North Korea has often been cited as a worse or comparable humanitarian/economic collapse relative to its peers for decades (especially food insecurity and deprivation), though it’s also hamstrung by war, sanctions, and isolation.
Before Romania's Communist leader Nicolae Ceausescu was executed by firing squad after a summary trial in 1989, he operated one of Eastern Europe's most repressive Secret Police regimes. Hundreds of thousands of people were systematically "disappeared" as Ceausescu splurged cash on megalomaniac projects such as the construction of the "People's Palace," even today one of the world's largest buildings.
Cambodia under the Khmer Rouge (1975–1979) was Maoist communist insurgent regime supported by China's CCP and run as a radical collectivist “Year Zero” project; mass starvation and mass death were extreme even by “socialist project” standards. In the Khmer Rouge's Killing Fields Cambodian genocide systematic persecution and murder of innocent Cambodian citizens by the Khmer Rouge killed 2.2 million under General Secretary Pol Pot killed 2 million people from 1975 to 1979, around 25% of Cambodia's 1975 population.
Ethiopia under the Derg (1970s–80s) (Marxist-Leninist era) was a large-scale coercive collectivization plus civil conflict contributed to catastrophic famine over a million were murdered under the Derg.
Soviet Union in the 1930s (and WWII-era devastation): The USSR isn’t “socialism failed” in one tidy moment, but the combo of forced collectivization, political repression, and famine is among the worst episodes attributable to the Soviet command model. Excess deaths associated with Stalin-era collectivization and related famine across the USSR is roughly 5–10 million. In the Soviet Holodomor, the Ukraine-specific famine during 1932–1933, killed an estimated 3.3–3.9 million
In China's "Great Leap Forward" (late 1950s–early 1960s) Maoist communist economic policy (“backyard” industrialization and extreme collectivization) coincided with mass famine on a historic scale.
Estimates for deaths during China’s Great Leap Forward famine (1959–1961) vary because the underlying demographic data is incomplete or non-existent. Scholars use different methods to estimate excess deaths and have arrived at between 15 and 45 million, depending on the study.
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