Essential vaccines are running out in Nepal. It’s time to act

Nepal's public health system is grappling with a persistent crisis, characterized by severe shortages of essential vaccines and life-saving medications, compromising the well-being of its citizens. This systemic issue extends beyond mere administrative delays, impacting critical treatments like chemotherapy and basic immunizations.

In oncology departments, vital platinum-based chemotherapy drugs such as carboplatin, cisplatin, and oxaliplatin have been unavailable for months. This scarcity is attributed to rigid government-imposed price caps that deter importers from covering rising raw material costs. Consequently, patients are forced to seek these drugs in unregulated markets, paying exorbitant prices, up to Rs15,000 for a vial of carboplatin that should cost around Rs1,300.

The crisis is compounded by structural deficiencies in preventive healthcare. The routine Japanese Encephalitis (JE) immunization program excludes the adult population, who constitute the majority of recent infections and fatalities in affected districts. Furthermore, the cessation of bilateral international funding has dismantled community-based HIV prevention services, leaving high-risk groups without essential pre-exposure prophylaxis. Even for conditions like tuberculosis, where treatment is theoretically free, patients face catastrophic costs due to non-exempt clinical tests and transportation expenses.

The government's response has often involved downplaying the severity of these shortages and shifting procurement burdens to under-funded local authorities. To rectify these chronic failures, the article advocates for a transition from reactive crisis management to proactive systemic reform. Key recommendations include establishing a dynamic, automated pricing mechanism for imported pharmaceuticals and expanding immunization coverage to include all at-risk populations, ensuring the state fulfills its primary duty to preserve its citizens' lives and well-being.