his future successor. 

Kim is clearly not desperate to meet with Trump, and these days, the United States has fewer means to pressure him. Without Chinese and Russian support, the US can only dial up international sanctions so much. As for military pressure, the US has been moving military assets out of the Korean peninsula to the Middle East and recently redeployed its last aircraft carrier out of Asia. 

As Trump’s actions this week demonstrate, he’s not all that interested in working with US allies in the region to pressure the North Koreans. But if he were considering pairing his warm overtures to Kim with a stick, a “fire and fury” threat wouldn’t pack the same punch today.  

Is there any reason for new US-North Korea talks?

Still, there are reasons Kim might want to sit down with Trump again. North Korea would still like US sanctions lifted. Kim’s influential sister has stated that the regime is looking for the US to formally accept its status as a nuclear power, as Russia has now done.  

Former US State Department North Korea negotiator Joel Wit suspects that given Trump’s desperation for talks, Pyongyang might try to press its advantage even further. 

“If I was a North Korean, I would ask the United States for what I would call a ‘peace agenda,’” he said. “That would mean more than just reducing the size of US-[South Korean] exercises. It could include cutting back on US troops in South Korea or even Guam.”

Trump, who has repeatedly, including in his recent Truth Social post, made clear that he sees the US military presence in South Korea as a waste and the South Koreans as coddled, wealthy freeloaders, might be amenable to concessions like this. 

But what could the US get out of talking to North Korea if denuclearization is off the table? Some analysts have suggested a limited deal might be possible, which could see North Korea dismantle its reactors or some of its centrifuges, slowing down the growth of its nuclear program if not eliminating it. 

Pak also noted that given North Korea’s refusal to engage in nearly any diplomacy with the US since 2019, just holding talks and building some confidence between the two sides would be progress. “The meeting itself would be the win,” Pak said. 

On the other hand, holding talks that do not explicitly aim at eliminating North Korea’s nuclear program would be seen as effectively accepting that North Korea is a nuclear power now. At this point, there’s a strong realist case to be made for accepting North Korea’s nuclear status and proceeding from there, but it’s hard to square with the administration’s stance on Iran’s nuclear program. 

It’s also likely that the kind of incremental concessions North Korea might, in the best of circumstances, be willing to offer, would not satisfy a US president with a penchant for grand bargains. 

In his first term, just the fact that Trump and Kim sat down made history. Now that that’s been accomplished, they may find that, like many a romance a few years in, they’ve run out of things to talk about. 

Since January, many Cubans have lived a life of near-constant darkness. The Trump administration’s oil blockades have led the country into a worsening energy crisis, collapsing what was already an eroding national power grid. 

Daily blackouts have plunged the Cuban nationalized, universal health system, once the pride of the country, into a humanitarian crisis. For months, hospitals have been without necessary power and ambulances strapped for fuel. Piles of trash line the streets, increasing the risk of disease. Cold storage issues threaten lifesaving vaccines, and a combination of the frail economy and US sanctions has left pharmacy shelves almost empty. 

The public health crisis exposes an often overlooked aspect of the way we tend to think about the promise of universal healthcare. Having accessible and free medical services is only one part of the solution. While Cuba’s once-vaunted health system is bound up in its own history and national context, it still demonstrates that public health of all kinds can only be as resilient as the electricity, water, transportation, refrigeration, supply chains, and institutions that enable it. 

An old prototype for universal healthcare 

Not long ago, Cuba’s health system was seen as a promising model for successful free universal healthcare. In the years following Fidel Castro’s rise to power, health authorities focused on the integration of healthcare delivery models into a single public system. The Castro government aimed to expand services once concentrated in Havana into rural areas, such that the entire population would have access to basic care services. In 1974, the government launched community-based polyclinics that placed primary care specialists in almost every Cuban community. 

Over the decades that followed, that widened access to healthcare led to significant, measurable returns. Infant mortality in the country has dropped from 37 per 1,000 live births right after the revolution to seven per 1,000 live births in 2024. Infectious and parasitic disease mortality also improved, dropping from a rate of 45.4 per 100,000 inhabitants in 1970 to 9.8 per 100,000 inhabitants in 2019, according to data reported by the Cuban Public Health Ministry. 

It’s not entirely surprising that the successful Cuban national health model has been the site of curiosity and enthusiastic scrutiny in American health equity circles, despite vast differences in state ideologies. The US has never ensured that every citizen has affordable access to healthcare, and large disparities persist in low-income and rural populations. The chokehold of private insurance has ensured that, unlike nearly every other country in the world, the US has largely rejected the prospect of universal care. Even historic gains in insurance coverage have faced rollback threats under the One Big Beautiful Bill. 

On certain key metrics, the US also falls far behind Cuba, which boasted 9.5 physicians to 1,000 people in 2021. That same year, the US reported just 3.7 physicians to every 1,000 people. The 2019 measles epidemic demonstrated a gap in childhood vaccination rates as well: 92 percent of children ages 13 to 17 in the US received two doses or more of the measles, mumps, and rubella vaccine. In Cuba, the childhood completion rates were well over 99 percent, and the country has not seen a measles outbreak since 1993. 

From its early years, the Cuban health system has functioned against a background of economic decline particular to the country, one attributable to a complex combination of external pressures, among them US blockades, a complicated economic reliance on Venezuela, a struggling state-run economy, and a flailing industry heavily impacted by the Covid-19 pandemic. 

While other sectors faced attrition, Cuba’s health system, at least, appeared capable of weathering these crises. During the pandemic, the country proved to be a model in global health, having developed a homegrown Covid-19 vaccine rapidly and reaching a 95 percent vaccination rate. Its robust supply of trained health professionals made headlines when Cuban healthcare workers provided essential pandemic aid to a small town in Italy.

 So why has this system proved to be so fragile now? 

New blockades deal the final blow after Hurricane Melissa 

Torrents of rain and flooding from the Category 3 Hurricane Melissa hit Cuba in October of last year, affecting much of the island’s eastern provinces. More than 735,000 people were evacuated, and the environmental disaster has put the country’s basic health infrastructure in a precarious state. 

In the storm’s wake, a combination of flooding and damaged water systems increased the spread of viral infections of arboviral diseases such as dengue and oropouche. A report by the Pan American Health Organization published in March placed water, food, and vector-borne diseases in the “very high” health risk categories. Apart from damaged water and sanitation infrastructure, the report describes how disruptions to health service access, routine surveillance of disease vectors, and environmental conditions that breed mosquito-borne disease outbreaks have dramatically increased the risk of infectious disease spread. 

Hurricane Melissa arrived during a recovery period from earlier storms, such as Hurricane Rafael in late 2024, as well as sporadic earthquakes in recent years. These natural disasters also heavily damaged health facilities, leading to collapsed roofing, damaged roads and cables, and the loss of supplies and equipment. 

For years, Cuba’s economy was propped up in large part by its relationship with Venezuela. In exchange for support from Cuba’s highly trained professionals — especially healthcare workers — Venezuela long provided a critical supply of crude oil, which helped the country keep the lights on even in the face of US sanctions. 

That partnership ended in January after the nighttime capture of former Venezuelan President Nicolás Maduro, and the sweeping Trump oil blockade soon after has dealt a challenge too difficult for the energy infrastructure to withstand. 

Already struggling to recover from other disasters, Cuba plunged further into its present crisis. Mario Cruz Peñate, Pan American Health Organization representative for Cuba, said that while the public health situation has been evolving for a while, he has seen more acute upheavals as sanctions persist, causing mass blackouts that have made it impossible to sustain vital health services and emergency care.

Disease control continues to struggle post-Melissa, with aid organizations worrying about communicable food- and water-borne diseases, such as hepatitis A and diarrhea, that can be caused by unrefrigerated food. On the administrative level, limited transportation resources and electricity have led to a dearth of vaccine supplies, which typically require cold rooms for transfer and storage. 

Continuity of care, in particular, has been affected for the worse. More than 100,000 elective and reconstructive surgeries have been postponed, for example, because of a lack of supplies and a backlog of emergency surgeries. At a briefing in May, representatives of the UN Office for the Coordination of Humanitarian Affairs and the World Health Organization reported that over 32,000 pregnant women faced limited access to diagnostics and limited amounts of the stable electricity needed to sustain neonatal units. Prenatal care faces delays because of the lack of everything from testing supplies to available facilities. And now, even once successful improvements in health indicators have fallen: a report from the Center for Economic and Policy Research measured an increase in infant mortality rates from 4.0 to 9.9 per 1,000 births between 2018 and 2025. 

For humanitarian aid organizations, alleviating this health crisis also poses a stark challenge. Cruz Peñate ascribes this to availability, timing, and opportunity to distribute aid supplies, all of which have been made inconsistent by the ongoing blockade. 

“The response to the situation in Cuba has to increase; we have to scale up the response. All the support we can manage to receive will be important,” Cruz Peñate said. “Here in Cuba there is really a situation that needs attention.”

Is Cuba now an outdated prototype for universal healthcare? 

While Cuba’s healthcare system was never bound to map precisely onto the US, some of its most notable successes — the high physician-to-patient ratio, the almost entirely vaccinated population, the ample health screenings — still remain desirable. And yet those very accomplishments have crumbled under the threat of extreme weather events and the country’s inability to restore its broken power grid.  

Trump targeted even more petroleum suppliers in his latest round of sanctions on July 23, leaving Cuba scrambling still further to revitalize its energy sector. Those same sanctions also took aim at the Cuban healthcare export economy, alleging that it involves forced labor. 

Earlier this month, Cuba’s government loosened constraints on a handful of private operations, including pharmaceuticals and elder-care facilities, in response to the shortage of medicine in the country.  With state-stocked shelves running empty, the new decree allows private pharmacies with Cuban health registration to fill in the medicine gap. Similarly, privatized elder facilities are also allowed to operate at a capped rate of 60 people per home, with mandatory visits from state physicians. 

The government still prohibits private sector medical and dental care, and Cuban officials remain adamant that the “socialist state enterprise keeps its central role,” so it’s difficult to claim that the country’s medical model is being pressured towards privatization. But the erosion of some of its elements still speaks to a state-run health system under strain. 

We often think of healthcare itself as an equation of medical services along with healthcare personnel and the authorities — government, industry, or both — that control it. But the crisis facing Cuba gets at the dependence of all of these factors on the broader energy ecosystem. Even a once-promising healthcare model can quickly collapse when a crucial component is missing: fuel.

A version of this story originally appeared in the Future Perfect newsletter. Sign up here!