More than 10 million North Korean citizens urgently need humanitarian assistance, a new United Nations report published on Wednesday said.

The annual “Needs and Priorities Plan,” compiled by the UN’s Resident Coordinator for the DPRK, was the latest warning from a humanitarian organization that a high percentage of North Korea’s population still lacks access to vital nutrition, medicine, and clean water.

According to the report, some 10.4 million North Koreans — about four out of every 10 people in the country — require humanitarian help.

“The people of the [DPRK] remain caught in a protracted cycle of humanitarian need that,