Aid pours into Nepal, but where be vaccines?

The United States, the EU, Australia, China, Singapore are all flying in emergency supplies to help Nepal battle a fierce Covid-19 second wave, but noticeably lacking are much needed vaccines. 

It has to be said that the outside world seems to care more about Nepal than the country’s own leaders, who have been squabbling for power for the past year, and their minds now diverted to controversial early elections in November. The government’s vaccine diplomacy has so far failed to convince India, the US or Europe to rush jabs.

Activists and public health experts say even though Nepal’s friends abroad have been generous with relief, the country is not getting the urgent help it needs to vaccinate 1.4 million people with their second dose, and then the remaining population.

Nepalis took to cybresphere to thank the United States and Europe for announcing help with oxygen concentrators and PPEs this week, but said what Nepal really needs is vaccines after India banned the export of its AstraZeneca Covishield vaccines.

Responding to a USAID post about emergency medical supplies to Nepal, dental surgeon Neil Pande who has been trying to mobilise help, tweeted: ‘Thank you for your generosity. What we need the most is vaccines. It will save many from suffering. Please help. 1.3 million 65+ are waiting for the second dose of Astra Zeneca.’

Another user Prabhat Shrestha wrote, ‘Please help with vaccine. Only vaccines can save us from this disaster. Thank you.’ Ra Vee Shah commented, ‘Hope this aid contains enough vaccines to continue vaccination drive.’

Nepal will have fully inoculated 700,000 of its 30 million population next week, after its ongoing Chinese VeroCell vaccination drive comes to an end. But there are no more jabs left for 1.3 million people waiting for their second dose of AstraZeneca Covishield.

Nepal ran out of its stock after India banned vaccine exports, and the COVAX Facility could not supply its remaining 1.8 million vaccines because of the global supply bottleneck. There was a lengthy debate in the UK House of Lords about supplying the vaccines to Nepal, but no firm commitments were made. 

Activists and pressure groups have been urging the Biden administration to immediately rush some of its 80 million AstraZeneca doses to Nepal. Yuba Raj Khatiwada, Nepal’s ambassador in Washington said this week that efforts were underway to send 3-5 million AstraZeneca vaccines from the US stockpile to Nepal.

On Thursday 20 May, the USAID announced emergency assistance to Nepal with the first of three flights arriving in Kathmandu on Saturday carrying surgical masks, face shields, and gloves for frontline health workers. 

The USAID maintains that it has provided more than $15 million to help Nepal government scale-up testing, contact tracing, treatment, and infection prevention and more than $50 million in the past 15 months to combat the pandemic.

On Saturday, the Embassy of Switzerland in Nepal flew in 30 tons of medical supplies from Zurich that included 40 ventilators, oxygen concentrators, 1.1 million rapid antigen test kits and PPEs worth $8 million.

“Switzerland stands in solidarity with Nepal and the Nepali people in the fight against Covid-19, these essential medical supplies will help save lives and provide support to the government of Nepal to contain and control the pandemic,” said Swiss Ambassador Elisabeth von Capeller while handing over the consignment to Health Minister Hridayesh Tripathi on Saturday at Kathmandu airport.

Later in Saturday, the Singapore-based Temasek Foundation, together with the MiRXES Private Limited and Lotus Life Foundation are sending 15 tons of diagnostic and medical supplies on a Nepal Airlines flight. The consignment includes 36 ventilators, 4,000 pulse oimeters, 50 B-PAPs, 123,000 PCR test kits and RNA extraction kits.

On Friday, the United Nations launched the Nepal Covid-19 Response Plan calling for $83.7 million in emergency relief over the next three months to assist 750,000 of the most vulnerable people affected by the pandemic. 

“The current outbreak is having a devastating impact not just on health but across all sectors, hitting the poorest and most marginalised people in Nepali society the hardest,” said UN Resident Coordinator Sara Beysolow Nyanti. “The Response Plan calls for swift action and international solidarity that is desperately needed to save lives and prevent unnecessary suffering today, tomorrow, and in the difficult weeks to come. We have no time to lose.”

However, even in the UN’s help list, there is no mention of vaccines. The WHO had promised vaccines for 20% of Nepal’s eligible population throughout the COVAX Facility. However, 1.8 million of the 2.4 million Covishield vaccines never came, and its Indian manufacturer said this week it would not be able to export vaccines till end-2021.

On Thursday, an Iberia Airbus 330 landed in Kathmandu with 50 oxygen cylinders, 10 oxygen concentrators and 15 ventilators, among other medical kits donated by organisations in Spain. The shipment facilitated through the EU Civil Protection Mechanism is the first of several to follow from the EU Member States in the coming days.

Finland, France, Germany, Spain and Belgium are donating a combined total of 50 oxygen cylinders, 20 concentrators, 77 ventilators, 14 respirators, 164,000 antigen tests, 3.4 million masks, 42,500 gloves, 30,000 isolation gowns and 20,000 oxygen cannulas. 

“The Covid-19 surge in Nepal is claiming more lives every minute as it spreads across the country. We stand in full solidarity with Nepal in its fight against the pandemic,” said Janez Lenarčič, Commissioner for Crisis Management. “We are also quickly mobilising emergency support with an initial €2 million. We stand ready to provide further assistance.”

Also on Thursday, the Tibetan Autonomous Region of China sent overland 200 cryogenic cylinders holding 150 litres of liquid oxygen, 10 oxygen concentrators, 5 ventilators, 200 ICU beds and 15,000 antigen kits to strengthen Nepal’s response to the pandemic. 

About half of the 20,000 empty oxygen cylinders China donated to Nepal has been flown in by Nepal Airlines from Beijing. However, there is no word about the 2 million more doses of SinoPharm VeroCell vaccines that Nepal wants to order from China. The Ministry of Health is said to be delaying that purchase, and is in favour of the Russian Sputnik V.

Meanwhile, Australia on Thursday also announced AUD7 million (Rs635 million) in funding to Nepal to procure essential equipment and health supplies, such as oxygen for provincial hospitals and personal protective equipment for health workers.

This is part of Australia’s aid package to support Bangladesh, Nepal and Sri Lanka, to strengthen the resilience of the South Asian region during the pandemic.

New Zealand has also committed $1 million to support Nepal's Covid-19 response. The fund will go to UNICEF to help with emerging health needs and community resilience, wrote New Zealand’s Minister of Foreign Affairs and Trade Nanaia Mahuta on her twitter.

Another US-based group, Direct Relief, chartered an aircraft to rush oxygen concentrators and Covid-19-specific medical supplies on 25 May. 

‘People in Nepal are facing the worst Covid crisis in the world today based on per-capita confirmed cases, and they need urgent help, we will do whatever we possibly can to help,’ said Thomas Tighe of Direct Relief in a statement. 

International relief for Nepal is picking up but its most immediate needs are oxygen and vaccines, especially as the pandemic has now infiltrated the remotest villages in the country where there is no hospital care, medical equipment or doctors. In Rolpa and Humla districts in Nepal’s mountains, as high as 90% of PCR tests are coming back positive. 

Even in cities, major hospitals have stopped admitting patients due to the shortage in oxygen supply and people are now dying because of low oxygen saturation in their blood. 

Nepal needs 50,000 cylinders a day, 30,000 of them in Kathmandu’s hospitals, but presently there are only 19,000 cylinders available across the country.