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What have you done the most often during the lockdown?

A lot of Netflix. Plus, a lot more cooking than I ever thought I was capable of.

A movie/series you would suggest for the lockdown?

There are many on Netflix. For those who haven’t, all the five seasons of “Narcos” is a good start. “Tiger King” was another short, yet amusing series. But nothing beats the latest Netflix series, “The Last Dance” based on the Chicago Bulls Dynasty and their last season together in 1997-98 as Jordan and the Bulls. 

Have you read something good lately?

Duvvuri Subbarao’s “Who Moved My Interest Rate”, based on his tumultuous years as the Governor of the Reserve Bank of India right after the Financial Crisis of 2008. Maybe a good read for our Rastra Bank employees in order to boost the economy after this Covid-19 crisis.

Best music to listen to during the lockdown?

Classic rock never goes out of style. My favorites: The Beatles, Fleetwood Mac, Dire Straits, The Doors, Jimi Hendrix, etc.

How do you work out during the lockdown? 

Haven’t had a chance to work out. The only lifting I’m doing is the remote-control. However, once the lockdown ends, I will head to the mountains, and that’s always been my workout of sorts.

How long do you think the lockdown will last? 

Not sure, but I’d assume end of May 2020. As of now, countries around the globe are trying to buy time as the vaccines being experimented. Current estimates are that vaccines could take from six months to a whopping two years to develop. With that in mind, this lockdown could continue for a year or more, in the worst-case scenario.

What is the first thing you’ll do when the lockdown is over?

Drive around Kathmandu to see what has become of the city.  

If not at home, where would you preferably be locked down?

In the mountains, if the lockdown lasted 2-3 weeks. Anything longer, forget it...I’d rather be home.

If you were to be locked down with a Nepali celebrity for 21 days, who would it be?

My brother and friend, Nirmal Purja (Nims Dai). We will be able to better plan our climbs for next year.

One dish you wouldn’t mind eating every day during the lockdown?

Can’t get enough of a good Dal Bhat Thali. I don’t mind doing it daily for a week or two. However, if it’s eating the same item for a month, “NOTHING” is my answer. 

How would you evaluate Nepal’s healthcare system in the new federal set-up?

Previously, we had a central ministry under which various department and offices functioned. There were five regional centers overseeing district health offices. At the grassroots level, there were health post and sub-health posts. Then there were health volunteers and Aama Samuha (‘mother's groups’) at the grassroots to deal with general health issues. We used those entities for both preventive and curative measures, and there was a lot of coordination among them. We have now adopted a federal structure, which is good in principle. Yet we have failed to ensure robust health structures under it.

How has Nepal’s healthcare system changed in the new set-up?

Earlier, district health offices directly supervised health posts and sub-health posts. Regional health offices supervised and monitored district health offices. The Ministry of Health and Population and its departments in turn monitored the regional health offices. There was a robust chain of command from the center to the grassroots. This helped maintain order in the healthcare system. In the federal set-up, we have a three-tier government. Health posts, PHCs and hospitals with fewer than 15 beds are now under the local government. Under the federal government, there are just big 6-7 hospitals. 

Are you suggesting Nepal’s healthcare system has been facing problems since the country was declared a federation?

A couple of things have created problems. First, the federal government has failed to properly manage human resources. The adjustment of civil servants has not been completed even in over three years; there is either over- or under-staffing. In rural areas, human resources are scant. In a centralized system, we could have forced staff to go to rural areas. We are allocating more and more budget to the provinces, but they are unable to instruct local units to work. That’s the crux of the problem. There is no coordination between provincial and local units. This weakness was also evident during the Dengue fever outbreak last year. 

Second, management of logistics and infrastructure has been faulty. For example, we gave provincial governments budget to buy necessary vaccines and medicines. Of the seven provinces, only Sudur Paschim was able to buy Vitamin A capsules for children. Finally, the federal government had to itself purchase Vitamin A and provided them to other provinces. The bodies authorized to buy vaccines—provincial social development ministries—cannot even make such simple purchases. There is no proper supply-chain for it. Provincial governments have failed to buy and manage other medicines also. There are instances of corruption while purchasing medicines. At the same time, provincial and local units are unable to spend their health budget. And when they spend, they do it unnecessarily.

What about management of information on various diseases? 

The management of information related to diseases is also problematic. Previously, there was a system of proper reporting to the ministry and Department of Health when there was even a minor outbreak of a disease at the grassroots. This reporting process has been disrupted in the federal structure. Local units are not reporting to the upper levels about diseases and health problems in their areas. If we fail to pass the information to the concerned agencies, we cannot handle new diseases. Again, we saw such problems during the outbreak of Dengue in Kathmandu last year. But we seemed to have learned little from our experience.

What could have been done to avoid such problems? 

When I was the Acting Secretary at the Ministry of Health and Population in 2018, we had recommended establishing testing labs in each of the seven provinces because we have only one lab for infectious diseases in Teku, Kathmandu. Labs are needed to immediately test suspected patients at local levels. They also minimize overload at the center. If there were labs in all seven provinces, testing for Covid-19 could have been much easier. But the provincial governments did not take any initiative towards this end. We see coronavirus samples of suspected patients being sent to Kathmandu for a test. There are qualified people outside the government. We can hire them for the provincial labs. 

Do we need a specialized body to tackle epidemics and pandemics? 

Yes. There has been a lot of discussion on it but no progress. We should immediately set up a Center for Disease Control (CDC). We see such entities in countries like the US and India.  Such a body at the central and provincial levels can do research on how to deal with new viruses like corona, as well as train healthcare workers, and inform the public. Additionally, they will empower health workers in dealing with new viruses. Such centers can also conduct research on future pandemics.

Nepal may become an epicenter of other infectious diseases in the future. Before the coronavirus, there was an outbreak of common cold in Humla and Jajarkot districts but we failed to study them. The diseases may also be different in the mountains, hills and plains. A center like the CDC can help prepare us. We are now totally dependent on the World Health Organization since we don’t have an independent research center. After the outbreak of Dengue, we had prepared a plan of action about the CDC. 

Are you suggesting that even in the federal structure, the healthcare system should be centralized? 

Certainly. There should be some sort of centralized system in public health. When we deal with an epidemic or pandemic, there should be a proper chain of command because qualified professionals are concentrated in Kathmandu. We can hand over the duties to provincial levels once they get qualified manpower. But unless provincial and local governments are capable, a proper chain of command should be maintained. Currently, there is a lack of coordination among the three tiers of government. 

Health is a fundamental right of every citizen. There should be universal health coverage. All governments shoulder equal responsibility to provide health services to the people. But the performance of local bodies in health services is dismal; even the health workers are deprived of basic facilities. Our federal structure has failed to ensure the constitutional provision of mandatory healthcare to all citizens. 

Can you share the experience of other countries with federated healthcare systems? 

Different countries have different systems so there cannot be a perfect comparison. But we can learn from others. Consider Pakistan, whose federal model is similar to Nepal’s. They had to centralize some of their health systems when their federally administered programs failed. The provinces of developed countries are resourceful so they can make their own infrastructure. But that is not the case in Nepal. For instance, the Kathmandu Metropolitan City has far more resources than a rural municipality. In some places, there is a lack of technical manpower, while in other places logistics are missing.

We adopted federal health structures without sufficient homework and thinking. There was a hurry. The problem is that non-medical people dominate provinces and local units. Instead of having provincial social development ministries look after health-related issues, we need separate health ministries at the provincial level. You cannot expect good output when you break the chain of command. 

So the existing healthcare system should be totally revamped? 

Definitely. First, all systems should be centrally commanded. Instead of social development ministries at the provincial level, there should be health ministries. There should be CDC in all seven provinces. There should be well-equipped labs in all seven. For this, we need political commitment. All political parties should understand the flaws in our current system. If these flaws are not corrected immediately, we can neither guarantee universal health coverage nor ensure health as a fundamental right. We have to make federal and provincial structures coordinate effectively. 

Why was the federal healthcare system botched even though there was a lot of time to get it right?

There was a lot of discussion about the healthcare system suited for a federal set-up. To be frank, higher authorities of other ministries were dominant in decision-making. The constitution allows deployment of necessary manpower to provide health services. But this did not happen because people who were in decision-making process did not take strong stand when it was needed.  

Nepal also seems to have learned little from the experiences of other countries.

You are correct. We shared the experiences of other countries with our bosses. We prepared a blueprint of the healthcare system suitable for Nepal. However, certain people acted like they knew everything and ignored our suggestions. There was dissatisfaction with the new structure, and some health workers threatened to protest. But people in decision-making simply ignored them.

How do improve communication and coordination between the three tiers of government?

There is coordination in some places but only due to individual efforts. The system as a whole is not working properly. There is a sort of vacuum but no one is paying attention. Until we have separate health ministries at the provincial level, there will continue to be a void. The current provincial health departments cannot give orders to peripheral health posts under local units. You see that both local units and provincial governments are now building corona quarantine centers and temporary hospitals on their own. There is no coordination. It would be more efficient for the two tiers of government to combine their efforts and resources. 

How do you assess the role of Nepali Congress as the main opposition party?

Nepali Congress is the oldest party around. But more than that, it has contributed and sacrificed a lot to emancipate people from autocratic regimes and establish democracy. It has played a vital role in ensuring freedom of speech and expression and creating a pluralistic society. It led the democratic movement of 1950 that brought changes in the social, political and cultural spheres. Even today, Nepali people have great affection for the party.

Now we see some weaknesses in party leadership. It has failed to make some crucial decisions. If the Congress is weak now, it’s only because of the leadership, not its policy and programs, in which it is far ahead of others. Even the com­munist parties tread on its footsteps to build their rhetoric of social and political change. But having failed to act per public expectation, time has come for a revamp of party organization.

What in your view makes Sher Bahadur Deuba a weak leader?

Certainly, he has some weak­nesses. But we have to look back at the party’s recent history. Vet­eran leaders Girija Prasad Koirala, Ganesh Man Singh, and Krishna Prasad Bhattarai also had weak­nesses. Deuba is no exception. If the party operates in a democratic way and its organization is robust, the weakness of a single person doesn’t make much difference.

The new generation does not have to accept all decisions of party lead­ership. Deuba-led NC has failed to meet the expectations of both the people and the party members. Deuba has made several mistakes as the party leader. He never tried to correct those mistakes even when he got multiple chances to do so. That is why dissatisfaction has piled up against him. Deuba has pub­licly confessed to his mistakes on different occasions. But he keeps repeating them. Now he is not in a position to answer his critics. Party leaders and cadres loved him and gave him many opportunities. But he split the party. As president, he has failed to deliver.

But Deuba is still mighty power­ful in the party. Why?

The party president of Nepali Con­gress has traditionally been strong. Even if two-thirds central working committee members and district cadres stand against him, the party president will still be powerful. In the past, Krishna Prasad Bhattarai ran the party his own way. Members sat in protest against Girija Prasad Koirala in front of his residence, but he was still a powerful presi­dent. Cadres showed him black flags on several occasions. Compared to them, Deuba appears weak.

If he is weak, why has no seri­ous challenger emerged against Deuba?

Just listen to the speeches of oth­er top leaders. They talk about the past, they discuss the current sit­uation, and they criticize the gov­ernment. But they can’t come up with any plan for the future. They don’t have a vision to claim party leadership. There is no policy-re­lated discussion in the party. Even party cadres do nothing more than make rounds of top leaders’ homes hoping to bag lucrative appointments. Top leaders look at the fawning cad­res and think their public base is secure.

So isn’t there anyone to replace Deuba in the Nepali Congress?

One thing is sure: the NC cadres want to see leadership change. But change does not mean change of an individual. Changing certain leaders alone cannot bring fresh hope to the party. Similarly, change should not be based on age alone. There should be transformational changes in different areas. Even now, no member has opposed Deuba’s leadership in terms of policy and programs.

There are discussions only from the angle that if a certain person gets leadership, he can bring about dynamic changes. Till now, no one has officially announced their candidacy for party president. Instead of new faces, people expect a concrete vision for the party. Even the contenders to Deuba’s post do not have a new vision or policy to revamp the party. Cadres are looking for a new vision, not only a new face.

Why is there always a dispute over the holding of the NC General Convention?

The party’s General Conven­tion should be held within the stipulated timeframe. In the case of Nepali Congress, there is a tendency of deferring General Convention on various pretexts. The communist parties held their conventions even during the Panchayat era when they were outlawed.

But the NC did not hold a sin­gle convention at that time. Even after that, party president has always tried to avoid convention to stay in power. Such a tendency is evident in the NC sister organi­zations as well. The president wants to defer convention to strengthen his position. In case of crisis and difficult situations, the party statute allows exten­sion of the president’s term. But this liberal policy has often been misused.

What are the chances of anti-Deu­ba camps banding together to defeat him in the upcoming convention?

It would be too early to say any­thing about it. There is still a lot of time before the convention. Even the leaders loyal to Deuba may later abandon him. Considering the sen­timents of the cadres, Deuba’s aides may ask him not to run for party president again. His long-supporters may be telling him that time is not in his favor.

Who could be Deuba’s successor from his own camp?

Right now, I cannot say anything about any individual. It is also pos­sible that Deuba himself declares he would not run for presidency. The current camp may not remain intact. History shows that leaders tend to switch camps. For instance, after 1990, Deuba supported Girija Prasad Koirala for a long time. Deu­ba became home minister and ulti­mately prime minister with Koirala’s support. But Deuba later challenged Koirala for party presidency.

Should senior leaders like Deuba and Ram Chandra Poudel retire from active politics, as some have suggested, and clear the ground for new faces?

Many have suggested that they retire. I do not think that they should give up politics entirely. But it would be better if they confine themselves to the roles of party guardians. They can still have some in energizing party organizations. If they play such a role, it could bring some novelty to the party.

Is it possible that the upcoming convention will hand over lead­ership to the younger generation?

I do not think a new generation means just a new face or young age. New vision and direction are need­ed. Change only on the basis of age does not make much sense. Even Deuba’s election as party president was taken as a handover of party leadership to new generation and there was huge expectation from him. He became president suppos­edly representing the party’s young voice. Now, see, the new generation is totally disappointed by Deuba.

What explains the persistent rifts within the Nepali Congress since the 1990 political change?

Not only Nepali Congress, oth­er parties have a similar problem. Only the appearance of such rifts differs from party to party. Lack of discipline is a major weakness in the NC. 

Q.    What’s the favorite thing in your closet right now?
A.    A green semi woolen sweater that my grandfather passed on to me.

Q.    What are you holding on to that you need to let go of? 
A.    I hoard Apple products. I need to let go of 4 Macbooks and iPhones right now. (Wanted to say past relationships but again it’s too cliché.) 

Q.    What is your pet peeve?
A.    When someone I am talking to is too busy on their phones. It’s so annoying and irritating.

Q.    If you could have any three people (dead or alive) over for dinner, who would they be?
A.    Robin Williams, Arun Thapa, Kobe Bryant.

Q.    What’s on your playlist right now?
A.    Solomun / Lane 8 / Dennis Lloyd

Q.    If you had to work but didn’t need the money, what would you choose to do?
A.    Cut coconuts off trees somewhere in the Caribbean

Q.    Iphone or Android?
A.    Android for now

Q.    Is there an app that you hate but use anyways?
A.    Smoke Free (I haven’t smoked for over two years)

Q.    What is the stupidest thing you’ve done because someone dared you to?
A.    Ate a live, walking cockroach in high school over a bet.

Q.    You get an elephant. You can’t get rid of it. What would you do with it?
A.    Invite kids from all over the country to come play with it.