<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be7f69c7e80680e087831jpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Photos: BNMT</figcaption></figure>Drone therapy for tuberculosis diagnosis in Nepal’s remote and hard to reach mountains has won at the <a href="https://tiaca.org/tiaca-press-release/pelican-biothermal-and-nepal-flying-labs-win-2020-tiaca-air-cargo-sustainability-awards/" target="_blank" rel="noopener noreferrer">2020 International Air Cargo Association (TIACA)</a> Sustainability Awards and will receive $10,000 in prize money as a start-up category winner.The winning project, <a href="https://www.nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy/" target="_blank" rel="noopener noreferrer">Drone Optimised Therapy System</a> (DrOTS) by Nepal Flying Labs links rural health posts with high-end diagnostic tool via drones to improve the accessibility of tuberculosis diagnostic tests.“In a year marked by a global pandemic which disrupted our industry, problem solving and forward-thinking companies like Nepal Flying Labs bring hope that air cargo can come out of this crisis stronger and more resilient,” says Céline Hourcade of TIACA, which celebrates and encourages outstanding industry initiatives driving sustainability in air cargo.Under DrOTS, drones fly from a central district hospital to health posts in the mountains to collect sputum samples and deliver both diagnoses and treatment to patients living in up-country villages. The samples are tested using a <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener noreferrer">high-end GenExpert kit</a>.If they are positive, patients are given DOTS (directly observed treatment short course) treatment using smart pill boxes, which keep electronic records of whether or not patients have taken the antibiotics regularly.The highly competitive award evaluated humanitarian projects based on three aspects of sustainability -- economic social and environmental -- as well as innovation and practicality of the applied solution. The winners were announced online on 10 December.The project had also won the prestigious industry award from the <a href="https://www.auvsi.org/industry-news/winners-2020-xcellence-awards" target="_blank" rel="noopener noreferrer">Association for Unmanned Aerial Vehicles</a> – the AUVSI XCELLENCE Award 2020 in Humanitarian and Public Safety category in October.The goal of this project is to assist Nepal’s Ministry of Health in generating data on <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener noreferrer">tuberculosis</a> and support it in its efforts to reduce the prevalence of the infection. This perfectly curable medieval disease is the biggest infectious killer in the world today, more than HIV or malaria.https://www.youtube.com/watch?v=Xf4OpwoblRc&amp;feature=emb_logoWhile Nepal is a role model in the community-based DOTS treatment, which ensures index patients are taking their medicines, this alone will not suffice in the battle against TB, since a patient would often have already infected others in the household and workplace. Which is why active case finding and early treatment is the key.The first comprehensive national TB prevalence survey 2018-19 in Nepal showed that the burden of TB in Nepal is much higher than previously estimated. There are now known to be 245 TB cases per 100,000 people – which means there are 69,000 new cases each year. Some 6,000 people in Nepal die every year because of the infection while every other Nepali is a carrier of TB.“Tragically over 35,000 cases of TB are not due to difficulties reaching the basic health services. To accelerate progress towards the end of TB in Nepal we must increase efforts to reach remote and disadvantaged populations with high quality TB services,” says Maxine Caws, epidemiologist with BNMT. “The drone project project represents one such approach to solve this problem, and also has the potential to address many other health challenges facing rural populations of Nepal.”The DrOTS test flight was conducted successfully in Piuthan district in western Nepal last year. Since then, over 106 flights have been carried out, collecting and delivering more than 742 sputum samples, with a result of 26 positive cases from eight remote health facilities. The technology has also been used for TB control in Zimbabwe and Papua New Guinea.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be7fa9c7e80680e087832jpeg.jpg" alt="" width="1500" height="1125"><figcaption>Locals wait for drone to arrive.</figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be7fe9c7e80680e087833jpeg.jpg" alt="" width="1500" height="1125"><figcaption>Using the drone interface.</figcaption></figure>The drones weigh 9kg when empty and can carry another 7kg in a cargo hold designed to protect against biohazards; they can be airborne for 30 minutes. The craft flies at speeds of up to 1km per minute, and is controlled by a pilot at the take-off point who coordinates with a health worker at the destination.The DrOTS project is a multidisciplinary consortium of Birat Nepal Medical Trust (BNMT Nepal), DroNepal, Nepal Flying Labs, Liverpool School of Tropical Medicine, UK and WeRobotics, Switzerland working in partnership with the Nick Simons Institute, National Tuberculosis Centre, and Stony Brook University, USA.Says Biplav Pageni of Nepal Flying Labs: “We hope to scale our drone cargo technology to other rural locations and establish networks of medical cargo drones to help more people in the coming days. Drones are said to be the future of air cargo but I believe they are the present and we are using it to save lives in Nepal.”

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Nepal anti-TB drone project awarded

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636beef44b0ad905ca02ef7ajpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Photos: BNMT</figcaption></figure>Drone therapy for tuberculosis diagnosis in Nepal’s remote and hard to reach mountains has won at the <a href="https://tiaca.org/tiaca-press-release/pelican-biothermal-and-nepal-flying-labs-win-2020-tiaca-air-cargo-sustainability-awards/" target="_blank" rel="noopener noreferrer">2020 International Air Cargo Association (TIACA)</a> Sustainability Awards and will receive $10,000 in prize money as a start-up category winner.The winning project, <a href="https://www.nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy/" target="_blank" rel="noopener noreferrer">Drone Optimised Therapy System</a> (DrOTS) by Nepal Flying Labs links rural health posts with high-end diagnostic tool via drones to improve the accessibility of tuberculosis diagnostic tests.“In a year marked by a global pandemic which disrupted our industry, problem solving and forward-thinking companies like Nepal Flying Labs bring hope that air cargo can come out of this crisis stronger and more resilient,” says Céline Hourcade of TIACA, which celebrates and encourages outstanding industry initiatives driving sustainability in air cargo.Under DrOTS, drones fly from a central district hospital to health posts in the mountains to collect sputum samples and deliver both diagnoses and treatment to patients living in up-country villages. The samples are tested using a <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener noreferrer">high-end GenExpert kit</a>.If they are positive, patients are given DOTS (directly observed treatment short course) treatment using smart pill boxes, which keep electronic records of whether or not patients have taken the antibiotics regularly.The highly competitive award evaluated humanitarian projects based on three aspects of sustainability -- economic social and environmental -- as well as innovation and practicality of the applied solution. The winners were announced online on 10 December.The project had also won the prestigious industry award from the <a href="https://www.auvsi.org/industry-news/winners-2020-xcellence-awards" target="_blank" rel="noopener noreferrer">Association for Unmanned Aerial Vehicles</a> – the AUVSI XCELLENCE Award 2020 in Humanitarian and Public Safety category in October.The goal of this project is to assist Nepal’s Ministry of Health in generating data on <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener noreferrer">tuberculosis</a> and support it in its efforts to reduce the prevalence of the infection. This perfectly curable medieval disease is the biggest infectious killer in the world today, more than HIV or malaria.https://www.youtube.com/watch?v=Xf4OpwoblRc&amp;feature=emb_logoWhile Nepal is a role model in the community-based DOTS treatment, which ensures index patients are taking their medicines, this alone will not suffice in the battle against TB, since a patient would often have already infected others in the household and workplace. Which is why active case finding and early treatment is the key.The first comprehensive national TB prevalence survey 2018-19 in Nepal showed that the burden of TB in Nepal is much higher than previously estimated. There are now known to be 245 TB cases per 100,000 people – which means there are 69,000 new cases each year. Some 6,000 people in Nepal die every year because of the infection while every other Nepali is a carrier of TB.“Tragically over 35,000 cases of TB are not due to difficulties reaching the basic health services. To accelerate progress towards the end of TB in Nepal we must increase efforts to reach remote and disadvantaged populations with high quality TB services,” says Maxine Caws, epidemiologist with BNMT. “The drone project project represents one such approach to solve this problem, and also has the potential to address many other health challenges facing rural populations of Nepal.”The DrOTS test flight was conducted successfully in Piuthan district in western Nepal last year. Since then, over 106 flights have been carried out, collecting and delivering more than 742 sputum samples, with a result of 26 positive cases from eight remote health facilities. The technology has also been used for TB control in Zimbabwe and Papua New Guinea.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636beef84b0ad905ca02ef7bjpeg.jpg" alt="" width="1500" height="1125"><figcaption>Locals wait for drone to arrive.</figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636beefb4b0ad905ca02ef7cjpeg.jpg" alt="" width="1500" height="1125"><figcaption>Using the drone interface.</figcaption></figure>The drones weigh 9kg when empty and can carry another 7kg in a cargo hold designed to protect against biohazards; they can be airborne for 30 minutes. The craft flies at speeds of up to 1km per minute, and is controlled by a pilot at the take-off point who coordinates with a health worker at the destination.The DrOTS project is a multidisciplinary consortium of Birat Nepal Medical Trust (BNMT Nepal), DroNepal, Nepal Flying Labs, Liverpool School of Tropical Medicine, UK and WeRobotics, Switzerland working in partnership with the Nick Simons Institute, National Tuberculosis Centre, and Stony Brook University, USA.Says Biplav Pageni of Nepal Flying Labs: “We hope to scale our drone cargo technology to other rural locations and establish networks of medical cargo drones to help more people in the coming days. Drones are said to be the future of air cargo but I believe they are the present and we are using it to save lives in Nepal.”

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141132/636babf89c7e80680e077f08jpeg.jpg" alt="" width="1400" height="933"/><figcaption>Photo: NEPALI TIMES ARCHIVE</figcaption></figure>COVID-19 has made headlines every day over the past two months, but tuberculosis (TB) patients across South Asia have their treatment interrupted due to the lockdown.South Asia is a vast hub for TB. India alone had 2.7 million new cases and 440,000 deaths due to TB in 2018 — the highest in the world. Every year, tuberculosis kills at least 6,000 people in Nepal and every other person is a carrier of the microbe.The WHO has set <a href="https://www.who.int/tb/End_TB_brochure.pdf?ua=1" data-saferedirecturl="https://www.google.com/url?q=https://www.who.int/tb/End_TB_brochure.pdf?ua%3D1&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNHVd_kVz8K7Q1LZxUa_CWkwSdG7Vg">global targets</a> to reduce new cases of TB by 90% and deaths by 95% between 2015 and 2035. However, the fight against TB faces a setback of an estimated 5-8 years globally, due to COVID-19.The COVID-19 crisis has uncovered gaps in the present healthcare system in the Subcontinent. There is now a shortage of functioning sputum testing centres as well as DOT (Directly Observed Treatment Short-course) centres. Healthcare workers are also wary of going on-ground and carrying out tests and diagnoses.Migrant workers with TB, who are travelling away from their workplaces, are at risk of treatment interruption, which may lead to <a href="https://en.wikipedia.org/wiki/Multi-drug-resistant_tuberculosis#:~:text=Infectious%20disease,drugs)%2C%20isoniazid%20and%20rifampin." data-saferedirecturl="https://www.google.com/url?q=https://en.wikipedia.org/wiki/Multi-drug-resistant_tuberculosis%23:~:text%3DInfectious%2520disease,drugs)%252C%2520isoniazid%2520and%2520rifampin.&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNEkqQ32ZjQluu9UU_sZ8EeTipApXQ">multi-drug-resistant (MDR) TB</a>. Additionally, due to the stigma attached with the symptoms of COVID-19, people are now afraid to get tested for TB, which has symptoms similar to those of COVID-19.This can exacerbate the problem, as undiagnosed patients can infect many more. Those with lung injuries due to TB may be <a href="https://www.thetruthabouttb.org/coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.thetruthabouttb.org/coronavirus/&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNHh8d8TmjVl40wPRPytgXeQDPsiww">prone to more severe outcomes</a> if infected with COVID-19.“In India, health-seeking behaviour has completely changed after COVID-19. People think twice before seeking a doctor,” says Khasim Sayyed of TB Alert India. “We are expecting a very high number of patients across all DOT centres and outpatient departments once the lockdown is lifted, because the patients are afraid to get diagnosed right now.”A combination of strategies will be required to restore normal TB services, with the objective to reduce the accumulated pool of undetected TB patients. Here are some other steps that can be taken to strengthen both diagnosis and treatment:Diagnosis<ul><li>Governments should collaborate with non-profits and use technology to ramp-up active case-finding and contact tracing.</li> 	<li>Community health workers should conduct door-to-door sample collection.</li> 	<li>Health system should ensure diagnostic services for TB. Currently, most labs are being used for COVID-19 testing only.</li> 	<li><a href="https://www.nepalitimes.com/here-now/a-covid-19-game-changer-for-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/a-covid-19-game-changer-for-nepal/&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNEqv3e5bpooFbMQx594hHcms3j7uA">GeneXpert</a> test should be enabled for MDR TB cases as they are quicker and can identify if a person has resistance to the drug.</li></ul>Treatment<ul><li>Healthcare workers and non-profits should facilitate tele-counselling to sensitise family members about the possible side effects and severe symptoms of TB.</li> 	<li>The government, in collaboration with non-profits, should run a helpline so that TB patients can better manage severe symptoms or side effects.</li> 	<li>Health practitioners should leverage digital tools to diagnose patients and prescribe first-line treatment.</li></ul>Additionally, institutions must also work to safeguard healthcare workers from tuberculosis, as well as COVID-19, during any intervention. And as more private practitioners turn to digital facilities for diagnosis and consulting, there is a need to design solutions for marginalised communities.The projected numbers for TB highlight the urgency for a better intervention strategy. While the COVID-19 pandemic deserves attention and intervention, the response to it should not come at the cost of another disease. (IPS)Devika Agarwal has worked with TB Alert India, Ministry of Health and Family Welfare, Government of Delhi, and the non-profit Aaroogya. This story was <a href="https://idronline.org/managing-an-epidemic-within-a-pandemic/" data-saferedirecturl="https://www.google.com/url?q=https://idronline.org/managing-an-epidemic-within-a-pandemic/&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNGlN78X8O31tWoB2VkPn1rFIadjaA">originally published</a> by India Development Review (IDR) and has been reprinted under an arrangement with Inter Press Service (IPS).

TB patients in limbo due to COVID-19

<figure><img width="1400" height="933" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171112/63692ee19c7e80680e03c076jpeg.jpg" alt=""/><figcaption>Bikram Rai</figcaption></figure>Neglect by Nepal's rulers of the poor, the disenfranchised and marginalised has been a given throughout our history. Royal or revolutionary, democrats or demagogues, upliftment of the underserved has always been a mere slogan. This chronic inattention has determined who gets to live, and who dies. Till about a decade ago, Nepal’s main problem was with infectious diseases like diarrohea, pneumonia, typhoid, and insect-borne ailments. The first line of defence against communicable diseases is communication: and the government’s campaign for public health awareness through a network of female health volunteers yielded dramatic results. Even though the emphasis has now shifted to <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">non-communicable diseases</a>, there is still one infectious disease that has fallen below the radar: tuberculosis. It is obvious why, TB afflicts the poorest in the remotest parts of the country. Read also:<a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB</a>, Sonia AwaleThis is true not just in Nepal but worldwide. Despite advances in medicine, TB is still the biggest infectious killer – 35 million people died of it in the past 18 years. If nothing is done, another 30 million will die of TB from now till 2030. Tuberculosis is caused by a bacterium transmitted through coughing, and if left untreated, affects the lungs and leads to a slow and painful <a href="http://archive.nepalitimes.com/news.php?id=14477#.W7Xml3szbIU" target="_blank" rel="noopener">death</a>. The fact that it is still killing millions every year despite the availability of antibiotics is an indictment of the global and national inequity in health care. Most Nepalis are carriers of the bacillus that causes TB, but the disease is kept in check by our immune system. Chandra Shumsher had TB, and many of Nepal’s kings died of it. The bacteria proliferates when a person becomes weaker due to malnutrition, age, or other diseases like <a href="http://archive.nepalitimes.com/article/nation/ending-AIDS-in-Nepal,2707" target="_blank" rel="noopener">HIV</a>. Last year, 45,000 new cases were detected in Nepal, and nearly 7,000 of them died. Although Nepal is a role model in the community-based DOTS process that requires medical supervision of the administration of antibiotic treatment to patients, researchers say a more active case detection method is now required. This calls for an increase in Nepal’s annual TB control budget of $18million of which about half is met through donor contribution.Last week in New York, the United Nations held its first ever high-level meeting on TB during which leaders adopted a historic UN Political Declaration on TB timed for World TB Day on 26 September. This largest ever gathering of world leaders hoped to do for TB what had earlier been achieved with such meetings for diseases like <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/stigma-ostracisation-for-HIV-patients-remain-in-western-nepal,1724" target="_blank" rel="noopener">HIV </a>and <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/ebola-in-asia,1764" target="_blank" rel="noopener">Ebola</a>.The declaration had a checklist that included reaching 40 million people by 2022 with diagnosis and treatment, and another 80 million with preventive therapy. It also committed to double the current $13billion to fund the World Health Orgnaisation (WHO) End-TB Strategy and the Stop TB Partnership’s Global Plan to End TB. WHO developed the End-TB by 2035 strategy in 2014 but it was clear more investment and political commitment was needed. Globally and within countries, it is the poor who suffer, which means the disease is not a priority for<a href="http://archive.nepalitimes.com/article/nation/growth-of-antibiotic-resistance-in-nepal,1975" target="_blank" rel="noopener"> pharmaceutical companies</a>, the private health care industry and most governments. Tuberculosis and poverty go hand-in-hand: TB fuels poverty, and poverty in turn fuels TB. In addition to the challenge of surveillance, detection and early treatment, there is now a new threat: the tuberculosis bacterium is getting resistant to prevalent antibiotics, and untreatable superbugs are spreading. Multi-drug resistant (MDR) tuberculosis is difficult and expensive to treat, and the drugs have severe side effects. ew drugs, diagnostics and vaccines are urgently required but investment in TB research falls far short of what is needed. BCG vaccines are no longer considered effective enough, and diagnosis of multi-drug resistance is too expensive for poorer countries like Nepal. The ‘Alaska Model’ of treating all carriers preventively with antibiotics would be too expensive and too difficult here. Nepal’s location is an added problem: the two countries with the heaviest TB disease burden are India and China. Both have increasing numbers of MDR TB, and eradicating TB within Nepal will not be the end of the story.There are new interventions on the horizon like the GeneXpert molecular diagnostic kits, but there are only 50 of them in Nepal and each cartridge costs the government Rs1,800. The Britain Nepal Medical Trust is using drones for delivery of specimens and drugs in a pilot project in Piuthan to overcome the accessibility barrier. (Story: page 14-15).Since a national eradication program is too complicated, Nepal’s strategy should be to adopt best practices from elsewhere like establishing TB-free zones district-by-district. One thing is clear: business as usual will mean this medieval disease will be around for much longer.Read also: <a href="https://archive.nepalitimes.com/page/resistance-to-live-saving-drugs-threatens-to-set-back-progress-in-nepal" target="_blank" rel="noopener">The return of the microbes</a>, Sunir Pandey <a href="http://archive.nepalitimes.com/news.php?id=18115#.W7Xi6HszbIU" target="_blank" rel="noopener">Double whammy : Heart Attacks and Infections</a>, Buddha Basnyat <h2>10 years ago this week</h2> The front page of Nepali Times ten years ago (#419) 26 September – 2 October, 2018 covered the visit by Prime Minister Pushpa Kamal Dahal to New York for the UN General Assembly, and attendance at a reception by US President George W Bush. The editorial cited Dahal’s promise to generate 10,000MW of power in 10 years. It has been 10 years, and we still generate less than 1,000MW. Excerpt from the editorial:‘The Maoist-led government wants to “think big” and increase present generating capacity from 600MW to 10,000MW in 10 years. This will cost Rs 1.4 trillion. There’s no harm in dreaming, but even if we manage to generate that amount of electricity by 2018, our domestic demand will have risen to 3,000MW and India’s generation capacity will be 300,000MW. Our exports will make up only 2% of India’s electricity needs in 10 years, so they can do quite well without our power. We need it much more here. Nepal needs to generate more electricity to meet rising domestic demand and then sell the surplus to balance our Rs150 billion annual trade deficit with India. The most prudent course of action for us is to fast-track hydroenergy projects by turning Nepal into an investment-friendly destination. For this, the new government must get serious and streamline licensing, respect the sanctity of contracts, and temper militant labour. If that isn’t done, forget about 10,000MW in 10 years.' <img width="640" height="1020" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171112/63692ee59c7e80680e03c077jpeg.jpg" alt="">

TB or not TB

Samsung Nepal has opened pre-orders for the Galaxy A57 5G and A37 5G. Both phones run Samsung’s One UI 8.5, featuring AI capabilities like voice transcription, Circle to Search, and photo editing. They feature a 50MP triple-camera system, a Super AMOLED display, and six years of OS and security updates.

Galaxy A series

Know your Ministers

Prime Minister Balendra Shah on Wednesday broke tradition and met with 17 foreign envoys collectively, a move that was a notable departure from how his predecessors operated.&nbsp;
Shah had already set himself apart by talking less, listening more, and delegating to trusted friends. But by meeting all ambassadors at one go in the presence of the Foreign Ministry, he signalled a paradigm shift in how he wants Nepal to be seen: no longer just balancing India and China, but as a country confident about its <a href="https://nepalitimes.com/opinion/guest-editorial/tripolar-contestation-over-nepal">strategic importance and place in the world</a>.
In just two weeks, the <a href="https://nepalitimes.com/news/rsp-dos-and-don-ts">RSP has sprung into action </a>on multiple fronts to implement its ambitious 100-point, 100-days action plan. It has taken short-term measures to mitigate the impact of the Gulf war, as well as medium- and long- term measures to streamline the bureaucracy. A few high-profile figures have been made examples of to drive the message home.
Earlier this week, the government recalled six politically appointed ambassadors, the most notable being long-serving Shankar Sharma from New Delhi. The Kathmandu District Court issued arrest warrants against former prime minister Sher Bahadur Deuba and his former foreign minister wife Arzu Rana on charges of money laundering and corruption.
Each ministry has been trying to clean up the accumulated rot from the past three decades: regulatory overhaul of microfinance, education, health and service delivery.&nbsp;
These actions widely disseminated campaign-style on YouTube and TikTok have made most Nepalis hopeful that the party they installed in power means business.
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BACKLASH
But such attempts to overhaul a long-entrenched political culture were bound to face backlash. In their impatience and enthusiasm to get things done, some of Prime Minister Shah’s ministers have over-reached.
It was common knowledge that government-paid advertising in the mainstream press was kickback-driven, but the PMO’s directive that official notices be published or broadcast only on state-run media has been denounced — especially as the media industry struggles to stay afloat.
More serious are some recent appointments by ministers of relatives and figures closely associated with the RSP to key positions. This has rankled because this party built its political plank on ending nepotism and graft.&nbsp;
News that Home Minister Sudan Gurung allegedly had not paid rent on leased land, which illegally encroached on the lake in Pokhara did not help. &nbsp;
Prime Minister Shah himself has come under scrutiny for appointing a kitchen cabinet full of male buddies from his time as Kathmandu mayor. To douse criticism he brought in as adviser investigative journalist Deepa Dahal, who has exposed corruption in high places of the previous coalitions.&nbsp;
Shah’s appointment of another political adviser Asim Shah to the head Constitution Amendment Task Force, is also seen as problematic. He is a filmmaker and former lawmaker, but does not have a background in constitutional law.&nbsp;
Even more controversial is the Cabinet’s decision to appoint RSP Chair Rabi Lamichhane’s legal counsel, Narayan Kandel, as Attorney General. Kandel used to be a UK permanent resident, and does not have as much experience practicing law in Nepal.&nbsp;
Kandel’s appointment drew flak and raised eyebrows, and with the pending legal cases against Lamichhane this appointment represents a flagrant conflict of interest.
Health Minister Nisha Mehta was also accused of favouritism after reappointing Junu Shrestha, wife of Labour Minister Dipak Kumar Shah, as member of the Health Insurance Board which had earlier suspended her. The Labour Minister’s rambling rant at the Board’s meeting on Tuesday has not helped the RSP’s image.&nbsp;
(UPDATE: On Thursday, Prime Minister Shah sacked the Labour Minister after the RSP found him in breach of the party's code of conduct and discipline. He served 14 days in the Cabinet, one of the shortest tenures for a minister in Nepal )
It is hard to know what <a href="https://nepalitimes.com/news/ball-in-balen-s-court">Balendra Shah is thinking</a>, and how Rabi Lamichhane is going to justify some of these moves. After all, making politics, governance, and bureaucracy a meritocracy has been the core tenet of the RSP, and it risks alienating its mainly youth base if these missteps persist.
But at least for now, most RSP supporters seem to be giving the party the benefit of doubt.

Nepal’s new government springs into action

In a classic arc of political sociology, a revolutionary figure takes several decades to complete their cycle: mobilisation, institutionalisation, and finally governance. 
However, the timeline of this trajectory has been telescoped in the case of Home Minister Sudan Gurung, who in 2025 described himself as a social activist and volunteer, has gone from the barricades of the GenZ protests to the mahogany desk of the Ministry of Home Affairs.
Gurung is a personal pick of Prime Minister Balendra Shah, and played a pivotal role in getting him to join the RSP by mediating with Rabi Lamichhane. His journey serves as a real test bed for the ‘Outsider-to-Insider Transition’, raising a fundamental question about someone who now leads the very apparatus that he once fought against: the police, intelligence service, and the bureaucracy.
Social capital can indeed be built during a crisis exacerbated by state failure, and that is where we first see Sudan Gurung — expediting relief delayed by systemic corruption and red tape. Gurung’s delivery aid through a social-media-driven volunteer network bypassed the government. 
Whether or not he really rushed a dying child to hospital after the 2015 earthquake does not matter, it has become an urban legend. 
His work evolved into the non-profit Hami Nepal in 2020, serving as a ‘parallel state’ mechanism that would later become central to his public identity. Later, his group sprang into action during the Covid crisis, organising oxygen cylinders and beds . He was there after flood disasters in Manang and Sidhupalchok, and even organised Rs15m worth of aid to Turkey after the 2023 earthquake. 
Moral Legitimacy became his primary source of power, and he strategically positioned himself as an alternative emergency response system. But the real rupture happened on 8 September 2025 when years of frustration, corruption scandals, lack of transparency and state accountability culminated in a rally that the next day descended into anarchy. 
There was no single leader. The movement was fully decentralised, but as elsewhere such upheavals produces a recognisable face. Among them was Sudan Gurung. Who despite being a millennial himself, became the most visible interlocutor of the GenZ movement. 
He negotiated with the state’s key actors, including the president and the Chief of Army staff, during the period of uncertainty When the country was on the brink. This led to the dissolution of parliament and the formation of the interim government under Sushila Karki, paving the way for the election on 5 March.
Since then, Sudan Gurung’s role has become contradictory. Within days of touching Prime Minister Karki’s feet after her swearing in, he was at the gates of Baluwatar spearheading midnight demonstrations calling for her resignation. He accused her and Home Minister Om Prakash Aryal of not consulting the youth over Cabinet appointments and not arresting the previous government officials.
This oscillation became a hallmark of Gurung’s own version of the ‘Radical Flank Effect’ — erratic behaviour to force the establishment to make concessions. 
On 18 January Gurung formally joined the RSP, and started campaigning from his home constituency of Gorkha-1. He won decisively and was appointed home minister by Balendra Shah. The transition was complete. 
As minister his role spans core security areas: overseeing internal security through the Nepal Police, Armed Police Force and the intelligence bureau. The man who took part in anti-government rallies is now in charge of the riot police that aresupposed control anti-government protests.
His portfolio also handles state administration matters such as citizenship, immigration, and border security, coordinates with the judicial system on prisons, detention, and policies related to punishment and clemency. For example will be overseeing the fraud case against his own party’s chair, Lamichhane.
In his book Power in Movement, political scientist Sidney Tarrow observes that social movement leaders encounter ‘institutional capture’ upon entering government. In a sociological paradox, the man who previously denounced the police for killing youth protesters is now the person who issues directives to those same forces.
Preventive detention, surveillance, and the control of public festivals are the same instruments that the former old guard employed to stifle his movement. The activist who demanded transparency at the B P Koirala Institute now manages the state’s most secretive security apparatus.
In this arc, Gurung is not alone, there are parallels around the world for leaders emerging from the ashes of revolt. It is not so much a prediction, but for Gurung the challenge is even more acute because youth expectations are so high.
The bar for performance has been raised by citizens demanding change and quicker, more efficient service delivery. He is under constant public scrutiny, which is why he has to take YouTubers every time he goes on inspections of the airport, the BP Highway, police stations, picking trash on the sidewalks or meeting the Swiss ambassador to ask about repatriating the ill-gotten wealth of politicians.
Sudan Gurung is facing intense public glare. There have been calls to reveal the truth behind Hami Nepal’s finances, the alleged links to Free Tibet, and lately not paying five years of rent for an illegal lakefront property in Pokhara. 
As minister, he will find that moral legitimacy alone is no longer sufficient, it must be reinforced by transparent and consistent institutional accountability. Sudan Gurung’s ascent is evidence that the public mostly trusts ‘outsiders’ during times of crisis. However, history also cautions us that the state only permits ‘insiders’ to operate. 
Gurung will have to organise systemic reform to inject the transparency of his volunteer days to the Home Ministry’s traditionally secretive disbursements. If he fails, he runs the risk of validating Michels’ Iron Law of Oligarchy, which would serve as a warning about how revolutionary energy is dissipated by the very structures it was intended to overthrow.
Nepal is watching the man who said he once held a dying child in his arms after an earthquake. The volunteer has become the Warden.
Nischal Raj Gautam is a student of Media Studies and Mass Communication at St. Xavier's College, Maitighar. He is a member of the EU Delegation's Youth Sounding Board (YSB), and a journalist for TheirWorld's The Education Issue 2026.

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