Many of its 22 million people need handouts from defectors, who have escaped to South Korea, for basic medicines.
Given the puny size of its economy - per capita income is less than $2,000 a year - one of the few ways the North can attract world attention is by emphasising its military threat.
It wants the United States to resume aid and to recognise it diplomatically, although the April launch scuppered a planned food deal.
The North is believed to be some years away from developing a functioning nuclear warhead although it may have enough plutonium for about half a dozen nuclear bombs, according to nuclear experts.
It has also been enriching uranium, which would give it a second path to nuclear weapons as it sits on big natural uranium reserves.
“A successful launch puts North Korea closer to the capability to deploy a weaponised missile,” said Denny Roy, a senior fellow at the East-West Center in Hawaii.
“But this would still require fitting a weapon to the missile and ensuring a reasonable degree of accuracy. The North Koreans probably do not yet have a nuclear weapon small enough for a missile to carry.”
The North says its work is part of a civil nuclear programme although it has also boasted of it being a “nuclear weapons power”.