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As Nepal moves toward the March 5 elections, tensions between Prime Minister Sushila Karki’s government and the main opposition, the Communist Party of Nepal–Unified MarxistLeninist (CPN-UML), have intensified. What began as political disagreement has evolved into a full-blown confrontation, with the UML positioning itself as the principal challenger to Karki’s administration.

Nepal’s political environment remains volatile since the promulgation of the new constitution in 2015. The three major parties—the Nepali Congress (NC), CPN-UML, and CPN (Maoist Center)—have alternated between alliances and rivalries amid frequent government changes.
 

Maoist Chairman Pushpa Kamal Dahal (Prachanda) was among the first to claim credit for saving the country from a constitutional crisis after the turmoil of September 8–9. He has since positioned himself as a key supporter and negotiator in the formation of the Karki-led government, even announcing early on that elections would be held on March 5.

Over the past few weeks, the relationship between the UML and the government has deteriorated sharply. PM Karki has reportedly refused to meet top leaders of the major political parties, including Dahal, UML Chair KP Sharma Oli, and NC President Sher Bahadur Deuba. At a recent press conference, she allegedly remarked that she “does not want to see the faces” of the three senior leaders, suggesting they should retire and make way for younger politicians.

This statement provoked strong reactions from both Oli and Dahal, though the latter remains broadly supportive of the government. Maoist leaders have accused Oli of failing to adapt to changing political realities, while UML leaders have denounced the Karki administration as “unconstitutional.”

In contrast, the Nepali Congress has maintained a cautious stance—neither overtly supporting nor openly criticizing the government—choosing to avoid the kind of direct confrontation pursued by the UML.

Two major issues have fueled the government-UML conflict. First, early in her tenure, PM Karki reportedly held consultations with security agency chiefs regarding the possible arrest of KP Sharma Oli over his alleged responsibility for the deaths of 19 students during the September 8 protests. The move infuriated the UML.

Soon afterward, a probe committee led by Gauri Bahadur Karki—under government pressure, according to UML leaders—suspended Oli’s passport and restricted his movement outside the Kathmandu Valley. Oli has repeatedly complained that he has been prevented from visiting his burned-down house in Jhapa, allegedly destroyed by protesters.

Meanwhile, Home Minister Om Prakash Aryal’s sharp remarks against UML leaders have further deepened hostilities. UML politburo member Mahesh Basnet has emerged as a leading voice against the government, organizing rallies and public programs that the Home Ministry has condemned as provocative.

At the heart of the dispute lies the contrasting interpretation of the September 8–9 protests.
The Karki government views the unrest as a “Gen-Z revolt”, a spontaneous youth uprising reflecting generational frustration. The UML, however, insists it was a political conspiracy aimed at undermining the party and destabilizing the country.

According to UML leaders, Gen-Z activists withdrew on the afternoon of September 8, and the subsequent violence on September 9 cannot be considered part of a youth movement. Oli has repeatedly dismissed the term Gen-Z, calling it “a western construct irrelevant to Nepal’s socio-political reality.”

UML has rejected the legitimacy of the Karki-led government, accusing it of acting unconstitutionally. On November 9, Oli alleged that “those who set the country on fire” during the protests are the same individuals now in power. The UML has declared a nationwide protest campaign, from grassroots mobilization to mass demonstrations in Kathmandu, to challenge what it calls a “repressive and illegitimate regime.”

As the government finalizes preparations for the March 5 elections, the UML is mobilizing on the streets, setting the stage for a high-stakes showdown. Meanwhile, the Karki administration has demanded the restoration of Parliament to establish what it calls a legitimate constitutional mandate.

COP30 Leaders’ Summit concluded with the adoption of the ‘Call of Belém for the Climate’, a declaration urging accelerated global efforts to confront the worsening climate crisis. Meeting in the Amazonian city of Belém—33 years after the 1992 Rio Earth Summit and marking the 10th anniversary of the Paris Agreement—heads of state reaffirmed their commitment to multilateral climate action, solidarity, and sustainability.

The declaration underscored that “climate change is no longer a threat of the future—it is a tragedy of the present.” Leaders highlighted the urgent need to address intensifying floods, droughts, and wildfires that disproportionately impact vulnerable populations. The Call of Belém emphasized bridging the “ambition, implementation, and means-of-implementation gaps” that continue to hinder progress toward the 1.5°C target.

The declaration outlined several key priorities, including tripling adaptation finance by 2030 and fully operationalizing the Loss and Damage Fund. It also emphasized implementing the Baku–Belém Roadmap, which aims to mobilize $1.3trn annually by 2035 for developing countries. Leaders stressed the need to strengthen climate governance, reform global financial systems, and expand fair, grant-based climate finance. 

Furthermore, the declaration called for advancing the transition away from fossil fuels in a just and equitable manner to achieve net-zero emissions by 2050, while integrating technology transfer, digital innovation, and inclusive development into all aspects of climate action.

‘Climate crisis is our daily reality’

Representing Nepal at the summit, government officials reaffirmed the country’s leadership in nature conservation and sustainable development despite its negligible carbon footprint.

“Nearly 46 percent of Nepal’s land remains under forest cover, protected in partnership with local communities and Indigenous Peoples,” Nepal’s statement read. “Home to Mount Everest and the Himalayas, our country sustains vital ecosystems that provide clean air and fresh water to billions downstream,” said Rajendra Prasad Mishra, Secretary at the Ministry of Forests and Environment.

Nepal highlighted its rapid transition toward electric mobility and clean energy, and its strong policy frameworks through NDC 3.0 and the National Adaptation Plan (NAP). Earlier this year, the country hosted the Sagarmatha Sambaad, a global dialogue that reinforced collective commitment to multilateralism and keeping global warming below 1.5°C.

However, the statement warned that for mountain nations like Nepal, “the climate crisis is not a future threat but a daily reality.” Over 300 lives were lost this year alone to floods, landslides, droughts, glacial lake outbursts, and forest fires intensified by extreme temperatures.

Nepal called on COP30 to deliver concrete outcomes, including the realization of the Baku–Belém Roadmap for mobilizing $1.3trn in climate finance, tripling adaptation finance, and fully operationalizing the Loss and Damage Fund with simplified and direct access for vulnerable countries. “We no longer have the luxury of delay,” Nepal’s statement concluded. “Let us act now—together—to safeguard our people, their livelihoods, and our planet.”

Youths call for climate justice and inclusion

Youths have called for urgent and equitable climate action through a pre-COP30 discussion with government representatives including Madan Prasad Pariyar, Minister for Agriculture and Livestock Development. The dialogue “From the Himalayas to the Amazon: Understanding Climate Negotiations and Nepal’s Engagement” highlighted youth priorities and Nepal’s climate agenda, connecting voices from the Himalayas to the Amazon. For young people in Nepal, a country contributing less than 0.1 percent of global emissions yet among the most climate-vulnerable, the climate crisis is not a future concern but a lived reality. Melting glaciers, erratic rainfall, and worsening floods and droughts have already threatened livelihoods, ecosystems, and our collective future.

In Nepal, youth are already leading the way, organizing climate campaigns, promoting clean energy, and advancing resilience in communities. Yet, their inclusion in decision-making remains limited. Genuine youth participation must be institutionalized, not symbolic, so that young people are recognized as partners in shaping climate policy and solutions, they say.

The event, organized by Clean Energy Nepal, Nepalese Youth for Climate Action (NYCA), and in collaboration with other youth networks, aimed to strengthen youth understanding of international climate processes and align youth advocacy with Nepal’s national climate priorities.  “This initiative gave us the platform to translate our concerns into concrete policy recommendations. Nepalese youth are not only demanding change, we are helping shape it,” said Aakriti Dotel, Network Coordinator of NYCA.

During the meeting, youth representatives presented a joint statement outlining collective priorities for Nepal’s engagement at COP30. In their official submission to the Ministry, they urged the government to keep 1.5°C alive by upholding science-based ambition, emphasizing that every fraction of a degree matters for mountains and communities. 

They called for climate justice, prioritizing fairness for the Global South and ensuring that vulnerable nations receive support rather than debt. The statement highlighted the need for grant-based finance, technology transfer, and capacity building to enhance adaptation and resilience, alongside the operationalization of the Loss and Damage Fund for recovery from unavoidable climate impacts. It further called for 80 percent of climate finance to be directed toward locally led adaptation efforts.

The youths also emphasized the importance of advancing the Dushanbe Glacier Declaration 2025, integrating the mountain agenda into global policy, and institutionalizing the participation of youth, women, and Indigenous Peoples in all climate processes. Additional priorities included promoting clean energy and a just transition through renewable energy and green jobs, recognizing the linkages between climate change, health, and sexual and reproductive health rights (SRHR), and upholding accountability and human rights in line with the ICJ ruling obligating all nations to align their actions with the 1.5°C target. 

Minister Pariyar welcomed the youth recommendations, assuring that their perspectives would be integrated into Nepal’s COP30 position. “Youth voices are vital in shaping effective climate strategies. The government will continue to create platforms for young people to contribute meaningfully to climate action,” he said.

Over the past three and a half decades of political upheaval, Nepal’s healthcare system continues to undergo transition. 

Governance has shifted from a centralized to a federal model. Financing has evolved from a mix of state-funded programs and out-of-pocket payments to include health insurance and growing for-profit incentives. The scope of care has moved from preventive services to hospital-based treatment, with increasing focus on chronic non-communicable diseases.

Political instability has repeatedly delayed or obstructed reforms. Yet profound societal transformations have made restructuring both urgent and unavoidable. These transformations include a shift from a largely rural, agrarian society to a predominantly urban and “modern” one; the rapid evolution of new challenges such as climate change and environmental degradation, antimicrobial resistance, migration-related health issues, and the unchecked commercialization of healthcare. At the same time, ongoing transitions in governance, financing, and professional capacity present opportunities to reimagine the health system.

The COVID-19 pandemic exposed deep structural weaknesses in Nepal’s healthcare system. Unlike some comparable low- and middle-income countries that managed the crisis more effectively, Nepal lacked a trusted primary care network and a data-driven public health infrastructure rooted in communities. Longstanding neglect of socioeconomic and political determinants of health made it almost inevitable that the country would struggle to respond effectively.

With this context in mind, here are the 10 changes that I would like to see in the healthcare arena in Nepal.

1. Bring health to the community: build a robust primary care system.

2. Develop a dynamic public health system from the ground up.

In Nepal, “healthcare” is still largely understood as the treatment provided in hospitals or smaller health centers operated by various levels of government or by non-government entities. Preventive and public health services, which can contribute far more to keeping the population healthy, are often not even recognized as important health services. The scope of public health is narrowly confined to childhood immunization, maternal and child health, and a few other initiatives run by inadequately trained staff or untrained volunteers.

Because state priorities have long centered on health centers, services are naturally focused on diagnosis and treatment. Yet real health is produced not in hospitals, but in households and communities. Awareness and habits formed early in life—regarding hygiene, nutrition, education, the importance of preventive care, the rejection of superstition and addiction, and the pursuit of financial security—determine lifelong wellbeing. Strengthening these social and economic determinants through family- and community-level interventions is the most effective and least expensive investment a state can make to build a healthy nation.

The center of gravity of healthcare must therefore shift from hospitals to households. This requires the systematic expansion of a public health network that reaches every community and is led by well-trained professionals who combine data, science, and social engagement. Such a system would empower citizens to take ownership not only of their personal health behaviors and lifestyle choices, but also of the broader determinants of health—such as pollution control, food safety, green spaces, walkability, traffic safety, and ecological sustainability.

Only such a system can free the country from the persistent grip of food- and waterborne diseases that continue to plague Nepali households—illnesses that most of the world eliminated decades ago using the most basic public health tools. It would also better equip Nepal to confront emerging mega-challenges such as air pollution and environmental degradation, mental health crises, antimicrobial resistance, and future pandemic threats.

A community-based primary care system—staffed by competent general practitioners, nurses, and community health workers, and supported by a strong referral network of secondary and tertiary hospitals—is essential for achieving universal, affordable, and equitable healthcare.

3. Create a National Health Service.

4. Prohibit all financial conflict of interest among healthcare provider organizations and professionals.

5. Phase out profit motives in healthcare.

6. Reform and professionalize the health bureaucracy; improve governance and enhance resilience and adaptability of the healthcare centers.

7. Develop health ministry departments or divisions into centers of expertise and innovation, and end reliance on INGOs and international agencies for health policy and programs. 

Government-run healthcare in Nepal is largely confined to poorly managed and poorly equipped district hospitals and overcrowded provincial or federal facilities. As a result, an estimated one-third to two-thirds of Nepalis seek care from private, for-profit providers. The health market is driven by profit, rewarding the overuse of tests and treatments—particularly intravenous over oral medications—and encouraging unnecessary procedures, including surgeries, excessive follow-up visits, and longer hospital stays.

There are no effective legal or regulatory checks on such conflicts of interest. Oversight bodies have been weakened by regulatory capture, with for-profit interests deeply embedded in professional councils, medical associations, education boards, and even government institutions. Over time, this erosion of ethics has spread to public hospitals as well.

Ordinary citizens ultimately bear the burden—facing information asymmetry, stark inequities in access and quality, unsustainable expenses, and a healthcare system that fails to serve anyone effectively.

These problems cannot be solved through technical adjustments or procedural reforms alone. Real progress requires a fundamental realignment of incentives toward universal, high-quality, and equitable care—beginning with a planned, gradual phase-out of profit motives in healthcare as seen in many Western nations where free market capitalism is idolized. The first step must be to reform remuneration and financial policies so that all arrangements creating conflicts of interest in patient care are strictly prohibited.

State-run health institutions are suffering from chronic inefficiency, weak management, and a lack of direction. There are numerous examples of comparably funded non-government hospitals delivering far better care and higher patient satisfaction with similar resources. Basic protocols for safety and quality—standard elsewhere for decades—are often missing, despite requiring minimal cost or technology.

The health bureaucracy shows little capacity to assess population needs, anticipate future challenges, or use available expertise effectively. It remains overly dependent on I/NGOs to set agendas and even run programs. Weak systems for workforce management, occupational safety, and fair remuneration further undermine morale and performance.

Built without a culture of continuous improvement, this bureaucracy struggles to deliver even basic functions—such as ensuring paracetamol availability during dengue outbreaks or protecting communities from preventable diseases like cholera. Without fundamental reform, it cannot be expected to reduce financial barriers to care, curb out-of-pocket spending, or achieve universal health coverage.

Nepal’s healthcare system—both public health and clinical—requires a complete overhaul. A National Health Service should be established to realize health as a human right and to deliver universal care through a unified, adaptive system capable of meeting the country’s evolving health challenges.

Human resource and remuneration policies must be flexible and competitive to attract and retain expertise at all levels. Only such a system can deliver reliable, community-based primary care; integrate public health with clinical services; uphold professionalism and accountability; realign incentives toward equity and innovation; and advance quality, efficiency, sustainability, and social justice.

8. Reinvest on, and ensure the highest quality of, health education and healthcare professionals’ education.

Education must target both the public and the healthcare workforce:

For the public: awareness of healthy diet and lifestyles, disease prevention, and ecological health.

For professionals: training in evidence-based public health and clinical medicine, quality improvement, and patient-centered, systems-based care.

The Health Education Commission should work with the government or National Health Service to assess system needs for human resources and guide public and private academic institutions accordingly. The immediate priority is to develop skilled human resources in primary care, clinical subspecialties, nursing, allied health, and laboratory sciences. The different levels of the government should financially incentivize both the training and post-training recruitment pathways of critical human resources, such as rural primary care specialists, that are not currentlyconsidered attractive careers.

9. Reorganize budget priorities and expand healthcare investment.

The healthcare budget should be increased to match the vision of health as a public good, not a commodity. Health financing must be made more efficient, sustainable, and focused on continual improvement of the standards, scope and accessibility of the services, and on reduced financial burden for citizens and the state. Nepal can learn numerous lessons from other low- and middle-income countries that have built robust healthcare systems through effective health financing. Health insurance should be reoriented for sustainability and impact - but it is only one part of the solution. The state must view healthcare as a long-term, high-return investment in national development rather than just a fiscal obligation.

10. Build a culture of research and innovation.

Health research in Nepal suffers from poor awareness of priorities, lack of rigor and quality, limited funding in a “market” ecosystem, and weak institutional support or even bureaucratic obstructionism. The body assigned with the dual role of regulating research in the country as well as promoting and conducting research - the Nepal Health Research Council - is itself mired in serious conflicts of interest and needs urgent restructuring, retaining only the regulatory functions. Research should be embedded within ministry divisions, academic institutions and major hospitals and public health units to generate evidence that drives reform. Building such internal research capacity within the government health network (or the National Health Service) is essential for an accountable, self-learning, adaptive, and independent healthcare system.

In conclusion, Nepal’s healthcare reform must be guided by one principle: health is a human right, not a commodity. A unified, science-guided, community-rooted health system - free from perverse incentives and powered by research, education, and public trust - can finally deliver health and dignity for all.

Lorenzo Viviani’s ‘Leadership and Democracy: A Political Sociology of the Personalization of Leadership’ examines how political leadership is transforming in contemporary democracies. He argues that power is increasingly personalized, shaped by the charisma, image and populist styles of individual leaders. These developments, Viviani explains, redefine leadership, legitimacy and democratic institutions. To understand modern leadership, he emphasizes, one must analyze how the relationship between leaders and voters is evolving and what factors shape perceptions of legitimacy and trust (2024). 

Nepal’s recent political developments can be interpreted within this framework. The youth-led protests of Sept 8–9 raised profound questions about leadership, legitimacy and governance. A major turning point came earlier that month, when the government imposed a social media ban on Sept 4. The subsequent protests not only forced the government’s resignation but also fundamentally reshaped Nepal’s political discourse. A lack of transparency, declining charisma among political leaders and the rise of populist rhetoric were central to this crisis.
Thousands of young people mobilized against the Oli government, accusing it of authoritarian behavior and widespread corruption. Tragically, security forces killed a number of protesters and injured many others on the first day. The government’s response was marked by indifference; no cabinet minister resigned or expressed remorse. 

Instead, officials used harsh language against demonstrators, exposing the regime’s authoritarian tendencies despite its democratic mandate. Public anger intensified, and by the second day, the protests had turned violent. Government and private properties, including the Prime Minister’s Office, the Supreme Court and residences of political figures, were set ablaze. Unable to control the situation, the Oli government resigned, and the prime minister was evacuated under military protection. Prominent figures, including Nepali Congress leader Sher Bahadur Deuba, were assaulted by crowds in an unprecedented display of public outrage.
In the aftermath, an interim government was established under former Chief Justice Sushila Karki, with a mandate to conduct parliamentary elections within six months. From a conflict studies perspective, this transition offers valuable insights into the erosion of democratic legitimacy and the interplay of leadership, governance and populism. 

The Oli administration had failed to meet public expectations, relying on nationalist rhetoric as a political survival strategy rather than pursuing genuine reform. His government’s verbal attacks, manipulative politics and outdated economic vision alienated the public. Instead of strengthening institutions, it punished opponents selectively and used the justice system for retribution. Transparency collapsed, and bureaucratic inefficiency appeared to serve as a shield to corruption.
The decline of charisma among Nepal’s political elite further deepened the crisis. Charisma, in this context, refers not to personal appeal but to visionary leadership and moral authority. Long-standing political leaders failed to articulate a compelling national vision. The traditional rhetoric of democracy, development and prosperity no longer inspired the youth. Dominated by aging figures with conventional mindsets, major parties have struggled to deliver tangible progress, leading to public disappointment. When leaders lose moral grounding and credibility, authority inevitably weakens. 

Figures such as KP Oli, Sher Bahadur Deuba and Pushpa Kamal Dahal saw their influence erode as perceptions of self-interest and moral decay grew. Their visible wealth and comfort contrasted sharply with public hardship, reinforcing cynicism. The resulting collapse of charisma contributed to governance instability and accelerated democratic erosion.
Neo-populist trends also played a critical role in Nepal’s recent upheaval. Both emerging and established leaders adopted populist strategies to gain influence. Within the Nepali Congress, Gagan Thapa’s campaign for youth leadership directly challenged the establishment authority of senior figures such as Sher Bahadur Deuba. While the movement mobilized younger voters, it often prioritized personal ambition over institutional reform and civic education. 

Although frustration with the older generation’s corruption and stagnation is understandable, turning to populist shortcuts risks further democratic erosion. Leaders propelled by populist appeal frequently weaken institutions, restrict civil liberties and centralize power, even when elected through democratic means. Consequently, Thapa and his allies, despite their electoral legitimacy, risk undermining Nepal’s fragile democratic foundations if populism continues to define their political trajectory.
As Viviani observes, political power has become increasingly personalized. Nepal’s youth movement and subsequent political transition exemplify how populist manipulation of public discourse can disrupt democratic stability. 

Fueled by technology and vast, often misleading information flows, young protesters demanded instant transformation and prosperity. 

However, the absence of civic education and unrealistic expectations led to frustration and destructive outcomes. The violence and instability that followed severely damaged Nepal’s international standing. Foreign investors, already cautious, became even more hesitant. The destruction of historic landmarks, private enterprises and public infrastructure symbolizes not renewal but regression. Ultimately, the crisis has left Nepal more polarized, ego-driven and fragile, posing serious challenges for the nation’s democratic future.
Nepal’s recent political crisis reflects the growing personalization of power that Viviani describes in Leadership and Democracy. The 2025 youth-led protests, sparked by government repression and corruption, exposed the collapse of transparency, moral leadership and public trust. As traditional leaders lost credibility and populist figures rose, Nepal’s democracy weakened further, marked by violence, institutional decay and deep generational frustration with unfulfilled promises.