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On Feb 4, the world gathers under the new World Cancer Day theme, “United by Unique,” to emphasize the transformative power of personalized, patient-centered care in the global fight against cancer. This theme, which will guide efforts from 2025 to 2027, highlights the need to put individuals and their stories at the heart of cancer care. For Nepal, this presents an opportunity to reimagine its healthcare landscape, focusing on equity, tailored treatments and the human connections that strengthen resilience in the face of cancer.

A significant burden

Nepal’s cancer burden remains significant, with GLOBOCAN 2022 data revealing 22,008 new cases and 14,704 deaths annually. The most common cancers—lung, breast and cervical—continue to impact thousands, with lung cancer alone causing 15 percent of all cancer-related deaths. However, these numbers only tell part of the story. Behind each statistic lies a person—a father battling lung cancer, a mother fighting breast cancer, or a young girl grappling with cervical cancer. Their journeys are defined not only by their diagnoses but also by the unique social, economic and emotional challenges they face.

In rural Nepal, a cancer diagnosis often means traveling long distances for treatment, navigating financial hardship and confronting cultural stigmas. Recognizing these challenges, “United by Unique” underscores the need to build systems that see each patient as an individual with distinct needs.

A whole-person approach

Personalized care goes beyond tailored treatments; it focuses on addressing the whole person, considering their unique circumstances, challenges and needs. In Nepal, this requires understanding the specific risk factors that contribute to cancer, such as tobacco use, diet and environmental pollutants, and creating interventions that resonate with diverse communities.

Tobacco use remains the leading cause of lung cancer in Nepal. Smoking, a deeply ingrained habit for many, requires more than generic anti-smoking campaigns. Personalized tobacco cessation programs that consider cultural attitudes, social contexts and individual motivations can significantly reduce smoking rates. These programs should offer tailored guidance, support systems and resources to help individuals quit smoking while addressing the underlying factors that perpetuate tobacco use.

Access to cancer screening is another critical aspect of personalized care. In Nepal, women in remote areas often face barriers to breast and cervical cancer detection due to a lack of healthcare infrastructure and awareness. Expanding mobile clinics and implementing localized awareness campaigns can bridge this gap, ensuring that early detection services reach those most in need. These efforts can empower women to take proactive steps in managing their health and reduce the burden of advanced-stage cancer diagnoses.

Psychosocial support is equally essential in the fight against cancer. Beyond its physical toll, cancer significantly impacts mental well-being. Providing counseling services and support groups tailored to patients' life stages, family dynamics, and cultural backgrounds can greatly improve their quality of life. These initiatives not only offer emotional relief but also foster a sense of community and resilience among patients and their families, reinforcing the holistic approach central to personalized care.

Care and advocacy

The theme “United by Unique” invites us to listen to and amplify patient voices. Each story sheds light on barriers in the healthcare system, from delayed diagnoses to limited treatment options. These narratives can inspire advocacy efforts for better policies, increased funding and greater collaboration among healthcare providers.

In recent years, initiatives in Nepal have shown the power of a human-centered approach. Programs like community-based cancer awareness drives and partnerships with local organizations have improved outreach and fostered trust among marginalized groups. However, more needs to be done to integrate patient feedback into the design of healthcare services.

Personalized care

Achieving the vision of “United by Unique” in Nepal demands a comprehensive and multifaceted strategy to strengthen systems for personalized cancer care. A crucial first step is investing in infrastructure by establishing provincial cancer centers equipped with advanced diagnostic tools and treatment facilities. This will bring care closer to communities, reducing the need for patients to travel long distances and ensuring timely access to essential services. Equally important is promoting equity in care by addressing financial, geographic and social barriers that prevent many individuals from accessing treatment. Subsidized care, transportation support and inclusive policies can help bridge these gaps and ensure no one is left behind.

Leveraging technology is another vital component of this approach. Digital tools can be used to maintain detailed patient records, enabling healthcare providers to create personalized treatment plans and monitor follow-up care effectively. Technology also facilitates better communication and coordination among care teams. Additionally, fostering partnerships with international organizations, NGOs and local governments can enhance resource sharing, expertise and innovation, strengthening Nepal’s overall healthcare capacity. Finally, empowering patients and their families through educational programs is essential. Providing information about conditions, treatments and care processes equips families to offer informed support to their loved ones, creating a foundation for holistic and compassionate care. Together, these strategies can transform Nepal’s cancer care landscape and bring the vision of personalized care to life.

One patient at a time

This World Cancer Day, Nepal stands united with the global community to affirm that every patient’s journey matters. “United by Unique” challenges us to move beyond one-size-fits-all solutions and focus on the humanity at the core of healthcare. Together, by placing individuals at the center of cancer care, we can close gaps, foster hope and create a brighter future for all.

The author is a public health professional

Eight Madhes-based parties are working to form an alliance to push for the unfulfilled demands of the Madhesi and Tharu communities. Over the past few days, these parties have been meeting regularly to finalize the alliance's structure, code of conduct and leadership. They are also reviewing past agreements with the government, assessing what has been addressed and what remains pending. However, there is a broad agreement that the alliance should not have "Madhes" in its name to present itself as a national political force rather than a regional one.

These parties have clarified that their coalition is not anti-government. The discussions involve the Janata Samajbadi Party, Janamat Party, Janata Samajbadi Nepal, Nagarik Unmukti Party, Loktantrik Samajbadi Party, Rastriya Mukti Party Nepal, Janata Pragatishil and Tarai Madhes Loktantrik Party. Once a dominant force in Nepal’s first Constituent Assembly (CA), Madhes-based parties have gradually lost influence in recent years.

Madhes-based parties opposed the 2015 constitution, which led to its first amendment in 2016, addressing some of their demands. However, after the 2017 local elections, these parties largely abandoned their initial agenda, prioritizing power instead. Now, they are paying close attention to constitutional amendment discussions, especially remarks by major party leaders suggesting that Banke and Bardiya be incorporated into Karnali province—a proposal strongly opposed by Madhesi and Tharu leaders.

Resham Lal Chaudhary, coordinator of Nagarik Unmukti Party, stated that a task force has been formed to identify common concerns, review the implementation of past agreements and highlight unresolved issues. The timing of this effort coincides with ruling parties' plans to amend the constitution, which could directly impact Madhesi and Tharu representation. For instance, the government aims to increase electoral thresholds and modify the current electoral system, changes that Madhes-based parties view with skepticism.

A key demand remains the public release of a report prepared by a commission constituted under former Supreme Court Justice Girish Chandra Lal, which investigated human rights violations during the 2015-16 Madhesi uprising. Madhes-based leaders argue that the government’s failure to make this report public has denied justice to victims, particularly in the Tharu community.

Additionally, Madhes-based parties are aligning with other identity-based movements in Nepal. They have expressed solidarity with protests against a proposed cable car project in Pathibhara, a site known as Mukkumlung in Kirati scriptures. During a solidarity event, Rajendra Mahato, leader of Rastriya Mukti Party Nepal, urged the government to address the demands of Limbuwan activists, reaffirming his party’s support for their cause.

The renewed push for Madhes unity comes as Nepal’s major parties prepare for constitutional amendments, new political forces emerge and local elections approach. In the 2022 federal elections, the strength of Madhes-based parties declined significantly. Upendra Yadav’s Janata Samajbadi Party and CK Raut’s Janamat Party each secured six seats, while Janata Samajbadi Party Nepal won five, Loktantrik Samajbadi Party four and Nagarik Unmukti Party four.

Despite ongoing discussions, it remains uncertain whether Madhes-based parties will succeed in forming an alliance, let alone achieving party unification. Previous attempts have failed due to leadership disputes. Moreover, these parties often align with major national parties—Nepali Congress, CPN-UML and CPN (Maoist Center)—to secure electoral victories rather than uniting among themselves. Many in Madhes are disillusioned with their leadership, seeing them as power-hungry rather than committed to fulfilling their promises.

Should CPN (Maoist Center) Chairperson Pushpa Kamal Dahal’s efforts to break the NC-UML coalition government falter, he may extend support to Madhesi and Janajati demands. If the coalition remains intact until the 2027 elections, an alliance between Maoist, Madhesi and Janajati forces could emerge. However, whether this will translate into lasting political gains for Madhes-based parties remains to be seen.

In the realm of Nepali music, one name stands out as a beacon of talent, dedication, and artistic excellence—Prajwal Lama, an extraordinary pianist and keyboardist. With over 13 years of experience and an impressive presence from Nepal to the global stage, Prajwal’s mastery of the keyboard transforms any melody into an extraordinary masterpiece.

I first encountered his prodigious talent during the inaugural season of Nepal Idol, where I was involved as a director and project head. His presence in the backup band not only reassured the contestants but also the judges. This is why he has remained a top choice for renowned Nepali musician and Nepal Idol judge Nhyoo Bajracharya.

Beyond Nepal Idol, Prajwal has collaborated with celebrated artists such as Sajjan Raj Vaidya and performed in the Ghum Phiri Tour across the United States and Canada. His music has graced some of the world’s most iconic stages, including the Eventim Apollo in London, the Hordern Pavilion in Sydney, and the Festival Hall in Melbourne.

A true bridge between traditional and contemporary music, Prajwal has worked with international artists like Ani Choying Drolma, infusing modern world music with Nepal’s rich cultural heritage. However, his expertise extends far beyond the piano and keyboard—he is a multi-instrumentalist, proficient in guitar, bass guitar, tabla, recorder, madal, damphu, nagara, and vocals. His ability to seamlessly adapt to various musical genres makes him an ideal collaborator for artists across different styles.

Prajwal’s contributions to Nepali music have been recognized on numerous occasions. In 2022, he won the ASP Muzic Community Piano Challenge, showcasing his technical brilliance. In 2019, he was featured on Aimee Nolte Music’s YouTube channel, marking his recognition on an international platform. His performances have also been integral to the Hits FM Music Awards, Tuborg Open Sessions, and The Voice of Nepal.

In addition to his live performances, Prajwal has paid tribute to legendary artists such as Michael Jackson, Queen, Rajesh Hamal, Bon Jovi, Narayan Gopal, and Tara Devi, reinterpreting their music through his unique artistic lens.

Committed to taking Nepali music to the global stage, Prajwal has performed in the UK, Australia, Malaysia, India, and beyond, earning widespread acclaim. Notably, his performance alongside Ani Choying Drolma at the Feel the Heal concert in Malaysia and collaborations with Indian music legends like Asha Bhosale, Anuradha Paudwal, Sanjeevani Bhelande, and Deepa Jha have further cemented his reputation as a versatile and accomplished musician.

Having begun his professional journey as a teenager, Prajwal holds a Bachelor’s degree in Ethnomusicology from Kathmandu University and has earned special qualifications from the Associated Board of the Royal Schools of Music (ABRSM), UK, as well as Nepal Sangeet Level 5. Following Nepal Idol Season 5, he has continued his musical education in the United States, further refining his craft.

With relentless dedication and passion for music, Prajwal Lama is poised to reach even greater heights in the international music industry. His melodies will continue to resonate across Nepal and beyond, leaving a lasting imprint on the world of music.

By all accounts, the country is not on the right path. Nepal is facing a multitude of challenges that require immediate and concerted efforts to address. From agriculture and corruption to climate change and political instability, the issues are deeply interconnected. Without urgent action, the country risks further decline, with long-term consequences for its economy, society, and democracy. To support my argument, I have identified the 10 major problems Nepal is facing today.

Agriculture

I do not want to rely on government statistics, but based on my visits to Karnali, Sudurpashchim and areas surrounding the Kathmandu valley, I can say that Nepal’s agricultural sector is witnessing an alarming decline, with decreasing productivity. On one hand, there is a lack of youth willing to work in agriculture; on the other, a small group of local politicians and government officials are hijacking government subsidies, sidelining genuine farmers. One must be an active member of a political party to receive fertilizer and seed subsidies. Additionally, some people are forging fake agricultural documents to siphon funds that never reach the farmers. Market access for local farmers remains a major issue. Fertile agricultural lands are dangerously becoming barren, and their visible impact will be evident within the next 10 years.

Corruption

For a long time, everyone has been saying that corruption is everywhere, so this issue may seem redundant. However, believe me, it has reached an alarming level, especially at the local level. Corruption has severely compromised the quality of infrastructure projects. There is a dangerous nexus between politicians, government officials and contractors. For instance, I have personally witnessed cases where less than 30 percent of the allocated budget is actually spent on infrastructure projects. Corruption exists even in small health posts—people do not receive the free government-provided medicines because they are diverted to private pharmacies for profit. Corruption has permeated every level of budget allocation and project implementation.

Economy

Government indicators may suggest a gradual economic recovery, as it is also a necessity for the government to manipulate economic data to show progress. For example, the current government has claimed improvements compared to the previous administration. However, the overall sentiment in society clearly indicates that the economy is struggling. Business owners are under severe stress. Visit any small shop, and you will hear about the difficulties they face. People are hesitant to start new businesses due to high loan risks. Even top businesspeople are gradually losing confidence in the national economy. Whether you talk to a small tea shop owner or a leading business figure, optimism is hard to find.

Climate change

Again, this may not sound like a new issue because everyone is talking about it, but Nepal is facing a severe crisis due to climate change. Unfortunately, for our politicians, it is not a matter of urgency. But don’t just blame them—even US President Donald Trump called climate change a hoax. However, visit farms and talk to farmers, and you will feel its devastating effects firsthand. The September floods swept away agricultural lands around the Kathmandu valley. Over the past few months, prolonged droughts have seriously affected winter crops. In the coming years, both floods and droughts will continue to impact vital areas such as water availability, crop production, biodiversity and human settlements.

Misinformation and disinformation

This has emerged as one of the biggest risks to society. Social media platforms are filled with disinformation, and it is disheartening to see that people believe misinformation more readily than the facts. There is a low level of awareness about deepfake technology and how such content is created. This issue could lead to social unrest at any time. Politicians are aware of the spread of disinformation, yet there is no urgency to address it. Passing a few laws alone will not be enough; the government must launch a large-scale awareness campaign. Without it, disinformation could create security threats and other serious problems.

Youth migration

Every young person with a high school degree wants to go abroad. At college classrooms, I hear students discussing their plans to leave. In tea shops, I hear young people talking about how to gather funds to migrate. And in my home village in Kavre, I rarely see young people—most have already left. When I travel abroad, I find many Nepalis working and studying there. This trend does not need further explanation; its long-term economic impact will be severe, especially in the next decade.

Geopolitical tensions

Growing geopolitical tensions are gradually affecting Nepal. The Russia-Ukraine war has had economic and social repercussions here. Additionally, the escalating tensions between the US and China during Trump’s administration will not spare Nepal. Meanwhile, the growing influence of major global powers is increasing polarization within Nepali society. Our politicians are losing their ability to manage or leverage these global developments for the country’s benefit.

Political vacuum

Nepal currently has seven national political parties. Three major ones—Nepali Congress, CPN-UML, and CPN (Maoist Center)—united to promulgate the 2015 constitution. Superficially, it appears that these parties still dominate the political landscape. However, dissatisfaction is growing. More and more people are beginning to believe that traditional parties can no longer solve the country's problems, yet credible new political alternatives have not emerged. Even dedicated local-level cadres of major parties—except those who benefit directly—are considering changing their voting preferences in the next election. This has created a political vacuum at the local level. Which political force will fill this gap?

Pessimism

Nepalis are getting increasingly pessimistic about the country’s future. A majority believe conditions will worsen rather than improve. Many have lost hope that economic growth will create jobs and opportunities. This growing pessimism is contributing to rising mental health issues, which in turn are causing a surge in crimes.

Constitution

The 2015 constitution played a crucial role in maintaining peace, but it is now under threat. Anti-constitution forces are gaining momentum. Meanwhile, the commitment of political parties to the constitution is wavering. If the constitution and current system come under attack, the public is unlikely to rally to protect them because they feel the constitution has failed to improve their lives. If people do not safeguard the constitution, political instability could worsen at any time, potentially endangering democracy itself.