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The region associated with very high Human Development Index (HDI) countries is indeed the USA and Canada. The Human Development Index is a composite statistic of life expectancy, education, and per capita income indicators used to rank countries into four tiers of human development.

Countries like the USA and Canada exhibit high levels of education, significant access to healthcare, and robust economic performance, which all contribute to their high HDI rankings. In contrast, the other regions listed do not generally show similar metrics of development. For example, many countries in Africa struggle with lower HDI due to various factors, including economic challenges and access to basic services. North Korea, with its isolation and economic difficulties, also registers low on the HDI scale. While some countries in the Middle East may have high HDI levels, the region as a whole is not predominantly associated with very high HDI as strongly as North America is. Hence, the USA and Canada distinctly stand out as a region with very high HDI.