Washington - Hunger still threatens millions in North Korea, and one symptom of the harsh conditions is the desperation of North Korean refugees trying in the past few days to elude Chinese police and seek asylum at American and Japanese consulates in China.

As the Bush administration prepares to restart talks with North Korea, food, as well as weapons and troops, should be on the agenda. Despite the tense relationship between the two countries, the United States is the leading donor of food to North Korea, which cannot feed its 22 million people.

American negotiators should insist on assurances that this aid is reaching those most in need. Since 1995, the United States has provided more than $500 million in food and other commodities to North Korea - up to 350,000 metric tons of food each year.

This year this aid is down to 155,000 metric tons because of demands for aid in Afghanistan; other countries are also sending less to North Korea. But American deliveries of food and fuel remain critical to Pyongyang. Sending food aid has helped the United States persuade the North Koreans to engage in talks on military-strategic issues.

The aid also shores up the Pyongyang regime, which Washington would rather see improve than collapse, since sudden disintegration could overwhelm South Korea with refugees and create political and economic turmoil. But there is also an overriding humanitarian imperative.

More than two million North Koreans are reported to have died from starvation and related diseases between 1994 and 1998, and large pockets of hunger and starvation remain.

At least 40 percent of children under 5 are malnourished, according to the World Food Program, a United Nations agency. No one really knows, however, how much donated food is diverted to the North Korean military, police, Communist Party officials, essential workers and those loyal to the regime.

The World Food Program argues that food aid is not going to the military because the military has the first cut from national harvests. But the agency has no evidence because there is no independent monitoring of donated food. As the main conduit of American aid, the World Food Program (WFP) has managed to increase the number of North Korean counties it can visit to 163, but its staff is barred from more than 40 and its visits everywhere are supervised. It cannot make random spot checks or bring its own Korean-language interpreters or visit farmers' markets where it could find out whether its food aid is being sold on the black market.

At a Congressional hearing this month, the World Food Program claimed to have a "reasonable degree of assurance" that the food was getting to those who need it. But others at the hearing strongly disagreed. "Anyone who has sat and talked to the North Korean refugees would find it really difficult to believe the assurances of the WFP," Sophie Delaunay, North Korean project representative for Medecins Sans Frontieres, told Congress.

In interviews by humanitarian groups and journalists in the past few years, refugees among the 100,000 to 200,000 who fled to China in search of food have said that they never got any donated food in North Korea and that the regime has denied food aid to those whose loyalty it questions.

It is time for the United States to set some standards. America must not be complicit in food distribution that favors some and discriminates against others. In the coming negotiations, the United States should insist upon unrestricted access to all areas of the country where food is delivered. It should require lists of the actual institutions to which food and medicines are going and uncontrolled access for the World Food Program.

It should press the North Korean government to allow international aid groups to set up feeding stations of their own that are accessible to all hungry North Koreans. The precarious situation of the North Koreans who have crossed into China should also be on the table. These desperate people foraging for food are treated as illegal immigrants and hunted down. When forcibly returned to North Korea, they may face imprisonment.

North Korea wants economic aid and investment, and it desperately needs machinery, fertilizer and technical assistance to improve its agriculture and reform its inefficient collective farms. Equitable distribution of food aid should be a prime condition for such assistance. Roberta Cohen is a senior fellow at the Brookings Institution.