Amidst this New Yorker Q&A regarding North Korea (you should read the whole thing, by the way), there is this:

Why was the famine so bad? Was it a natural disaster or was it politically created?

Amartya Sen, the economist and Nobel Prize winner, who has studied famine at length, has come up with the very compelling discovery that there has never been a famine in a working democracy. The idea behind Sen’s finding is that, with a free press and full public expression, and with the ballot box as the ultimate form of that popular voice, outrage at conditions that are killing people will instigate the necessary changes. So famine is always, at some level, political.

I think this might be true today, and might be true historically, but I can certainly see how famine might occur in a democracy (especially in a small country, with limited resources, coupled with several bad seasons).

But the generalization, I think, is sound. In North Korea's case it is certainly true.

In the case of North Korea, there were two reasons that people starved to death. One is that you had perfectly wretched management of the economy over a period of three or four decades. Everything was run strictly according to ideology, with absolutely no regard for market economics. And you had a prevailing fiction, which is that the country is self-sufficient, and self-reliant, when in fact the regime was dependent on Soviet support. When the Soviet Union collapsed, they were forced to realize suddenly that they didn’t have food. And, compounding all of this mismanagement, they had some bad floods. Ultimately, though, the reason people starved is that the government didn’t care enough to do what it would take to allow food to get to them. Allowing foreign food into the country, on the condition that it would actually get to the people rather than to the Army or the Party loyalists, would have required them to allow aid workers freedom of movement and control over distribution and so forth. They preferred to preside over the deaths of millions of their people. To put it very clearly, and to be absolutely correct about it, Kim Jong Il murdered two to three million of his people by starving them to death and has never in any way indicated that that bothered him.

I think the West often makes the mistake of looking at sheer dollars or tonnage of food aid given to other countries, which often doesn't reflect the amount of food actually getting to the people who need it.