The festival is dedicated to the sun God, with offerings made to the rising and setting sun. It is observed for four days, from Kartik Shukala Chaturthi to Kartik Shukla Saptami as per the lunar calendar.

It usually falls between Mid-October and Mid-November in the Gregorian calendar. The Sun, considered as the god of energy and of the life-force, is worshiped during the Chhath festival to promote well-being, prosperity and progress.

Those observing the Chhath fasting take a bath in the morning and partake only a single meal today. This observance is called the ‘Nahaya Khaya’. Although the Chhath rituals commence from the day of Kojagart Poornima, the major fasting rituals start from Chaturthi.

The next day or Kartik Shukla Panchami, those observing the fast, offer a special rice pudding mixed with molasses called ‘Kharana’ to the Shasti Mata deity, and partake it. They abstain from food items mixed with salt and only take fruits for meal.

On the day of Kattik Shukla Shasthi which is the main day of the Chhath festival, the devotees observing the fast practice a rigorous fasting even not drinking water. In the evening, they worship the setting sun, making the Arghya offerings, said Anil Singh who is facilitating the Chhath worship at Guhyeswari Gaurighat Chhath Worship Committee. 

This year, the main day of Chhath festival falls on November 7.

In Kathmandu, the area from Guhyeswari to Gaurighat, Gahana Pokhari, Naag Pokhari, Kamal Pokhari and the different ghats along the Bagmati at Thapathali, Nakhkhu and the ghats along the Bishnumati and other rivers have been decorated for the Chhath festival.

The ritual of Chhath Parba includes taking holy bath, fasting, standing and worshiping the sun for a long time and offering Prasad and Argha to the ‘rising and setting Sun”.

Chhath is a festival of bathing and worshipping that follows a period of abstinence and segregation of the worshipper from the main household for four days.

During this period, the worshipper observes purity and sleeps on the floor on a single blanket. This is the only holy festival which has no involvement of any pandit (priest). The devotees offer their prayers to the setting sun, and then the rising sun in celebrating its glory as the cycle of birth starts with death. It is seen as the most glorious form of Sun worship. (RSS)

Pat Garcia-Gonzalez, cofounder and chief executive officer of the foundation, arrived in Nepal a couple of days ago. Gonzalez came to Nepal on the occasion of her late son’s birthday and interacted with the patient who was undergoing treatment with the help of the foundation. She has said that the help she gave has been put to good use. She says that despite losing one child, she was able to save millions of children. An interview by Dhan Bahadur Khadka and Romika Neupane :

Talking about The Max Foundation, how did the concept for the foundation evolve?

Yeah, thank you so much. (With a heavy emotional voice, Pat said) So, The Max Foundation was established in memory of Max. Max was my stepson. He was diagnosed with leukemia when he was 14. We’re from Argentina, and at the time when Max was sick, for his type of leukemia, there was no treatment available, only a bone marrow transplant—if we could find a matching donor. So we searched for two and a half years for a donor for Max, but we never found one. He passed away at 17. We started The Max Foundation to help other families avoid going through what we did, to provide a bridge between resources and families. Along the way, we learned that there are many resources, but they can be difficult to find. When you first get a diagnosis, you don’t know anything. So, we started a website—themaxfoundation.org—and opened an email for people to reach out for help. Through that email, we received many messages from all over the world, particularly from low- and middle-income countries, where patients needed treatment that wasn’t available locally. We dedicated ourselves to trying to bring this treatment to these patients.

That’s great. The Max Foundation is doing amazing work in 83 countries, if I’m not mistaken, and it’s been 22 years now.

Yes, it’s been 22 years. We’ve developed a smart model to bring innovative medicines to people because we believe that no matter where you are, you want the best for your family. We’re not God, so sometimes the outcome isn’t what we hope for, but at least you try, and you give your loved ones the best chance. We work with pharmaceutical companies to get support, and with oncologists and hematologists who diagnose the patients. Then, we send the necessary medication to the doctor treating that patient. We are currently helping around 40,000 families every year across 83 countries, working with about 200 hospitals, particularly in low- and middle-income regions.

That’s wonderful. We’re somewhat aware of The Max Foundation’s vision. But why focus specifically on medicines? Why not shift towards prevention or screening programs?

That’s a great question! No one has ever asked me that before. When we started The Max Foundation, we made two philosophical decisions. First, we wanted to be a bridge between resources and patients. Second, we wanted to help those who no one else was helping. Many organizations focus on prevention and screening, but no one was providing medicines. So, every time we had to make a decision, we chose to do what others weren’t doing. That’s why we focus on delivering medicines.

Speaking of medicines, specifically in Nepal, how many areas does The Max Foundation cover for distributing medications?

We have mainly worked in two hospitals: Patan Hospital and BP Koirala Memorial Cancer Hospital. Recently, we opened a program at SushilKoiralaPrakhar Cancer Hospital, where we distribute only one medication. (Sweta Agrawal, Program Coordinator of The Max Foundation, assisted Pat in providing this information). Through Patan Hospital, we distribute 13 medications; through BP Koirala Memorial, we distribute 8, and 1 medication at SushilKoiralaPrakhar Cancer Hospital.

Have you faced any policy barriers during this process in Nepal?

Sweta Agrawal (Program Coordinator): Yes, there are a few barriers. One is the timing of diagnosis—patients in remote areas often can’t access the facilities they need in time and have to come to Kathmandu or Bharatpur for diagnosis and treatment. After diagnosis, their socioeconomic status can also prevent them from continuing treatment. We’ve had to follow up with patients, asking why they haven’t come for their supplies, only to find out they couldn’t afford to travel, or faced road blockages.

Pat added: Another issue is that no one covers the cost of diagnostics. If cancer is suspected, the patient’s family has to pay for confirmation before any support is available. This is an area where policy improvement is needed—there should be funds to help with diagnostics.

Sweta further added: There’s also a lack of awareness. And when a female is diagnosed, especially after marriage, many families don’t support her. In some cases, parents hide a diagnosis to get their daughter married, not wanting to reveal her illness to the in-laws. These are just a few examples of the barriers we face.

The Max Foundation is clearly doing unique work. Have you thought about expanding beyond Patan Hospital to other hospitals or rural areas?

This program started 20 years ago at Patan Hospital, which was chosen by the company that developed the medicine. Seven years ago, we took over the program. We’ve since decentralized to BP Koirala Memorial and Sushil Koirala Prakhar Cancer Hospitals. While we’re mindful of decentralization, cancer requires specialization. Even Patan Hospital, with its excellent setup, faces challenges. Instead of decentralizing and risking a drop in treatment quality, Wechose to support patients with transportation to ensure they receive the best care. However, we do recognize the need for more oncologists, particularly in the public sector.

Shifting from medications, are there any plans to introduce Next Generation Sequencing (NGS) in Nepal?

It’s on my wish list! We don’t have a specific plan yet, but we hope to bring NGS to Nepal. However, it requires significant support, both for the instruments and for ensuring a steady supply of reagents. It would also need to come hand in hand with the expansion of oncology units.

You’ve been in Nepal for three days now. How has your experience been?

I’m so happy to be here. It took me 20 years, but I really wanted to visit the hospitals, meet the patients, and see the systems in place. (With eyes full of tears, Pat said) It has been a dream. Meeting the patients and seeing Max’s legacy continue has been emotional for me. I feel energized to go home with a list of things we need to do to improve. But I’m confident in the strong systems here and in the capacity of the country to manage the program.

Do you have any suggestions for our doctors or physicians?

I do not have any specific suggestions. The doctors are doing a great job, though the hospitals are very crowded. (Dr. Arun added, “But we’re not complaining.”) Pat replied, “Yes, not complaining, even with the crowd, everything is managed so well. And I must mention my colleague Sweta, who has been representing The Max Foundation in Nepal for eight years and is doing an amazing job keeping everything together.”

As you said, you interacted with the patients, what feedback did the patients give you?

Patients are incredibly grateful. They have formed a bond, supporting each other like family. This helps break the stigma of cancer. It was a dream for me to meet them, and it was wonderful.

You mentioned it took you 20 years to come to Nepal. Do you feel your dream has been fulfilled?

It’s more than fulfilled. When I saw Max’s photo on the wall in the consultation room at Patan Hospital, it was overwhelming. I never dreamed that his name and legacy would be in a hospital in Nepal. It’s beyond anything I could have imagined.

Thank you so much for everything you’re doing for our country.

I’m grateful to you for helping raise awareness. In the past, we focused solely on helping patients, but I’ve come to realize that talking about our programs can bring more resources and help more patients. Amplifying our voice is now one of our top priorities. Thank you for helping with that.

Dr. Pant posted the lab report and wrote, ‘Do not use antibiotics without consulting a doctor’ and in no time, it went viral in social media groups of doctors’. She did not want to reveal the source of the report, but she further added that such reports of antibiotic resistance keep coming at the Kanti Children’s Hospital where she works.

Similarly, on June 24, the same Klebsiella bacteria was also seen in a patient during a urine test. During the antibiotic sensitivity test, 18 antibiotic-resistant bacteria were found to be resistant.

Comparing the mentioned lab report with the research report of the Ministry of Health (CAPTURA Country Report: Nepal), there are many similarities to confirm the truth. According to the report, most of the antibiotics mentioned in the report are resistant. Reportedly, ampicillin 91.9 percent, amoxycillin 77.43 percent, cefepime 72.58, cefuroxime 65.69, and cefixime 62.69 percent resistance have been observed. In that report, 22 antibiotic-resistant cases have been mentioned, and the least resistant of all was seen in Amikacin with 22.15.

Both the lab report and the study reported harm and danger for random use of antibiotics in Nepal. According to the report, high resistance has been seen in Acinetobacter, E-coil, S. aureus, and S. typhi.
Dr. Madan Upadhyay, former focal person of antimicrobial resistance (AMR) under the Ministry of Health, says that for the last three decades, no new medicine (antibiotic) has been discovered to kill bacteria.
The bacteria have built resistance to the old antibiotics, causing the medicine not to work. According to the World Health Organization (WHO), if this trend continues, it is estimated that by 2050, the number of patients who will die due to antibiotics not working will reach 10 million per year. Doctors say that developing countries like Nepal are suspected to be the most affected by it.

Viruses, bacteria, fungi, and other parasites are also microbials despite their appearance and forms, and the term antimicrobial covers them all.

Former VC and ICU Specialist of Patan Institute of Health Sciences Dr. Arjun Karki said that antimicrobial resistance (AMR) is a condition in which bacteria become immune to those drugs that kill them.
“The existence of bacteria is similar to humans, and like us, they also want to survive no matter how hard the situation becomes. They cause diseases and infections, so we want to cure them as soon as possible, but bacteria develop resistance to the medicine, which is called antimicrobial resistance and also antifungal for fungus. Anti-virus is given for viruses,” said Karki.

Susceptibility Testing without Antibiotic Prescription
It is a universal belief that before prescribing antibiotics to patients, healthcare workers should do antibiotic susceptibility testing (AST). According to a study conducted by the Nepal Health Research Council, it has been found that 68 percent of people in Nepal use antibiotics without AST.

According to Dr. Meghnath Dhimal, chief of the research section at the Nepal Health Research Council (NHRC), in the Situational Assessment of Antibiotics Use and its Resistance in Nepal, only 32% of the doctors/health workers have access to laboratory facilities for AST; among them, only 49% recommend antibiotic susceptibility testing before prescribing antibiotics, which is a significant reason for influencing rational prescriptions of antibiotics. Similarly, around 59% of doctors and health workers had heard of national guidelines for antibiotic prescriptions, among which only 54% had access.

Community Pharmacies: The majority of the drug dispensers (43.4%) dispense antibiotics without a doctor’s or health worker’s prescription.

Azithromycin (24.5%), Amoxicillin/Amoxyclav (20.5%), Cefixime (14.8%), Ciprofloxacin (14.1%), and Metronidazole (9%) were the most commonly dispensed antibiotics without prescriptions from doctors and health workers.

Outpatients: The majority of the outpatients (85.4%) consult with doctors or health workers before consuming antibiotics. About one-fourth (22%) of the outpatients did not consume a full course of antibiotics. Similarly, about 10% and 8% of the outpatients consume antibiotics as prophylaxis and consume double-dose antibiotics for fastest recovery, respectively. Around 22% of them save residual antibiotics for treating similar symptoms in the future. Additionally, around 28% of the outpatients mentioned that they buy antibiotics without a doctor’s or health worker’s prescription.

Prescription and consumption of antibiotics: About 85% of health workers/doctors did not prescribe antibiotics by their generic name. Similarly, more than one-third, that is, 37.8%, of prescribed medicines were antibiotics, which is higher than the standard as given by the WHO. The consumption of antibiotics by inpatients based on the AWaRe classification showed a majority of antibiotics consumed was from the Watch group, i.e., 70%, followed by the Access group, i.e., 29.8%, and 0.1% was from the Reserve group. The five most frequently consumed antibiotics were ceftriaxone, metronidazole, ornidazole, piperacillin tazobactam, and azithromycin, respectively.

Veterinarians/Para-veterinarians: About 34% of veterinarians/para-veterinarians have access to laboratory facilities for AST in their working area; among them, only 32% recommend susceptibility testing prior to antibiotic prescriptions. Additionally, it was found that only 18% of veterinarians/para-veterinarians always recommend antibiotic susceptibility tests before prescribing antibiotics.

Veterinary Pharmacists : About 66% of the veterinary pharmacists do not keep an animal’s record for dispensing antibiotics, and the majority of veterinary pharmacists consider the weight of the animal before prescribing antibiotics. Tetracycline, oxytetracycline, enrofloxacin, and gentamicin were identified as the most commonly dispensed antibiotics from the vet pharmacies.

Farmers (Cattle/Poultry) : Around 44% of the farmers responded that they treat their sick animals by themselves. The majority of the farmers treat animals by using local medicines (37.4%), followed by buying drugs (30.5%), and isolating sick animals from others (15.5%) as measures for self-treatment. More than half (55%) of the farmers were found using residual antibiotics for the future.

Random use of antibiotics
A cross-sectional study at Patan Hospital in 2021 found that the total DDD of parenteral antibiotics increased by 23% from 2017 to 2019. An older assessment in 2017 found that 79% of 324 participants (selected from the public) purchased antibiotics over the counter, and 43% of the participants understood that fever could be treated with antibiotics. The same study interviewed 33 private pharmacies, 23% of whom responded that antibiotics could be used to treat viral diseases.

Some hospitals have given strong antibiotics to patients as soon as they enter the hospital. A few years ago, in a study conducted by swasthyakhabar.com, it was seen that B&B Hospital in Kathmandu used antibiotics without AST. In a study conducted on four patients, it was seen in the pharmacy bill of the hospital that antibiotics were used continuously for 37 to 52 days even after resistance.

The lab report of B&B Hospital has shown that the two drugs used in the patient (colistin and Cilanem) have been repeatedly resistant. According to the lab test, one patient, Arjun Bhandari, was found to have antibiotic resistance to imipenem (Cilanem) five times and colistin four times.

However, the use of antibiotics has continued. They looked for an alternative to B&B Hospital because the infection was not controlled even after long treatment. Dhan Bahadur Khadka made a special report on this topic in the Swasthya Khabar newspaper in April 2016. The case filed by the hospital against the report reached the Supreme Court through the District Court and High Court.

Later, after a long run, the Supreme Court decided in favor of Dhan Bahadur Khadka and Swasthya Khabar newspaper.

Antibiotics in poultry and fish
According to the study published in MDPI titled “Antibiotic Use in Broiler Poultry Farms in Kathmandu Valley of Nepal: Which Antibiotics and Why?”, a cross-sectional questionnaire study was conducted involving field visits to large poultry farms (flock size ≥ 3000) in the Kathmandu, Bhaktapur, and Lalitpur districts. Out of 30 farms (total flock size 104,200; range 3000–6000), the prevalence of antibiotic use was 90% (95% CI: 73–98%). Six farms (22%) used antibiotics as prophylaxis, while 21 farms (78%) used them for therapeutic purposes. A total of seven antibiotics from six classes (including quinolones, macrolides, and polymyxins) were used. The most commonly used antibiotics were tylosin (47%), colistin (47%), and dual therapies with neomycin and doxycycline (33%). In total, 50,000 grams of antibiotics (including both active and inactive ingredients) were used, averaging 0.5 grams per chicken over a 45-day flock life, with eight farms (26%) using more than two antibiotics.

Dr. Samirmani Dixit said that antibiotics are being used in chickens and fish at an alarming rate. “Antibiotics have been mixed with fish meal and poultry feed. Especially chicken chicks should be given a vaccine, but instead of that, the practice of giving antibiotics is increasing,” Dixti added.

According to Dr. Dixit, this is being done because after giving antibiotics, the chickens will become stronger, not get sick, and also give better eggs. Some time ago, in a study conducted by the Department of Food Technology and Quality Control, it was found that the use of antibiotics in broiler chicken (poultry chicken) meat was excessive.

In the study report of the department, it is mentioned that the amount of tetracycline, macrolides, aminoglycides, sulfonamide, and penicillin, among others, was found in chicken meat. The department collected 75 samples and conducted a study titled ‘Antibiotic Residue in Chicken Meat: A Potential Threat to Food Safety’.

Due to the weak monitoring system in Nepal, the rate of consumption of antibiotics in the veterinary sector has increased recently, Dixit further said. “The bacteria that digested the antibiotics in the chicken’s body have been released very harmfully after moving into the human body.”

He says that the danger caused by the bacteria entering the human body due to eating undercooked chicken meat can be lethal. In addition, he pointed out that the use of antibiotics is increasing in pigs, vegetables, and cattle to produce more milk as well.

It has affected people. Within animal health, a 2020 publication examined poultry rectal swabs and urine from patients visiting Kantipur Hospital in Kathmandu and found multidrug resistance in 80% of E. coli from poultry and 79% from clinical specimens.

In the fiscal year 2017-2018, an assessment of 150 commercial poultry farmers gave insight into farmers’ knowledge, attitudes, and practices. Notably, antimicrobial use for growth promotion was employed by 13% of producers, among whom 35% were using colistin. (The Swasthya Khabar newspaper has written about this in detail in January 2017).

Nepal at high risk
Various studies have shown that antimicrobial resistance is increasing in Nepal. Nepali medical experts and doctors say that Nepal is one of the countries where antibiotics are becoming more ineffective. In charge of the ICU of the TU Teaching Hospital, Dr. Subash Acharya, up to 70 percent of the bacteria (superbugs) that have digested the strongest antibiotics are found in hospitals in Nepal. Whereas in America it is only 10 to 20 percent.

Doctors say that a patient who came to the hospital with some other disease died of pneumonia. According to Dr. Acharya, this death is due to the failure of antibiotics, and pneumonia can happen when the medicine doesn’t work.

Antimicrobial resistance contributes approximately 700,000 deaths annually, and by 2030 it is estimated of global economic loss of more than $ 1.0 trillion annually. It is estimated that by 2030, AMR could force up to 24 million people into extreme poverty and could jeopardize the achievements of the Sustainable Development Goals 2030 for ending poverty, ending hunger, ensuring healthy living, reducing inequality, and revitalizing global development partnerships.

The World Health Organization (WHO) has declared AMR among the top 10 global health threats; it can no longer be addressed by single, isolated interventions with limited impact.

Pneumonia is also caused by hospital-acquired infections because hospital walls, gowns worn by health workers, and equipment also contain bacteria that have digested antibiotics. Acharya said that it will be difficult to protect the patient if they are infected. These bacteria called’superbugs’ are becoming a new challenge in the world. The hospitals should be needed to control it. He said that even though the drugstore, hospital management, and doctors were aware of this, they did not pay proper attention.

Attention of policymakers
Only recently have the stakeholders started talking about AMR. At the 79th United Nations General Assembly (UNGA) Antimicrobial Resistance (AMR) high-level meeting, world political leaders have expressed commitment to a clear set of targets and action plan to reduce human deaths associated with AMR, including reducing the estimated 4.95 million human deaths associated with bacterial antimicrobials.

The declaration also calls for sustainable national financing and US$100 million in catalytic funding, to help achieve a target of at least 60% of countries having funded national action plans on AMR by 2030. This goal is to be reached through, for example, diversifying funding sources and securing more contributors to the Antimicrobial Resistance Multi-Partner Trust Fund.

Head of the ICU department, Dr. Acharya, says that there is a growing fear if the world leaders don’t take this matter seriously because now the biggest fear for humans is from bacteria. So, special attention has also been started because bacteria are the cause of various infections.
“The world has felt the challenge from bacteria after the medicine given against bacteria (antibiotics) started to be ineffective,” Acharya said.

Dr. Roshan Pokharel, secretary of the ministry, says that the study on AMR has been increased, and policies like the National Action Plan for Antimicrobial Resistance (AMR) in Nepal have been made. At the South Asia Regional Media Workshop to Prevent Antimicrobial Resistance (AMR) held in Kathmandu some time ago, he said, they have made a policy. Now is the time to unite for implementation.

According to Dr. Pokharel, in May 2015, the 68th World Health Assembly endorsed the Global Action Plan (GAP) on Antimicrobial Resistance (GAP-AMR) to tackle AMR and urged the member countries to make their own National Action Plan on AMR in alignment with GAP-AMR by May 2017. Commitment by global leaders to combat AMR was further strengthened at the High-Level Meeting on AMR at the United Nations General Assembly on 21 September 2016. He added, ‘The Government of Nepal has undertaken several measures to address the commitment made to contain the challenges of AMR in Nepal. The National Health Policy of Nepal, 2076 BS, has prioritized AMR as an important public health issue and has highlighted the need to develop a national action plan (NAP) to reduce AMR and effectively regulate and control antibiotic use through multisectoral collaborative action. With the growing burden of AMR in the country and commitment made, Nepal requires a National Action Plan (NAP) to tackle the issue of AMR through a ‘One Health’ Approach.’

Dr. Madan Upadhyay says that if humans are not to be defeated in the battle with bacteria, they should be stopped from allowing the bacteria to digest the existing medicine until a new medicine is discovered. He further says, there has been no new antibiotic as a reserve for the past 30 years. “There is a need to work on it as soon as possible,” said Upadhyay.

“The only way to prevent this is stewardship. ‘Every hospital should implement a stewardship program. The government should make a rule that the stewardship program should be implemented compulsorily when renewing or renewing the license of hospitals with more than 100 beds,” said Acharya. “Considering hospital pharmacy as the backbone to support the hospital is the biggest weakness,” he added.

(Khadka is the Executive Editor at NepaliLiveToday.com’s sister organization, the health-related news magazine Swasthyakhabar Patrika)

President Ramchandra Paudel, Vice President Ramsahay Prasad Yadav, Prime Minister KP Sharma Oli, and Speaker Devraj Ghimire, among other dignitaries, attended the function.

The ceremony featured a march-past by personnel from the Nepal Army, Nepal Police, and Armed Police Force. Additionally, various organisations presented a cultural parade.

Constitution Day, observed on Ashoj 3 in the Nepali calendar (September 19 this year), commemorates the promulgation of Nepal’s Constitution by the Constituent Assembly in 2015.

Aerial view of Peribharani Lake. Photo: RSS

Rakhi (an ornamental wristband) is offered by sisters to their brothers on this day to wish their brothers long life and success.

However, ignoring the calls from medics, his parents instead took him home. But his condition further deteriorated, and then he was taken to the Lumbini Provincial Hospital. The kid, who was in a worse medical condition, was given an anti-snake venom injection. Sadly, the kid succumbed, and was pronounced dead by doctors. It was even worse as his nine-year-old brother was also brought dead to a clinic with fang marks in his right hand. 

Both of them had died of negligence, shared Dr Hemant Ojha, section chief at Epidemiology and Disease Control Division.

During a program organized by Rotary Club of Kathmandu Mid-Town on “Snakebite Prevention Project”, Dr Ojha said snakebite is a neglected tropical disease, and from a lack of attention largely due to insufficient awareness, it results in thousands of fatalities annually.

“People have been dying because communities are unaware of measures to prevent snakebites. They are adopting harmful traditional practices such as tight tourniquets. Also, they have not been reaching healthcare facilities on time due to these traditional methods,” he said. “As people follow methods like tight tourniquets, there have been cases where hands should have been amputated.”

The government data shows Nepal has been recording 1,000 snakebite-related deaths annually. However, different independent studies and research show more than 3,000 die from snakebite a year. According to Ojha, the number is underreported, as many cases where people die in communities are not properly reported.

The government of Nepal is committed to achieving the national target, which is aligned with the World Health Organization’s goal of a 50 percent reduction in deaths and disabilities due to snakebite envenomation by 2030.

As per the plan, the government joined hands with Rotary Club which initiated this program. This program, also supported by the World Health Organization, B.P. Koirala Institute of Health Sciences to raise awareness on various aspects related to snakebite and to reduce the life-threatening impact as well as to prevent disability resulting from snakebites, is focused on the 26 most affected districts and is being implemented nationwide.

According to experts who spoke in the program, the majority of deaths related to snakebite occur before reaching a treatment center, either during transportation or in the village. “At least 40 percent of individuals die during transportation, another 40 percent die in communities, and the remaining 20 percent die in health facilities,” said Ojha, highlighting a significant lack of awareness among people. “If individuals are taken to the nearest health facilities on time, thousands of lives could be saved.”

The lack of awareness has led to difficulties in identifying snakebites, according to them. “Signs and symptoms, such as local gangrene from tight tourniquets, abdominal pain, and vomiting due to the use of substances like chilies and herbal medicine, can resemble those of snake envenoming. Tight tourniquets may cause pain, swelling, and congestion, which can be mistaken for local envenomation.”

According to experts, individuals engaged in activities such as collecting fodder in fields, farmers, and children playing in open areas face an increased risk of snakebites. “Also, those residing in thatched-roof dwellings, often families from lower-income backgrounds, are at significant risk as snakes seek rodents in such houses. Particularly in the Terai region, where rising temperatures prompt people to sleep outdoors, the likelihood of snake encounters increases.”

Experts also recommended the use of mosquito nets while sleeping to reduce the risk of snakebites. “Residents in the Terai should carry torchlights when venturing outside at night, and they can tap the ground with a stick to deter snakes from approaching. In emergency situations, opting for motorcycles instead of waiting for ambulances is the best option.”

This four-year Rotary-funded Nepal Snakebite Prevention communication campaign aims to impart awareness and prevention knowledge about the several venomous snake species in Nepal, how snakebite can be prevented, and the immediate steps to take when someone is bitten.

The campaign includes FM radio broadcasts (radio magazine and PSAs), in-person outreach activities (kickoff meetings and other face-to-face engagements), and knowledge products (posters, social media content, YouTube videos, and web resources). “”We transmit on over 41 local FM radio stations and also on two national carriers. Also, we have been organizing awareness programs in most affected districts,” said Dr Nirmal Rijal of Rotary Club of Kathmandu Mid-Town, claiming that awareness among people has increased following the program.

Each policy has its own set of bootleggers and Baptists who try to shape economic reforms. It is critical to examine Nepalese policy through a similar perspective. Doing so is essential for making educated judgments that are free of external biases. The protectionist laws have their own advocates and protestors. They generally lead to a few winners and many losers. So, if the losers outweigh the winners, why are the laws still practiced? Who are the advocates, who wins, and who loses? These are some of the questions to ponder upon.

Industries as Bootleggers

Protectionist policies provide a haven for industries, which are the usual bootleggers in Nepal. They seek refuge from all the competition and technological changes that happen in the world. It’s not an unethical conspiracy, but rather a survival instinct for a stable market where profits can surge without any interruptions from external factors. 

In Nepal, industries generally form associations and participate in lobbying. The motives are obvious: reduced competition equates to a better market share. It is a language that any profit-oriented businessperson understands. So, in certain instances, the political arena becomes a space where various interests converge. Politicians and industries come together to support policies that serve their own positions of power and financial gains.

Politicians as Baptists

Protectionist policies are frequently draped in the apparel of moral or public interests. They are promoted by politicians who see themselves as protectors of national well-being. These politicians are Baptists. They present the laws as beneficial, highlighting their support for local industry, employment, and cultural identity. However, the general population fails to see the subtle link with the objectives of bootleggers beneath this portrayal. 

Politicians, using Baptist language, build stories that resonate with the general population, i.e., the customers. They become defenders for local businesses and influential entrepreneurs. It’s a mutual arrangement in which the Baptists’ presentation offers cover for the bootleggers to operate inside the closed walls with near to no competition from the outside world.

Consumers

The consumers are caught in the crossfire as their interests are seldom heard or even presented. Protectionist policies, although supposedly protecting national interests, can result in higher costs and fewer options for an average person. Policies seemingly aimed at protecting public welfare may ultimately contribute to a less dynamic and competitive market.

If individuals attempt to lobby for policies, the cost of effort would outweigh the cost of tariffs. So, their incentive to form a lobby group is very low. Moreover, there have been some instances where consumer groups have been formed but could not be influential.

A carefully constructed regulation can accomplish all kinds of anticompetitive goals of this sort, while giving the citizenry the impression that the only goal is to serve the public interest.

High tariffs serve as a means for producers to narrow competition, but the benefits fall flat for consumers. From clothes to coffees, a series of taxes strangles choice and inflates prices. Take textiles, for example, where tariffs ranging from 1 percent to a staggering 30 percent on carpets turn protectionist measures into financial burdens for consumers. The taxation on agriculture also follows the same theme. A 40 percent customs duty per kilogram on imported coffee and tea has locked these international products out of the average consumer’s choice pool. This stifles competition, leaving the domestic industry complacent and consumers thirsting for variety. Chips, crisps, peas, even apples – all face protectionist measures, narrowing selection and driving up prices. While local producers might enjoy a temporary advantage, the long-term performance suffers. Consumers have fewer options, domestic industries lack inspiration, and everyday goods cost more.

The policies, in most cases, attempt to protect the industries at the expense of consumers. Let us take an example of the taxes on shoes. A 40% tax is levied on a pair of shoes. Nepal’s domestic shoe industry is internally competitive. Brands like Goldstar and Caliber even offer shoes with premium pricing. Goldstar has also expanded to the international market. So, who are we protecting when the industries themselves want to be exposed to the bigger market? With the measures currently in place, only the consumers are bearing the loss.

An alternative perspective suggests that if Nepali products are of high quality, they should be able to thrive in a competitive market. A level playing field, where domestic and foreign products compete based on merit, would not only give consumers more choices but also encourage local industries to enhance their products to meet global standards. This competitive environment fosters innovation and efficiency over time. A scenario like this is called free trade, where there are no protectionist measures applied to imports and exports. It can make the economy competitive, leading to better jobs and improved economic conditions.

Lobbying with the government is not inherently problematic. The government seems satisfied collecting indirect taxes, ultimately paid by consumers in the form of high prices. It is one of the biggest sources of their revenue, and the industries are content assuming that their businesses are protected. The lack of vision in policies as such is a concerning matter. It is evident that these policies produce a net loss to the economy. Producers seem to be winning in the short run with protectionist policies, but they are worse off in the long run. For a net win, free trade is the best alternative where both producers and consumers gain in the long run with no efficiency losses.

In cases where citizens are swayed by the preachings of the Baptists while, in reality, they are mediating the interests of the bootleggers, finding a balance becomes paramount. It’s okay to acknowledge the concerns of both sides, but the well-being of the everyday citizen should be at the forefront. For Nepal, the path towards economic prosperity lies in reforms that foster healthy practices in the market. The market works beautifully on its own. Therefore, it is vital to ensure that intervening laws like protectionism don’t stifle competition, hinder innovation, or compromise the interests of the very consumers they aim to protect.

Subhekshya Ghimire ​​is a researcher at Samriddhi Foundation, an economic policy think tank based in Kathmandu. The views expressed in this article are the author’s own and do not represent the views of the organization.

The story starts with the birth of the Hindu god “Shri Rama” in the ancient city of Ayodhya, the capital of the kingdom of Kosala, over seven millennia ago. Such is mentioned in the earliest records to date, that were written somewhere around three and a half thousand years ago. One of the principal deities of the Sanatana Dharma, the birthplace of Shri Rama is an important landmark that carries an especially holy meaning for Hindus throughout the world. 

According to scriptures, the Lord was an avatar of the preserver of the universe, Shri Hari Vishnu, born to establish the divine purpose of Dharma and Righteousness and to slay the demon-king of the kingdom of Lanka–Ravana. Over the past decades, several scriptures, inscriptions and artifacts have been discovered that relate to the historic epic of Ramayana. All of the accumulated proof points towards the city of Ayodhya as the “Rama Janmabhoomi” or “The land where the god Rana was born”. In mythology and our scriptures, the location is said to be situated on the banks of the river Sarayu, and bearing the name “Ayodhya”. 

The second piece of this problematic puzzle comes into play in 1527 AD, when the mughal empire was a sapling freshly plante. The mughal commander Mir Baqi built the Babri Masjid in the city of Ayodhya under the rule of emperor Babur by “supposedly” destroying a temple that stood as a marker of the lord’s birthplace. The place would later come under the rule of Awadhi Nawabs and hence, the mosque would cement its place in the landscape of the city. Gradually, the land forgot about the existence of such a temple, but the scars remained fresh in the memories of Hindus who hoped to pray undisturbed at the same spot someday soon. 

For centuries, the legitimacy of the temple and the mosque was contested, fueled by archeological finds that gave conflicting results in favor of three major religious communities–Hindus, Muslims and Jain-Buddhists. Hindus argued that the temple stood first, the Muslims debated that the mosque was built on land inhabited by their “people” first, and the Jain-Buddhists argued that a Chaitya stood on those grounds originally.

Even if the temple was reduced to rubble and a mosque was built on top, Hindus would travel from far and wide to pray at the spot, in the masjid or mosque’s courtyard, while Muslims would offer prayers inside. This unfazed behavior of the two communities at odds would shock the Britishers, and they would create a formal system for this arrangement; two segregated areas corresponding to each religious group. This system continued until the independence of India, after which the site soon became a “disputed land” again and the communities returned to their hostile methods for what they believed was “justice”.

While the British archeologists are said to have found only “rubbish” and “rubble” at the site, archeological studies that took place in the later half of the 20th century discovered artifacts that deepened the confusion. Perhaps the discovery of artifacts by later archeologists and not the ones employed by the British government can be credited to the advancements in technology. From the findings, two “muslim” graves, and animal remains declared that the site was home to a non-vegetarian civilization of Islamic influence. The discovery of the “Jain ascetic” terracotta figure strengthened the Buddhist claim. However, the Vishnu-Hari inscription and the 12-stone pillars of Hindu influence inside the mosque itself pointed towards the Sanatan sect being correct. 

The time period from India’s independence to the Supreme Court’s ruling was marked by various, sometimes deadly, clashes that rendered the mosque-temple site unsafe for public use. Hence, it was locked and barred from entrance. However, various mystical events took place that fascinated Hindus, resparking interests in their claim to the site. The guard on duty seeing a “beautiful boy” inside the locked compound and the appearance of a Rama idol increased the desperation of Hindus for a temple. These instances are alleged to be the propaganda efforts of the “Hindu Vishwa Parishad” and the BJP party, with no known conclusive proof. The careful influence by political parties led up to the demolition of the masjid in 1992, that sparked conflicts nation wide and led to the demolition of as many as 30 other Hindu temples throughout the nation and the neighboring country of Pakistan, and the death of about 2000 people. 

Media outlets fuelled this fire by adding twisting facts that angered the public even more. Riots and nationwide protests were common. The Congress party, which was the ruling party back then, was blamed for illicit behavior and public appeasement to try and win the upcoming elections by promising the area to the majority Hindus. As such, an ensuing land title case was lodged in the Allahabad High Court, whose verdict was pronounced on 30 September 2010. 

In the judgment, the three judges of the Allahabad High Court ruled that the Ayodhya land should be divided into three parts, with one third going to the “Ram Lalla” or Infant Rama represented by the Vishwa Hindu Parishad, one third going to the Uttar Pradesh Central Sunni Waqf Board and the remaining third going to Nirmohi Akhara, a Hindu religious sect. This verdict was dubbed the “Five acre Justice” as a land area of five acres was provided to Muslims for the construction of a mosque whereas the temple was to be built on an area of 2.7 acres. This decision finally put an end to the debate after five centuries. 

The “pran-pratishtha” ceremony or the “invocation of god into the idol” ceremony of the newly built Rama Mandir took place on January 22, 2024 after a full 497 years of the temple’s demolition. The decision is covered in allegations of non-secular behavior and politics to win votes in the upcoming elections, yet again. Throughout the world, Hindus celebrate this news in the same way they celebrate the festival of “Deepawali”. While the Hindus celebrate this occasion as a festival, it is necessary to know that they do not look upon this as a celebration of the defeat or loss of some other community, but as a justice they have finally received after a long and painful struggle. The realization of the loss and pain that led up to this moment is well known and so is the regret that slightly sours this moment of glory.

Sergio Shumsher JB Rana is an A Levels student at Trinity International College.

Other articles by Sergio Shumsher:
What is the luxury of life?
Nepal: Glory of the past, vision for future

Positively like for the second edition held in 2019, the Federal Government is also trying to fix some holes on how the country can do a much better job at attracting foreign investors, proposing new amendments to a series of policies and legislations that are in place but are not fit for an investors friendly climate.

Yet if the economy remains the top priority and the country is in dare need of portraying itself as a top destination for global businesses, then I am wondering if an equal amount of energy should be also put into organizing an international conclave focused on the Sustainable Development Goals and sustainable development.

After all, this week the capital of the nation has the privilege of hosting the World Social Forum, a great showcase to demonstrate both the advances undertaken by Nepal in the last 15 years of national development.

It is also an important opportunity to discuss the remaining challenges that are still an obstacle to create an inclusive society where no one is by default of her gender, caste or social economy conditions, bound to be left behind and ultimately fail.

So while the government deserves a big endorsement for putting a big effort in preparing the 3^rd Investment Summit, this column should be seen as a gentle nudging for the Feds to also bring the SDGs back at the center of policy making.

As we will see, there are many ways of doing so.

As I write preparations are going on at United Nations Economic and Social Commission for Asia and Pacific (UN-ESCAP) for the upcoming 11th Asia-Pacific Forum on Sustainable Development that will be held in Bangkok between the 20-23 of February.

This is annual premier event regarding the implementation of the SDGs that as we know, are part of the Agenda 2030.

This big event normally is preceded by the launch of the annual Asia and the Pacific SDGs Progress Report 2024 that is schedule for this week, on February 15.

While these events are traditionally held in the Thai capital where UN-ESCAP is headquartered, why could not we imagine the 13th Asia-Pacific Forum on Sustainable Development happening in Kathmandu?

It would be something very intriguing for the UN officials to discuss, the possibility to move away from their regional hub and organize the forum in the capital of an emerging nation like Nepal.

With the right preparation, I do not really think that this idea is logistically nor financially impossible to implement.

It can be a win-win for both the Federal Government and the UN System to showcase that what, and we can say it now, a nation that used to be a least developing country, is now instead ambition and confident enough to host a big event focused on the Agenda 2030.

Moreover, let’s not forget that Agenda 2030 with all interlinkages that cover the whole spectrum of the policy making, includes, by the way, also investments and industrialization and responsible consumption.

These dimensions are often neglected and this is a problem.

Due to a silos approach that still prevails with rigid segmentations it is as if the investments that the country needs so desperately are not supposed to be green, sustainable and respectful of human rights.

Indeed, there is no much discussion on the potential of SDG 8 focused on promoting sustained, inclusive and sustainable economic growth.

Nor the ongoing drive to develop the hydropower sector in the country is seen through the prisms of SDG 7 that is centered on ensuring access to affordable, reliable, sustainable (italics is mine) modern energy for all.

Even though policy makers and their international financial backers pretend to ignore the problems associated with top-down approaches used to develop new dams and power stations that do not respect the rights of local indigenous inhabitants, we all know that respecting human rights in the business sector is paramount.

The fact that the Government very recently approved its first ever National Action Plan on Business and Human Rights is very important but, as we know, not many are confident on its implementation.

In addition, last August the UN Country System in Nepal and the Government organized what was supposed to be a very important workshop, the SDG Acceleration Visioning workshop, that, unfortunately, went almost completely unnoticed.

As per an article in The Kathmandu Post reporting “the National Vision for SDG Acceleration will be prepared through a consultative process based on the outline coming from this workshop will be presented to the global leaders as Nepal’s commitment at the 2023 SDG Summit being held at the United Nations Headquarters in New York on September 18”.

Personally, I am not aware of any follow up but if there was one, it probably might not have generated the attention it deserved nor was, frankly speaking, very inclusive in terms of enabling a variety of stakeholders to attend.

Moreover, who really knows which are the commitments taken by Nepal during the 2023 SDG Summit?

I am afraid that shortsightedness rather than long term planning was the goal of that August workshop.

The lack of a serious, consistent conversation on the Agenda 2030 is another reason why the Federal Government, together with the provincial governments and local municipalities, should talk and act big on the Agenda 2030.

The whole 16^th Periodic Plan that Nepal is still drafting, should be centered around leveraging the SDGs.

The drafting process itself should be really inclusive and participatory and few interactions, here and there, would not make it so.

If the idea of bringing to Kathmandu the UN-ESCAP summit is too complex, then the Nepal could organize its own international event on the SDGs, perhaps focused on localizing the SDGs.

Localizing means enabling local stakeholders, not only to be part of the discussion, but also have a role, a voice in the decision making.

And with local stakeholders, to be crystal clear, I am not referring only to mayors and provincial officials but also to the people that must be have a powerful role to play.

Such international conference could be preceded by an inclusive national conversation on the implementation of the SDGs, basically a follow up to the not so inclusive workshop held last August.

There is another reason why the Federal Government should be interested in forging ahead a sustainable social and economic agenda.

In 2021 the Federation of Nepalese Chambers of Commerce & Industry, FNCCI, had come up with a very ambitious National Economic Transformation Plan 2030, a bold attempt at mainstreaming and harnessing the Agenda 2030 into national economic planning process.

Does anyone know what happened to the implementation of this document?

Is there anyone ready to bet if a discussion about it would be included in the upcoming Investment Summit?

Talking, discussing the SDGs is not just a developmental gimmick, rather the contrary.

A prosperous and inclusive nation can only happen if investments are not just “coldly” seen as big dollars and big assets coming into the country but rather as opportunity to truly transform, equitably, Nepal.

That’s why we should never be tired to discuss the SDGs.

Simone Galimberti writes about development, human rights and youths. Opinions are personal.

On November 26, the government announced its plan to organize the NIS 2024 in April in Kathmandu. In light of this, Pushpa Raj Acharya from the Investment Board Nepal sat down with Baikuntha Aryal, Chief Secretary & Ex-Officio Member of Investment Board Nepal. Aryal, who also serves as the chairperson of the Third Investment Summit Implementation Committee, shared about Nepal’s current investment climate, among other topics. 

Below are the edited excerpts:

The fiscal budget 2023-24 has underscored the need to mobilize domestic and foreign investment (capital and technology) by developing an investment-friendly environment considering the sluggish growth of private investment and vowed to initiate reforms to attract private investment. What are the major initiatives of the government to create a conducive investment climate in the country?

The fiscal budget has announced the promotion of private investment, both domestic and Foreign Direct Investment (FDI), through reforms in legal, procedural, and structural (institutional) fronts. Legal reforms fall mainly within the jurisdiction of the Parliament; however, the government has been taking the initiative to submit amended Bills to the Parliament. Apart from laws, the government will make necessary amendments to policies and regulations, as well as procedural reforms. The government is set to convene the Nepal Investment Summit in April 2024, with the objective of attracting and mobilizing domestic and foreign investments. In this regard, the Implementation Committee, under my leadership, has been preparing a comprehensive report listing the required reform agenda and actions for implementation.

Also, prompt service delivery and gaining the confidence of investors (by ensuring returns on their investments) should go hand in hand. There needs to be an efficient platform, mechanism, and promotional activities for sharing information with investors. Investors should have access to all the required information regarding investing in Nepal through a single platform. We should, at the very least, be able to disseminate investment-friendly arrangements to investors. For example, company registration fees have been drastically lowered, exit provisions have been eased, and the One Stop Service (OSS) has been made functional and effective. Along with delegating authority to OSS, the authorized person shall be equally accountable.

We have One Stop Service at the Office of the Investment Board and Department of Industry. Could you briefly explain how these platforms will be made more effective?

We have established different organizations/operators, however, problems have surfaced due to the reluctance of the concerned people to delegate authority with regard to the Department of Industry. If a similar situation occurs at the Office of the Investment Board, Nepal, the OSS will not be able to function unless the concerned ministries and agencies act on this. These are some of the illustrations that legal reforms alone cannot push forward the desired change until we make some interventions at the functional level. Institutional reforms are equally important. We do not have to do big things; we can bring about a big change by tinkering with small things.

The government has already announced it will host the Nepal Investment Summit 2024 in April. What are the priority areas, projects and investors?

Different technical teams in various ministries are working on priority areas. As we are talking about mobilizing private investment, we are also onboarding the private sector to explore potential areas and projects. While talking about potential areas, traditionally, we used to speak about ‘TEA’ – Tourism, Energy and Agriculture. That has been further revised over the period of time as ‘ICETEA’ – Information and Communication Technology, Export-oriented products and services, Tourism, Energy and Agriculture. Some have also been talking about ‘HAT’ – Hydropower, Aviation and Tourism. We will not stick to only the aforementioned areas, for instance, Manufacturing is another priority area. We might invite more franchises and production of intermediary goods, among others. The Technical Committee, chaired by the Secretary of the Ministry of Industry, Commerce and Supplies, has been assigned to develop potential projects to be showcased at the summit. In addition, we might showcase some brownfield projects as well. Moreover, we will invite potential investors from around the world as well as encourage our private sector to invest in both Public-Private Partnership (PPP) and direct investment projects.

What are the plans to make the summit more outcome-oriented?

We are going to make the summit outcome centric by attracting investments in low hanging sectors and projects. We will not just take pledges. We want the commitments to be realized within a desired time frame from capable investors. We will be showcasing credible projects that are screened through proven practices for de risking them during their execution and operation.

Will we just showcase or carry out market sounding of the projects or also call for Expression of Interest?

We are yet to make any decision and we will discuss it in the Steering Committee meeting chaired by the Hon’ble Finance Minister. We will make a decision based on the preparations carried out by the Technical Committee. If we are able to make all necessary preparations to call for the Expression of Interest (EoI), that will be a lot better. I think all the necessary preparations of a few projects will be completed in the near term and we will be able to call for EoI and also Request for Proposal (RfP) for them.

Considering the expanded committed liability of the government and shrinking revenue base, when will the government come up with the concrete categorisation of projects to be executed through sovereign funds, PPPs and direct private investment?

I think that will not take much time and we have to do it. With regard to public expenditure, the government has been trying to avoid the situation of financing recurrent expenditure through borrowing. Borrowing should be mobilized for capital formation only and I have been consistently advocating this since long. Not only in private investment, but we must also have to distinctly outline which source of public expenditure namely, revenue, borrowing, foreign aid, can be mobilized on what. Similarly, we must categorize projects to be executed through sovereign funds, public-private partnership and exclusively from private sector investment. Otherwise, we will miss the opportunity to efficiently use the sovereign funds. PPP has different modalities and options, including blending the resources as well as viability gap funding (VGF). 

Specifically, investments for public goods creation should be carried out through sovereign funds because the government’s investment is not always for profit, it could be for social benefits as well. Apart from that the private sector is more profit oriented but we can create public goods from private investment too, however, that requires the government’s strong support to harness the potential. Hydroelectricity development in Nepal is a successful example under PPP modality. The upcoming Investment Summit will be an opportunity to showcase the reform initiatives for PPP and direct investment projects to attract private investment including FDI, where investors can lodge their interests in different sectors.

The Public Private Partnership and Investment Act, 2019 has given authority to the concerned ministries and subnational governments to develop projects under public-private partnership. Why is PPP often ignored by the concerned ministries and subnational governments and what should be done to develop PPP culture?

I would like to reiterate again that the legal framework only is not sufficient to make things workable. Subsequently, it demands functionaries with understanding and expertise and we will take it forward.

How favorable is the macroeconomic situation of Nepal to attract FDI as far as the stability of the economy is concerned?

The macroeconomic situation is stable and improving. We have been able to contain inflation to below six per cent. The external sector is more stable though we’ve got to worry about deteriorating exports. The recent review of the Monetary Policy has eased out the ongoing complexities faced by the private sector, however, it requires improvement in government financing and private sector investment for stability as government expenditure stimulates private sector investment mobilization. The first quadrimester has given a sign of hope for further improvement in the economy. However, the government still needs to cautiously watch the situation to ascertain whether the current situation is cyclical, seasonal or sustainable. In spite of that we can confidently say that Nepal’s macroeconomic situation and more stable external sector are favorable for FDI.

As the Chief Secretary of the Government of Nepal, what message would you like to convey to investors across the world?

I would like to invite investors from across the globe to come and invest in Nepal, where they can earn better returns. We welcome feedback and suggestions from our valued investors. If they face any hassles, we will promptly take the initiative to resolve such issues. The Government of Nepal is committed to provide security to your investment and effective hand holding for the entire project lifecycle.

(This interview was first appeared in IBN Dispatch, bimonthly newsletter of the Investment Board Nepal)

A prohibition on the sale of an addictive carcinogenic substance was welcomed by a substantial percentage of the city’s population. Still, like with other policy judgments, it merits additional scrutiny. It remains to be seen how the Metropolitan will finish this massive, self-imposed task. 

Following a claim of legal jurisdiction to carry out such a decision, the Metropolitan specifies three primary reasons for the ban: Negative effects on public health, pollution and sewer clogs produced by such plastic wrapping, and the drain on state money caused by tobacco usage. 

The city believes that making it harder for people to sell tobacco will deter others from purchasing it. Will this, however, work? 

One of the key challenges that the Metropolis will have in attempting to apply this selling restriction will be the shared jurisdiction of different levels of government and the policy mismatch that results from it. 

The Nepali constitution empowers local governments to pass laws covering basic health and sanitation, as well as local market management and environmental protection (Schedule 8). The environment, like health, is subject to concurrent federal, state, and local control (Schedule 9).  Significant collaboration and policy consistency at all state levels will be necessary to accomplish a partial tobacco prohibition, which the city claims will eventually become a complete ban. The essence of the implementation challenge is whether the state and federal governments have enough incentive to align their policies with Kathmandu. 

The precedent, however, suggests otherwise. When the High Powered Committee for Integrated Development of Bagmati Civilization (HPCIDBC) issued a notice on November 11, 2023, to squatters in the Kathmandu Valley to clear their encroachment on public land and sought KMC’s assistance in clearing those settlements, KMC found itself in a paralyzing quagmire when the Federal Home Ministry refused to immediately support the move. The ministry noted a need for more planning and legal compliance. The tobacco ban is a bootless errand without inter-governmental consensus, which, for the time being, is a far cry. 

The federal government will have little incentive to outlaw tobacco products outright because it relies heavily on the tax revenue generated by such products.  

The tobacco sector in Nepal is one of the country’s largest taxpayers. In the fiscal year 2079/80, tobacco-based items like cigarettes and bidi contributed 26.22 billion Nepali rupees to the total excise duty collected by the federal government. The whole sum equals 25.22 percent of total excise duty collection, trailing only collection from beer (31.38 percent). Liquor comes in third with a contribution of 24.93 percent. Meanwhile, all other industrial products produced in Nepal accounted for 18.47 percent of total excise duty collections.

The data speaks for itself. The federal government will have little incentive to outlaw tobacco products outright because it relies heavily on the tax revenue generated by such products. 

Coincidentally, KMC’s decision to ban plastic-wrapped tobacco items comes not long after New Zealand abandoned its ambitious smoking ‘generation ban’ to “help fund tax cuts,” which was set to go into effect in July, 2024. 

To make a product ban successful, the incentives to accept the restriction must be greater than the incentives to ignore it, especially for the sellers. The Municipality Executive has the authority under the KMC’s Local Government Operation Act (2074), to control, inspect, and regulate the sale and consumption of consumer goods with negative effects on public health, as well as environmental pollution and dangerous substances. KMC’s own Public Health Act (2080), which the city has cited in its statement, requires a permit to sell tobacco-based products.  It also allows the city to designate limited and open areas for the sale of such products. For now, KMC has also warned the shop owners that it will cancel their permits if they find repeated violations of the prohibition. Assuming KMC successfully inspects sellers throughout the city, which appears to be unfeasible given the city’s lack of a robust inspection apparatus, it further raises the question of whether the arm-twisting will be sufficient to deter tobacco sales. 

The ban’s supply-side dynamics are still complicated. Even if a comprehensive prohibition on sales is enacted, there is still room for cross-border smuggling.  KMC shares its borders with a metropolitan city and nine other municipalities. Lalitpur Metropolitan City and the municipalities of Budhanilkantha, Chandragiri, Gokarneshwor, Kageswori-Manohara, Kirtipur, Madhyapur Thimi, Nagarjun, Tarkeswor, and Tokha all share borders with KMC. Buyers can still purchase tobacco goods in these places if KMC’s neighbors do not follow suit with the tobacco ban. As with any banned commodity, the creation of black markets for such things within KMC is unavoidable, raising the prices of these products and contradicting KMC’s original motive for the ban. 

To add to the stalemate, on December 15, the Patan High Court issued an interim order suspending KMC’s tobacco ban until the final verdict on the writ case filed by Shri Ram Tobacco Udhyog. The corporation filed a writ petition against KMC, claiming that it had a major impact on their legal operations. It further stated that it was already planning to use biodegradable packaging in all of its products beginning April 13, 2024, as per Nepal’s government regulation. 

The World Health Organization estimated that 80 percent of the world’s 1.3 billion tobacco users reside in low- and middle-income nations and that tobacco kills up to half of those who do not quit. Its position is that tobacco control regulations generate more cash for health and development efforts. In 2006, Nepal also ratified the WHO Framework Convention on Tobacco Control (FCTC), which envisions a tobacco-free society. A 2019 survey revealed that 28.9 percent of those aged 15 to 69 used smoked tobacco or smokeless tobacco products.  It also revealed that a smoker in Nepal smoked an average of 151 cigarettes each month, which cost them approximately 1049.3 rupees. 

For the time being, KMC’s partial or eventual blanket ban on tobacco sales, while a wise step for public health, will be a token gesture if not adequately implemented. It will, in some ways, expose the city’s bootstrap mentality, in which policy enactment is more significant than policy implementation. 

Rhishav Sapkota is a researcher at Samriddhi Foundation, an economic policy think tank based in Kathmandu. The views expressed in this article are the author’s own and do not represent the views of the organization.