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Every year brings hopeful news about brain disease. Scientists discover drugs that remove toxic proteins. Experimental treatments rescue neurons in animals. Brain scans now reveal damage to extraordinary precision. From the outside, it feels as if cures for Alzheimer’s disease and Parkinson’s disease must already exist somewhere, waiting only to reach patients. Yet inside clinics, the conversation sounds very different.

Doctors can help reduce tremors, improve mobility, and temporarily slow memory decline. But stopping the disease itself remains rare. Families struggle to understand this contradiction. If science is advancing so rapidly, why does the illness continue to progress? This question has quietly become one of the central challenges of modern medicine.

Across all areas of drug development, treatments for brain disorders fail more often than therapies for heart disease, infections, or cancer. Large analyses of pharmaceutical pipelines published in Nature Biotechnology, Biostatistics, and BIO industry reports show that only about 6 to 8 percent of neurological drugs entering clinical trials eventually reach approval. Most fail during Phase II clinical trials; the stage designed to prove that treatment improves human life rather than laboratory biology. In the laboratory, disease looks solvable. In real people, it behaves differently.

When the brain looks better, but the person does not

For decades, Alzheimer’s research focused on amyloid plaques and sticky protein deposits in the brain. The logic seemed simple: remove the plaques and the disease should slow. After many failures, medicine finally succeeded biologically.

Antibody therapies now visibly clear amyloid on brain scans. The EMERGE and ENGAGE trials of Aducanumab showed plaque removal but inconsistent clinical benefit, leading to controversial approval based on biomarker change rather than functional improvement. The CLARITY-AD trial of Lecanemab, published in The New England Journal of Medicine in 2022, showed a statistically significant slowing of decline by about 27 percent, yet the difference in daily life remained modest. The TRAILBLAZER-ALZ 2 trial of Donanemab, published in JAMA in 2023, reported similar results. For families, the outcome felt confusing. The scans improved clearly. Life improved only slightly.

Researchers eventually understood why. Long-term biomarker studies summarized in Lancet Neurology show Alzheimer’s disease begins 15 to 20 years before forgetfulness appears. By the time treatment starts, large parts of the brain network are already lost. Removing plaques changes biology, but it cannot restore neurons that have already died. The treatment works. It simply arrives too late.

Parkinson’s disease, which involves degeneration of dopamine neurons, taught the same lesson. Scientists hoped that protecting these cells would slow progression. In animals, the strategy repeatedly succeeded. In patients, it did not work.

The PRECEPT trial testing CEP-1347 showed no disease-modifying benefit. The STEADY-PD III trial of Isradipine, published in The New England Journal of Medicine in 2020, confirmed that a drug protective in laboratory models did not prevent disability in humans. More recently, anti-alpha-synuclein antibody trials such as PASADENA and PADOVA demonstrated target engagement but failed to produce meaningful clinical improvement.

Pathology studies had already hinted at the explanation. By the time tremor appears, roughly half of substantia nigra dopamine neurons and most striatal dopamine are already lost. A drug cannot protect cells that no longer exist.

The disease begins long before diagnosis

In laboratory models, disease is fast and clear. Toxin damages neurons within days. A mutation produces symptoms within months. Cause and effect are visible. Human neurodegeneration behaves differently. It resembles slow aging under a microscope. Sleep disruption, inflammation, metabolism, environmental exposure, and genetics interact quietly for decades before symptoms appear. By the time someone notices tremor or memory loss, the brain has been compensating for injury for years. Many drugs were designed for early disease but tested in late disease. The medicine did not necessarily fail. The timing did.

One name, many diseases

Another discovery of a further complicated treatment. Alzheimer’s disease and Parkinson’s disease are not single, uniform disorders. Research in Nature Reviews Neurology and Neuron shows multiple biological subtypes involving inflammation, mitochondrial dysfunction, vascular injury, and immune signaling. Parkinson’s may even begin in the gut in some patients and in the brain in others.

Two patients may look identical in clinics but have different underlying biology. When placed in the same clinical trial, a drug helping one subgroup can appear ineffective overall. Cancer treatment improved only after medical science accepted that one diagnosis could contain many diseases. Neurology is now learning the same lesson.

Why this matters even more in Nepal

The gap between discovery and benefit becomes wider in countries like Nepal. As life expectancy rises, dementia and Parkinson’s disease are increasing. Early symptoms such as loss of smell, constipation, sleep disturbance, or slowed movement are often dismissed as normal aging. Medical care is usually sought only after tremors, falls, or major memory problems appear, indicating that the disease has already advanced. At such a stage, treatments designed to slow early degeneration can do little. Scientific progress exists globally, but its impact depends on timing. The challenge is not only access to medicine, but access early enough for medicine to matter.

Why failed trials still move science forward

A failed clinical trial sounds discouraging, but it rarely means the idea was wrong. Often, it means the treatment was given too late, to the wrong subgroup, or measured over too short a period. Because of these lessons, neuroscience is changing direction. Blood biomarkers, imaging, and genetic screening are being developed to detect disease years before symptoms appear. Prevention trials such as AHEAD 3-45 and DIAN-TU now test therapies in people who are biologically positive but still healthy. The central question is shifting from "Does the drug work? To whom should it be administered, and when?”

The real meaning of progress

For families living with brain disease, progress feels painfully slow. Yet decades of disappointing trials revealed something profound: these illnesses begin long before diagnosis. Many treatments did not fail because hope was misplaced. They failed because they met the disease at the wrong moment. The future of brain medicine may depend less on discovering a miracle cure and more on matching the right therapy to the right person at the right stage. When early detection, precise diagnosis, and timely treatment finally align, scientific breakthroughs will stop fading after headlines and begin changing everyday life both around the world and in Nepal.

The author is a PhD candidate in the Department of Neurosciences and Neurological Disorders at the University of Toledo

In the modern era, we often think of state power as the presence of a stable monopoly, borders, bureaucracy, and security forces. But in reality, state power is not confined to such a situation. World history has repeatedly shown that no political power gains stability in popular support until long-standing rulers and their dominance are suddenly overthrown. In my copyrighted theory, “A Theory of Understanding State Power Through Knowledge, Identity, Liberty, and Power, and State-Power” I propose a revolutionary framework for understanding this situation: the “ladder of control.”

I argue that state power is the institutional culmination of a five-step progression. This ladder of knowledge, identity, freedom, and power ultimately leads to state power. By examining this ascent, we can better understand how authority is constructed and why it is resisted.

Step 1: Knowledge as a foundation

The first rung on the ladder of knowledge is knowledge. Knowledge provides the ability to interpret and apply knowledge to shape social outcomes. Historical events have shown that the ultimate gatekeeper of power is the right to control knowledge. Ancient Egyptian scholars used literacy as a means of consolidating power, while today state actors and corporations use “big data” and algorithms to control power.

Knowledge can wield the power of states to monitor and manipulate, like a double-edged sword, through propaganda or censorship. It empowers individuals and institutions. While print media fueled reform in the modern era, the Internet has fueled the rise of Arab and South Asian rebellions and upheavals in the postmodern era. Without the technical, historical, and strategic foundational mastery and maturity of knowledge, any attempt to climb the ladder of statehood is bound to fail.

Step 2: Identity as the catalyst

If knowledge provides the tools, identity provides the motivation. To move beyond individual understanding toward collective action, there must be a shared sense of ‘who we are’. I highlight how ‘imagined communities’—built through national anthems, flags, and shared history—legitimize the state by fostering loyalty.

Yet, identity can also be a source of profound instability. When identity is manipulated to exclude or marginalize, as seen in the ethnic divisions of the Rwandan genocide or modern populist movements, it fragments the very society the state seeks to govern. To successfully ascend this rung, leaders must forge a cohesive identity that unites rather than divides.

Knowledge and identity are two sides of the same coin. Knowledge provides tools, while identity provides inspiration. Identity is collective rather than individual. There must be a shared sense of “who we are.” This highlights how “imagined communities”—constructed through national anthems, flags, and shared histories—enhance the state by fostering loyalty. However, identity can also be a source of deep instability. When identity is manipulated to exclude or marginalize, the brutal events of the Rwandan genocide are even more ancient. This is evident in the ethnic and racial divisions of modern populist movements. The power to govern thus tends to fragment society. For sustainable development and a creative society, leaders must promote and protect a unified identity that unites rather than divides.

Stage 3: Freedom for individual and collective prosperity

The third stage, freedom or liberation, is where knowledge and identity are transformed into productive action. This stage represents the freedom of people to think, speak, and organize freely. In authoritarian regimes, freedom is not for everyone but is limited to a small elite, while in democracies it is widely distributed through voting and citizen participation.

However, the modern era has introduced new tensions in the trade-off between freedom and security. Through surveillance technologies, states curtail civil and business freedoms in the name of security. Without the freedom to organize, even groups with knowledge and identity cannot effectively challenge the status quo.

Stage 4: Power as a mechanism of influence

The final rung and bridge to statehood is power. Power operates through a variety of means. Power operates through coercion (power), economic (resources and resources), cultural (ideology), and political (institutions). However, my theory supports Max Weber’s notion that power must be legitimate in order to endure.

We see a positive transition in great figures like Nelson Mandela. These men of the era transformed the “illegitimate” power exercised by the state into the exercise of “legitimate” power through popular support and moral authority. Such a transformation requires the use of knowledge, identity, and freedom to influence the behavior of others and to gain control over institutions.

Stage 5: State power as the supreme power

State power sits at the top of the ladder, with the institutional authority to govern a territory through legitimate violence, taxation, and a monopoly on law enforcement. Yet I argue that this is not a fixed endpoint. State power is a constantly evolving process that requires maintenance over time.

These five stages represent the basic components of the “ladder of control” and are a framework used to understand how individuals and institutions exercise governance and authority.

The following summary outlines how these elements work to maintain state power:

Knowledge: Serves as the basis for control, using technical expertise and legal frameworks to maintain state legitimacy. It includes the ability to interpret and enforce political outcomes.

Identity: Acts as a catalyst for collective action by uniting populations through shared personal and group narratives and symbols, fostering the sense of loyalty and belonging necessary to maintain state authority.

Freedom: It allows for healthy civic participation and the management of dissent, providing the necessary space for individuals and groups. Freedom acts as a “crucible” that transforms knowledge and identity into tangible action.

Power: It acts as a mechanism of influence through coercive, economic, or political means to enforce authority and defend the territory of the state.

These steps, while not strictly linear, are interdependent, which strengthens the stability of the governing body.

The feedback loop of governance

The premise of this theory is rooted in the recognition of interdependence. The ladder is not a one-way street but a feedback loop. Once achieved, state power must be able to shape the conditions of knowledge, identity, and freedom for the next generation.

The main reason why consensual social welfare states have been stable in Scandinavian countries, including Sweden, is because these elements are balanced there. When these elements are out of balance, as during the French Revolution’s “Reign of Terror,” this controlled ladder collapses when uncontrolled freedom leads to chaos. This imbalance persists into the 21st century, as leaders exploit misinformation (knowledge) to manipulate identities and erode democratic norms (liberties).

Conclusion: A human process

Ultimately, I believe that state power is not a static entity but a human process shaped by agency. Understanding this ladder is all the more important in an era where non-state actors such as corporations and digital networks are challenging traditional boundaries.

To build systems that are powerful, just, and resilient, it is essential that the ladder be accessible to all. The ladder must be built on a foundation of legitimate knowledge and inclusive identity. The struggle for control may never be easy. But it is through this struggle that the soul of a society is defined.

In today’s hectic life, with harrowing conditions like stress at work and home, the impossible traffic gridlock of urban life the moment you step out of your doorstep, the daily struggle, the claustrophobic asphalt jungle, the hive of frantic activity, the choking dust and emission, the almighty swell of humanity, and a city drowned in a din and nasty stench—there is no escaping it.

That apart, with mounting demands and needs to cope with, which never seem to end, it is but natural for you to fall prey to conditions like anxiety, restlessness, distraction, panic attacks, and depression. These are the realities of modern life that we all have to deal with, and they can take a toll on our mental and physical health. That’s where Sky Breath Meditation comes in, offering a way to find peace and balance amidst the chaos.

If those disturbing conditions are not addressed promptly, they invite health issues such as hypertension, heart disease, and diabetes, with life-threatening or even fatal consequences. Nothing is more accurate than the saying: a sound mind in a sound body if you visualize living a happy, stress-free, healthy life.

Sky Breath Meditation, or Sudarshan Kriya Yoga (SKY), stands out from other meditation techniques. It’s a specific breath-based technique that guides your body and mind into a profound state of meditation through cyclical, rhythmic breathing. This unique approach sets it apart and makes it a compelling choice for those seeking a different meditation experience.

Some people may be concerned about the religious or spiritual aspects of the practice, but it’s important to note that SKY is a secular practice that can benefit people of all faiths or none. This emphasis on its secular nature ensures that everyone, regardless of their religious beliefs, can feel comfortable and included in the practice of Sky Breath Meditation.

A regular SKY breath session is more than just a detox. It’s a comprehensive purging of the mind, body, and emotions, relieving the stress and anxiety imposed by social responsibilities and limitations. Beyond this detox, Sky Meditation acts as a creativity booster, a focus sharpener, and a happiness and wellness generator from within. It’s a beacon of hope amid life’s chaos, offering tangible health benefits that can significantly improve your well-being.

Don’t just take my word for it, here’s what Sarah, a regular practitioner, has to say: “Since I started practicing Sky Breath Meditation, I’ve noticed a significant reduction in my stress levels and an increase in my overall well-being. It’s truly been a game-changer for me.” Sarah’s testimonial is a testament to the transformative power of Sky Breath Meditation, inspiring hope and optimism among those considering incorporating it into their lives.

SKY Breath Meditation was created by spiritual teacher Gurudev Sri Sri Ravi Shankar in 1982 in Shimoga, India. One year earlier, in 1981, he started The Art of Living Foundation. This volunteer-based, humanitarian, and educational organization promotes peace and equality through humanitarian projects.

As a token of humanitarian well-being, Sri Sri Ravi Shankar observed a ten-day silence at the foundation’s initiation. The Art of Living Foundation has centers in 180 countries worldwide, including Nepal, located at Shankhamul Park, Shankhamul. This brief history of the practice, along with the global reach and impact of The Art of Living Foundation, helps us understand its roots and inspires respect for the values it embodies.

A Sanskrit word, Sudarshan Kriya translates to: ‘Su’ means power, ‘darshan’ means vision, and ‘Kriya’ means cleansing the body. Thus, Sudarshan Kriya (SKY) symbolizes ‘proper vision by purifying action’. This definition adds depth to our understanding of the practice and its goals. It’s not just about physical health, but also about spiritual growth and self-realization. By practicing SKY, you’re not just improving your health, but also deepening your understanding of yourself and the world around you.

SKY breath meditation is a unique yogic breathing practice that embraces different cyclical breathing forms, varying from slow and soothing to rapid and exhilarating. It is a yogic practice of breathing for health. The best part is, you can do it anywhere, anytime. Whether you’re at home, in the office, or even on a crowded bus, you can always find a few minutes to practice SKY and reap its benefits. This flexibility and ease of integration into your daily routine empower you to take control of your well-being.

Sky Breath Meditation, also known as Sudarshan Kriya, originates in traditional yoga and is based on the yogic practice of Pranayama. In Sanskrit, Prana means life and energy, while Yama signifies the practice of breath regulation. Pranayama is an integral part of yoga that people have practiced for ages to promote physical and mental wellness.

How to do it

The cyclic breathing of Sky Breath Meditation involves four distinct stages: Ujjayi (victorious breath), Bhastrika (Bellow Breaths), chanting of Om, and finally, the Sudarshan kriya. The Sudarshan kriya, the last stage, consists of 20 extended, slow in-and-out breaths, 40 medium-length breaths, and 40 short, fast breaths. This controlled breathing cycle of 20-40-40 is repeated three times.

Let’s examine the purported health benefits of Sky breath meditation, which has gained widespread popularity quickly and influenced over 45m people worldwide. These benefits include: improved sleep, reduced anxiety and depression, increased focus and concentration, enhanced immune function, and better cardiovascular health. These are just a few of the many ways that Sky Breath Meditation can improve your health and well-being.  

May alleviate stress and anxiety

The rise of serum cortisol or ‘stress hormones’ levels causes stress. It’s the main culprit behind all ailments, including life-threatening metabolic diseases like diabetes and hypertension. According to the American Medical Association, stress is responsible for close to 80 percent of all diseases.

A regular session of Sudarshan Kriya (SKY) operates at the cellular level, purifying and organizing cells, tissues, organ systems, and organisms from the smallest to the most complex. This yogic meditation boosts your energy levels and shields you from stress.

Sudarshan Kriya Yoga (SKY) is also recommended for physicians. Their work often involves intense stress and burnout.

Helps calm your mind

When practicing Bhastrika pranayama, you must perform rapid, continuous breathing, which soothes your brain. You can feel the flow of calmness and control surge through your body.  

Manages your lipid profile

Clinical studies show that regular practice of Sudarshan Kriya (SKY) lowers LDL cholesterol and raises HDL cholesterol. SKY also helps maintain heart health by preventing heart failure, stroke, arrhythmia, heart attack, and other issues. It strengthens your foundation for health and well-being.

The International Journal of Yoga reported on a study of undergraduate engineering students. Regular Sudarshan Kriya (SKY) and Pranayama helped improve exam stress and participants’ lipid profiles and blood parameters.

SKY’s controlled breathing regulates the autonomic nervous system. This has positive effects on many physiological processes. Scientific research supports the benefits of Sky Breath Meditation for mental, heart, and immune health.

Fortifies the immune system

Research at AIIMS, New Delhi, studied Sudarshan Kriya (SKY). Results show that regular practice appears to enhance the body's antioxidant defenses at the enzyme, RNA, and DNA levels, thereby protecting cells from oxidative stress damage.

Helps diabetics

Studies have found that a routine regimen of Sudarshan Kriya (SKY) practice promotes self-awareness, behavioral changes, and mindfulness, helping you adopt a better lifestyle, eat healthier food, and avoid self-harmful habits if you have diabetes.

Research and studies support the idea that Sudarshan Kriya (SKY) enhances cellular metabolism by supplying each cell with adequate oxygen, improving insulin resistance and glucose tolerance, and boosting insulin sensitivity. Thus, SKY yogic meditation helps reduce oxidative stress, a bane for type II diabetes. And the boost in antioxidant enzymes helps wreak havoc on free radicals.

The benefits of SKY breath meditation remain untold, almost at arm’s length. Some of them are as follows:

• Relieves depression  and post-traumatic stress disorder (PTSD)
• Relaxes body organs
• Recharges energy and stamina
• Alleviates fatigue
• Reduces body and joint pains (Muscle or musculoskeletal pain)
• Enhances creativity
• Activates the brain
• Boosts mental focus and clarity of mind
• Promotes better sleep
• Betters self-esteem
• Imparts tranquility and peace of mind
• Alleviate PTSD (post-traumatic stress disorder)
• Improves the asthma condition

In a nutshell, SKY Breath Meditation, or Sudarshan Kriya, is a yogic practice that works wonders. It relieves mental stress, fights off life-threatening diseases, and offers a healthy, calm, and peaceful life. Best of all, it’s a practice that you can easily incorporate into your daily routine, giving you the power to take control of your well-being. OM!

Disclaimer: The views expressed in the above text are solely research-based, not medical advice; the author solicits reader discretion and cross-references or consulting a healthcare practitioner for further validation. For a better understanding and more fruitful results, please seek guidance from a qualified and experienced yoga expert before practicing SKY, or call the Foundation’s phone number given above

[email protected]

I am on a gap year after high school, and I refuse to study in Nepal. Before you dismiss this as privilege or unpatriotic, understand: I don’t want to leave because I want to, I am leaving because staying means accepting mediocrity.

Former Prime Minister KP Sharma Oli claimed Nepali students choose foreign universities “by will, not necessity.” This is a comfortable lie. Last year, 112,593 students received government permission to study abroad. Fewer than 1,000 attended top-ranked universities. The remaining 111,593 aren’t chasing Ivy League dreams—they’re fleeing a system that has abandoned them, packing their entire lives into suitcases because survival, not ambition, demands it.

Ask the right questions: Why do parents sacrifice decades of savings not for elite education, but for basic opportunity? Why do students choose debt in foreign countries over ‘free’ education at home? Why do education consultancies occupy Kathmandu’s most expensive real estate while government schools lack benches? The answer isn’t student choice. It’s a system failure. And this election, we must vote like our futures depend on it, because they do.

The trust deficit in Nepali education

When 112,593 Nepali students received government permission to study abroad in FY 2023/24, nearly half the country’s entire university enrollment, they weren't chasing prestige. They were fleeing dysfunction. Surveys reveal the core problems: outdated curricula focused on rote memorization rather than problem-solving, chronic faculty shortages driven by political appointments over merit, campuses closed for union strikes more often than exams, and infrastructure so weak that science students lack functioning laboratories. A telling statistic: 65 percent of study-abroad aspirants cite “better academic facilities” as their primary reason, but the deeper issue is trust. Nepali employers themselves view local degrees skeptically, placing even high-scoring MBA graduates in entry-level roles because they know what the credential represents. 

When your own universities cannot vouch for their graduates, when political parties control student unions and hiring decisions, when classrooms teach students to “crack tests, not solve real-world problems,” education becomes a charade. Students aren’t abandoning Nepal because foreign universities are slightly better. They’re leaving because staying means accepting a degree the market doesn’t respect, taught by faculty hired through connections rather than competence, in institutions that close for political rallies more than they open for research. This isn’t brain drain. It’s a rational escape from institutional collapse. 

While India sends over 1m students abroad annually, its 0.07 percent per capita rate suggests most return with skills. Nepal’s 0.37 percent rate is the highest among comparable nations. We’re losing proportionally five times more educated youth than India, nearly double Vietnam (0.20 percent), and six times more than the Philippines (0.06 percent).

China, despite 1.41bn people, maintains just 0.03 percent outflow because domestic universities now rival Western institutions. Bangladesh (0.05 percent) leveraged its garment industry into upward mobility. Their students return as entrepreneurs. Sri Lanka (0.15 percent), despite economic collapse, maintains stronger public universities. Even Pakistan (0.06 percent), facing political instability, invested in engineering schools that retain talent.

The pattern is clear. Countries investing in domestic education see lower outflow. Those that neglect it watch their brightest queue at consultancies. Our 110,000 annual departures from the 30m population means every extended family has someone abroad. When nearly two out of every 1,000 Nepalis leave annually (19 percent of tertiary-age cohort), we’re not experiencing brain drain. We’re witnessing structural collapse of faith in national institutions.

South Korea transformed from aid recipient to developed nation in one generation by making education the national obsession. If they could do it, why can’t we?

South Korea’s education miracle

South Korea’s transformation from $158 GDP per capita in 1960 to $33,000 by 2023 wasn’t luck. It was political will. Post-Korean War leaders made education the national obsession. They standardized a 6-3-3-4 schooling system, enforced compulsory middle school by 1985, and used lottery-based school assignments to eliminate inequality. When private tutoring threatened equity, they regulated it while maintaining universal access. By 2023, 71 percent of young Koreans held tertiary degrees, the OECD’s highest rate.

The lesson isn’t just policy. It’s leadership. Park Chung-hee, despite authoritarian flaws, treated education as infrastructure, not charity. He built 20,000 classrooms by 1967 because he understood that factories need educated workers. Singapore followed the same playbook, spending 4.5 percent of GDP on merit-based streaming systems, achieving 100 percent secondary enrollment and $82,000 GDP per capita. Taiwan focused on vocational training post-1960, creating the semiconductor talent pool that now powers global tech.

Nepal spends 4.2 percent of GDP on education, below UNESCO’s six percent standard, yet no major party has released a comprehensive education manifesto this election. South Korea proved education delivers 10-15 percent ROI in development. Their leaders chose textbooks over rhetoric. Ours choose highways over human capital. The question isn’t whether Nepal can replicate Korea’s miracle. It’s whether our politicians have the courage to try.

Before you vote, look at your younger sibling studying for SLC. Look at your nephew who dreams of engineering but whose school lacks lab equipment. Ask yourself: what do they actually need?

They need universities where politics stays outside. They need education as public service, not private business. They need research funding so students don’t flee Nepal to run experiments. They need startup culture as normalized as ragging is in medical colleges, as common as alcohol seems in engineering hostels.

Right now, entrepreneurship is a hobby. Research is a luxury. Education is a transaction. Politics controls every hiring decision. Bring one question to rallies: “What is your education plan, and how will you fund it?” Don’t accept “we prioritize youth.” Demand specifics. Will you increase spending to six percent? Remove political appointments? Fund research? Build labs? When?

Post their answers. Vote for plans, not slogans. South Korea’s leaders chose textbooks over rhetoric. If we demand it, ours can too. Your vote decides whether your siblings build futures here or pack them in suitcases.