Submit your Article

Nepal, nestled in the heart of the Himalayas, boasts a rich tapestry of culture, tradition and natural beauty. Yet, beneath its picturesque landscapes lies a healthcare sector grappling with challenges while teeming with untapped potential. As the nation strides toward socio-economic prosperity, the transformation of its healthcare landscape can prove to be substantive through interventions like augmenting investment along with promoting public and private sector collaboration in bolstering medical tourism, oriental health care practices, pharmaceutical industry and medical education.

At the core of Nepal’s healthcare discourse lies the issue of healthcare expenditure, measured as a percentage of the country’s gross domestic product (GDP). While developed nations like the United States allocate a substantial portion of their GDP — 17.3 percent, to be precise — toward healthcare, Nepal’s investment in this vital sector remains comparatively modest. However, as the wheels of economic development gain momentum, there exists a ripe opportunity to bolster healthcare spending, thereby catalyzing improved health outcomes and driving socioeconomic advancement.

The dichotomy between public and private healthcare sectors paints a nuanced picture of Nepal’s healthcare landscape. The Health Management Information System (HMIS) 2020-21 data shed light on the significant role of private hospitals, with a higher proportion of patients seeking care in these facilities compared to their public counterparts. Yet, rather than viewing this as a stark division, fostering collaboration between the public and private sectors emerges as a potent strategy to fortify Nepal’s healthcare ecosystem. By incentivizing private sector investment in healthcare infrastructure, quality assurance measures, and capacity-building, Nepal can forge a path toward enhanced service delivery and sectoral development.

In the realm of medical tourism, Nepal remains as a hidden gem, offering a blend of high-quality medical treatments at affordable rates against the backdrop of breathtaking landscapes from the touristic perspective and the intensity of the global flow of medical tourists. The global medical tourism industry, valued at $9.7bn in 2022, presents a lucrative opportunity for Nepal to showcase its prowess in healthcare provision. Cosmetic procedures, dental care, infertility treatments — Nepal’s offerings resonate with individuals seeking quality healthcare services without breaking the bank. Organizations like the Nepal Medical Tourism Organization (NEMTO) play a pivotal role in elevating Nepal as a premier medical tourism destination, thereby bolstering the economy and the healthcare sector in tandem.

While modern medicine holds sway, the integration of alternative medicine — Ayurveda, Yog, traditional healing practices — presents a symbiotic relationship between health improvement and tourism development. Embracing these age-old practices not only expands healthcare options for citizens but also taps into the burgeoning trend of holistic wellness travel. As global travelers seek sanctuary in Nepal’s tranquil abodes, the convergence of traditional wisdom and modern healthcare catapults the nation onto the world stage as a beacon of well-being and rejuvenation.

In terms of pharmaceuticals, Nepal stands at the cusp of innovation and self-reliance. With pharmaceuticals constituting a significant portion of healthcare expenditure, investing in local production holds the promise of reducing dependence on imports and stimulating economic growth. Strategic investments, regulatory reforms and international partnerships pave the way for Nepal to emerge as a pharmaceutical powerhouse, aligning its healthcare sector with global standards and amplifying its impact on regional markets.

Amidst the promises of progress lie challenges that demand attention and resolve. The unfilled MBBS seats for international students underscore the need for strategic interventions to attract talent and maximize the sector's potential. Strategic advertising campaigns highlighting Nepal’s quality medical education, affordable fees and promising career prospects can serve as a beacon, drawing aspiring medical professionals to Nepal's shores and addressing economic concerns in one fell swoop.

In conclusion, Nepal’s healthcare sector stands at a crossroads of transformation and innovation. By embracing challenges as opportunities, Nepal has the potential to emerge as a beacon of healthcare excellence in the region and beyond. Through sensible interventions in the aforementioned sectors Nepal can chart a course toward a healthier, more prosperous future — a future where healthcare transcends boundaries and transforms lives.

Nepal has a new Minister for Youth and Sports.

Perhaps this is the opportunity for the nation to come up with robust solutions to develop two areas of policy-making that have been traditionally neglected and relegated to a second-class status within the domains of decision-making. Biraj Bhakta Shrestha is the new minister and he has some daunting tasks ahead of him.

To be fair to his predecessor, Dig Bahadur Limbu, it would be interesting to assess what has been done during the previous government. Yet is it not yet a practice to review and give scores to what has been achieved. Perhaps it is also difficult to do so because rarely do governments of the day have a clear vision of goals and tasks to be achieved portfolio-wise.

Coming to the new minister, from what newspapers are saying, there is an air of optimism about Shrestha and what he could do.

Let’s not forget that he belongs to a party, the Rastriya Swatantra Party, that has considerable leverage over Prime Minister Pushpa Kamal Dahal.

The first big mission for him is to make his ministry relevant, a heavy weight within the echelons of power in Singha Durbar.

For now, it is almost a mission impossible considering the disregard that, so far, youth-related policies have been objects of.

How about starting a series of consultations with youth organizations and sports stakeholders?

This is certainly a no-brainer and I do hope that Shrestha and his team are already coming up with a bold exercise of listening to and engaging with them.

Imagine a series of meetings, quite informal in nature, in Kathmandu but outside the walls of Singha Durbar and around the nation where “open mike” sessions can unfold in an environment where participants can feel the freedom to speak their minds.

They would also feel empowered because perhaps, this time around, there is now a higher chance that their voices and concerns would also count.

Indeed, there are a lot of things that need discussing.

To start with, are the current national policies effective?

Well, we already know the answer to this question.

The key point would be finding practical, doable ways to turn them around.

Probably, commonsense would indicate that there is no time to radically change the existing plans.

Instead, there might be space to twist them and modify them a bit, in order to make such plans more effective.

Giving ownership to the stakeholders is one step to strengthen the Ministry of Youth and Sports but then, it is going to be paramount to get the buy-in of the prime minister.

This means not only more resources for it but also a special attention to the policy proposals that are going to be mapped out and then implemented.

Coming up with an ambitious but at the same time realistic action plan with achievable milestones is going to be the second most important thing for Shrestha.

Reviewing and assessing the institutional effectiveness of the bodies under the ministry should be on top of this list.

For example, how fit for the purpose are institutions like the National Youth Council or National Sport Council? What about the National Olympic Committee?

What about the motivation, strengths and constraints of the employees of these bodies? How can the staff working there provide more value for their work?

Having their concerns fully on board would give Shrestha an edge to turn around these institutions.

Within both portfolios under the purview of the ministry, youths-related and sports-related, there are certainly linkages and commonalities that have not been meaningfully exploited.

Ideally, the National Youth Council or National Sport Council should not work in silos as it is common practice now.

Instead, there should be in place an institutional cooperative framework to carry out, though through different means, the overarching goals of the ministry.

Talking about implementation, it is also essential to come up with a partnership framework with NGOs and not for profit organizations, especially in the youth sector.

There are so many promising organizations active in areas like youth leadership and climate action but funding is always a thorny issue.

The more the ministry works with them, the easier for the nation to realize ambitious goals of development.

It’s also of paramount importance to work out a strategy to empower the provinces’ work in the empowerment of youths, including through sports.

This is a tough area also because, within the Rastriya Swatantra Party, there is a certain dose of skepticism toward provinces.

At the same time, each of these two dimensions has specific subsets of areas. For example, promoting volunteerism should be a major agenda of the ministry.

Perhaps this is the right time to dust off the draft National Volunteering Policy that has been waiting for a formal endorsement by the Federal Cabinet for more than three years.

We know very well that volunteerism has been underappreciated and its value has been underestimated.

It should not be the case because civic engagement, the engine behind any volunteering activity, is an essential part of the national fabric.

The problem is that it has never been fully leveraged nor understood.

In the sports field, there is so much to be done, especially at tapping the potential of youngsters, starting from childhood.

Nepal should not only focus on boosting and developing its elite athletes even though, for obvious reasons, it is essential to recognize and acknowledge them.

Positively enough, at least for the major sports, something has been happening in this regard.

Yet it is essential, while making difficult choices and prioritizing for funding, to recognize that promoting sports at young ages is very important.

Doing so would require a cross-sectoral effort because, for example, schools and colleges do play an important role in this regard.

Think about the role of private colleges in promoting basketball.

Yet future champions should also emerge from public schools and here some collaborations with the Ministry of Education, also under Minister Shrestha’s party, could make a difference.

Then there is the vastly-neglected area of adaptive sports.

Athletes with disabilities deserve the same respect and treatment received by their able-bodied peers.

Many of them are frustrated and their potential is severely impacted by lack of action to support them.

Wheelchair table-tennis, wheelchair basketball, blind cricket and deaf football, for example, just to mention a few disciplines, have a huge scope for growth if investments are made.

Then, setting some targets will matter. How many youths of the nations would be undertaking volunteering activities?

How many of such acts would be one-off versus more long-term ones? How many interschools sports competitions should be organized?

How many medals should Nepal aim for at the next South Asia or Asian Games? What about the targets for Los Angeles 2028?

The new Minister for Youth and Sports has tons of work ahead but only a different style of work and grounded ambition can help him.

I wish Minister Shrestha best of luck.

The author is the co-founder of ENGAGE and The Good Leadership. Views are personal

The present political scenario of Nepal is very much challenging and unpredictable. Nepali Congress (NC) was dethroned from the government in a very dramatic and unanticipated move as per the design of KP Sharma Oli and Pushpa Kamal Dahal. Naturally, NC is in a highly ferocious and revenge-taking mood and hence watching and waiting for the opportune moment to retaliate while CPN-UML chair Oli and the party is in a very happy and victorious mood. They think they have won a very difficult war. Madhav Kumar Nepal and his party, though a part of the government, are confused—they don’t know whether joining the government was a right decision. 

Rastriya Swatantra Party (RSP) is happy and satisfied after getting important berths and good representation in the government. Madhes-based parties are divided and they are fighting among themselves as enemies and not just as competitors. Rastriya Prajatantra Party (RPP) seems deeply annoyed and indignant for her isolation in the whole making and breaking process. Some power centers are very much happy while some are extremely sad. People are eagerly waiting for good governance, service delivery, job and political stability.

The question now is how the situation moves ahead? RPP and some Hinduvadi (pro-Hindu) forces are talking about street protests and have announced some slogans and programs for this purpose after submitting a memorandum consisting of their demands to the prime minister. In my opinion, they will try their level best to cash in on the situation and destabilize the whole scenario to create an atmosphere for effecting changes in the Constitution. For this purpose, they are likely to continue with their efforts to garner the sympathy and support of all those forces who are against the present government and coalition. Some power centers may extend their support to those who are not happy with the present coalition.

Now the question is what will be the tactics and strategy of NC? Will the party extend any kind of sympathy or support directly or indirectly to the street protestors? As a true parliamentary democrat, will it instead play the role of a strong and constructive opposition inside and outside the parliament? Presently, the party is blocking the House session and demanding the resignation of the Home Minister accusing him of involvement in a Cooperative Scam. The House is tense and anything can happen.

Madhav Nepal’s party is also not in order and seems to have a high degree of dissatisfaction and grudges inside. Nobody can predict what will happen at that party. There are two distinct political trends in that party. One trend is for left unity and the other for left and democratic unity. Madhav Nepal is suffering from the policy of indecisiveness and confusion.

Hence the present coalition seems very fragile. Hostilities between the present coalition and the main opposition party, Nepali Congress, is increasing and there is a risk that competition between the two may transform into enmity. If such a political situation arises, it may injure and damage the democratic course. It may weaken or retard the constitutional process and ultimately encourage and strengthen the revivalist forces.

Confrontation or long indecisiveness will create political instability and hence chaos and uncertainty in the country. It is not good for a smooth political and economic development of the country. 

Nepal needs political stability and people need good governance, service delivery, jobs and social peace.

The present government should focus on people’s daily life and their needs as well as their aspiration of a corruption-free country and a job-creating economy. If the government cannot deliver and bring stability and win hearts and minds, it does not have political or moral rights to govern. And the duty of the opposition in parliamentary democracy is to raise the plight and hardships of the common people in the parliament, focus on national issues and stand for political stability and economic development of the country.

In my opinion, the present political and economic situation of the country is very challenging, which should be the agenda of all political forces despite their different political places. Some political forces are challenging and questioning the federal democratic republican and secular fabric of the Constitution. So, there should be some level of understanding among the pro-Constitution forces.

The national economy is in poor shape. Capital expenditure is not increasing, public revenue is not satisfactory, mass-migration of young people is ongoing, market is suffering from depression, business activities are slowing down, jobs are hard to find, industrial activities are declining, people’s purchasing power is decreasing, there is crisis in the farm sector and the economy is mainly dependent on remittances and loans. Such a scenario may cause a Sri Lanka-type crisis anytime. Hence for political stability, for the protection of the Constitution and for overcoming the economic crisis, major political forces of the country should reach a political understanding and consensus.

Views are personal

Established in 1985 with the aim of regional cooperation, integration and socio-economic development of its member countries and the region as a whole, South Asian Association for Regional Cooperation (SAARC), as of now, is a “zombie” organization that could only be technically said to be operational; its spirit, ambitions and zeal dead as no progress has been made in its mandate. Upon its foundation, SAARC’s main goals included enhancing the well-being of South Asians, advancing their quality of life, fostering economic growth, social progress, and cultural advancement, ensuring dignity and realizing full potential for all individuals, and furthering collective self-sufficiency. However, despite having great potential as an intergovernmental organization to uplift the entirety of the South Asian diaspora, SAARC’s performance in recent times is underwhelming at best and utterly disappointing at worst.

Failure of SAARC

SAARC currently finds itself in a state of inertia, lacking clear direction and meaningful mandates for the future. This stagnation can be attributed to a multitude of factors plaguing the organization. Foremost among these are the longstanding bilateral conflicts, notably the deep-rooted animosity between India and Pakistan, which overshadows SAARC's agenda and hinders consensus-building among member states. The Indo-Pak conflict deeply impacts SAARC, hindering its functionality by causing recurrent tensions that divert attention from its agenda, fostering insecurity and instability in South Asia. This cycle of suspicion undermines cooperative efforts within SAARC, exacerbated by India’s dominant position in the region, which complicates efforts to promote equality. 

The last SAARC Summit was scheduled to be held in Islamabad, Pakistan, in Nov 2016. However, it was indefinitely postponed due to escalating tensions between India and Pakistan. The URI surgical strike, which occurred on 29 Sept 2016, led to heightened military activity along the Line of Control (LoC) and exponentially increased the already dense diplomatic hostilities between the two countries. This ultimately led to the cancellation of the summit. The ongoing bilateral conflicts and diplomatic hostilities between India and Pakistan have since prevented the resumption of SAARC summits, underscoring the organization's challenges in fostering regional cooperation amidst deep-seated geopolitical rivalries.

Further adding to this issue is a pervasive lack of trust among member nations, stemming from historical grievances and competing geopolitical interests. Political instability and governance challenges within member states further detract from regional cooperation efforts, while economic disparities limit the scope for mutually beneficial initiatives. SAARC’s institutional capacity is also hampered by weak administrative structures and bureaucratic inefficiencies, exacerbating its inability to deliver tangible outcomes. External interference from global powers and regional actors seeking to advance their own interests further complicates SAARC’s ability to pursue an independent and coherent agenda. Collectively, these challenges render SAARC a ‘zombie organization’, struggling to navigate a complex landscape fraught with obstacles to meaningful regional cooperation and development.

Amidst the failure of SAARC to fulfill its mandate, India to strengthen its geopolitical grasp in South Asian region as well as Southeast region made a strategic move by extending invitations to the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) leaders to the BRICS summit held in 2016 at Goa. This move signaled a major diplomatic shift, showcasing India’s willingness to turn to BIMSTEC in response to SAARC’s ineffectiveness at meeting its expectations. Subsequently, the Indian Prime Minister engaged in a bilateral meeting with BIMSTEC leaders. Since then, the member states have been reluctant to resume the SAARC summit. India has been consistently participating in the BIMSTEC summit, looking to establish it as a formidable alternative regional platform for the five SAARC nations to discuss sub-regional cooperation.  

Rise and Significance of BIMSTEC

BIMSTEC was established on 6 June 1997 through the Bangkok Declaration. At present, BIMSTEC consists of seven member states out of which five member states are also the member of SAARC namely, Bangladesh, Bhutan, India, Nepal, Sri Lanka and two member states are from Southeast Asia, namely Myanmar and Thailand. Basically, BIMSTEC is a sector-driven institution unlike SAARC and many other regional alliances. Since its establishment, fourteen priority sectors of cooperation have been identified through the BIMSTEC ministerial summit held on different occasions. These sectors are trade and investment, transport and communication, energy, tourism, technology, fisheries, agriculture, public health, poverty alleviation, counterterrorism and transnational crime, environment and disaster management, people-to-people contact, cultural cooperation and climate change. The member countries of BIMSTEC  lead these sectors which are divided among them. They meet at different levels, like BIMSTEC summits, ministerial meetings, senior officials’ meetings, and expert groups.

BIMSTEC, as a trade bloc, presents numerous opportunities as the combined GDP in the region is around $2trn which is likely to grow exponentially in the near future. Among the member states, Myanmar’s intra-BIMSTEC trade accounts for approximately 36.14 percent of its overall trade, while Nepal and Sri Lanka have intra-regional trade shares of roughly 59.13 percent and 18.42 percent respectively. Bangladesh’s intra-BIMSTEC trade share stands at 11.55 percent, whereas India and Thailand have shares of around three percent within the BIMSTEC. 

Could BIMSTEC be an alternative to SAARC?

SAARC is a purely regional organization characterized by member nations sharing a collective history, geographical closeness, shared cultural identity and regional values. The member countries of SAARC are bound not only by historical ties but also by common developmental challenges, necessitating collaborative efforts for effective resolution.

Conversely, BIMSTEC serves as a bridge between South Asia and Southeast Asia, leveraging its potential to connect the economies of both regions. By integrating South Asia with the vibrant economies of ASEAN, BIMSTEC acts as an inter-regional organization facilitating economic cooperation and trade. Its scope extends beyond the confines of South Asia, embracing a broader regional outlook.

SAARC and BIMSTEC are not interchangeable options or substitutes for each other. Rather than viewing SAARC and BIMSTEC as competing entities, it is more appropriate to recognize them as complementary frameworks with distinct but mutually reinforcing objectives. SAARC’s emphasis on intra-regional cooperation complements BIMSTEC’s inter-regional connectivity aspirations. The collaborative efforts within SAARC pave the way for addressing common developmental challenges, while BIMSTEC’s outreach to ASEAN economies opens avenues for enhanced trade and economic prosperity.

The authors are a law student at Kathmandu School of Law