Kathmandu. In 2081 BS, the health sector had to bear the brunt of some achievements, controversies and the impact of foreign aid cuts. This year, along with the discussion on health insurance, the issue of appointing a junior as the health secretary, leaving a senior, was seen as a controversial issue.
The availability of the human papillomavirus (HPV) vaccine used against cervical cancer and incidents including arson at an herbal medicine company have garnered attention this year. The protests by former king supporters have caused major damage to physical infrastructure, leading to a halt in drug production.
On the other hand, women and children in remote villages have been affected by the suspension of basic health services due to the suspension of foreign aid. Despite these difficulties, the health sector has achieved some achievements this year.
About 1.7 million girls get HPV vaccine
The Ministry of Health and Population has stated that the ‘HPV vaccination’ campaign against cervical cancer will be included in the regular schedule from next year. This is an important achievement this year.
The ministry had conducted the HPV vaccination campaign from last Magh 22 to Falgun 6. About 1.7 million girls have benefited from the campaign. It ranks first in Nepal and fourth in the world among cancers among women. It is reported that four women die from cervical cancer every day in Nepal.
The path shown by the Health Insurance Report
Although the government has launched a health insurance program to make quality health services accessible to the people, questions continue to be raised about its sustainability at various times. Experts say that if the structure and functioning of the Health Insurance Board cannot be brought into innovation, the health insurance problem will continue to fester.
Only 20 percent of citizens have been affiliated with it in the 10 years since the implementation of health insurance. The report of the recently released Health Insurance Reform Suggestions Task Force has shown ample ways to improve the health insurance program.
Since the current benefit package is not sufficient in the event of a fatal disease, it has been suggested that the benefit package should be increased to at least Rs. 500,000 by arranging premiums and co-payments based on the ability of the person to pay.
The task force’s report includes suggestions such as restructuring and renaming of health insurance, making the board fully automated through the use of modern information systems, and expanding the scope of the benefit package.
It has been said that the general public will be compulsorily covered by health insurance and that government employees and workers in the organized sector will be covered by health insurance after a decision is made by the government. Recently, Dr. Raghuraj Kafle and Chandra Bahadur Thapa Chhetri have been appointed as the Executive Director of the Board and the Chairman. Significant improvements in the insurance sector can be expected from them.
Compulsory 100% deadly pictures on tobacco product packages
The Ministry of Health and Population has introduced a rule that 100% deadly pictures should be printed on tobacco product packages from the coming Bhadra 1.
The previous provision of printing warning messages on 90 percent of the area has been amended and the ‘Directive on Printing and Marking Warning Messages and Pictures on Tobacco Product Packages, Packets, Wrappers, Boxes and Parcels, Packaging, 2081’ has been approved, and provision has been made for the production, sale and purchase of tobacco products without warning messages and deadly colored pictures.
Anti-cancer medicines for children
Nepal has received three types of essential medicines for one year in the first phase to treat childhood cancer under the ‘Global Platform for Access to Childhood Cancer Medicines’. The medicines have been made available at Bhaktapur Cancer Hospital, Kanti Children’s Hospital, Patan Institute of Health Sciences and Bharatpur Cancer Hospital for the treatment of childhood cancer.
As per the agreement, Cancer Medicines will provide 35 types of essential medicines free of cost for the next five years (from 2025 to 2030). Around 1,500 children in Nepal are diagnosed with cancer every year.
Distribution of medicines for cerebral palsy
The government is going to provide free treatment to citizens suffering from cerebral palsy (brain stroke). With the support of the American donor organization ‘Direct Relief’ and the facilitation of Nepal’s ‘One Heart Worldwide’, free treatment and medicines will be provided to cerebral palsy patients.
The Ministry of Health and Population has stated that the medicines will be available at Bir Hospital, Tribhuvan University Teaching Hospital and Bharatpur Hospital in the initial phase.
Free treatment for burn victims
The government has decided to provide free treatment to burn victims. Arrangements have been made for free treatment of all burn-related problems except cosmetic ones.
Nepal Aushadhi Limited receives GMP certificate
Nepal Aushadhi Limited has received Good Manufacturing Practice (GMP) certificate as per the standards of the World Health Organization. Ltd. has received this internationally recognized certificate from the Department of Drug Management after fulfilling all the criteria, five decades after its establishment.
With the receipt of the certificate, the company has paved the way for selling medicines, exporting abroad and participating in international tenders. The company has stated that it is currently producing 14 types of medicines under Oral Rehydration Salt (ORS), Tablets and Hemoglobin Fluid (Part-1 and 2).
Breast Cancer Genetic Testing
Hereditary testing (gene sequencing) of breast cancer is now possible at the National Public Health Laboratory. Earlier, it was necessary to send samples outside the country for this test.
This test will determine whether breast cancer is likely to be hereditary. Doctors say that if treatment is provided in the early stages, breast cancer victims can be saved.
Ministry of Health ranks second in semi-annual progress report
The Ministry of Health and Population ranks second in the semi-annual progress report of ministry/agency milestones.
Based on the progress made by the Office of the Prime Minister and Council of Ministers until last December, the Ministry of Health ranks third in the ministry and agency level and second in the evaluation among ministries.
According to the public statement, the Ministry of Health has completed nine of the 11 tasks to be completed by mid-December. Based on this progress, the office has awarded the Ministry of Health 81.8 points. In addition, the Ministry has also received 70 points for the progress of the milestones that should have been started in the current fiscal year and achieved a certain target.
Damage to herbal company
On Chaitra 15, supporters of the former king set fire to the Herbal Production and Processing Company Limited in Koteshwor during a protest, causing damage worth crores of rupees.
In addition to the damage to the building, including the Good Manufacturing Practice (GMP) facility, the fire destroyed raw materials, equipment, packaging equipment, furniture, documents, and other materials used in drug production.
If the company is not restructured in time, it is estimated that it will take years to return it to its previous state.
USAID’s suspension of assistance affects the health sector
The health sector has been dealt a blow by the United States Agency for International Development (USAID) this year. The suspension of USAID assistance is likely to have a long-term impact on health sector programs. Programs such as nutrition, vaccination, newborn and maternal health, and reproductive health are likely to be affected.
In addition, it will also affect the goal of achieving sustainable development by 2030. The US government had been providing $5 million annually to Nepal’s health sector. Although experts have been raising the voice that at least 10 percent of the total budget should be allocated for improving Nepal’s health sector, this sector has not been prioritized.
Spokesperson for the Ministry of Health and Population, Dr. Prakash Budhathoki, said that the reduction in the health budget ceiling has added challenges and that it has also been seen as an opportunity. He informed that although the programs have been affected due to the suspension of assistance from the US agency, priority programs will continue.
He said, ‘There is a budget shortage in the health sector. Only 10 percent of the total budget is allocated for this sector. If the budget were to be increased, no one would be deprived of basic health and emergency health services. We are also trying to implement the recommendations of the health insurance report.’
Spokesperson Budhathoki said that there has been a problem in the work of 396 basic hospitals that have been under consideration for a long time and said that a solution would be found as soon as possible. Minister for Health and Population Pradeep Poudel has been seen as an active minister.
Some have expressed happiness saying that ‘there is a zeal to work’, while others have suggested that ‘time has been spent on continuation of old programs and declarations’ and effective steps should be taken with a new plan.
Public health expert Dr. Rita Thapa said that investment in the health sector is going more towards treatment costs than prevention. She said, “Recently, non-communicable diseases have been increasing. We are not able to pay attention to preventable diseases. Focusing only on treatment costs is becoming more expensive and unnecessary budget is being spent.”
With the health sector’s workforce migrating abroad, creating permanent positions and retaining skilled workforce in the country is seen as the main challenge. Although resident doctors have been protesting, saying that the government is not providing the services as per the government’s guidelines, their demands have not been addressed so far.
The government needs to make the health insurance program systematic and effective and work systematically to prevent non-communicable diseases.
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