Medicine appeared in Chinese customs data on exports to North Korea for the first time this year, making it the DPRK’s second-most-imported item after tires, in what one expert described as a possible sign that authorities are seeking to address health problems in the country.

Among the paltry $16.8 million worth of goods that went from China to North Korea in July, tires used on buses or trucks took up more than 28% of the share, or some $4.7 million, according to China’s General Administration of Customs (GAC). Medicine and other “pharmaceutical products,” such as insulin and antibiotics