HMPV: A known virus, not a mystery
Recent reports of a Human Metapneumovirus (HMPV) outbreak in China have triggered global concerns, with echoes of the early Covid-19 pandemic raising speculation about a potential health emergency. However, HMPV is not a new or mysterious virus. It has been well-documented for decades as a significant cause of respiratory illness in children, elderly and immunocompromised individuals.
Identified in 2001 at Erasmus Medical Center in the Netherlands, HMPV was initially isolated from children with respiratory illnesses. Published in Nature Medicine, this study indicated all Dutch children were exposed to HMPV by the age of five. Retrospective analyses, however, suggest HMPV has been circulating in humans for 50 years.
HMPV belongs to the Pneumoviridae family along with respiratory syncytial virus (RSV) and the Metapneumovirus genus. This enveloped, single-stranded negative-sense RNA virus has two genetic lineages, A and B, further divided into six sublineages: A1, A2.1, A2.2.1, A2.2.2, B1 and B2. Emerging sublineages A2.2.1 and A2.2.2, were recently identified in pediatric respiratory infections in South India, as reported by the International Society of Infectious Diseases in 2025.
A Virology Journal 2009 genetic study by Vanderbilt University suggests HMPV diverged from Avian Metapneumovirus 200–400 years ago via zoonotic spillover from an avian reservoir, with phylogenetic evidence indicating a spillover event around 200 years ago, emphasizing HMPV’s long-standing presence in human populations.
Symptoms, risk groups and treatment
HMPV is a common etiological agent of respiratory tract infections, affecting infants, children under 15, the elderly, and immunocompromised individuals. Nearly all children are exposed by age five, with reinfections occurring throughout life. According to the US Centers for Disease Control and Prevention (CDC), it spreads via respiratory droplets, close contact, or contaminated surfaces, similar to the transmission of SARS-CoV-2, with an incubation period of 3–6 days. Symptoms vary from mild cough, nasal congestion, fever, and breath shortness to severe pneumonia, bronchiolitis, asthma exacerbations, especially in high-risk groups.
Infants and young children are prone to severe bronchiolitis and pneumonia. The elderly, often with comorbidities like asthma, may experience complications. Immunocompromised individuals face prolonged or severe illness, and pregnant women are at risk of respiratory complications that could affect both maternal and fetal health.
No specific antiviral treatment or vaccine exists for HMPV. Management relies on supportive care, supplemental oxygen, antipyretics and intravenous hydration when needed.
Seasonal outbreaks
HMPV is a seasonal respiratory virus, primarily circulating during late winter and early spring in temperate regions, similar to influenza and RSV. Recent reports of increased cases in China and parts of Asia align with this seasonal pattern. US CDC data also highlight annual outbreaks during these months, influenced by climatic conditions.
Despite comparisons to the Covid-19 pandemic, HMPV is not a novel virus. Identified over two decades back, it has been extensively studied, with over 300 PubMed scientific articles available. While it causes localized outbreaks, its transmission dynamics and clinical severity do not indicate pandemic potential. For instance, HMPV was the predominant virus during the 2002–2003 winter in Norwegian children hospitalized for respiratory infections, as reported in The Pediatric Infectious Disease Journal. Severe pneumonia occurred in some cases, but widespread outbreaks have remained limited to specific populations.
HMPV outbreaks have been documented globally, including Israel (2003), Japan (2003–2004), South Africa (2009-2013), Nicaragua (2011-2016), Western Sydney (2018), South Korea (2022), India (2022), China (2017-2023) and various regions. In Pakistan, HMPV accounted for 5–7 percent of pneumonia admissions in children at Aga Khan University Hospital (2009–2012). HMPV causes 5–10 percent of pediatric acute respiratory infections (ARIs) hospitalizations and is the second most common viral pathogen in certain settings. ARIs are a major global public health problem, causing significant morbidity and mortality, particularly in children.
A 2019 study at Nepal’s Kanti Children’s Hospital revealed a prevalence of 13 percent among children with ARIs, with infections more frequent in those under three years old (22 percent). Symptoms like cough and fever were universally observed.
Besides, data from Nepal’s Sarlahi district (2011–2014) detected HMPV in five percent of infants, identifying three genotypes (A2, B1, B2). A recent Chinese CDC analysis ranked HMPV second among 11 respiratory viruses affecting children under 15 years, with a positivity rate of 6.2 percent in influenza-like illness.
These findings reflect a seasonal uptick, not an unprecedented surge. Factors like colder weather and increased indoor crowding contribute to HMPV’s seasonal prevalence.
Covid-19 lessons
The Covid-19 pandemic highlighted the importance of preparedness, evidence-based communication and robust public health strategies in managing infectious disease outbreaks. While HMPV does not pose the same threat as Covid-19, its current attention emphasizes the need to apply these lessons. Strengthened surveillance systems are essential for early detection, while public education can counter misinformation, reduce anxiety and encourage preventive behaviors. Investment in research on HMPV’s pathogenesis, treatments and vaccine development is key to mitigating its long-term impacts and bolstering public health resilience.
Precautions
The rise in HMPV cases in China and India warrants vigilance but not alarm. Vulnerable populations—infants, rural children, immunocompromised individuals—are particularly at risk, in regions with limited healthcare resources like Nepal. Preventive measures, supportive care and community-driven initiatives are critical to minimizing HMPV’s burden.
Between 2011 and 2014, HMPV infections in rural southern Nepal were associated with adverse outcomes, including an increased risk of small-for-gestational-age births in pregnant women. Interventions targeting febrile respiratory illness in pregnancy could improve maternal and neonatal health in resource-limited settings.
Hygiene practices, regular handwashing and respiratory etiquette, alongside isolation during illness, can reduce HMPV transmission. Enhanced diagnostic capabilities and heightened awareness will support disease management and safeguard at-risk groups.
Policymakers, healthcare providers and community leaders must collaborate to strengthen surveillance systems, improve diagnostics and develop effective preventive strategies. Public health messaging should prioritize education and reassurance, focusing on practical actions to protect vulnerable populations. By taking informed and measured steps, HMPV’s impact can be effectively mitigated, fostering resilience against future viral outbreaks.
The author is a researcher with a PhD degree at Nexus Institute of Research and Innovation
Issues and voices for gender equality
Gender equality has become a challenge in Nepal due to several sociocultural factors. Adhikari R and Sharma J (2022) write in European Bulletin of Himalayan Resource that (in Nepal), women are stereotypically represented as vulnerable, uneducated, or less educated Third World women. The social and political system of Nepal dominated by a patriarchal structure and rooted caste-based hierarchy system has a crucial role in this. Harmful traditional practices (HTPs) such as Chhaupadi, caste-based discrimination, witchcraft accusations, child marriage, dowry and persecution are root causes behind domestic violence and gender inequality.
The United Nations (UN) and the Nepal Administrative Staff College (NASC) define gender as the set of characteristics, social roles, responsibilities, power relations, identities and behavior patterns that distinguish women from men, which are constructed socially and culturally. Sex refers to the biological and physiological differences between males, females and intersex (reproductive differences based on genitalia, chromosomes and hormones) as determined by nature. It is universal and unchangeable. In short, sex refers to biological, born with, not changeable, and gender refers to socially constructed, not born with, changeable.
The International Organization for Migration states that, in Nepal only 22.9 percent of working-age women are in some form of employment compared to 48 percent of men. A UN Women report states that in 2021, only 13 percent of women were in managerial positions in Nepal whereas 22.9 percent of working-age women were engaged in minimum level of employment in comparison with men (employed at 48 percent). It states further that one-third of girls are still married before 18, and the highest rate of polygynous marriage is found in Bagmati Province (at 3.7 percent).
Nepal Police records for the year 2020-21 show that 4222 men committed suicide compared to 2919 women, probably pointing toward the effect of toxic masculinity and social pressure.
It’s been 23 years since Nepal signed and ratified the United Nations Convention on the Elimination of All Forms of Discrimination against Women (UN CEDAW), but gender equality is still a far cry in the country, notwithstanding some improvements at the institutional level. For example, the Constitution of Nepal 2015 has inclusion as a key feature. Formulation and implementation of other relevant acts and policies has increased women’s representation in the parliament to nearly 40 percent.
There are two primary aspects to gender equality: a) human right or institutional perspective b) social or religious perspective.
The social-religious perspective is more relative and contextual as it influences the entire society and institutions to build a system to be continued for development as a process.
The Global Gender Gap Report 2024 from the World Economic Forum reveals that Iceland, Finland and Norway are the top three countries in terms of gender equality, each achieving a score exceeding 87 percent. This improvement is primarily attributed to a positive shift in the personal attitudes and behaviours of individuals, particularly among men toward women; however, the percentage of women in political representation remains around 44-46 percent. According to this report, Rwanda is in the 39th position with women making up 63.8 percent of parliamentary representatives (55 percent of cabinet members are women) and four out of seven judges in the Supreme Court are women. Nepal ranks 117th out of 146 countries in gender equality with a gender inequality index score of 0.661.
This shows that measures like formulation of policies and inclusion of women in top leadership positions roles may not be enough to ensure meaningful inclusion and equality in society. In the pursuit of inclusion, many countries exhibit tokenism driven by superficial advocacy and promotional efforts. In reality, true inclusion and equality stem from recognizing the inherent worth and resilience of every individual while embracing diversity with an open mind and a genuine commitment to education that translates knowledge into meaningful action.
In order to transform a patriarchal society into a gender-equal society, we must begin by giving boys and girls equal rights in ancestral property apart from empowering women with targeted programs and ensuring balance in power dynamics through affirmative actions for proportionate inclusion and meaningful participation of every woman in the system and structures.
The author is a Disability Inclusion Advisor at the United Mission to Nepal
Stability vs growth: Banking at a crossroads
The banking sector in Nepal is currently grappling with a multitude of challenges that have far-reaching implications for the economy. One of the most significant issues is a marked decline in dividend distribution. Historically, banks in Nepal were able to deliver a hefty number of dividends. However, in the last fiscal year, many institutions struggled to provide even a 10 percent dividend, with the sector-wide average falling below five percent. This decline has eroded investor confidence, prompting large investment groups to reconsider their stakes in the sector. The shrinking returns on both capital gains and dividends have exacerbated this hesitancy, underscoring the urgent need for reforms to restore trust and stability.
The decrease in dividend capacity is not a result of NRB policies but stems from the individual banks’ operational challenges. Efficient banks have still been able to distribute dividends, with some banks providing dividends of up to 26 percent, while others have not been able to do so. The banking sector’s struggles are primarily driven by external pressures, including market rumors, which have hindered the functioning of lower-level bank branches. This external pressure has added complexities to the financial ecosystem, and despite the solid capital base of the banks, non-performing loans have risen.
Regulatory changes, particularly the proposed amendments to the Bank and Financial Institutions Act (BAFIA), have further complicated the situation. A contentious provision restricting shareholders who hold more than one percent of a bank’s shares from obtaining loans from other financial institutions has raised concerns among stakeholders. Historically, industrialists have played a pivotal role in establishing banks, but such measures could compel them to liquidate shares or settle loans, leading to market instability. These regulatory changes, coupled with declining demand and operational strain, have stifled the sector’s growth potential. In this context, the Nepal Rastra Bank (NRB) has introduced provisions designed to protect the financial system and avoid a panic scenario. These measures are meant to ensure stability without stifling the long-term viability of the sector.
Economic downturns have also driven a sharp increase in non-performing assets (NPAs), a critical metric for assessing financial health. The average NPA ratio has risen from 1.67 percent two years ago to approximately 4.5 percent, with some ‘C’ category financial institutions reporting NPAs exceeding 10 percent. Even with loan restructuring facilities, NPAs remain near five percent, posing a significant threat to the sector’s stability and the broader economy. Weak loan demand and structural challenges continue to compound these risks, further destabilizing the financial system. This reflects the broader macroeconomic challenges, as well as the unique pressures faced by the banking sector.
The NRB recognizes these challenges and has been working on regulatory frameworks that aim to ensure the resilience of the banking system. While some banks have faced difficulties in profitability, it is essential to note that the NRB’s measures are intended to safeguard the sector, providing the necessary framework for long-term stability. For instance, while external issues have raised questions about profitability, it is clear that banks cannot operate without profitability, and returns on capital investments are critical for sustained operations. The NRB's efforts are geared toward ensuring that the banks remain operational and sustainable, even amid a challenging environment.
Profitability in the banking sector has significantly declined. The return on equity (ROE), a key indicator of financial performance, fell from 21.94 percent in FY 2021-22 to just 4.80 percent in FY 2023-24. Reduced net interest income, weak loan demand and regulatory constraints on fee and commission income have collectively strained earnings. Operational costs, particularly investments in IT infrastructure and compliance, have added to these pressures. While banks like Standard Chartered Bank and Everest Bank reported relatively higher ROEs, others, such as Nepal Bank, struggled to remain profitable. Despite these challenges, NRB’s approach to banking supervision is aimed at creating a balanced environment where the banks are supported through difficult periods without compromising the sector’s financial health.
Credit expansion has been stagnant these days mainly due to the lack of demand. A mismatch between liquidity and demand further compounds the problem, leaving banks with substantial liquidity but limited opportunities for productive lending. This scenario underscores the need for a balanced regulatory framework that promotes both stability and growth. While the NRB’s policies may limit some aspects of banking operations, they are designed with the long-term health of the sector in mind, ensuring the banking system remains solvent and resilient even during challenging periods.
Nepal’s broader economic structure adds another layer of complexity. The government faces a revenue deficit of Rs 170bn, low capital expenditure and high recurrent costs, all of which highlight fiscal imbalances. Federalism has introduced additional financial burdens without commensurate resources for development. High debt-servicing obligations strain the budget further, forcing the government to issue treasury bills even for routine expenditures. Stagnation in the real estate sector and declining investor morale exacerbate these economic pressures, highlighting the need for systemic reforms.
Leadership in the banking sector is undergoing significant changes. Younger leaders, often with decades of experience, are driving digital transformation and operational efficiency. At leading banks, approximately 80 percent of transactions are now digital, enhancing customer satisfaction and streamlining operations. However, aggressive lending strategies aimed at stimulating loan growth have often compromised profitability. A more sustainable approach that aligns banking operations with national development goals, such as job creation and productive investments, is essential for long-term stability.
While some macroeconomic indicators provide grounds for cautious optimism, the persistent lack of credit demand in productive sectors remains a concern. Stabilized foreign exchange reserves and declining interest rates offer a foundation for recovery. However, a comprehensive review of federalism’s fiscal structure, along with targeted expenditure cuts, is critical to avoid a potential debt trap. Transparent collaboration between the private sector and the state can help restore confidence and drive economic recovery.
To address these challenges, a multi-faceted approach is essential. Regulatory frameworks should be revised to strike a balance between stability and growth. Encouraging productive lending and reducing excessive constraints can create a more conducive environment for banking operations. Establishing high-level commissions to address systemic issues and promote transparent collaboration between the private sector and the state is crucial. Additionally, investments in technology and innovation will enhance operational efficiency and customer satisfaction.
The NRB’s policies are continually evolving to ensure the stability of the banking sector while navigating the external challenges it faces. The regulator remains committed to safeguarding the financial system’s integrity, ensuring that both stability and growth can coexist in the long term. Banks are expected to adapt to the changing economic landscape while continuing to contribute to national development. The NRB’s framework aims to foster a balance between operational efficiency, profitability and financial stability, ultimately enabling the banking sector to thrive in challenging economic times.
In a nutshell, while the banking sector in Nepal faces significant challenges, a concerted effort to implement targeted reforms and foster collaboration between stakeholders can pave the way for recovery and growth. By addressing structural inefficiencies and focusing on sustainable practices, the sector can overcome current adversities and emerge as a cornerstone of Nepal’s economic stability and progress. The path forward requires bold decisions, innovative solutions and a collective commitment to building a robust and resilient financial system that supports the nation’s aspirations for sustainable development.
The author is deputy director at Nepal Rastra Bank
Melody of Makar Sankranti in Madhes
“The festival of Makar Sankranti traditionally coincides with the beginning of the Sun’s northward journey (the Uttarayan) when it enters the sign of Makar (the Capricorn). It falls on the 14th of January every year according to the Solar Calendar. This day has a very special significance because the day and night on Makar Sankranti are exactly of equal hours. It is celebrated as a festival right from the times of the Aryans and is looked upon as the most auspicious day by the Hindus,” according to PK Das’ ‘Hindu Feasts And Festivals: Makar Sankranti’.
Madhes is a legendary land of fairs and festivals. There is a festival which falls every month of the year. Most of these festivals are related to gods and goddesses. Makar Sankranti is a unique festival because it is not associated with any god and goddess. It is not even related to a local deity. But it is somewhat related to the sun god visible all over the world. It is celebrated on the first day of the month of Magh according to the Bikram era. It falls in the winter season in which the earth reaches the southernmost point and starts returning to the northern hemisphere. The people of Madhes celebrate it for bright, beautiful and sunny days because there is a shivering cold at that time of the year. So they worship the sun god after immersing themselves in a water body. People dare to dive into the cold water of any river and pond and pool for a ceremonial bath. Bath is compulsory on this occasion for purification of body and mind. So they go to the confluence of rivers for a sacred bath.
Either they go to the Kankai river which is popularly known as Maibeni Mela or Narayanghat where three rivers like Narayani, Seti and Gandaki meet. There they take a customary dip in the river to purify themselves.
Days get warmer and warmer from this auspicious day. A great poet of English literature, PB Shelly is quite right when he says, “If winter comes, can spring be far behind?” So, people are hopeful of winter coming to an end soon. Lazy people also feel enthusiastic, spirited and strong on this day. The message of the Makar Sankranti is to enliven and encourage the lazy and lethargic souls. After taking a bath in a nearby river, they pray to the sun for better health and after coming back home they also seek blessings from elders.
After taking bath early in the morning, people of Mithila eat Khichadi (a mixture of rice and lentils) with pure ghee which is available in their sweet homes. They eat delicious dishes to beat this shivering cold of Magh.
This festival is called ‘Tila Sankranti’ in the Maithili speaking area and Khichadi in the Bhojpuri-speaking area. This festival represents Makar (Capricorn), the tenth sign of the Zodiac. Thus according to the Hindu scriptures the first day of Magh is observed as Makar Sankranti. The month of Magh is considered as a merrymaking month. The month of Poush is considered inauspicious whereas Magh is considered auspicious. Some religious people start bathing the whole month early in the morning, though it is very cold in the morning hours. Even idle and sick people take bath on the auspicious occasion of Maghe Sankranti. It has been articulated astrologically and astronomically that on this day the sun, the only visible god, is the farthest from the earth. So days become longer, better and warmer from this day. The people of Madhes celebrate Maghe Sankranti on the first day of Magh. It is worthy to note that Madhesi culture is very rich and renowned.
Various fairs and festivals are the demonstrators of this richness, bathing rituals and processions take place at various religious places such as Janakpurdham, Dhanushadham and Jaleshwardham. Women throng these pious places and worship Lord Mahadev, the god of gods. They prefer to take bath on the confluence (Sangam) of at least two or more rivers because it is considered sacred. The people of Madhes rush toward rivers and rivulets and take a ceremonial bath to purify themselves. After taking the holy dips, they prepare several sweet recipes such as Mudhi and Lai made of molasses.They also prepare Khichadi—a mixture of rice, vegetables and lentils. So this festival is also called Khichadi in some places of Tarai-Madhes.
Tharu people also celebrate Maghi for three consecutive days. They eat special and decent dishes on this occasion. They sacrifice he-goats, chickens, pigeons and buffaloes. They celebrate their greatest festival by singing and dancing. They call it Maghi in their native language, celebrating it as the beginning of their new fiscal year whereas the people of Mithila celebrate it for one day only.
Non-vegetarian people eat several kinds of dishes of meat according to their choices. Vegetarian people eat sweet potatoes and eat ladoos made by mixing Tila and molasses. This is a very healthy food item as it produces energy and heat in the human body. They also eat Dahi (curd) and Chiuda (beaten rice) and sugar. Khichadi with ghee is also considered a very nutritious food. People prefer to eat this type of food on this occasion. They also invite their married daughters and their husbands’ in-laws and other close relatives for family feasts.
This festival gives enough opportunity for socialization. It is a perfectly cultural and social festival of the Hindu people who constitute a majority in Madhes. This is a great occasion for the grand gathering of this community for exchanging greetings and well-wishes. The main motto of this festival is peace, fraternity and unity in the society. This festival helps in creating an amicable atmosphere of social harmonization.
Makar Sankranti is an important festival that falls in mid-January. It is preceded by Lohri (bonfire) into which is thrown harvest produce like sugarcane stalks, parched rice and sesame seeds. On the day of Sankranti, Khichadi (mishmash of rice, lentils and vegetables) is prepared and given in charity. Sankranti, signifying light, also gives the message of intellectual illumination. It is the Viveka (discriminatory wisdom) to choose between the right and wrong that is believed to lead man on the path of happiness, Utpal K Banarjee fittingly states in his book titled ‘Hindu Joy of Life’.
