<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161152/636d1e259c7e80680e0af3f5jpeg.jpg" alt="" width="1524" height="1000"/><figcaption>The 4.1 million doses of Moderna and J&amp;J vaccines sent by Germany via COVAX facility arrived in Kathmandu this week. Photo: UNICEF</figcaption></figure>Till a few months ago, Nepal was struggling with a critical shortage of vaccine doses, and the situation was so dire that the 1.4 million senior citizens were <a href="https://www.nepalitimes.com/here-now/lonely-wait-of-nepals-elderly-for-2nd-doses/" target="_blank" rel="noopener noreferrer">waiting past the due date for their second doses</a>.How the tables have turned. Today, the vaccine stockpile is so large that there is a danger of vials having to be destroyed because of the lack of refrigerated storage — and there are millions more vaccines in the pipeline.“There is no shortage of vaccines anymore, there are millions of doses in stock and we now need to inject them into arms as soon as possible,” says Buddha Basnyat, a physician at the Patan Academy of Medical Sciences.“The best strategy now is to continue inoculating those who haven’t yet been vaccinated while simultaneously also administering boosters, given the decreasing antibody levels and the rise of new variants,” he adds.Health experts are now recommending that the Nepal government also <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">start booster shots for high-risk populations</a> such as the immuno-compromised, senior citizens and frontline workers. They urge better planning and clarity from the government about booster shots, and who should get them to prevent influential people from jumping the queue, or misusing the doses.So far Nepal has got 20 million doses of vaccines, and has used an estimated 10 million. In the next three months, the country will be taking delivery of over 34 million doses of AstraZeneca, Coronavax, VeroCell, J&amp;J, Moderna and Pfizer vaccines. This week alone, Germany sent 4.1 million doses of Moderna and J&amp;J vaccines via the COVAX initiative. It also supported the procurement of ultra-low temperature freezers.But it is not only the lack of storage facility and nearing expiry date that validates the logic behind booster shots. Studies have shown that the antibody levels afforded by vaccines and natural infections wane significantly over time. The memory cells also provide immunity against the infection, but there is uncertainty about how long that lasts.“From the perspective of science, a booster dose is necessary especially with <a href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/" target="_blank" rel="noopener noreferrer">Omicron in the picture</a>, boosters have been shown to significantly reduce hospitalisations” explains Lhamu Yangchen Sherpa, an epidemiologist with IPAS Nepal.She adds, “However, we in Nepal have a moral dilemma because a majority of our population haven’t yet received even a single dose. We need to balance this and come up with protective mechanisms that will save the most lives.”Indeed, despite adequate vaccines in the stock and millions more in the pipeline, only 30% of Nepal’s target population have been fully vaccinated against Covid-19. Some 36% have been partially inoculated.Some of Kathmandu’s hospitals are starting to observe an increase in hospitalisations, severity and deaths among people who had been fully vaccinated six months ago. This makes the case for boosters, starting with those with co-morbidity, or those above 60.“This can be an early warning for what is in store for us, the best way to prevent future surge is proper management and distribution of the vaccines we have,” says Sher Bahadur Pun, a virologist at Kathmandu’s Teku Hospital.“Nepal’s priority remains <a href="https://www.nepalitimes.com/here-now/do-nepalis-need-covid-booster-shots/" target="_blank" rel="noopener noreferrer">vaccination for all</a>, but this does not mean we leave those who have taken two doses to die. Individuals above 60 and those more vulnerable to Covid-19 must get boosters on time and that is now,” Pun adds.Going by this week’s figures, Nepal is registering on an average of 260 new Covid a day with the positivity rate at 2.3%. While this figure is not as alarming as <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">the second wave in April-May</a>, the arrival of the Omicron variant is of serious concern.The new variant has been credited for a steep increase in the number of infections across the globe. The UK reported over 76,000 cases a day on Wednesday, and the WHO has warned that Omicron is spreading at an unprecedented rate across the world.“The new variant while comparatively less virulent than the Delta is at least two to three times more transmissible, which means it can still cause a significant number of deaths given the higher number of infections and more morbidity, underwhelming our health infrastructure,” warns Anup Subedee, infectious disease specialist at HAMS hospital.“It may not lead to another big surge like the second wave but we have to be on a high alert,” he adds.Nepal’s poor health infrastructure is not <a href="https://www.nepalitimes.com/latest/nepal-needs-to-prepare-for-new-covid-wave/" target="_blank" rel="noopener noreferrer">fully prepared for another spike</a> in infections. While doctors and nurses may have experience with the pandemic, and city hospitals are mostly well-equipped, ventilators are gathering dust due to the lack of skilled workers to operate them. New oxygen plants have not been monitored properly, and ICUs do not have enough trained nurses.“Everything Covid wise is now under control, we haven’t had a single case in the last two weeks but we are no better prepared,” says Binod Dangal of Charikot Hospital in Dolakha District. “If there is another wave, we are done for. <a href="https://www.nepalitimes.com/latest/donated-ventilators-gather-dust-in-nepal/" target="_blank" rel="noopener noreferrer">Our equipment is not functional</a> and we don’t have trained staff either.”There is once again a false sense of security, and the public cannot wait to go back to pre-Covid days with marriage parties, political conventions, packed classrooms, and crowded markets. For the foreseeable future, experts say we must continue to mask up and follow safety protocols despite the vaccine rollout, especially with the rise of new variants.Says physician Buddha Basnyat: “The mask is the best vaccine. It is cheap and effective, while we attempt to vaccinate everyone and give boosters.”

original

674x448

610x380

500x500

400x266

400x240

400x203

301x200

1250x600

1084x550

From scarce vaccines, to storage shortage in Nepal

<figure><img width="1098" height="732" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161148/636d1d329c7e80680e0af39djpeg.jpg" alt=""/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure>The fact that Omicron was detected in an individual who had arrived in Nepal five days before the new variant was first identified in Botswana is proof it was already circulating and travel bans do not work.
<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/" target="_blank" rel="noopener noreferrer">The new strain</a> has been detected in over 40 countries mere two weeks after it was first detected. What is known so far of Omicron is that it is highly transmissible but likely not very severe as there has been no significant increase in hospitalisations among infected individuals in places with outbreaks.
“Looking at preliminary findings I don’t think it will lead to another <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">major surge or lockdowns like Delta</a>, but having said that we must be prepared and contain it to prevent further mutation and more virulent strains,” says epidemiologist Lhamo Yangchen Sherpa of IPAS Nepal.
She adds: “We do that by vaccinating as many people as possible including boosters if they are nearing expiry date as we know them to be, following safety measures especially indoors and by better communicating government policies to control the spread of new strains.”
One of the main concerns with Omicron is mutations in the spike protein that binds it to the receptor. Most vaccines including Pfizer, Moderna, AstraZeneca and J&amp;J primarily target this spike protein, so there are worries that the new variant will escape immunity afforded by jabs.
Mutations are natural, but coronaviruses make fewer of them than other viruses because of their much stronger <a href="https://www.sciencedirect.com/science/article/pii/S1097276520305189" target="_blank" rel="noopener noreferrer">proofreading system</a> to survive.
<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.indiaspend.com/indiaspend-interviews/omicron-wont-be-much-more-dangerous-than-other-circulating-covid-19-variants-790812" target="_blank" rel="noopener noreferrer">Speaking with India Spend</a>, Polly Roy, professor of virology at the London School of Hygiene &amp; Tropical Medicine said: ‘Even though we have a mutation, it’s not in the receptor-binding site area so much. Thus, if they change too much, the virus will not bind to host cells and will not survive. And the vaccines target that area, so the vaccines will still work against Omicron infection.’
Says infectious disease specialist at HAMS Hospital Anup Subedee: “Even if the vaccines are less effective against this variant, it will still provide significant immunity to fight off new infections. And given that antibodies wane over time, <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" target="_blank" rel="noopener noreferrer">Nepal’s frontline workers</a> and the elderly should be prioritised for boosters, if possible with vaccines known to have higher efficacy.”
There are also concerns that despite registering only mild symptoms Omicron could affect vulnerable populations much later as it is the younger mobile population who are usually infected first without much impact on their health. 
Most of the initial Omicron infections are said to be mild and among young and vaccinated people, which means Nepal could be ripe for another surge. 
“Don’t be surprised if we do,” says Sushil Koirala, a Nepali public health expert based in Bangkok. “We have all the necessary fuel to start the wildfire: low vaccination coverage, poor adherence to public health measures, lackluster preparedness, and questionable surveillance,” Koirala warns.
But <a href="https://www.nepalitimes.com/here-now/do-nepalis-need-covid-booster-shots/" target="_blank" rel="noopener noreferrer">the moral dilemma over booster</a> remains when over 60% of Nepal’s targeted population is yet to even receive the first dose.
“In an ideal world, universal coverage is the way to go but the government hasn’t been able to vaccinate the majority of Nepalis, so we cannot wait forever for boosters either,” adds Subedee.With the rapid spread of Omicron in the region, the Nepal government has announced that it will vaccinate at least 200,000 people a day and the Health Minister Birodh Khatiwada has asked people who have inoculated with two doses of vaccine to also receive the third dose to prevent <a href="https://www.nepalitimes.com/latest/nepal-needs-to-prepare-for-new-covid-wave/" target="_blank" rel="noopener noreferrer">the risk of the third wave</a>.
Khatiwada was quoted as saying that the government had a stock of 20 million doses of different jabs and it will start administering the booster from mid-December with 16,000 vaccination centres across the country.
So far Nepal has received 25,658,630 doses of the Covid vaccine of which some 660,000 doses still in stock. In the next three months, a total of 34,594,460 doses of different jabs are arriving in Nepal: 9,403,000 doses of AstraZeneca, 3,000,000 Coronavax, 2,386,800 VeroCell (one vial, one dose), 2,174,400 J&amp;J and 1,965,600 Moderna.
But the government’s focal person for vaccine Shyam Raj Upreti told Nepali Times health authorities are authorised to administer only an additional dose, not <a href="https://www.nepalitimes.com/latest/booster-lack-strands-israel-bound-nepalis/" target="_blank" rel="noopener noreferrer">a booster</a>, and only for immunocompromised people and individuals above 60 who had received VeroCell, as recommended by the WHO.
“Our priority is still to vaccinate the targeted population and hence those who are still not vaccinated,” adds Uprety. “And for this, we are focusing on activities to convince more people to inoculate, add vaccination booths to increase access and where required administer the doses door to door.”
At present, 29% of Nepal’s population has been fully inoculated while 33.9% have been vaccinated partially. Experts say better communication about vaccination schedules a few days before the campaign in local language and on platforms most consumed is crucial in further <a href="https://www.nepalitimes.com/opinion/giving-all-nepalis-a-shot-at-the-covid-vaccine/" target="_blank" rel="noopener noreferrer">increasing the uptake</a>.
Equally important is building a storage facility for Pfizer and Moderna vaccines that are in the pipeline to vaccinate children 12 and above. A limited number of students who revived Pfizer jabs last month are yet to receive their second dose, recommended after three weeks of the first.
Speaking on his social platform, Sameer Dixit of the Centre for Molecular Dynamics Nepal recommended patience over panic: “Let’s wait and watch until we have more concrete findings on Omicron. Until then mask up and vaccinate as soon as it is available. As for boosters, those in vulnerable groups should get it.”

Sonia Awale

Omicron may not be as risky, but take care

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161144/636d1cd69c7e80680e0af37ejpeg.jpg" alt="" width="1331" height="888"/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure>After a dozen or so people were admitted to a hospital in Delhi with suspected omicron strain of Covid, neighbouring <a href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/" target="_blank" rel="noopener noreferrer">Nepal is on a high alert</a> fearing a similar outbreak that ravaged the two countries earlier this year.Although the new variant is said to be more transmissible and resistant to existing vaccines, the good news is that those infected have only reported mild symptoms.Studies the European Centre for Disease Prevention and Control (ECDC) have found out that the omicron strain was already circulating in Nigeria from October, and it was already in Europe before flights arrived from South Africa last week.Until more is known about the new virus strain, public health experts in Nepal have recommended that people get vaccinated if they have not done so already, wear masks and avoid crowds for now. The WHO on Thursday advised those above 60 and with co-morbidities to avoid air travel for now.Epidemiologists have recommended strengthening safety measures over travel restrictions, which is often too late to entirely stop the surge as seen during the <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">devastating second wave</a> in the subcontinent. Nepal has issued travel ban on eight African countries and Hong Kong.“General people are now letting their guards down, public places are most crowded than during normal times, people have all but forgotten about social distancing, and masking has become minimal,” says virologist Sher Bahadur Pun at Teku Hospital.Mutations are natural but the higher the spread of the existing virus, the higher the threat of more virulent variants to arise. Public health experts have blamed the rise of new strains on <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">inequitable vaccine distribution globally</a>.Roughly 30% of Nepalis are now fully vaccinated and with 30 million more doses of various vaccines in the pipeline, the Health Ministry has set a goal to vaccinate the entire targeted population by mid-April. The government has also expanded vaccinations to everyone above 12.Nepal’s vaccine infrastructure and network of community health workers have played a significant role in reaching the far corners of the country with <a href="https://www.nepalitimes.com/here-now/do-nepalis-need-covid-booster-shots/" target="_blank" rel="noopener noreferrer">Covid-19 jabs</a>. But now the challenge is to increase vaccine acceptance among those who have so far refused to take it.This means better communicating pandemic risks and training more healthcare workers to administer the vaccine. The information that is regularly shared through the Viber group, composed of hundreds of health officials and open to the public, is not necessarily accessible to everyone due to language barriers.“Covid related information is either in English or Nepali, people who don’t speak either have a hard time accessing them. Language equity has been a major issue,” says Bijay Acharya of the Nepal-Johns Hopkins University Advocacy Group, adding that this has also exacerbated misinformation spreading through Whatsapp and Facebook as people attempt to informally translate and interpret information about the virus.Lack of translation can also affect the ability of <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" target="_blank" rel="noopener noreferrer">community health workers</a>, who act as the front line of information about the pandemic, to counsel their communities on the vaccine and how to best protect themselves.In what is now termed as ‘vaccine discrimination’, the US, Australia and the majority of the European countries do not recognise all the Covid vaccines equally. Such discrepancies have been most notable in the case of labour migrants and foreign students who have been barred from their station because they didn’t receive mRNA vaccines such as Pfizer or Moderna.“Even those who are fully vaccinated with a viral vector booster will only be considered partially vaccinated and there will be lot more issues like this in the future,” adds Acharya.China’s VeroCell <a href="https://www.nepalitimes.com/banner/the-jabs-and-jabnots/" target="_blank" rel="noopener noreferrer">is still largely unaccepted</a> while Indian-made Covishield is not recognised even in countries that accept AstraZeneca. This is unfortunate at a time when Omicron with multiple mutations in the spike protein is on the rise. mRNA vaccines primarily target this protein, rending it ineffective against the new strain.Experts say that only VeroCell, Covaxin which is manufactured by Bharat Biotech, are made from inactivated viruses and are better placed to ward off new spike proteins in mutants.The pandemic has also affected routine <a href="https://www.nepalitimes.com/latest/pandemic-hits-non-covid-vaccines-for-children/" target="_blank" rel="noopener noreferrer">childhood immunisation</a> in countries like Nepal. Lockdowns and fear of contracting the virus have stopped many parents from travelling to health clinics for measles, polio, whooping cough or tetanus shots. Nepal has also seen a <a href="https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/" target="_blank" rel="noopener noreferrer">rise in  maternal and infant death rates</a> during the pandemic due to reduced institutional deliveries.Officials say it will be important for the Nepal government to be prepared with oxygen, ICU beds, medicines and medical staff to prepare for a new Coid-19 surge in spring. A measurement widely used by epidemiologists, called excess mortality, is applied to contextualise the differences in deaths during a pandemic compared to a normal year.Excess mortality data, however, may not be applied in the case of stateless people, have no documentation or property and where families have no interest in reporting deaths. There might also be deaths that cannot be recorded or accounted for. Nonetheless, this will help governments prepare for <a href="https://www.nepalitimes.com/banner/economic-cost-of-5-months-of-nepal-lockdown/" target="_blank" rel="noopener noreferrer">economic slumps</a> and with informed decision-making.Adds Acharya: “Excess mortality data can be used to predict the future and inform future preparation. Just looking at excess deaths in Nepal in the past five years will give us a good idea about how to respond to pandemics.”

Nepal needs to prepare for new Covid wave

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151116/636d08649c7e80680e0a6014jpeg.jpg" alt="" width="1319" height="1975"/><figcaption>Photo: UNICEF NEPAL</figcaption></figure>The <a href="https://www.nepalitimes.com/opinion/eu-will-stand-by-nepal-in-hard-times/" target="_blank" rel="noopener noreferrer">European Union</a> has renewed its committment to sharing more than 200 million doses of Covid-19 vaccines with low and middle-income nations, including Nepal, by the end of 2021.The doses will be delivered mainly through <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">the COVAX initiative</a>, which has so far provided 122 million doses to 136 countries. This is far less than the quantity originally promised because of supply chain issues and India’s ban on export of its AstraZeneca Covishield vaccine.“Team Europe takes its responsibility in helping the world fight the virus, everywhere. Vaccination is key – that's why it is essential to ensure access to Covid-19 vaccines to countries worldwide,” said EU President Ursula von der Leyen at this week’s Global Health Summit in Rome.In parallel, Europe is providing better access to vaccines, medicines and health technologies in Africa, in part by helping create the right conditions for local vaccine manufacturing in Africa.The initiative will be backed by a €1 billion grant from the EU, and European development finance institutions such as the European Investment Bank (EIB).On 9 July, Team Europe agreed to support large-scale investment in vaccine production by the Institut Pasteur in Dakar. The new plant will reduce Africa's 99% dependence on vaccine imports and strengthen future pandemic resilience in the continent.The European Union is one of the biggest donors of COVAX and has contributed at least €2.47 billion to the initiative, which had committed to providing free vaccines for 20% of Nepal’s population.It sent its first consignment to Kathmandu back in March with 348,000 doses of AstraZeneca Covishield manufactured by Serum Institute of India. But owing to a global manufacturing bottleneck and the export ban in India on vaccines, it was <a href="https://www.nepalitimes.com/opinion/im-sad-vaccines-are-delayed-in-nepal/" target="_blank" rel="noopener noreferrer">unable to deliver any more doses</a> till recently.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151116/636d08679c7e80680e0a6015jpeg.jpg" alt="" width="448" height="537"><figcaption></figcaption></figure>Even as Nepal was in the grip of the <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">devastating second wave</a> in May-June when there were close to 10,000 new cases daily and up to 250 fatalities a day, there was a complete stop to vaccinations.Nearly 1.4 million Nepalis above 65 are <a href="https://www.nepalitimes.com/here-now/lonely-wait-of-nepals-elderly-for-2nd-doses/" target="_blank" rel="noopener noreferrer">still waiting for their second doses of Covishield</a>, which they may now get with a grant of 1.6 million doses of AstraZeneca from Japan.In early July, the Americans flew over 1.5 doses of single-shot Johnson &amp; Johnson to Kathmandu under COVAX, which is sending another 350,000 doses by August.At present VeroCell and <a href="https://www.nepalitimes.com/latest/johnson-johnson-in-nepal/" target="_blank" rel="noopener noreferrer">J&amp;J vaccination</a> drives are running in parallel across Nepal and the vaccine supply chain is <a href="https://www.nepalitimes.com/latest/vaccines-start-trickling-into-nepal/" target="_blank" rel="noopener noreferrer">less constrained</a>.But the decline in the number of new infections and deaths has now stalled. Public health experts have warned <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">of a third wave</a> and there are threats of newer, more virulent variants as long as a major chunk of the population remains unvaccinated.Covid mortality rose by 50% this week, and urban centres in Kathmandu, Lalitpur, Chitwan, Kaski and Jhapa have recorded the most new cases.On Friday, there were a total of 2,977 new cases across the country, taking the total active infections to 28,518. There were 18 fatalities in the last 24 hours and 1,678 recoveries. So far, 9,679 people have succumbed to Covid-19 in Nepal since the outbreak in January 2020.

EU to share 200 million vaccines by 2021

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151116/636d07f09c7e80680e0a5febjpeg.jpg" alt="" width="2048" height="1365"/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure>For the first time in weeks, Nepal recorded more than 3,000 new cases on 20 July. There were 25 deaths. The country is on the tail end of what has been a deadly second wave, but the rate of decline in infections and mortality has stalled.Public health officials blame it on <a href="https://www.nepalitimes.com/banner/kathmandu-covid-19-lockdown-relaxed/" target="_blank" rel="noopener noreferrer">sudden reopening following two-months of lockdown</a> in which many mingled without masks, low vaccination rate, and minimal testing and tracing.While some experts say Nepal and India are now safe against another major surge of the Delta variant that was largely responsible for <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">the second wave</a>, others warn of a third wave if safety measures are not enforced.The Delta mutant is now ravaging Indonesia, and spreading across Europe and North America. And scientists say it has affected mostly countries and regions with low vaccination rates.“The third wave is a matter of when not if. And if we don’t vaccinate as many people as soon as possible, there will be a continued threat of more dangerous variants, and we will be repeating the whole cycle,” warns Buddha Bansyat, a physician at the Patan Academy of Health Sciences.So far, Nepal has fully vaccinated 1,158,130 people, 3.6% of its total population. Some 10% Nepalis have received the first dose of either AstraZeneca Covishield, Chinese Sinopharm VeroCell or <a href="https://www.nepalitimes.com/latest/johnson-johnson-in-nepal/" target="_blank" rel="noopener noreferrer">single-shot Johnson &amp; Johnson</a> jabs.Another 8 million doses of various Covid-19 vaccines are expected by September – some purchased from China, more doses from COVAX, as well as a direct grant from Japan. This should take the total fully vaccinated population near 20%, which together with antigen positive population could cushion the impact of a possible third wave.“We have now moved on from vaccinating <a href="https://www.nepalitimes.com/here-now/spared-at-first-elderly-hit-hard-by-covid-19/" target="_blank" rel="noopener noreferrer">the elderly</a> and frontline workers to groups less at risk of the Covid-19, and we have more vaccines in the  pipeline,” says Shyam Raj Uprety, head of government's Covid Vaccine Strategy. “We have applied to buy 10.5 million more doses of vaccines from the COVAX at a subsidised rate.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151116/636d07f39c7e80680e0a5fecjpeg.jpg" alt="" width="448" height="537"><figcaption> </figcaption></figure>Indian public health experts have projected the third wave to hit that country in late August. What happens in India usually follows in Nepal within 12-13 days, and if that is true this time too, Nepal cannot be  unprepared like in March.“If the vaccination program progresses as smoothly as it is happening now compared to the first two surges, the third wave might not be as significant if it happens at all. By Dasain, a significant chunk of Nepalis should have been vaccinated,” explains Sameer Dixit of Centre for Molecular Dynamics Nepal.Apart from vaccines, in case of a sudden surge, hospitals need to be ready with sufficient beds and ICUs, oxygen, life-saving medical equipment, drugs and <a href="https://www.nepalitimes.com/here-now/helping-nepalis-breathe-again/" target="_blank" rel="noopener noreferrer">functioning oxygen plants</a>. Hospitals must also prepare their paediatric wards since the third wave could affect a younger population.Since the peak of the <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">second wave</a> when there were close to 10,000 new cases a day and over 200 daily fatalities, international donors have been supplying essential medical equipment to Nepal.The Health Ministry received 385 ventilators and 970 oxygen concentrators in May June from various donors. District hospitals at local levels have also received direct supplies from aid agencies. These should be in running  condition and on standby instead of being stockpiled in Kathmandu, say doctors interviewed for this report.With the <a href="https://www.nepalitimes.com/latest/vaccines-start-trickling-into-nepal/" target="_blank" rel="noopener noreferrer">vaccine supply chain less constrained</a>, there is now a debate about reprioritising the doses and a more strategic distribution of supply. Some experts have suggested a ‘firewall strategy’ wherein densely populated cities are fully vaccinated to reduce transmission, and to revive  the economy that will in turn restore jobs.Equitable vaccination is ideal, but in epidemiological terms inoculating a thinly-spread population is not the best use of limited doses. Inoculating  younger adults mean they are less likely to carry the virus and transmit it to <a href="https://www.nepalitimes.com/here-now/lessons-not-learned-from-the-pandemic/" target="_blank" rel="noopener noreferrer">children</a>, the largely unvaccinated group. Even within cities, the focus must be on the urban poor in congested areas.“Moving forward, we must now prioritise crowded cities and highly mobile groups for vaccination to help blunt the effect of another wave and save as many lives as possible,” says Sher Bahadur Pun, a virologist at Teku Hospital.However, epidemiologist Lhamo Yangchen Sherpa worries that focusing in cities may mean the underserved are neglected. “While reprioritising, our strategy should be such that the supply isn’t misused and the neediest aren’t missed out.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151116/636d07f59c7e80680e0a5fedjpeg.jpg" alt="" width="2048" height="1366"><figcaption> </figcaption></figure>At present VeroCell and J&amp;J vaccination drives are running in parallel across Nepal. Soon, the Japanese grant of 1.4 million <a href="https://www.nepalitimes.com/banner/despite-doubts-nepal-sticks-with-astrazeneca-jabs/" target="_blank" rel="noopener noreferrer">AstraZeneca</a> will be used to inoculate the elderly who have been waiting for four months for their second doses.Social media is rife with speculation about the jabs and who should and shouldn’t get it, leading to widespread confusion and vaccine hesitancy. People are also comparing the efficacy level of one vaccine against the other.“Let’s take any vaccine available, they do what they are supposed to do, prevent deaths and hospitalisations in most cases,” says Buddha Basnyat.  “I encourage people with heart conditions, cancer and liver diseases to vaccinate, they are high-risk group, as well as pregnant women.”According to Public Health England, Covid-19 vaccines have so far  prevented 13,200 deaths and 39,700 hospitalisations in the United  Kingdom, even while the country sees a surge in Delta variant cases.As Nepalis inoculate against SARS-CoV-2, people are starting to forgo <a href="https://www.nepalitimes.com/opinion/staying-safe-in-2021-and-beyond/" target="_blank" rel="noopener noreferrer">safety measures</a> even if the majority of the population remains unvaccinated. They are back on the streets taking part in political rallies and conducting crowded indoor meetings. Jam-packed and poorly- managed vaccination centres could themselves be super spreaders.Says Sameer Dixit: “In midst of vaccines, variants and new surges, we cannot forget masks and physical distancing, it is still our first line of  defence against the coronavirus.”

Vaccines, variants and a third wave

<img width="768" height="512" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d066a9c7e80680e0a5f5fjpeg.jpg" alt=""/>Much-delayed <a href="https://www.nepalitimes.com/here-now/nepal-needs-urgent-american-vaccine-support/" target="_blank" rel="noopener noreferrer">vaccine supplies to Nepal</a> appear to be picking up after another lot of Chinese Sinopharm vaccines arrived in Kathmandu on Friday, and assurances that the country will get additional doses through the COVAX facility in the coming weeks. In a government-to-government deal, Nepal ordered 4 million doses of Sinopharm’s VeroCell vaccines, which will be enough to inoculate an additional 2 million Nepalis. The first shipment of 800,000 doses was flown in by Nepal Airlines from Beijing on Friday. The United States has confirmed that it is working on the legal and logistical aspects of sending 1.5 million doses of its single-jab Johnson &amp; Johnson vaccine to Nepal under the COVAX initiative.  The British Minister of State for South Asia and the Commonwealth, Lord Tariq Ahmad in a written response to House of Commons MP Sir John Hayes on 30 June said that Britain would be sending more vaccines through COVAX by next month. ‘COVAX has allocated 2,000,000 vaccine doses to Nepal, of which 348,000 have already been delivered and we understand another tranche will arrive by August,” Lord Ahmad’s letter, which was made available to Nepali Times, states. However, it is not clear if the additional COVAX vaccines are the ones already pledged by the Americans, and if it is another lot how many doses of what kind of vaccines are involved. The Ministry of Health has said another 348,000 vaccines are coming through COVAX by August.  This fact is critical for the nearly 1.4 million Nepalis above 65 years who got their <a href="https://www.nepalitimes.com/latest/1-6-million-vaccinated-20-million-to-go/" target="_blank" rel="noopener noreferrer">first doses of AstraZeneca</a> more than 12 weeks ago, and their second doses are overdue. The elderly were inoculated first with Covishield AstraZeneca manufactured by Serum Institute India of which Nepal got 1 million doses as initial grant from India and then purchased another 2 million of which only <a href="https://www.nepalitimes.com/latest/the-gift-of-the-jab/" target="_blank" rel="noopener noreferrer">1 million were delivered </a>before New Delhi banned vaccine exports. Less than 3% of Nepalis have so far received both doses of Covishield or VeroCell, and another 2.6 million have got both shots. Nepal needs to inoculate at least 22 million of its eligible population. COVAX had originally promised 13 million doses of Covishield to inoculate 20% of Nepal’s population. The American announcement of 1.5 million J&amp;J doses are a part of the 7 million pledged by President Joe Biden to South Asian countries last month, of the 1 billion doses from the G-7 promised at a summit in the UK last month. ‘The majority of the doses will go through COVAX,” Lord Ahmad says in his letter. ‘In addition, the World Bank and the Asian Development Bank (both partially UK-funded) have made available significant funding to enable the Government of Nepal to purchase vaccines. This financing together with COVAX supplies can vaccinate 70% of the population of Nepal.’ Indeed, the World Bank has provided Nepal with a $100 million loan, and an additional $160 million from the ADB for vaccine procurement. World Bank country director Faris Hadad-Zervos told reporters in Kathmandu on Thursday that Nepal may have to wait a long time to get vaccines as grants through COVAX, and it might be a better idea to buy them. The EU had negotiated with vaccine manufacturers to provide 1.2 billion vaccines at cost to low income countries through COVAX. The EU has exported 340 million doses of vaccines, half its production, to countries around the world. Head of the EU Delegation to Nepal <a href="https://www.nepalitimes.com/opinion/eu-will-stand-by-nepal-in-hard-times/" target="_blank" rel="noopener noreferrer">Nona Deprez</a> says the EU is not sitting on a big stockpile of vaccines at the moment, and has not been blocking individual member states from having direct vaccine deals with countries like Nepal. <figure><img width="1017" height="652" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d066d9c7e80680e0a5f60jpeg.jpg" alt=""><figcaption> </figcaption></figure>A group of European, Nepali and Bhutanese personalities had written an <a href="https://www.nepalitimes.com/latest/nepal-bhutan-vaccine-appeal-to-european-commission/" target="_blank" rel="noopener noreferrer">open letter</a> to the European Commission president this week demanding that countries be allowed to send surplus vaccines directly to countries without having to go through Brussels and COVAX.“Nepal is very much on our radar, and direct vaccine supply depends very much on individual member states who are owners of the vaccines,” Deprez told Nepali Times. “In fact, we have received requests from 20 countries, including Nepal, and have tried to facilitate the bilateral donations.”The UN’s COVAX facility is mainly funded by the UK and EU, but its reliance on India’s Covishield as well as legally-binding shipments of doses to donor countries has set back its programs in Africa and Asia.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/anger-grows-in-nepal-over-covid-vaccine-delays/" target="_blank" rel="noopener noreferrer">Pressure has been building in the UK</a> from Gurkha veterans, MPs, and activists for Britain to provide AstraZeneca vaccines at least for the second doses. At least 63 Gurkha veterans have died in Nepal from Covid-19 during the second wave.  <img width="640" height="720" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d06709c7e80680e0a5f61jpeg.jpg" alt="">Nepal’s second wave has crested, but public health officials have warned of a second peak because of what they said was a premature relaxation of lockdown rules while the virus was still spreading in the community and not enough people had been vaccinated.On Thursday, there were 29 more deaths from Covid-19, and the number of infected people, while much lower than at the peak last month, was higher than the total recovered patients for the third day in a row. The number of active cases in Nepal has risen slightly again to 26,447, after dropping from 120,000.However, many experts have pointed out that the daily death and infections are severely undercounted.

Vaccines start trickling into Nepal

<figure><img width="1430" height="872" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d06329c7e80680e0a5f4djpeg.jpg" alt=""/><figcaption></figcaption></figure>A group of European, Nepali and Bhutanese personalities have sent an <a href="https://www.petitions.net/vaccines_to_himalayas" data-saferedirecturl="https://www.google.com/url?q=https://www.petitions.net/vaccines_to_himalayas&amp;source=gmail&amp;ust=1625660311215000&amp;usg=AFQjCNEuu109cz_uT0mzvuFORxCpVo-70A">open letter</a> to the European Commission, asking it to allow member states to send surplus vaccines directly to Nepal and Bhutan, by-passing delays through COVAX.
EU member states have millions of doses of excess vaccines, but donations or transfers of these surplus doses are severely constrained by the <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/&amp;source=gmail&amp;ust=1625660311215000&amp;usg=AFQjCNEOGELikZJFPj6cPmuERuwgR5_tDA">contracts between EU, member states and vaccine manufacturers. </a>
‘We appeal to European Commission to facilitate a mechanism which would allow member states to transfer vaccines bilaterally to other countries or enable member states to target their vaccine contributions multilaterally to the countries where it is most urgently needed,’ the appeal states. 
Millions of people in Nepal and Bhutan are in urgent need of Covid-19 vaccines, especially AstraZeneca, in order to vaccinate their citizens with second doses. Nepal needs 1.4 million doses immediately for people above 65 years who got their first doses, and are still waiting for their second jabs because India banned the export of Covishield AZ. 
Nepal has not even got an additional 1 million doses<a href="https://www.nepalitimes.com/banner/anger-grows-in-nepal-over-covid-vaccine-delays/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/anger-grows-in-nepal-over-covid-vaccine-delays/&amp;source=gmail&amp;ust=1625660311215000&amp;usg=AFQjCNG91MGxSlsuyUqVeeU6-wQZv9jkrg"> it already paid Serum Institute of India for</a>, and needs a further 20 million doses for the rest of its population. Nepal government is buying 4 million doses of VeroCell from SinoPharm in China and the first of the weekly shipments will start arriving on Thursday. 
Similarly, Bhutan has inoculated most of its eligible population of 500,000 with Covishield AZ from Serum Institute India, but only with their first doses. 
Some European countries like Denmark, Norway and the Czech Republic have excess AZ vaccines which they want to send to Nepal and Bhutan directly, but they are constrained by legal agreements to go through the EU and COVAX.
However, WHO’s COVAX facility has also not been able to dispatch promised vaccines to Nepal, Bhutan and other developing countries because it had sourced it from Serum Institute India. COVAX has only sent 835,000 of the 2.26 million it promised before India stopped its export. 
Nepali officials disclosed this week that 1.5 million doses of Johnson &amp; Johnson vaccines from the United States through COVAX would be delivered later this month.
The open letter states: ‘While COVAX is a fair mechanism of vaccine distribution among the low and mid income countries, its prioritisation is not taking into account the receiving country's actual situation amid Covid-19 pandemic, its specific vaccination needs and its vaccine administration preparedness. Ability to direct at least part of the available supplies to the places where the vaccines are currently most needed would overcome these shortcomings.’ 
Despite the urgency of second doses, the COVAX mechanism prioritises countries by population and not by the current pandemic situation. The open letter argues that European countries have stockpiles of vaccines that are nearing expiry, and the European Commission could expedite shipments if it facilitated direct transfer of doses from EU member states.  
It also says that by denying the requests by Bhutan and Nepal for direct vaccine donations, EU is ‘damaging its international image ... and reinforces the EU’s stereotypical image as bureaucratic, inflexible and alienated’. 
It says failure to respond to the urgent requests from Nepal would hurt the EU because other vaccine manufacturing countries ‘are successfully using vaccine diplomacy to increase their soft-power’. 
Signatories of this open letter are known personalities from EU countries, Nepal and Bhutan. This includes members of European Parliament Tomáš Zdechovský and Kateřina Konečná, academics Françoise Pommaret and Karma Phuntsho, former under secretary general of the United Nations<a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/&amp;source=gmail&amp;ust=1625660311216000&amp;usg=AFQjCNHDSyw9q0gS0XWMLZzZS82mvNgKcg"> Kul Chandra Gautam from Nepal, </a>artists, mountaineers, activists, public health workers and others. 
Other prominent Nepalis include writers Manjushree Thapa and Budhhisagar, as well as former Miss Nepals Malvika Subba and Srinkhala Khatiwoda.
The open letter idea was initiated by a group of Czechs with close ties with the Himalaya who sent an earlier open letter to the Czech Government calling on it to gift its surplus vaccines to Nepal and Bhutan. 
“In subsequent unofficial consultations, it became clear, that Czech Government is not at a liberty to donate or sell its excess doses of AstraZeneca vaccine due to the constraints of the contract between EU, Czechs and the vaccine manufacturer,” explained photographer Michal Thoma, one of those behind the initiative. “It also became apparent that the same situation applies for other EU countries which purchased vaccines through the EU vaccine procurement mechanism.”
So Thoma teamed up with Věra Exnerová, the Nepal Country Director of humanitarian organisation People in Need, mountaineer Jan Tráva and filmmaker Petr Horký to write to the European Commission with other Nepalis and Bhutanese.
On 1 July, Denmark announced that it would donate 250,000 vaccines to Bhutan. However, it is understood that these grants still need to be facilitated by the EU. 
Says Thoma: “The European Commission should stand up to its responsibility so that the EU can fight the pandemic not only within its borders but everywhere else around the world.” 
Those interested can sign the petition at <a href="https://www.petitions.net/vaccines_to_himalayas" data-saferedirecturl="https://www.google.com/url?q=https://www.petitions.net/vaccines_to_himalayas&amp;source=gmail&amp;ust=1625660311216000&amp;usg=AFQjCNE8S4KxCeyaljq2uj4jL7emQuTHgg">https://www.petitions.net/vaccines_to_himalayas</a>.
Full Text of the Open Letter:
European Commission Ms Ursula von der Leyen President of the European Commission 
Open Letter to the European Commission to facilitate direct transfers of excess Covid-19 vaccines from EU member states to the countries with most urgent needs, namely Nepal and Bhutan 
Dear Commission President von der Leyen, 
We would like to bring to your attention the pressing issue of excess vaccines which were purchased by the member states through the centralized EU vaccine acquisition mechanism. Many of these vaccines, such as Vaxzervia produced by AstraZeneca, are not being administered or their use in most EU member states is substantially restricted. As a result, millions of doses are now idly awaiting other allocation. 
Many foreign governments, namely Bhutan and Nepal, asked for donation or purchase of excess vaccines from EU member states. Many public initiatives in EU member states also appealed to their respective governments to facilitate transfer of excess vaccines to Nepal and Bhutan or other mid and low income countries. 
However, EU member states are not in liberty to donate the surplus vaccines directly due to the legal constraints of the contracts between vaccine manufacturers, member states and EU. 
We, an informal group of people with close relationship to the Himalayas, namely Bhutan and Nepal, are nonetheless convinced that these countries, currently affected by regional outbreak of Delta variant, would be best helped by direct vaccine donations. Nepal and Bhutan urgently need almost two millions doses of AstraZeneca vaccine in order to administer second rounds to its citizens. Unfortunately, it has been reported by the media that WHO’s COVAX facility asked Nepal and Bhutan to request doses from other vaccine manufacturers. This may cause delays and complications for rapid response to fight against Covid-19 pandemic in these countries.
We thus appeal to European Commission to facilitate a mechanism which would allow member states to transfer vaccines bilaterally to other countries or enable member states to target their vaccine contributions multilaterally to the countries where it is most urgently needed. 
The reasons for above are as follows: 
<ol><li>While COVAX is a fair mechanism of vaccine distribution among the low and mid income countries, its prioritization is not taking into account the receiving country's actual situation amid Covid-19 pandemic, its specific vaccination needs and its vaccine administration preparedness. Ability to direct at least part of the available</li>
</ol>Prague, 6th July 2021 
supplies to the places where the vaccines are currently most needed would 
overcome these shortcomings. 2. By denying the foreign government requests for direct vaccine donations, EU 
member countries and the EU itself is damaging its international image. At the same time, other vaccine manufacturing countries are successfully using vaccine diplomacy to increase their soft-power and will certainly yield from that in the future. 
<ol start="3"><li>Inability to react positively to the appeals of member states’ citizens to donate vaccines to countries in urgent need reinforces the EU’s stereotypical image as bureaucratic, inflexible and alienated. Allowing member states and its people to decide on how to distribute the excess of vaccines would counteract such feelings among EU citizens.</li>
<li>The USA just recently decided to distribute its excess vaccines partly through COVAX and partly bilaterally according to US foreign policy prioritization. We believe that this is an example to follow.</li>
</ol>On top of that, many EU member states will soon have vast caches of soon to expire vaccines for which there will be no recipients among the EU citizens. In such a case, European Commission should pave the way for the member states for the swift transfers of such expiring doses to the third countries which are ready to receive and administer such supplies in the short time. 
We would like to request you to consider the above points thoroughly. We have full faith and hope in the European Commission's ability to make the right decisions that would be taking into account a global responsibility of the EU as well as the international relations priorities and wishes of EU citizens. 
Yours sincerely, 
Michal Thoma, photographer and writer, Czechia 
Věra Exnerová, Nepal director of the humanitarian organisation People in Need, Czechia 
Jan Tráva, mountaineer, Czechia 
Petr Horký, filmmaker, Czechia 
Kunda Dixit, editor and publisher of <a href="https://www.nepalitimes.com/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com&amp;source=gmail&amp;ust=1625660311216000&amp;usg=AFQjCNFueSB5zZbscyAgy7DPVj7QFyZZuQ">Nepali Times</a>, Nepal 
Françoise Pommaret, ethnohistorian and Tibetologist, France &amp; Bhutan 
Karma Phuntsho, Loden Foundation, Bhutan and Cambridge University, UK 
Stanislav Tomka, entrepreneur, Slovakia 
Gabriel Točka, Namasté, Society for Nepal-Slovakia Friendship, Slovakia 
Zdeňka Karky, former Czech honorary consul in Nepal, Czechia 
Kul Chandra Gautam, former deputy executive director of UNICEF, Nepal 
Manjushree Thapa, essayist, fiction writer, translator and editor, Nepal &amp; Canada 
Tomáš Zdechovský, Member of European Parliament, Czechia Buddhisagar, writer, poet, columnist, author of Karnali Blues and Firfire, Nepal 
Saurav Dhakal, curator, Story Cycle, Nepal 
Malvika Subba and Shrinkhala Khatiwoda, both Miss Nepal, Nepal
Buddha Basnyat, Himalayan Rescue Association and Mountain Medicine Society of Nepal 
Kateřina Konečná, Member of European Parliament, Czechia 
Šimon Pánek, director of the humanitarian organization People in Need, Czechia

Nepal-Bhutan vaccine appeal to European Commission

<figure><img width="2048" height="1364" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d05fb9c7e80680e0a5f3ajpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>There is breaking news every other day: the United States donates 2 million Moderna shots to Bangladesh and Pakistan. Denmark announces 250,000 AstraZeneca doses to Bhutan. Japan pledges surplus AZ vaccines to Sri Lanka and the Pacific Islands.Nepal is never in the news, even though <a href="https://www.nepalitimes.com/here-now/lonely-wait-of-nepals-elderly-for-2nd-doses/" target="_blank" rel="noopener noreferrer">1.4 million people still wait for their second doses</a> of Covishield AZ vaccines and another 20 million people need to be inoculated before a possible third wave this year. So far, Nepal has only been gifted or bought vaccines from India, China or the COVAX initiative. It has not even got 1 million vaccines from Serum Institute India that it paid for, and <a href="https://www.nepalitimes.com/editorial/no-vax-ask-for-mask/" target="_blank" rel="noopener noreferrer">all other promises from western countries were never kept</a>.  Nepal’s vaccine diplomacy has failed miserably. And the only silver lining is that there are four million doses of the Chinese Sinopharm VeroCell starting next week to immediately inoculate its above 55 population.Nepal is still recording an excess of 2,000 new cases a day and is seeing a slight daily increase following the <a href="https://www.nepalitimes.com/banner/kathmandu-covid-19-lockdown-relaxed/" target="_blank" rel="noopener noreferrer">relaxation in travel restrictions</a>. Everyone, the public and the government, seem to have forgotten that the real peak during the first wave last year took place only after the lockdown was eased.“The third wave is already on its way, our figures are going up and we must assume we will be hit by new variants,” says Buddha Basnyat, a physician at Patan Academy of Health Sciences (PAHS). “We must vaccinate as many people as quickly as possible, if not we will get more difficult variants that are potentially resistant to the vaccines.”In other news, the Oxford Vaccine Group which developed the AstraZeneca (AZ) vaccine has found that administering two doses 44-45 weeks produced the highest antibody boost. This news, announced by <a href="https://www.nepalitimes.com/opinion/im-sad-vaccines-are-delayed-in-nepal/" target="_blank" rel="noopener noreferrer">Andrew Pollard</a>, one of the developers of the AZ, is glad tidings for countries like Nepal where people above 65 are waiting for their second doses.Pollard said antibody levels remained elevated for close to a year with <a href="https://www.thehindu.com/sci-tech/health/ten-month-gap-between-astrazeneca-doses-sees-highest-antibody-boost-oxford-study/article35019890.ece" target="_blank" rel="noopener noreferrer">a ten-month gap between AZ doses</a>, as well as antibody levels twice that after the second dose among volunteers who were administered a third booster dose, pointing to a long-term, possibly life long immunity, also against variants.“This is great news for the elderly, many of whom are panicking, unable to get their second dose in the recommended time frame. The additional time the study has afforded us shouldn’t lead to complacency in our effort to procure vaccines,” says Sher Bahadur Pun, an epidemiologist at Sukraraj Tropical and Infectious Disease Hospital. <figure><img width="950" height="633" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d05fe9c7e80680e0a5f3bjpeg.jpg" alt=""><figcaption> </figcaption></figure>Norway, Czech Republic and Denmark have unused AZ shots they want to donate to Nepal, but have been forced to go through <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">COVAX, which is unlikely to deliver</a> the doses before the end of 2021.On 1 July, Denmark announced that it would donate 250,000 vaccines to Bhutan. However, it is understood that these grants still need to be facilitated by the EU. Also in the news this week is the result of a new modelling study published in the European Centre for Disease Prevention and Control’s medical journal Eurosurveillance that further strengthens the link between <a href="https://www.nepalitimes.com/banner/despite-doubts-nepal-sticks-with-astrazeneca-jabs/" target="_blank" rel="noopener noreferrer">AZ vaccines and a rare blood clot</a>.The study models four months of a vaccine distribution strategy in France from May 2021 and concludes that using AZ on the entire adult population would avert 10 deaths from Covid among 18-39-year-olds. However, it would be associated with 21 deaths from blood clots in the same age group over the same time period. In other words, <a href="https://www.irishexaminer.com/news/arid-40328123.html?type=amp" target="_blank" rel="noopener noreferrer">clot risk to younger people from the AZ vaccine</a> is twice as high as Covid death risk. But public health experts in Nepal maintain that the benefit of mass vaccination still far outweighs the risk. “Similar studies in the context of the South Asian population are needed but as it is, transmission risk of Covid is much higher than the individual risk of blood clots here,” says epidemiologist Lhamo Yangchen Sherpa.Buddha Basnyat of PAHS concurs: “The UK with over half of its population fully vaccinated is now being hit by the <a href="https://www.nepalitimes.com/latest/covids-regional-threat-needs-regional-response/" target="_blank" rel="noopener noreferrer">delta variant</a>, although it has been largely spared from severity due to the mass inoculation. Nepal being mostly unvaccinated is unprotected both from transmission and severity. This should show us where our priority should lie.”The European Centre for Disease Prevention and Control finding about clot risk therefore could indirectly be a blessing in disguise for countries like Nepal by further freeing up AZ stockpiles in Europe, as well as Korea and Japan.Even so, blood clot risk has prompted leaders including Germany’s Angela Markel to opt for Moderna as a booster shot to her first dose of AZ jab.Several EU nations including Germany have said mix-and-match doses are safe for Covid prevention, which according to new findings also point to <a href="https://www.bbc.com/news/health-57636356" target="_blank" rel="noopener noreferrer">a better immune response</a>. This could also offer much-needed flexibility when vaccine supplies are uneven or limited.“We need to introduce mixing and matching also in Nepal in the face of more virulent delta variants, particularly for the elderly who are at the higher risk of developing severity from an infection, instead of waiting endlessly for Covishield,” says Basnyat.At a time when Nepal is yet to recover from a <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">devastating second surge</a>, only an equitable vaccination strategy will prevent an even more deadly third wave. But a mere 2.6% of Nepal’s population has been fully vaccinated, and less than 9% has received a single dose of either Covishield or VeroCell shots.  <figure><img width="1594" height="898" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d06009c7e80680e0a5f3cjpeg.jpg" alt=""><figcaption> </figcaption></figure>And even the doses are unevenly distributed within the country. More than half the first dose of VeroCell was distributed in Bagmati province, according to the government’s own figures. Moreover, 97% of the booster jabs of VeroCell were used only in Bagmati Province. “We are seeing a similar kind of disparity in vaccination that we saw in testing, concentrated in urban centres and in particular Kathmandu,” notes epidemiologist Lhamo Yanghen Sherpa. “The excuse for using most of the doses in Kathmandu is that people elsewhere refused to inoculate. If that’s the case what is the government and others doing to dispel vaccine myths?” Virologist Sher Bahadur Pun says the government should immediately deploy its 60,000 or so <a href="https://www.nepalitimes.com/latest/enlisting-female-health-volunteers-to-fight-covid-19/" target="_blank" rel="noopener noreferrer">female community volunteers</a> and healthcare workers who have historically done such effective work in non-Covid childhood vaccination drives.He adds, “They are spread across the country and are best placed to communicate the significance of vaccines and increase vaccination uptakes at  local levels.”

Vaccines too little, too late for Nepal?

<figure><img width="720" height="960" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121152/636b95289c7e80680e06f23fjpeg.jpg" alt=""/><figcaption>Migrant workers, including Nepalis, in Kuwait after being vaccinated. A Nepali worker gets his jab (right). Source: Ram Bahadur Basnet</figcaption></figure><img width="720" height="960" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121152/636b952b9c7e80680e06f240jpeg.jpg" alt="">In February 2020, Nepali migrant worker Min from Sindhupalchok was excited to visit Nepal after completing two years working in Kuwait. More than a year later, he is still here, due to a Covid-19 travel ban by Kuwait.  He could have returned by taking an indirect route via the UAE since there were no direct flights from Nepal. But since quarantining in the UAE was too costly, he decided to wait for travel restrictions in Kuwait to be lifted. “Now it looks like new rules regarding mandatory vaccination in Kuwait will further delay my return,” says Min.Another worker in Kuwait is Lila from Chitwan. He had spent 15 years there, but has been stuck ever since he came home for a break. Lila’s employer in Kuwait is getting impatient.Stories of stranded migrants are common, but with new vaccination requirements by destination countries, the situation has only become even more uncertain. “From 1 August, Kuwait will allow entry of non-citizens <a href="https://www.khaleejtimes.com/coronavirus-pandemic/covid-19-kuwait-to-allow-fully-vaccinated-non-citizens-entry-from-august-1" data-saferedirecturl="https://www.google.com/url?q=https://www.khaleejtimes.com/coronavirus-pandemic/covid-19-kuwait-to-allow-fully-vaccinated-non-citizens-entry-from-august-1&amp;source=gmail&amp;ust=1625121388603000&amp;usg=AFQjCNGRqFuLUOQyHv8xigeCvXBJcBO4MA">only if they are fully vaccinated</a> by one of the four vaccines: Pfizer BioNTech, Oxford/AstraZeneca, Moderna and Johnson &amp; Johnson,” says Nepal’s ambassador to Kuwait, Durga Bhandari. None of these vaccines are currently available in Nepal, and other countries that send workers to the Gulf also face the same problem. Saudi Arabia is also set to impose similar vaccination requirements from 1 August. Until then, those who are not vaccinated have to undergo quarantine for a week. While Qatar is allowing Nepali passengers with mandatory institutional quarantine, there has been no announcement regarding vaccines yet. Nepal is currently banned <a href="https://www.hindustantimes.com/business/uae-ban-on-flights-from-india-pakistan-and-12-other-countries-to-continue-101624791232360.html" data-saferedirecturl="https://www.google.com/url?q=https://www.hindustantimes.com/business/uae-ban-on-flights-from-india-pakistan-and-12-other-countries-to-continue-101624791232360.html&amp;source=gmail&amp;ust=1625121388603000&amp;usg=AFQjCNGNiLYfuDmDxMx29zavs0qeaH_35w">by the UAE</a> and <a href="https://www.arabianbusiness.com/culture-society/463675-bahrain-to-ban-travellers-from-india-pakistan-sri-lanka-bangladesh-nepal" data-saferedirecturl="https://www.google.com/url?q=https://www.arabianbusiness.com/culture-society/463675-bahrain-to-ban-travellers-from-india-pakistan-sri-lanka-bangladesh-nepal&amp;source=gmail&amp;ust=1625121388603000&amp;usg=AFQjCNEAlpu8KOlC-kc1Zsa4tH4PqRrmLg">Bahrain</a> for public health reasons. The UAE has approved Sinopharm, Pfizer, Sputnik V and Oxford-AstraZeneca, and has imposed double vaccination mandate to South Africa, Nigeria and India, which will likely be applied to Nepalis as well once the ban is lifted, according to UAE-based travel entrepreneur Krishna Bhusal. As the Gulf countries ramp up their vaccination drives and set ambitious targets for universal vaccination, they have started to <a href="https://gulfnews.com/world/gulf/saudi/saudi-arabia-bans-access-to-shopping-malls-for-unvaccinated-1.79888953" data-saferedirecturl="https://www.google.com/url?q=https://gulfnews.com/world/gulf/saudi/saudi-arabia-bans-access-to-shopping-malls-for-unvaccinated-1.79888953&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNGatchZ14YZDxeTeuO6gYsybD3TyQ">require proof of full vaccination</a> for all activities including workplace visits, public events, restaurants and malls. Nepal, on the other hand, is bearing the brunt of the global vaccine inequality with a dismal vaccination rate of 2.6%. It is uncertain when outgoing migrants will get their turn, and as they wait, how many will lose lucrative opportunities or have visas or contracts expire. “Even without these flight bans and the new vaccination requirements, it has been difficult for workers with expensive quarantine and testing costs,” says labour recruiter Saroj Pokharel.  <figure><img width="1280" height="720" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121152/636b952d9c7e80680e06f241jpeg.jpg" alt=""><figcaption> </figcaption></figure>It can cost from $800-$2,000 for institutional quarantine in Qatar depending on the standard of facilities, and many employers are reluctant to cover these expenses which get passed down to workers.  “The only way out is widespread vaccination, but at the rate we are progressing, I do not see the foreign employment sector recovering anytime soon,” Pokharel says. Quarantine costs are about $1,000 in Saudi Arabia as well. “Employers <a href="https://www.facebook.com/nepalembassysaudiarabia/photos/pcb.4383977018335352/4383976668335387/" data-saferedirecturl="https://www.google.com/url?q=https://www.facebook.com/nepalembassysaudiarabia/photos/pcb.4383977018335352/4383976668335387/&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNEmtN1gYwebB1uttNn6azamjkR9Ew">are required to foot the bill</a> and have to commit in writing in the job demand approval letter that they will bear the costs of quarantine. The Saudi authorities will also notify employers regarding this rule,”  says Nepali Labour Attaché Prem Upadhaya at the Consulate in Jeddah. However, given that workers are desperate it is likely that they will pay for it covertly, no matter how high the cost, or how inconvenient.  The rules on quarantine and vaccines do not just involve Nepali workers, and other countries face the same problem. In response, <a href="https://www.khaleejtimes.com/coronavirus-pandemic/covid-overseas-filipino-workers-now-priority-for-vaccinations-in-philippines" data-saferedirecturl="https://www.google.com/url?q=https://www.khaleejtimes.com/coronavirus-pandemic/covid-overseas-filipino-workers-now-priority-for-vaccinations-in-philippines&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNHnyJI2Ct6KhHvrodMix3HHdQo45A">the Philippines</a> has put its overseas contract workers in the ‘essential’ category alongside health staff which moves them up in the vaccination priority list.  <a href="https://www.thedailystar.net/bangladesh/news/migrant-get-pfizer-moderna-vaccines-2119989" data-saferedirecturl="https://www.google.com/url?q=https://www.thedailystar.net/bangladesh/news/migrant-get-pfizer-moderna-vaccines-2119989&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNELsJNafXsHgtlEvgStbVvrBX2UQQ">Bangladesh</a> will prioritise workers heading to Kuwait and Saudi Arabia for the Pfizer vaccines that it received as part of the global COVAX initiative. It is set to receive 2 million doses of the <a href="https://www.newagebd.net/article/142013/bangladesh-to-get-25m-doses-of-moderna-covid-vaccine-from-usa-soon" data-saferedirecturl="https://www.google.com/url?q=https://www.newagebd.net/article/142013/bangladesh-to-get-25m-doses-of-moderna-covid-vaccine-from-usa-soon&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNFbi4BS2QNvFQRAy-CH1Y9JsT1W0Q">Moderna vaccine</a> from the United States through COVAX. The country also has a scheme to reimburse quarantine costs of workers to Saudi Arabia.  In Pakistan, Saudi-bound expats <a href="https://edition.cnn.com/2021/06/28/asia/pakistan-expatriates-vaccination-center-intl-hnk/index.html" data-saferedirecturl="https://www.google.com/url?q=https://edition.cnn.com/2021/06/28/asia/pakistan-expatriates-vaccination-center-intl-hnk/index.html&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNFJRRpihnsIY9ucUrvaWzFkopcjsw">broke into a vaccination centre</a> in Islamabad after fears that the AstraZaneca vaccines would run out. Prime Minister Imran Khan has asked Saudi Arabia and other countries to accept the WHO-approved Chinese vaccine with which Pakistan is inoculating its population.  <a href="https://www.dailynews.lk/2021/06/28/local/252607/slbfe-arrange-covid-jabs-free-foreign-job-seekers" data-saferedirecturl="https://www.google.com/url?q=https://www.dailynews.lk/2021/06/28/local/252607/slbfe-arrange-covid-jabs-free-foreign-job-seekers&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNHjFonIPKoFSEU0CaUMXKxyigNsCA">Sri Lanka</a> has also announced free vaccines for those with confirmed overseas jobs, but is also dependent on the Sinopharm Chinese vaccine, which is not accepted by key destination countries.  In <a href="https://telanganatoday.com/relief-for-nris-as-saudi-approves-covishield" data-saferedirecturl="https://www.google.com/url?q=https://telanganatoday.com/relief-for-nris-as-saudi-approves-covishield&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNExwn7EkYkTzX80oqjEd5UFS0uLTw">India</a>, many migrant workers are stranded because their vaccine certificates refer to Covishield, and not Oxford AstraZeneca. However, Saudi Arabia finally recognised Covishield as equivalent to AstraZeneca after diplomatic dialogue. Vaccination camps have been set up for outgoing students and workers, although <a href="https://www.thehindu.com/news/cities/Tiruchirapalli/vaccination-camp-for-people-with-plans-to-go-abroad/article34889852.ece" data-saferedirecturl="https://www.google.com/url?q=https://www.thehindu.com/news/cities/Tiruchirapalli/vaccination-camp-for-people-with-plans-to-go-abroad/article34889852.ece&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNHEBvKQtQVlQtUD1cKoW-dlOYF1RA">demand far outweighs supply</a>. In Nepal, however, there is growing frustration with the lack of progress in sourcing vaccines. Says Sujit Shrestha of NAFEA (Nepal Association of Foreign Employment Agencies): “We need a way out because there is demand in these countries for Nepali workers. The government should get vaccines and prioritise outgoing workers, or coordinate with destination countries to provide quarantine and vaccines for workers. For many Nepali families, foreign employment is the only source of income.” After a few months of slow and uneven recovery of emigration, the second wave impacted both new and current Nepali workers. But even with cases falling and limited flights allowed, there is uncertainty because of the vaccines.  It is not just about whether Nepal can inoculate outgoing workers soon, but also whether the vaccination provided is accepted by the destination country.  Saudi Arabia has a demand for 40,000 Nepali workers that are waiting to be filled. In Kuwait, employers are struggling with labour shortages. This is in addition to thousands stranded in Nepal while on holiday like Min and Lila, who are at risk of losing their jobs overseas. Says Kuwait-based Nepali Ram Bahadur Basnet: “If flights normalise and the issue of vaccinations gets sorted out, Nepalis will be able to find attractive opportunities here.”  Some names have been changed. Additional reporting by Hom Nath Giri.

Upasana Khadka

Job-seekers now also jab-seekers

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111152/636b86709c7e80680e067854jpeg.jpg" alt="" width="1308" height="870"/><figcaption>Photos: AMIT MACHAMASI</figcaption></figure>The Covid-19 pandemic has already claimed the lives of 3.5 million people, worldwide, according to the World Health Organisation (WHO), although <a href="https://covid19.healthdata.org" target="_blank" rel="noopener noreferrer">Institute for Health Metrics and Evaluation</a> (IHME) puts the figure at an horrific 7.5 million -- projecting 9 million global deaths by September 2021.Waves of Covid-19 infections across the world have severely challenged health systems in the richest countries, but have been catastrophic for nations with more <a href="https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-covid/" target="_blank" rel="noopener noreferrer">limited health infrastructure</a>. It is predominantly older adults and those with other health conditions who are most seriously affected by the virus, but the impact on health services indirectly affects those seeking help for other health problems, and the pandemic has further affected economic resilience of nations and families. Quite simply, <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.facebook.com/the.university.of.oxford/posts/10165377035860107" target="_blank" rel="noopener noreferrer">we are all affected by the pandemic.</a>Against this backdrop, the wave of infections across South Asia this month is a cause for huge concern, with the reality of the pandemic being felt today so <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" target="_blank" rel="noopener noreferrer">acutely by the people of Nepal</a>. It is a pain I have shared, having worked very closely for the past 16 years with a talented team of doctors and researchers at Patan Hospital, Lalitpur, (led by Dr Shrijana Shrestha and Dr Buddha Basnyat) researching infectious diseases and vaccines in children.Today, I feel so far away, more than 4,500 miles from Kathmandu, and rather helpless as the media vividly brings the news of Nepali political debates, lockdowns, individual suffering, <a href="https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/" target="_blank" rel="noopener noreferrer">oxygen shortages</a> and the selfless dedication of the hospital staff into my living room.In early 2020, I started work with other academics in Oxford on the development of the Oxford-AstraZeneca/Covishield vaccine. My role was leading clinical trials of the vaccine, starting on 23 April 2020, and eventually enrolling 24,000 volunteers in the UK, Brazil and South Africa during the course of the year.In the trials, half of the volunteers were given <a href="https://www.nepalitimes.com/banner/despite-doubts-nepal-sticks-with-astrazeneca-jabs/" target="_blank" rel="noopener noreferrer">the Oxford vaccine</a> and the other half received a ‘control’ vaccination which wasn’t designed to protect against coronavirus. We then compared the number of people who developed infection in the two groups and found that disease was reduced by around 70% in those who received the vaccine.Importantly, the vaccine prevented all hospitalisations and deaths. These amazing findings were recently confirmed in a trial of the vaccine in the United States. Our vaccine is remarkably effective. The trials also taught us that the vaccine had the potential to reduce the risk of transmission of the coronavirus by blocking infection and reducing the amount of virus in the throat of those who did catch it.Since 4 January 2021, the Oxford vaccine has been used in the UK, and the national rollout has shown how powerfully effective vaccines are in ‘real world’ use, with a recent analysis by Public Health England indicating that around 12,000 deaths, and 33,000 hospital admissions from Covid-19 have been averted by the vaccines in just a few months here in the UK.Our aim at Oxford University was to develop a vaccine that could be <a href="https://www.nepalitimes.com/latest/unicef-urges-g7-to-dispatch-vaccines/" target="_blank" rel="noopener noreferrer">distributed equitably</a>, and we hoped to achieve that through our partnership with AstraZeneca, who stepped up to help and have supported more than 20 vaccine manufacturing sites around the world (including Serum Institute of India, who make Covishield).They are working flat out to scale up manufacturing even more, and it is through their efforts that over 450 million doses have already been produced this year, and how the vaccine is being distributed to over 160 countries. This incredible progress in such a short period of time will save hundreds of thousands of lives. But making vaccines is hard, takes time, and there are still not enough doses for the world, even with many other developers producing vaccines too.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111152/636b86739c7e80680e067855jpeg.jpg" alt="" width="1628" height="1062"><figcaption> </figcaption></figure>Covishield, made at the Serum Institute of India, was the version of the Oxford vaccine destined for Nepal, but the urgent need in India has delayed supply. The supply shortage has resulted in major concerns for countries with limited numbers of doses to decide what to do.Starting vaccinations programmes will have the greatest impact, with the first priority being getting a second dose to those left out, and the first dose to <a href="https://www.nepalitimes.com/here-now/spared-at-first-elderly-hit-hard-by-covid-19/" target="_blank" rel="noopener noreferrer">older adults</a>, those with other health conditions that make them more at risk of severe Covid-19, and health workers, as soon as possible.The WHO have issued guidance about each of the vaccines which have been reviewed by them, to help with policy decisions, and for the Oxford-AstraZeneca/Covishield vaccine we know that there is <a href="https://www.facebook.com/DHSCgovuk/posts/971145230300967" target="_blank" rel="noopener noreferrer">good protection for at least three months</a> after the first dose, with no sign of protection fading over that period.The immune system ‘remembers’ the first dose so that protection is boosted when the second dose is given. Where there are shortages of vaccine, longer delays will not compromise the booster response to the second dose. The main reason for giving a second dose is to increase the immune response, which might improve protection against variants, and will also extend the duration of protection.At this moment we do not have much information about mixed schedules where different vaccines are used for the first and second dose, although this is something that my colleagues here in Oxford are investigating. However, since all of the available vaccines use the coronavirus spike protein to stimulate the immune system, it is expected that there will be a response to a different vaccine for the second dose. Whilst we do need more data to confirm the best combinations, in the meantime, getting a first dose to those most at-risk people should be the absolute priority.While the vaccine roll out in high income countries is a remarkable success story measured in doses given, cases prevented, lives saved, and the green shoots of economic recovery, giving us hope for the future, it also reveals <a href="https://www.nepalitimes.com/here-now/nepal-needs-urgent-american-vaccine-support/" target="_blank" rel="noopener noreferrer">a serious concern</a> when looked at in the context of global equity.Some countries have vaccinated a high proportion of their citizens, while the pandemic continues to rage elsewhere. Many Nepalis have written to me asking why this situation is allowed to continue and asking what I am doing about it. Like you, I feel powerless.Since supply remains constrained, to save lives in the next few months, <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/" target="_blank" rel="noopener noreferrer">vaccine doses</a> have to be redistributed to those at greatest risk, wherever they live. This can only be achieved if governments work together to prioritise their supplies in a global objective to protect lives, taking an international view rather than a domestic perspective.This year is the 30th anniversary of my first visit to Nepal, on that occasion as a mountaineer. With such a long connection to the country I felt so proud when I saw the <a href="https://www.nepalitimes.com/banner/nepal-begins-covid-19-vaccination-drive/" target="_blank" rel="noopener noreferrer">first doses of the Oxford vaccine being administered in Kathmandu</a>, and the hope that it brought to Nepalis, but I am now saddened to hear that further supply is delayed.Whilst the pandemic has brought us closer together in a shared suffering, it has also shown how far apart we are when it comes to sharing health.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.facebook.com/bbcnews/posts/10158299353147217" target="_blank" rel="noopener noreferrer">Professor Andrew J Pollard</a> is Director of the Oxford Vaccine Group, University of Oxford, UK.Read also: <a href="https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci-Brief-ChAdOx1-S-recombinant-vaccine-Second-dose">WHO Technical Note on delayed shipments for vaccines: What are the implications for the administration of second doses? </a>

“I’m sad vaccines are delayed in Nepal”

One smoggy winter morning in February 2019, Ekta regretted coming to her sculpture class. It was the first day of her period, and the 19-year-old wished she was home, curled up in bed with a hot water bag to soothe her cramps.
Her class was at Kalapremi Ceramic Studio, a dark room on the ground floor of a house in Maharajganj, and Ekta’s teacher was the artist Gopal Das Shrestha ‘Kalapremi’, a noted sculptor.
Two other students were already there, using all their muscle strength to knead the sculpting clay. Ekta, now 24, recalls how Kalapremi asked her if she was feeling all right. She avoided him, as she did not want everyone to know she was menstruating.
Kalapremi repeatedly asked Ekta what was wrong. She finally muttered that she was having her period, after which he grabbed her hand and led her to a partitioned corner of the studio and sat her on a chair. Before she could stop him, he slid his hand under her dress, and started massaging her abdomen.
“I was horrified,” Ekta recalls. “I told him to stop, but he didn’t listen, asking me not to be shy, saying he knew how to relieve my pain. He stopped only after I protested furiously.”&nbsp;
The art tutor then said, “You’re like my daughter. I’m doing it out of love to make you feel better, but you’re so stubborn.”&nbsp;
“Instead of saying sorry he acted like I was the one having crazy thoughts,” remembers Ekta, adding that from April 2016 to August 2020 beginning the time she was 16, the artist sexually abused and harassed her on several occasions. &nbsp;
Now, Ekta and the artist’s other former students are finally sharing their experiences and some are pressing legal charges against him, hoping that others do not have to endure what they did.&nbsp;
Award-winning artist and teacher Gopal Das Shrestha ‘Kalapremi’ (the name means ‘Art Lover’) is known for his ceramic art, sculpture, and contemporary pottery. He was <a href="https://nepalitimes.com/review/the-house-of-kalapremi">profiled in Nepali Times after a collaborative exhibition</a>, ‘Where the Wild Things Are’ at the Siddhartha Art Gallery three years ago.&nbsp;
His pieces, titled Gaalis, featured sculpted female figures with the heads of dogs, sheep, and donkeys (pictured) to depict derogatory terms for women. Some critics said the collection was a satire on feminists.
Kalapremi started his artistic and teaching career in 1983 and over the years taught at Bhanubhakta School, Kathmandu University School of Arts, Lalitkala Campus and at his private Kalapremi Ceramic Studio. He has also lectured at Jeonju University in South Korea and recently at Tabor Academy in the United States.
Seven of Kalapremi’s former students were interviewed for this story. Five female students said he touched them inappropriately in his studio or at Kathmandu University. Two male students said they witnessed him abuse and harass the women. In all cases, the students struggled to recognise the abuse when it occurred, and the lack of reporting systems left them to cope on their own for years.&nbsp;
Earlier this year, students shared a social media post hinting at Kalapremi’s history of abusive behaviour following which more students of the artist reached out sharing similar experiences. Some students spoke of abuse that happened as long as 20 years ago.
Kalapremi, 60, has denied the allegations. He told Nepali Times: “Some years ago, there was a movement encouraging people to hug and kiss. I used to do it purely out of friendship and love. But after seeing posts on social media last year calling out my behaviour, I realised my actions may have hurt some people. I understand now that I should have been more mindful.”
He added: “I am also an auxiliary health worker, so I know the exact points to massage to relieve menstrual pain. It’s not just menstruation, I take anyone who is ill to the hospital.”
Sexual abuse is much more rampant than reported given how difficult it is to prove it in court. The law defines sexual abuse as occuring when someone touches another’s private parts, coerces them into touching theirs, uses vulgar language, shows degrading images, or behaves indecently towards them without consent.&nbsp;
Ekta and her fellow students are consulting lawyer Suneeta Regmi Pokhrel, who says they know that even if the court decides in their favour, it is difficult to survive after speaking up, and influential men defend themselves saying they are being framed.&nbsp;
“They are in a lot of pain and weep when recalling how he abused them,” Regmi Pokhrel told us. “They are angry and have filed a case against him, but they are also terrified. They know he is a powerful man and they have seen how our society treats women who speak up against abusers. Unless people speak up, perpetrators will be emboldened.”
Art and academia in Nepal simply reflect the power imbalances in society where people with intersecting identities experience worse forms of abuse. Theatre actors Raj Kumar Pudasaini, Rajan Khatiwada, and Sunil Pokhrel were called out during the #MeToo movement in the Nepali theatre scene in 2019. Even after the allegations Pokhrel went on to receive national awards, while others continued to work without repercussions.
“If you speak up against abusers, you gradually get sidelined from projects,” explained a theatre artist who wished anonymity fearing professional setbacks. “The theatre scene in Nepal is quite small, you just have to make peace with the perpetrators and work with them if you want to sustain yourself.”&nbsp;
In academia there is a history of faculty members sexually harassing students and getting away with it. After Tribhuvan University (TU) lecturer Krishna Bhattachan was accused of harassing women students, the university said it would follow Nepal’s sexual harassment law and set up a reporting mechanism. But nothing happened to the professor, who had already retired. Instead, he counter-accused the students of 'attacking the indigenous people’s movement with baseless allegations' as <a href="https://kathmandupost.com/letters/2019/01/29/bhattachan-responds">he told the Kathmandu Post in 2019</a>. He continues to be featured as a prominent speaker including at TU.
Other faculty members previously accused of sexual harassment include Jagadish Murti Koirala from TU, Bishnu Prasad Acharya from Ratna Rajya Campus, and Bodha Raj Tripathee from Lalitpur Madhyamik Vidhyalaya. A woman staff member from TU also filed a sexual abuse complaint against Dambar Chemjong from TU.
Prominent figures like <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">mountaineer Nims Purja</a> have been <a href="https://www.nytimes.com/2024/05/31/sports/mountaineering-sexual-harassment-abuse-nims-purja.html">accused of sexual assault</a>, and cricketer Sandeep Lamichhane, actor <a href="https://nepalitimes.com/news/celebrity-rape-case-spotlights-nepal-laws">Paul Shah</a>, and former speaker of Parliament <a href="https://nepalitimes.com/news/mahara-arrested">Krishna Bahadur Mahara</a> have been accused of rape, but society-at-large has let off the alleged perpetrators amdist a larger debate about justice for survivors and punishment of perpetrators.&nbsp;
‘Gaushala-26’ is the court name given to the 18-year-old who accused Sandeep Lamichhane, former captain of Nepal’s national cricket team and skipper of Biratnagar Kings in the <a href="https://nepalitimes.com/here-now/here-comes-the-nepal-premier-league">ongoing Nepal Premier League</a>, of rape. She left the country citing society questioning her character affecting her mental health while Lamichhane got an outpouring of support. In May, the Patan High Court overturned a prior verdict that found Lamichhane guilty of rape and had sentenced him to eight years in prison. During the 23-month legal battle to pursue justice, Gaushala-26 faced threats of gang rape and acid attacks.&nbsp;
Exhausted by the struggle, Gaushala-26 sought to “move to a new world” where she could live free without hiding her identity.
Actress Samragyee Rajya Laxmi Shah in an Instagram video now deleted detailed the harassment she faced from a filmmaker during a movie shoot. She did not name any name but veteran actor Bhuwan KC filed a defamation case against Rana, but the court ruled that the charge lacked sufficient evidence.&nbsp;
Former Kathmandu mayor <a href="https://nepalitimes.com/opinion/theytoo">Keshav Sthapit also mocked the #MeToo movement</a>, calling accusations against him by journalists Rashmila Prajapati and Ujjwala Maharjan “a rape of men’s rights”.
Serial Abuse
Back at the Kalapremi Ceramics studio, another former student, 24-year-old Rajiv, says he felt the need to speak out after seeing his female classmates being abused.&nbsp;
“He frequently kissed them on their cheeks,” he told Nepali Times. “Whenever they walked into the studio he flailed his arms like a child asking for a hug. They awkwardly hugged him from the side, but he pulled them closer, held their chin, and kissed their cheeks.”&nbsp;
Rajiv says he also saw Kalapremi pull the women’s bra straps, touch their breasts, and slap their buttocks. The young students would freeze, not knowing how to react, and if they protested, he would say it was “normal in art”. Rajiv, 19 at the time like his classmates, remembers thinking perhaps the well-respected artist was right after all.
Another student, Luna, who took lessons at Kalapremi’s studio from 2020 to 2022 did try to confront the tutor after he made an obscene proposal to her. She recalls: “One day when the other students had left the studio and it was just the two of us, he told me that God had given him special artistic talent and he could transfer those powers to me. But to do that both of us will have to be naked, inside a dark room, and have sex.”
Luna, who was 18 then, was livid and told him she did not want any of his powers, but she says he laughed at her as if he was joking. She did not tell her family about the incident because she thought no one would believe her.&nbsp;
“They were all in awe of this famous artist and felt I should be grateful that to be learning sculpting from him,” she says. “I was scared to be alone with him in case he talked about sex again. My coping mechanism was to be rude so he wouldn’t try to come close to me.”
Seeing how some classmates were standing up to Kalapremi, Ekta too tried to push back against his advances, but she said he found ways to coerce her. Since Ekta, Rajiv, and Luna could not afford Kalapremi’s Rs30,000 monthly fee for lessons, he had offered them all a stipend to assist him in the studio.
“He had spondylosis and took me to his therapy sessions to learn massage techniques, then he often made me and other students massage him,” says Ekta. Whenever she refused, he would feign pain to make her feel sorry for him. “He would insist that I put my hands under his shirt so that I could massage him better,” she adds.
The art tutor often tried to “seduce sympathy” from Ekta by sharing how he had never been loved as a child and was “sexually frustrated” as an adult.&nbsp;
“At 7PM, he would pour himself Signature whiskey and immediately go off again about how he was sex-starved. I didn’t know how to respond. It took me time to realise alcohol was just an excuse to talk about sex,” Ekta says.
If convicted, Kalapremi could face financial penalty and/or a prison sentence of up to three years according to Section 224 of National Penal (Code) Act 2017.&nbsp;
Data suggests that victims of child sexual abuse on average take nearly 24 years to tell someone about their trauma, and some may never disclose it at all.&nbsp;
“In our culture, children are rarely taught about boundaries. They often react, show anger when adults pinch their cheeks. But adults insist they did it out of love, and force the children to accept it,” says Sita Lama, a psychotherapist at Manka Kura. “And even when someone touches them inappropriately they struggle to identify and verbalise it.”
When perpetrators claim to be “acting out of love”, Lama says survivors are likely to perceive it as something safe, rather than recognising it as abuse.&nbsp;
“It may take years for them to realise they were abused,” she explains. "And even when they become aware, the power imbalance with the abuser and the associated shame often prevents survivors from speaking up."
Other former students from the School of Art at Kathmandu University have also come forward years later, saying Kalapremi sexually abused them. As young adults, they felt his behaviour was off but were uncertain if it was inappropriate, illegal, or they did not know how to respond. After having understood that it was indeed abuse, they say they are speaking out now to protect others.&nbsp;
Amina Singh, a visiting faculty member at Kathmandu University, says there is no clause against sexual abuse in contracts of teachers, and there is no formal grievance handling mechanism for the students.&nbsp;
“So the only way students can to deal with sexual abuse is approach someone they trust,” she says.
Eight other former art students of Lalit Kala Campus and Srijana College of Fine Arts of Tribhuvan University and other private art studios in Kathmandu say they were also sexually abused by their art teachers. Three faculty members interviewed from these institutions said they saw the abuse, but felt it was futile to report it given how powerful the teachers were.
In the absence of a formal system, some longtime women artists warned each other about “problematic” artists. They shared &nbsp;a “heads-up” to be more cautious when collaborating with them, and avoided responding to their calls and texts after work hours.
To ensure art institutions are safe for all, galleries, museums, artist studios, and smaller art spaces need to develop policies on sexual harassment. This would include a code of conduct or studio policies that hold the leadership accountable and outline the principles of professional ethics.&nbsp;
Students and employees should inquire about accountability mechanisms for raising concerns, both formally and informally, advocates say.
Three years after Ekta left the ceramics studio, she learnt that Kalapremi had harassed many other women. Still trying to get a footing in the art industry, she attended a workshop in Kathmandu where women artists discussed ways to stay safe in the art sector.&nbsp;
Since it was a close-knit group Ekta opened up about how she felt violated and realised she was not alone, he had been abusing underprivileged students for years, and this was common knowledge among artists in Nepal.
Ekta says that even after she quit, Kalapremi continued sending her text messages like ‘I am thinking of you’, ‘Why have you stopped speaking with me’, or ‘I am waiting for your call’.&nbsp;
But what really forced her to act was when Ekta found out that he was sending similar texts to her younger sister.&nbsp;
“I’ve had enough,” she told us. “He abused me all these years but I won’t let him abuse my sister.” &nbsp;
Ekta, Rajiv and Luna are not the real names of the students.&nbsp;

‘Art Lover’ accused of sexual abuse

It was 8:15 in the evening of 25 March 1968 when everyone in the village of Batulechaur near Pokhara heard a deafening sound like thunder as a bright flashing object hurtled down to land in a field.&nbsp; That field belonged to Kul Timilsina, and the next morning he retrieved a sheet of metal about 2m by 1m and carried it home with the help of a few others, thinking it would be useful for his buffalo shed.&nbsp; Before he died at age 83 three years ago, Timilsina had told photo archivist Sunil Ulak that the black metal sheet was not rectangular and had rounded corners. There are a few witnesses still alive who have a clear recollection of the object that fell from the sky that night.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014.jpg" data-media-id="editor_0" data-image-id="2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014" data-rendition-name="original" width="1170" height="601" loading="lazy" alt="UFO over Pokhara"> <figcaption>The field in Batulechaur belonging to Kul Timilsina where fragments of a flying object fell from the sky in 1968.</figcaption> </figure>  One of them is Timilsina’s wife Gyanu, who was 22 at the time. She had been at home, and remembers hearing the big bang and the sky becoming very bright. “We saw the thing in the field in the morning,” she told us. “It looked like a lid, a covering of some sort. The way it was stuck in the ground, it must have fallen from the sky. We thought we could use it to dry clothes on, and took it home.”&nbsp; Another witness is Kul Narayan Paudel. “I was only eight then. We ran to the field to see what had fallen. It was a four-sided metal sheet. The elders took it away, and I don't know what happened to it.” &nbsp; Ram Bahadur Baniya, a teacher at the local school, says he had heard the sheet had been brought to the school, and later handed over to the Zonal Commissioner at the time, Nanda Prasad Malla. “But that is all hearsay,” he says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54.jpg" data-media-id="editor_1" data-image-id="2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54" data-rendition-name="original" width="1170" height="610" loading="lazy" alt="UFO over Pokhara"> <figcaption>Gyanu Timilsina, wife of Kul Timilsina.</figcaption> </figure>  There are two versions of what happened to Kul Timilsina’s metal sheet. One is that an American Peace Corp Volunteer teaching at the nearby Bindyabasini School took it, and another is that it was handed over to the government. Recently declassified Central Intelligence Agency (CIA) and US State Department documents from the time say that the US Embassy in Kathmandu tracked down the object two years later and had it shipped back to the US. A telegram from the Department of State and Department of Defense tagged as ‘MOON DUST / Space Fragments’ dated 1 March 1972 stated: ‘1. Restored space fragment will be on board Embassy support flight 115 arriving Kathmandu on or about March 10. Fragment is packed in shipping crate (cargo no. 72-33365) marked in care of DAO.&nbsp; 2. State and Defense representatives examined fragments prior to shipment finding restoration acceptable.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df.png" data-media-id="editor_2" data-image-id="20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df" data-rendition-name="original" width="856" height="568" loading="lazy" alt="UFO over Pokhara"> <figcaption>Declassified CIA documents about the investigation into the object sighted in Pokhara. </figcaption> </figure>  The documents show that the US government, military and intelligence agencies investigated this incident thoroughly when it occurred, and have continued to revisit it ever since, as recently as five years ago. What is even more intriguing is that the object that fell in Pokhara was not the only unidentified space object that fell to earth that year. There were similar sightings of objects falling from the sky in Ladakh, Sikkim and Bhutan between 19 February and 25 March 1968.&nbsp; These mysteries were the subject of a CIA investigation in 1968 titled ‘<a href="https://www.cia.gov/readingroom/docs/CIA-RDP81R00560R000100070007-8.pdf">Sighting of Unidentified Flying Objects in Ladakh, Nepal, Sikkim and Bhutan</a>’, and the report is part of the recent online declassification of 800,000 top-secret documents from the period.&nbsp; &nbsp;Although unidentified flying objects (UFOs) have a connotation now of being alien craft, it could be pieces of satellite, missile, rocket or even aircraft. The CIA report documents six sightings in 1968 and quotes local sources as describing all of them having similar characteristics: bright blue or red streaks in the sky accompanied by loud sounds like lightning and thunder and objects falling to the ground. Aside from the metallic object that was found in Batlechaur, there were other items also found nearby in Tallakot, Tureypasal, Armalakot and Maidan. Whatever the object was, it seems to have disintegrated even before it hit the ground.&nbsp; The CIA report records the first sighting on 19 February 1968 in various parts of Sikkim and Olangchung Gola and Ghunsa in eastern Nepal. The light was said to be ‘long and thin’ and giving out ‘green and red light’. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb.png" data-media-id="editor_4" data-image-id="20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb" data-rendition-name="original" width="892" height="596" loading="lazy" alt="UFO over Pokhara "> </figure>  Two days later on 21 February, a soundless blue object was seen traveling fast across the sky above Thimphu in Bhutan. Then on 4 March there were multiple daytime sightings or white streaks in the sky at Chang La Pass, Fukche and Koyul in Ladakh. There were more sightings in Ladakh on the very day fragments fell near Pokhara on 25 March 1968.&nbsp; After the sightings in Pokhara, rumours started flying in Kathmandu that these were aliens trying to land on Earth, it could be Russian or Chinese spy planes or satellites, and some even say it as a sign from heaven that the end of the world was near. This was at the height of the Cold War. The Russians and Americans were testing their thermonuclear devices as well as intercontinental ballistic missile delivery systems. The Washington-Beijing rapprochement had not yet happened, and China was making quick progress testing atomic bombs. Within two years after its first atomic test, in 1966 China exploded its first hydrogen bomb at the Lop Nur site in Xinjiang, 3,000km to the north from Nepal. After neary six decades, what is still intriguing is that all the sightings within a few months of each other in 1968 were along the Himalayan arc bordering Tibet: from Bhutan, Sikkim Nepal, to Ladakh. The US military intelligence seems to have concluded that this was not a coincidence and there were frequent research trips to the site in Pokhara by American officials in the months after the incident. With the help of the Royal Nepal Army, the region north of Pokhara was thoroughly searched.&nbsp; A confidential memo dated 25 June 1968 by Jerry C Trippy to a ‘Mr Farley’ mentions that the US Air Force’s Foreign Technology Division had decided that the debris could be important because it may be related to a Chinese missile test or a Soviet ‘Vehicle Venik’ rocket.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe.jpg" data-media-id="editor_5" data-image-id="20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="UFO over Pokhara"> </figure>  On 28 August 1968 the US Embassy in Kathmandu sent a letter to Washington DC saying that the object could be of Soviet origin, possibly from when the rocket carrying the ‘Kosmos 208’ satellite re-entered the atmosphere. But why were the fragments falling to earth several weeks apart, and in the same region? No one knows where the metal sheet that Kul Timilsina recovered is now. It was definitely packed in a crate and taken to the US, and although it is rumoured that it was returned that is not very likely. Archivist Sunil Ulak heard from the Timilsina family that CIA officials had returned to the site five years ago. &nbsp; Interest in UFOs peaked in the US in the 1950s, with the Cold War space race and tests of atomic weapons and delivery rockets. CIA and scientists were being sent to investigate sightings, both publicly and privately. Could the Pokhara fragments as well as the sightings in Ladakh and Bhutan actually be alien craft falling to earth? The renewal in interest in space travel in large part due to Elon Musk’s SpaceX, UFOs and sightings are again subjects of public interest.&nbsp; Even 57 years later, even if there was definitive proof about whether the Batlechaur fragment was from a Chinese missile or a soviet rocket, it has not been made public in documents declassified so far. We may never know.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598.jpg" data-media-id="editor_6" data-image-id="20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598" data-rendition-name="original" width="642" height="320" loading="lazy" alt="UFO over Pokhara"> </figure>  Sunil Ulak speculates if the debris actually came from an American aircraft, perhaps on an intel mission upon China. “Which could explain why they were so thorough in collecting the fragments in Pokhara,” he says. But that still does not explain the multiple sightings weeks apart in 1968.&nbsp; Indeed, US military aircraft were at that time flying frequent night-time missions from air force bases in India to supply weapons to Khampa guerrilla camps in Nepal located north of Pokhara in Mustang. It could very well be that the Chinese shot down one such aircraft. The other sightings could have been contrails of US spy planes, or Chinese anti-aircraft missiles.&nbsp; There were quite a few developments regarding UFOs in 2024. In a US congressional hearing in July, former intelligence officer David Grusch claimed that the government had long been involved in a program to investigate and retrieve non-human craft crashes, and then try to reverse engineer them. However Grusch did not show any evidence.&nbsp; The UAP Disclosure Act of 2024 was signed into law by Joe Biden in December 2023. It plans to oversee the public disclosure of UFO information. However, there is a clause in it that prevents disclosure if it would cause threats to military defense, intelligence operations or foreign relations.&nbsp; It is unlikely that the declassified documents about sightings in the Himalayan will cause any real surprise about definite evidence of alien life even if it was found. It seems humanity will continue, at least for now, to wonder about curious lights in the sky and whether there is anybody out there.&nbsp;

UFO over Pokhara

When Rastriya Swatantra Party (RSP) president Rabi Lamichhane was arrested in October on charges of defrauding depositors of cooperatives, the party’s vice president Swarnim Wagle gifted him Fareed Zakaria’s book, Age of Revolutions.
Since then, Lamichhane has been shunted around from Kathmandu to Pokhara to Chitwan and back to Pokhara to attend police investigations and court proceedings. He was being flown to Birganj via Kathmandu on Buddha Air on Monday. There is another pending case in Janakpur.
Human rights groups and civil society have criticised the government for hounding Lamichhane with inhumane treatment that borders on physical torture. The two parties in the coalition, Nepali Congress (NC) and the UML, see Lamichhane’s RSP as a potentially formidable challenge to their power.
Even if the fraud charges against Lamichhane are true, the Nepali public is increasingly looking at the government’s actions through the police and courts as political vendetta.
Despite all the travelling, sometimes by plane and often by road at night, Lamichhane appears to be in high spirits, waving to supporters who often gather if they know he is going to be driven around. A social media video shows him giving high fives to fellow passengers on a recent flight to Pokhara.&nbsp;
In the past weeks, streets in Pokhara have erupted with parallel protests by Lamichhane’s supporters as well as depositors of cooperatives who lost their savings to the scam.&nbsp;
Although family visits are allowed, prison officials in Pokhara told Nepali Times that not many people visit Lamichhane these days. He added, “When he does get visitors, he asks them to bring him books.”
Lamichhane is currently Nepal’s most high-profile public figure in custody, and highlights the stark difference between how influential prisoners are treated compared to ordinary inmates.
There are six prison cells at Kaski District Police Office’s two-story detention centre, three on each floor. And while authorities pack prisoners into already overcrowded cells, Lamichhane has an entire room on the second floor to himself.&nbsp;
He has also been allowed to call his family every few days. Other prisoners are not permitted phone calls except for emergencies.
Meanwhile, Lamichhane’s former business partner Chhabilal Joshi, an ex-Deputy Inspector General of Police with whom he established his Gorkha Media Network, is in custody under the same charges in the prison cell next to him.
Lamichhane is accused of siphoning off depositors' money to the tv network in which he was part-owner and anchor. &nbsp;
Both Lamichhane and Joshi are able to buy food from the police canteen instead of being served the regular meal like other prisoners. Joshi has also given his statement to authorities in Rupandehi and Kathmandu for his alleged role in the scam. Lamichhane is yet to be presented in Kathmandu for questioning.
While he was in custody at the Kathmandu District Police Complex, Joshi expressed his desire to sleep in a police officer’s office, reportedly assuring authorities that he would not run away and he was entitled to certain facilities as a former officer of the law.
“He seemed to be under the impression that he is still a police officer,” says a source at the Kathmandu District Police. “We made it clear to him that as someone accused of a crime, he was not entitled to special treatment.”
Former ministers Balkrishna Khand and Top Bahadur Rayamajhi, and ex-home secretary Tek Narayan Pandey, who were arrested in connection with the fake refugee scam last year, were similarly housed in the offices of law enforcement officials instead of prison cells. Khand has since been released after six months in jail.
While there is no legal provision to keep high-ranking officials in separate detention centres when they are arrested, authorities granting them special facilities is not uncommon. Law enforcement officials say VIP detainees expect preferential treatment while in police custody.
Among those is former Kosi Province minister Lila Ballav Adhikari, who was arrested from Biratnagar on 10 November over his alleged involvement in human trafficking and brought to Kathmandu. Adhikari had flown to Japan without government approval with three individuals on 29 October to attend a cultural conference, but had been sent back to Nepal from Narita.&nbsp;
His three companions were arrested at Kathmandu airport upon their arrival, but Adhikari was able to exit unscathed from the VIP lounge. Adhikari had resigned as the Kosi Province Minister for Internal Affairs and Law when it became public that his companions had been taken into custody, and was himself arrested shortly after. He has since been cleared by the courts.
Throughout his detention, Adhikari was kept separately from other inmates. Senior Superintendent of Police (SSP) Basant Rajouri, head of the Bhadrakali complex, says that while there is no separate detention area for VIPs, some detainees are kept separately depending on the nature of their crime.
However, sources say that arrangements were made for retired judges and others to visit Adhikari frequently worked at the office of a Deputy Superintendent of Police (DSP) during his time in custody.&nbsp;
“He used to constantly pester the authorities to let him sit outside in the sun, and to be able to use the police officer’s shower area,” added an officer.
Adhikari was released on 25 November after the government prosecutor’s office decided not to charge him in a move that was seen to expose the government’s double standards.
Over at Kathmandu’s Dilli Bazar Prison, former Kist Bank CEO Kamal Gyawali emerges from his prison cell into the courtyard of the prison’s ‘Ka (क)’ block every morning with a thick book in his hands, ready to give his daily sermon.
With his long beard, Gyawali, who is serving a prison sentence for banking fraud, looks the part of a religious guru as he implores his rapt listeners to “walk the right path, abandon bad thoughts and turn to scripture and spirituality”.&nbsp;
Afterward, the attendees gather to discuss politics and current affairs. Inmates at his daily sermons at the prison include other high-profile detainees, including former MP Ichchha Raj Tamang, who is in jail for money laundering and cooperatives fraud, former joint secretary Chudamani Sharma, who was convicted of corruption, as well as NC leader Chandra Bahadur Lama and Krishna Bahadur Upreti of the UML both of whom are on trial for embezzling billions of rupees.
Victims of the cooperatives scam that former lawmaker Tamang was involved in have made trips to the prison and requested visits, but he has refused to meet with any of them.
“Tamang often complains that the state has prevented him from returning the money to the victims by locking him up,” says a police officer at the Dili Bazar jail.
“All you hear every day from the VIP prisoners is that they have been framed,” adds the officer. “No one admits that they were involved in misdeeds.”
But while most high-profile prisoners complain about prison conditions, one exception is former provincial lawmaker Deepak Manange, who is serving a sentence at Dilli Bazar Jail for attempted murder.
“He is the happiest prisoner here,” says a warden. “Unlike the others, he doesn’t claim to have been framed, in fact he doesn’t seem to care that he is in prison.”
Manange is detained in the ‘Kha (ख)’ block of the prison complex, which he renovated at his own expense. The block previously housed female prisoners, but Manange used his influence to transfer them elsewhere. He faces no shortage of visitors, who range from political leaders to people from the underworld.
Along with Manange, other well-known prisoners in this block include Nepal Telecom Managing Director Sunil Poudel, and former executive director of the Surakshan Printing Centre Bikal Poudel, who are serving time for corruption.
Former prisoners at Dilli Bazar prison include ex-ministers Khum Bahadur Khadka and Shyam Sundar Gupta, NC leader Ganesh Lama, Maoist MP Balkrishna Dhungel, Nagarik Unmukti Party leader Resham Chaudhary, as well as former IGs Ramesh Chand Thakuri, Om Bikram Rana, and Hem Bahadur Gurung.
Section 54 of Nepal’s Prison Act assigns each prison’s internal administration the
responsibility of governing its prisoners, which means the more favourable the jail management is, the more comfortable it is for prisoners.
Dilli Bazar prison has been the prison of choice for many high-ranking prisoners, especially those convicted of white collar crimes, due to its more accommodating administrators. The prison, which has the capacity to house 700 inmates, is also less crowded than other jails.
Anuj Bhattarai, spokesperson of the Department of Prison Management, says that there is no legal classification in Nepal for felons to be assigned prisons based on the nature of their crimes.
“That Dilli Bazar Jail has a higher number of prisoners convicted of crimes like corruption is most likely a coincidence,” says Bhattarai. “There is no provision for influential people to be able to choose where they will be incarcerated.”&nbsp;
Translated by Shristi Karki from the Nepali original published in himalkhabar.com

What Nepal’s VIP prisoners do in jail

If you were raised in Nepal, you must have picked up its unique set of vocabulary: आन्दोलन, चक्का जाम, बन्द, राँके जुलुस, आफ्नो मान्छे, हाम्रो दल, कर्फु and many more words connoting political protest.
We became familiar with the acrid smell of burning tyres, and eyes smarting from tear gas. And yet, everyone speaks of another revolution in the making. Not by desire, but by suffocation.
We heard speeches about नयाँ नेपाल, but the New Nepal never arrived. The governance system changed, but it did not reflect on people’s lives — except for those close to centres of power. The state is still unreachable and is not bothered about <a href="https://nepalitimes.com/here-now/matter-of-life-and-debt">victims of loan sharks</a>, cooperative scams and other injustices.
Politicians continue to speak in sound bites, but fail to deliver. They have mastered the game of pointing fingers towards an external enemy and convincing people that they are never at fault. The political narrative is so disconnected from the actual analysis of the problem that suffocation doesn’t go away after every revolution.
No genuine effort has been made to deliver at all, which is why there is a palpable sense of disillusionment in the air forcing us to seek another revolution, even if Nepal may not be able to afford it.
How has the current system successfully held power, even if the public is deeply frustrated? How is it that for three decades we continue to be led by the same faces, who have time and again, proved to us that they may be great politicians but not national leaders?
<a href="https://nepalitimes.com/opinion/improving-internet-governance-in-nepal">My experience at the epicentre of politics</a> has led me to identify three cultures that have enabled political parties to keep a tight hold on power: acceptance, silence and dependency.
We accept things the way they are. We use fatalistic phrases like “नेपालमा यस्तै हो” or “नेपालको कानुन दैब जानुन”. While this resilience enables us to rise back up from devastating calamities, it is also a reason for our compliance with the status quo.
Despite so many ‘revolutions’ that have led to significant reforms, these phrases keep getting reinforced, to the point that the upcoming generations have made it their lingo.&nbsp;
This acceptance is not a symbol of law-abiding citizens, but citizens living in fear of those in power, unable to ask the whys and why-nots.
Innovation suffocates in this culture of acceptance of the status quo. This is manifested in remarks like “but we don’t have any laws for this,” or “we don’t have the capacity to implement this”. An innovator or entrepreneur therefore has to spend that energy to become a political lobbyist, often educating and convincing the bureaucracy.&nbsp;
Remember when locally assembled <a href="https://nepalitimes.com/banner/designed-and-made-in-nepal">Yatri motorbikes</a>, despite having willing customers, had to suffer to secure license numbers because of a lack of regulations? Instead of creating new laws, the government kept chanting the “We will promote Nepal-made goods” mantra, leaving entrepreneurs in a labyrinth of bureaucracy. The weight of acceptance of the law lies heavily on innovators. Fatalism is a tactic used by those in power to generate mass fear in society.
When we accept, we become silent. This is a pervasive phenomenon. We are trained to keep quiet, lest we ruffle feathers, burn bridges, or not get the help we need in future. We know, yet we don’t speak.
Read also: <a href="https://nepalitimes.com/here-now/bureaucratic-hurdles-in-researching-nepals-bureaucracy">Bureaucratic hurdles in researching Nepal's bureaucracy</a>, Daniel W Edwards
Here is one example: the 2021 census shows that the number of baby boys born for every 100 baby girls is 112. This is a clear indication of female foeticide because of boy preference in society.
Despite such horrifying realities, there is finger-pointing within the government between the Ministry of Health and Population with the Ministry of Home Affairs. At the citizen level, we know those who are involved in killing girls. Yet, we don’t speak up. The Nepal Medical Council reports state that despite this gender imbalance at birth, there is no indication of any action.
But why would anyone speak against one's own fraternity, no matter how vile the act is?
When we accept and keep quiet, we become dependent on those who yield power. From getting our government procedure completed on time to getting transfers, to accessing any of our legally protected rights as well, we are forced to depend on our networks of चिनेको मान्छे people we know by blood, village, relations, political affiliation.
The culture of dependency has been the established way in Nepal. If you drive a two-wheeler or four-wheeler, and you get into a small accident, you will be asked to sort it yourself, dialing up the most powerful person you know. It becomes a competition of who knows who.
Recently I was told that there were calls from the Ministry of Health and Population and another from the Prime Minister's Office for just one medical position in a private hospital. Each was pushing its own candidate. Guess which candidate got the position.&nbsp;
The dependency of people is not on the laws or the state, it is with people in power, a reliance on the network of somebody who knows somebody, including those not officially in power.
These cultures are deeply ingrained in our heads, and in society. Collectively they form a vicious circle that helps those in power to retain power. This is not the society we want to live in.
Then, what do we do as a collective to break away from this? How do we break away from the cultures of acceptance and silence that have created this dependency? What can we do to ensure that our children do not have to learn the jargon of आन्दोलन before they learn about the state?
These are the cultures political parties need to shed rather than use them to perpetuate their power. This is what <a href="https://nepalitimes.com/opinion/comment/an-alternative-to-alternative-politics-in-nepal">alternative politics</a> needs to be about.
Sumana Shrestha is a member of Parliament’s Education, Health and Information Technology parliamentary committee and represents the Rastriya Swatantara Party.

astrazeneca