<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221129121128/6385ed659c7e80680e0cc8d3jpeg.jpg" alt="" width="540" height="350"/>This pandemic is a time for clinical research to help humanity out of the crisis, and scientists are scrambling to find a <a href="https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines">COVID-19 vaccine.</a>It is urgent because if they do not do human trials during the pandemic, the infection rate may decline and the vaccine will not be well-tested enough to prevent this disease.This lack of cases and the resulting inability to test a strong candidate vaccine is exactly what happened to the zika virus vaccine. Zika may have run its course even as the vaccine study was getting underway. But there is every likelihood it may return with a vengeance without an effective vaccine in place.Many big pharma including Astra Zenca, Pfizer, Merck, and Johnson and Johnson are involved in the testing and manufacture of the COVID-19 vaccine. Companies in India, China, and Japan are also ramping up their efforts.Unfortunately, no promising drug treatment is on the horizon. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext">Remdesivir,</a> convalescent plasma, interleukin inhibitors like tocilizumab, chloroquin are certainly not the silver bullets they are made out to be. But every bit of hope is useful.Last week, <a href="https://science.sciencemag.org/content/368/6495/1041">a riveting scandal rocked the medical world</a> that involved a team of doctors whose research into choloroquine and the journals that published the result.This antimalarial drug, discovered in 1934 and introduced generally in 1947, is one which humans have been most exposed to. Chloroquine is inexpensive and simple to administer. It remains a first-line treatment for non-falciparum malaria and is on the World Health Organisation (WHO) List of Essential Medicines.It has been used extensively as a continuous prophylaxis <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Buzz-guts-of-the-anopheles,548">against malaria</a> for individual periods often exceeding five years, and has been the prophylactic drug of choice in pregnancy in order to avoid non-falciparum malaria. In addition to its antimalarial use both chloroquine, and the closely related hydroxychloroquine, are used in continuous daily dosing for common joint diseases like rheumatoid arthritis and lupus.Cholorquine in viral culture cells in research laboratory has been shown to suppress the novel betacoronavirus SARS-CoV-2, the cause of the <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/">COVID-19 infection</a>. This effect occurred when the drug was given either before or immediately after viral inoculation, not after a long lag period.An observational study purporting to use data from a multi-country registry was recently published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31324-6/fulltext">The Lancet</a>, revealing that regardless of any benefit chloroquine may (or may not) have for the treatment of COVID-19, there were unacceptable side-effects on the heart leading to decreased survival of the patients.But there was a problem with the study. Sapan Desai, one of the authors and owner of <a href="https://www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine">Surgisphere Corporation</a> based in Chicago from where this registry  data was obtained, was, when requested, unable to share the dubious list.Desai’s colleague, Mandeep Mehra, the lead author, and other co-authors including Amit Patel have now <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">retracted the article from The Lancet</a>. But the story does not end there.This same group of authors, some of whom work in prestigious institutions like Harvard (Mehra), also retracted a recent <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2016638">New England Journal of Medicine (NEJM) article</a> regarding COVID-19 where they had used data from Surgisphere Corporation, and when requested, were unable to share it.These retractions by the same set of authors (one of whom owns the data collection corporation) from two of the highest impact medical journals could suggest possible fraud. In addition, the editors of both the <a href="https://www.nejm.org/doi/full/10.1056/NEJMe2020388">NEJM</a> and <a href="https://www.abc.net.au/radionational/programs/healthreport/major-research-papers-retracted-over-data-controversy/12326900" target="_blank" rel="noopener noreferrer">The Lancet</a> were caught with their pants down in the rush to publish data.Finally, a proper randomised controlled trial named the Recovery Trial from the UK that utilised large numbers of patients who were treated with hydroxychloroquine revealed this week that the drug does not work in the treatment of COVID-19 patients.But whether chloroquin works in prevention (as opposed to treatment) of <a href="https://www.nepalitimes.com/latest/nepal-must-hope-for-the-best-prepare-for-the-worst/">COVID-19</a>, especially in the vulnerable group of health workers, is not known and studies are continuing regarding pre-exposure to the virus. Medical science can be tricky. A drug not useful for treatment can often be useful for prevention.Potentially fraudulent studies notwithstanding, it is beneficial for countries like Nepal, after proper examination, to collaborate in international observational or randomised controlled trials like the <a href="https://www.nepalitimes.com/opinion/countries-cooperating-to-find-covid-19-cure/">WHO’s Solidarity Trials</a> for COVID-19 antidotes -- especially because it will help with capacity building in our region without desperately having to look for funding.The <a href="http://archive.nepalitimes.com/news.php?id=10203#.XuBQOS0w0Wo">Nepal Health Research Council</a> has been doing an excellent job of reviewing manuscripts and usually providing prompt feedback to the researchers in the region. However, what we medical researchers in South Asia lack is an appreciation of equipoise.‘Equipoise’ means curiosity, but it also has an element of humility. A true state of equipoise exists in research when there is no good basis for a choice between two or more options. In fact, the state of equipoise is the reason for doing research using RCTs.Unfortunately, many health care professionals in South Asia do not make room for this quality. For example, some institutions have turned down doing potentially useful, well-written and well-grounded multilateral studies in the mistaken belief that we know better that the drug or treatment in question does not work. How can this be assumed?This narrow belief may shut useful research out which ultimately could inform clinical treatment and help the patient. Helping the patient, at the end of the day, is what we all are trying to do.Buddha Basnyat is a clinical researcher at Patan Academy of Health Sciences and writes this <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/">frequent health column</a> Dhanvantari for Nepali Times.

Buddha Basnyat

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The truth about the chloroquine scam

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b71809c7e80680e0600d4jpeg.jpg" alt="" width="1440" height="1080"/><figcaption>Peking University campus on the 26th of January. Photo: MADISON PLASTER</figcaption></figure>For the past week, I have been in a voluntary lockdown in Beijing because of the rapid spread of the coronavirus in China. A trip to the supermarket to stock up on supplies felt like being in a post zombie apocalyptic breakout, not waiting for the infected to attack you but actively making a run when someone coughed or sneezed. Relying on homemade noodles, I am looking forward to flying out of Beijing soon with no knowledge on when I will be back as many universities in Beijing have requested students not to return until further notice.As seen in <a href="https://www.ncbi.nlm.nih.gov/books/NBK92479/" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/books/NBK92479/&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNF3tSZYxe_Ww_d6Hv2DoRvSoKHD5Q">China’s 2002 SARS pandemic</a> that infected more than 5,300 people and killed 349 nationwide, the government has yet again relied on putting almost 50 million people in quarantine to contain the crisis. According to <a href="https://www.youtube.com/watch?v=S2VoEvDEuxw" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.youtube.com/watch?v%3DS2VoEvDEuxw&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNHxS4nKpuTtjHXhJHlS4zi-tjlDMQ">news</a> from the BBC, as on January 26th, the number of people killed in China has risen to 81 with almost 3,000 confirmed ill.Embassies continue to work for the wellbeing of their citizens, and neighbouring countries such as Mongolia and North Korea are reported to have <a href="https://abcnews.go.com/International/wireStory/report-mongolia-closes-border-china-amid-virus-fears-68557875" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://abcnews.go.com/International/wireStory/report-mongolia-closes-border-china-amid-virus-fears-68557875&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNE4MB58BpGrDibXc8rfZpEgAZtTvw">closed down borders</a> with China. Acknowledging the uniqueness and severity of the situation as people were traveling for Lunar New Year, the Chinese government has extended the Lunar New Year holidays and both public and private sectors are adding buffer time periods before things start moving business as usual.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b71839c7e80680e0600d5jpeg.jpg" alt="" width="1125" height="1500"><figcaption> </figcaption></figure>Like many crises situations, there seems to be more unknowns than knowns. While Wuhan seafood market was initially believed to be the source of the novel virus, a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNF3MXldTizCebbsdGu1o3RPlNtrjw">new study</a> published in <a href="https://www.thelancet.com/journals/lancet/home" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.thelancet.com/journals/lancet/home&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNGSNtrH9F-1Q6aP25WKdl9kI4WfIw">The Lancet</a> of 41 hospitalised patients who had confirmed infections challenges that hypothesis. According to an <a href="https://www.sciencemag.org/news/2020/01/wuhan-seafood-market-may-not-be-source-novel-virus-spreading-globally" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.sciencemag.org/news/2020/01/wuhan-seafood-market-may-not-be-source-novel-virus-spreading-globally&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNFtb1KBIlj4mlVhbjLL_50gOHu5yQ">article published</a> in the <a href="https://science.sciencemag.org/" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://science.sciencemag.org/&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNFc4FOYJSQSQtW3Iv0WItiwgvZqLw">Science</a>, Daniel Lucey, an infectious disease specialist at the University of Georgetown, asserts that “The virus came into that marketplace before it came out of that marketplace.”Transparency from the government in reporting the crisis also continues to be questioned within and beyond China. While state run media channels such as CGTN are showing hundreds of medical personnel <a href="https://www.youtube.com/watch?v=ydphq5uA_Jg" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.youtube.com/watch?v%3Dydphq5uA_Jg&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNFO7K2xW_laJTA2asovWvLK4zJC1Q">voluntarily traveling to Wuhan</a> out of a sense of duty to the nation, and a <a href="https://www.youtube.com/watch?v=VbA2PRYsakA" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.youtube.com/watch?v%3DVbA2PRYsakA&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNGV9x-Kx5xOlevsbCmyhYdOFFvrgw">wonderfully staged case</a> of people recovering from the virus and heading back home, people continue to question the legitimacy of the magnitude of the crisis as reported from the Chinese government.While <a href="https://www.ncbi.nlm.nih.gov/books/NBK92479/" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/books/NBK92479/&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNF3tSZYxe_Ww_d6Hv2DoRvSoKHD5Q">previous experiences suggest</a>, be it during the air pollution crisis in 2008 or the 2002 SARS pandemic, that China has not been the most transparent in reporting crisis, the rise in social media and the internet means that complete lack of transparency from the government might not be just impossible but also counterproductive.https://www.youtube.com/watch?time_continue=2&amp;v=ydphq5uA_Jg&amp;feature=emb_logoBut in fleeing China for Nepal, I cannot question but wonder if I am safer in Beijing than I am in Nepal. A day after the first coronavirus case was confirmed in Nepal, two more suspected cases have emerged. While countries around the world are figuring out the best response mechanism to contain the crisis, Nepali authorities appear particularly unprepared.The Epidemiology and Disease Control Division reportedly chose not to speak to the media, in following the orders from the Ministry of Health.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b71869c7e80680e0600d6jpeg.jpg" alt="" width="1080" height="1440"><figcaption> </figcaption></figure>The rudimentary screening mechanisms alongside the lack of human resources and technology at the country’s only international airport needs no mention. And while China is <a href="https://news.sky.com/story/coronavirus-china-to-build-two-wuhan-hospitals-in-under-three-weeks-11917336" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://news.sky.com/story/coronavirus-china-to-build-two-wuhan-hospitals-in-under-three-weeks-11917336&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNHsoNgF7mWsi-yXGbB-mYgF5dsBeQ">building two health facilities</a> with enough space for around 2,300 patients over the next few weeks, the Sukraraj Tropical and Infectious Disease Hospital in Teku lacks even a <a href="https://newsinfo.inquirer.net/1219763/two-more-coronavirus-cases-suspected-in-nepal" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://newsinfo.inquirer.net/1219763/two-more-coronavirus-cases-suspected-in-nepal&amp;source=gmail&amp;ust=1580228862390000&amp;usg=AFQjCNHBbq7QdxT_FH6WsvrO7kZzHAEVOQ">dedicated isolation ward</a>.It is disheartening to see fellow friends at university hear from their respective embassies whilst I was forwarded with a “do and don’t” list issued by the Nepal Embassy from a WeChat group. It is not that Nepali people expect a lot from their governments, but I can’t help but contemplate why I feel safer in the hotspot of a global pandemic than I would at my own home country.https://www.youtube.com/watch?v=VbA2PRYsakA&amp;feature=emb_logoGrappling with this idea has been difficult, but it also serves as a reminder for the very reasons why we must continue to fight to contribute to the development of Nepal in every way possible.Rastraraj Bhandari is currently pursuing a Masters in Economics and China Studies at the Yenching Academy of Peking University in Beijing, China. <img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b71899c7e80680e0600d7jpeg.jpg" alt="" width="175" height="173">

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A Nepali in Beijing during coronavirus scare

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b70d49c7e80680e06009bjpeg.jpg" alt="" width="1500" height="803"/><figcaption>Photo : UNICEF</figcaption></figure>Last month, the prestigious <a href="https://www.nejm.org/" target="_blank" rel="noopener">New England Journal of Medicine</a> published a study of the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1905047" target="_blank" rel="noopener">successful trial of a new typhoid vaccine</a> that could prevent thedeaths of many children around the world. The vaccine research was conducted at Patan Hospital by a Nepali researcher.The randomised control trial of the typhoid conjugate vaccine (TCV) was conducted among more than 20,000 participants in Lalitpur district, and the efficacy of the new vaccine was found to be 81.6% -- a major improvement on previous vaccines. (See box below).The positive news from Nepal came as various parts of the world, including the US, Europe, Samoa and Africa, struggled to cope with the biggest measles outbreak in decades. Most of the cases have now been associated with people forgoing recommended preventive shots because of fears of side-effects fanned by social media.Fear of vaccination started ever since a paper in 1998 in the medical journal <a href="https://www.thelancet.com/" target="_blank" rel="noopener">The Lancet</a> cited a link between autism and the <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/maurice-hilleman-the-vaccine-man,1852" target="_blank" rel="noopener">measles, mumps, rubella (MMR) vaccine</a>. The research was later found to be fraudulent and retracted, but the anti-vaccine movement gained traction again in the past year after the rumours resurfaced on the Internet resulting in families rejecting early childhood immunisation against diseases like polio, rubella and measles.“The good news is that unlike in the rest of the world, people in Nepal demand vaccines. If we miss to vaccinate a child for any reason, parents come knocking, asking for the shots,” says Jhalak Gautam of the Family Welfare Division at Teku.Sameer Mani Dixit of The Centre for Molecular Dynamics Nepal concurs. “Entire communities actively participate in vaccination programs and are well aware of the benefits. Every mother in Nepal knows the immunisation schedule by heart.”The Centre for Molecular Dynamics Nepal has just completed a study on why the country has been so successful with its immunisation program, and the results will be published later this month. This study and similar studies underway in Senegal and Zambia are being conducted with  funding from the Bill and Melinda Gates Foundation, in an effort to analyse the success of vaccination programs in developing nations.Nepal’s national immunisation program started in 1988 and now vaccinates some 620,000 children under 15 months of age every year against 11 infectious diseases such as <a href="https://www.nepalitimes.com/banner/tb/">tuberculosis</a>, <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Bouncing-back-higher-wheelchair-basketball,3802" target="_blank" rel="noopener">polio</a>, pneumonia and measles.The last case of <a href="https://www.nepalitimes.com/banner/polio-hunt/" target="_blank" rel="noopener">polio</a> was detected in Rautahat district in 2010, and Nepal was declared polio free four years later. The country also eliminated maternal and neonatal tetanus in 2005. Similarly, Japanese encephalitis, diphtheria, pertussis and pneumonia have all been controlled, and there are regular vaccinations against congenital rubella syndrome and hepatitis B.Despite the high immunisation rate, thousands of Nepali children continue to die due to easily preventable and treatable communicable diseases <a href="https://archive.nepalitimes.com/news.php?id=16988#.XiBL7_4zaUk" target="_blank" rel="noopener">like diarrhoea</a> and according to Nepal Demographic Health Survey 2016, one in a hundred Nepali children have still not been vaccinated against any infectious diseases.Read also: <a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/" target="_blank" rel="noopener">"Nepal is a microcosm of all the change in world health"</a>Immunisation coverage data from last year also shows a worryingly high dropout rate. While 93% of newborns received BCG jabs, the first in the national immunisation schedule, the coverage dropped to 73% by the time children received the last vaccine, an immunisation against measles and rubella, recommended at the age of 15 months.Several cases of <a href="http://archive.nepalitimes.com/news.php?id=186#.XiBGW_4zaUk" target="_blank" rel="noopener">measles</a> have been detected in Kapilvastu, Dang, Makwanpur, Sarlahi and Manang districts recently, and Nepal has not been able to meet its previously set target to eliminate measles and rubella by 2019. The new goal is to eliminate the diseases by 2023.“Dropout rate is a challenge, we have not been able to reach the remotest corners of the country, and children miss their shots because of migration,” says Jhalak Gautam. “We now have a strategy to identify missed pockets and deliver shots at home if required.”The Immunisation Section of the Ministry of Health is now gearing up for a nation-wide measles-rubella vaccination campaign aimed at those who might have missed routine shots. Three million children between the ages 9 months to 5 years are expected to participate in two phases of the campaign later this year.Polio drops will also be administered at the same time to 1.5 million children under five in 19 Tarai districts. The Immunisation Section is also introducing a new vaccine against rotavirus this June to reduce the prevalence of childhood diarrhoea.The new challenge to vaccination comes from an unlikely quarter: federalism. There is confusion about where the vaccines are sourced and who should pay for them. There is concern about the quality of vaccines, many of which need a cold chain with refrigeration to the point of delivery.Warns Patan Hospital physician Buddha Basnyat: “Nepal’s immunisation program is a model of success, but we cannot afford to be complacent.We have to introduce newer and more effective vaccines while also prioritising hygiene and <a href="https://www.nepalitimes.com/banner/toilet-trained/" target="_blank" rel="noopener">sanitation</a> simultaneously.”<h2>Successful trial of new typhoid vaccine</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b70d79c7e80680e06009cjpeg.jpg" alt="" width="1500" height="1000">Over 20,000 children between 9 months and 16 years of age in Lalitpur district participated in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1905047" target="_blank" rel="noopener">first large-scale randomised controlled trial</a> of a new vaccine against <a href="http://archive.nepalitimes.com/news.php?id=17306#.XiBGav4zaUk" target="_blank" rel="noopener">typhoid</a>, a disease that affects millions across South Asia.Half of them received the vaccine and the other half received control shots. The efficacy of Typhoid Conjugate Vaccine (TCV) was found to be 81.6%, and the results were published last month in the prestigious New England Journal of Medicine.Prior to this, a small-scale TCV trial was conducted in Britain, and the World Health Organisation (WHO) has since strongly recommend the use of the vaccine for countries and regions where the water and food-borne infection is most common. "Pakistan has been able to control typhoid with this vaccine and <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30320-1/fulltext" target="_blank" rel="noopener">Vietnam</a> has eliminated it," says lead author of the paper, Mila Shakya, "Administration of this new, effective vaccine by our government will help control the most common bacterial disease in Nepal and South Asia."<a href="http://archive.nepalitimes.com/news.php?id=12158#.XiBGbP4zaUk" target="_blank" rel="noopener">Typhoid</a> is a contagious infection caused by the bacteria Salmonella typhi, which is found in contaminated food and water and which causes fever, diarrhoea and vomiting. It can easily be prevented with awareness, safe drinking water and frequent hand-washing.The vaccine is useful because it is a prophylactic in places where preventive measures are taking time to implement. There are some 21 million typhoid cases and 161,000 typhoid-related deaths annually worldwide. South Asia has been often dubbed as the hub of typhoid and there are some 500 cases per 100,000 population in the region.“This study is Nepal taking a lead in preventing typhoid, after never having really prioritised it. It might not kill as many people as other diseases do, but it still affects thousands of school-going children,” says physician Buddha Basnyat at Patan Hospital.TCV is <a href="http://archive.nepalitimes.com/news.php?id=18178#.XiBGdP4zaUk" target="_blank" rel="noopener">not the first typhoid vaccine to be developed</a>. Currently there is an injectable unconjugated polysaccharide vaccine for persons aged two years and above, and an oral capsule for those over six years of age. But they do not work well on young children and they provide protection only for a few years. TCV on the other hand can be given to children below 2 years and the immunisation lasts up to five years.“A single dose of the new vaccine is safe, immunogenic, and effective, and the deployment of the vaccine will reduce the burden of <a href="https://www.nepalitimes.com/opinion/so-far-so-good/infectious-enthusiasm-for-travel/" target="_blank" rel="noopener">typhoid</a> in high-risk populations,” stated the interim analysis. “This new evidence of efficacy is especially timely with the recent spread of extensively drug resistant typhoid fever, which threatens child health in affected regions.”Pakistan, which has been struggling against an outbreak of drug resistant typhoid fever since 2016 is already using TCV with positive results and its Sindh province will become the first region in the world to include TCV in routine childhood immunisations.<a href="https://www.gavi.org/" target="_blank" rel="noopener">Gavi, the Vaccine Alliance</a>, which has earmarked $85 million to fund the introduction of the vaccine in the world’s poorest countries, is supporting the program. Nepal is also eligible for funding from the alliance.Says Basnyat: “We should take action before we are also hit, like Pakistan, by the drug-resistant typhoid. What are we waiting for, when Gavi is ready to fund the vaccination program for free and its benefits are so clear. This is a case of vaccine under-utilisation.”Sonia Awale

Sonia Awale

A shot in the arm for vaccines in Nepal

India and Pakistan are twins separated at birth. Tensions between them have been at a hair trigger ever since independence and has erupted into full scale conflict at least four times in the past 80 years.
The 22 April terrorist attack in Kashmir that killed 25 Indian tourists and a Nepali citizen, threatens to escalate tension between the two nuclear-armed nations. India has squarely blamed Pakistan for the attacks, and Prime Minister Narendra Modi has given his military “operational freedom” to respond. Pakistan has said it has credible intelligence of an Indian military strike and its officials have promised a “full spectrum” response — a code for a <a href="https://nepalitimes.com/editorial/thinking-the-thinkable">nuclear retaliation</a>.
For Nepal, the killing of its national in the Pahalgam attack comes as another stark reminder that in conflicts from Afghanistan to Iraq, from <a href="https://nepalitimes.com/opinion/how-to-agree-an-armistice-in-ukraine">Ukraine</a> to Israel, <a href="https://nepalitimes.com/news/10-nepalis-from-one-town-fighting-in-ukraine">Nepalis are getting caught in the crossfire</a>. The last time full-scale fighting broke out between <a href="https://nepalitimes.com/opinion/peacemongers-at-india-pakistan-border">India and Pakistan</a> on Kargil in 1999, at least 22<a href="https://nepalitimes.com/here-now/india-s-trial-by-fire-for-soldiers-from-nepal?%27%5C%22="> Nepalis fighting for the Indian Army</a> were killed in action.
Three of Nepal’s immediate neighbours (China, India, Pakistan) have nuclear weapons, and they do not have good relations. With China supplying weapons, <a href="https://nepalitimes.com/editorial/war-and-warming">missile technology</a> and other support to Pakistan, this triangular friction could set off a regional conflagration.&nbsp;
<a href="https://www.nature.com/articles/s43016-022-00573-0" target="_blank">Research at Rutgers University</a> has calculated that even a week-long tactical nuclear exchange between India and Pakistan would throw up so much smoke and debris into the atmosphere that it would block out the sun for years, and lead to a collapse of the <a href="https://nepalitimes.com/news/grow-nourish-sustain-together-world-food-day">global food system</a>. This does not take into account the radioactive fallout that prevailing winds would blow up to <a href="https://nepalitimes.com/here-now/lives-on-the-line-in-the-himalaya">the Himalaya</a>, contaminating glaciers that are the sources of <a href="https://nepalitimes.com/here-now/saving-what-is-left-of-himalayan-rivers">Asia’s main rivers</a>.
The impact of <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">climate breakdown </a>on High Asia was already ringing alarm bells about its <a href="https://nepalitimes.com/news/himalayan-icecap-melting-faster-than-thought">shrinking ice cap</a> reducing the dry season flow of water downstream. Water was going to be the next strategic commodity, geopolitical experts warned, and the next wars in Asia would be over water.
That water war is already happening. India retaliated to the Kashmir attack by suspending the <a href="https://www.nytimes.com/2025/04/24/world/asia/india-pakistan-indus-waters-treaty.html" target="_blank">Indus Waters Treaty</a> of 1960 mediated by the World Bank that has withstood at least three wars between India and Pakistan. The treaty gives India control over the three eastern tributaries of the Indus (<a href="https://en.wikipedia.org/wiki/Beas_River" target="_blank">Beas</a>, <a href="https://en.wikipedia.org/wiki/Ravi_River" target="_blank">Ravi</a> and <a href="https://en.wikipedia.org/wiki/Sutlej" target="_blank">Sutlej</a>), while Pakistan got water from the Indus and two of its western tributaries (<a href="https://en.wikipedia.org/wiki/Indus_River" target="_blank">Indus</a>, <a href="https://en.wikipedia.org/wiki/Chenab_River" target="_blank">Chenab</a> and <a href="https://en.wikipedia.org/wiki/Jhelum_River" target="_blank">Jhelum</a>.
Pakistan was assured of 70% of the annual flow, and India could use a reasonable amount of water for<a href="https://archive.nepalitimes.com/news.php?id=15231"> irrigation and hydropower</a>. &nbsp;Within days of its threat, India stopped water flowing down to Pakistan from the Chenab river and is reportedly preparing to do the same on the Jhelum.
The sabre-rattling has reached a crescendo. Besides threats and counter-threats there are also symbolic drills, with the Indian Air Force practicing landing on an expressway in Uttar Pradesh by its Rafale, Su-30 and Jaguar fighter jets to demonstrate ‘operational readiness’. In response Pakistan test-fired its Abdali ballistic missile that can carry a nuclear warhead and has a range of 450km.&nbsp;
The danger is that with ultra-nationalist rhetoric and the beating the war drums by both sides, India’s government and Pakistan’s military may have to ‘do something’ to appease domestic public opinion. But any tactical strike, an artillery exchange, or territorial incursion could quickly escalate out of control.
Expecting an Indian retaliation for the Pahalgam killings, Pakistan is using<a href="https://nepalitimes.com/opinion/interfaith-collaboration-for-nuclear-disarmament"> nuclear deterrence </a>and warning of “catastrophic consequences”. The two neighbours came close to a nuclear exchange in 2019 after an attack on the Indian military in Kashmir, and prompt international intervention led by the United States cooled tensions.&nbsp;
This time, the <a href="https://nepalitimes.com/news/trump-shock-wave-hits-nepal">Trump administration</a> is too distracted and not as engaged. Pakistan has denied it was responsible for the terrorist attack and called on Washington to stop a possible Indian retaliation. India and Pakistan have stopped overflights by each other’s airlines, and some international carriers have even stopped flying over Pakistan fearing an air war.
Washington, Beijing, the UN and the EU have all urged restraint. Iran, which has good relations with both India and Pakistan has sent its foreign minister to urge both countries not to go into a tit-for-tat war. Iran has its own nuclear flashpoint to worry about with tensions in Israel, &nbsp;Yemen and Syria.
India and Pakistan both share similar problems of joblessness, <a href="https://nepalitimes.com/here-now/why-nepal-s-poverty-rate-is-stuck">poverty </a>and <a href="https://nepalitimes.com/here-now/climate-change-new-threat-to-nepal-s-rhinos">environmental threats</a>. Neither side needs the threat of a senseless war, and we in the neighbourhood do not need it either.&nbsp;
Kunda Dixit
This Editorial is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.

Nukes in the neighbourhood

The streets of Patan are alive this month with lavender jacaranda trees under rain-washed skies as <a href="https://nepalitimes.com/banner/the-red-god-rises-again-in-patan">the chariot of Rato Matsyendranath</a> is pulled across town. This is the festival of the rain god, and inevitably the heavens opened up and pre-monsoon showers pelted the chariot as it started being pulled in Pulchok last week. Thousands of devotees, onlookers and the chariot procession organisers thronged the streets on the first day last week. The rhythmic cymbals and drums exuded a vibrant energy as the enormous four wheels turned and the chariot lurched.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025051007050_81df97744db16f732a419dc1f1579d235ce3df37642b078f50b83bd4bd026688.jpg" data-media-id="editor_1" data-image-id="2025051007050_81df97744db16f732a419dc1f1579d235ce3df37642b078f50b83bd4bd026688" data-rendition-name="original" width="1000" height="1503" loading="lazy" alt="Divine chariot"> </figure>  The<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Red-rain-god,3141"> red rain god</a> has Hindu and Buddhist antecedents, alternatively called Bungadya and<a href="https://nepalitimes.com/here-now/kathmandu-s-gravity-defying-chariot-festival"> Karunamaya</a> — reflecting Kathmandu Valley’s syncretic mixture of the two religions.&nbsp; “Bungadya is a profoundly <a href="https://nepalitimes.com/opinion/12-full-opinion/marketing-the-intangible">intangible form of heritage</a>,” explains heritage expert Monalisa Maharjan. “It embodies traditional knowledge,<a href="https://nepalitimes.com/multimedia/reviving-nepal-s-craft"> artisanal skills passed down through generations</a>. Local communities and specific families have specified roles in being custodians of the heritage, ensuring their survival over the centuries.” There are many legends and stories about this annual tradition. Lichhavi king Narendra Dev is supposed to have brought Rato Matsyendranath from Assam to Kathmandu Valley to convince Guru Gorakhnath to lift a spell that created a two-year drought in Kathmandu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250510050520_347a9a398f8a9abc4a7fb4e2774fde8264cccbdce8bdab23851ab3f0e73c3e8a.jpg" data-media-id="editor_6" data-image-id="20250510050520_347a9a398f8a9abc4a7fb4e2774fde8264cccbdce8bdab23851ab3f0e73c3e8a" data-rendition-name="original" width="1503" height="1000" loading="lazy" alt="Divine chariot"> </figure>  Matsyendranath was Gorakhnath’s mentor, and upon seeing him, the serpents were released, unleashing the rains. The chariot festival honours the return of this life-giving rain. The deity is seen as an icon for thriving agriculture, t<a href="https://nepalitimes.com/here-now/before-the-next-monsoon">he arrival of monsoon</a> showers, and the welfare of the community. Read also: <a href="https://nepalitimes.com/opinion/the-reign-of-the-god-of-rain">The reign of the god of rain</a>, Vidhu Prakash Kayastha Till this day, the Rato Matsyendranath festival is no ordinary celebration. Patan does not sleep for a month as the chariot is pulled through various neighbourhoods. It unfolds at a state level with the president (formerly the king) attending the climax of the Bhoto Jatra in Jawalakhel later this month.&nbsp; The intergenerational transmission of tradition is unique in the world, and the reason the festival is one of the most vibrant cultural expressions that thrives despite inroads of modernity. The other unique aspect is that it is a transnational festival, binding Patan with Guwahati in the Indian state of Assam.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025051005058_8bc685ada13045d863b28e3eed91c931da2b510714586af6fd7eb5d1e298a24a.jpg" data-media-id="editor_9" data-image-id="2025051005058_8bc685ada13045d863b28e3eed91c931da2b510714586af6fd7eb5d1e298a24a" data-rendition-name="original" width="1000" height="1503" loading="lazy" alt="Divine chariot"> </figure>  “Unlike Nepal, where the deity commands grandeur and devotion, many in Assam are unaware of Rato Matsyendranath,” says Khagen Sharma of Gauhati University, which convened <a href="https://nepalitimes.com/news/nepal-assam-connection-revived">a symposium in February in Guwahati on the rain god</a>. Attending was a delegation led by Lalitpur Mayor Chiribabu Maharjan, organisers of the festival, and builders of the chariot. After the symposium, a committee was formed to explore and revive the tradition in Assam as well. Although the team had planned to visit Nepal this month, logistical challenges delayed the trip. Still, there are plans to build a Guru Matsyendranath statue in Assam to reestablish regular worship practices in the Guwahati shrine.&nbsp; The vines used to build the chariot in Patan are sourced from the jungles of Assam. But Sharma notes that in recent years unclear regulations have blocked the official import of the vines, although they are still brought to Nepal informally. The <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/makers-of-machhindranath,2204">chariot making</a> has also had a taste of modernisation in recent times. In the past, even a single nail or piece of steel was avoided. But over time, the wooden structure, particularly the shaft between the wheels, has been replaced with bronze. When that too proved unstable, metal clamps were introduced, which have become a pragmatic compromise.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250510050524_b2a819a5791612f14c81d30fc393dbd3f99f0c64b90a9110e8b0855d944bfa93.jpg" data-media-id="editor_12" data-image-id="20250510050524_b2a819a5791612f14c81d30fc393dbd3f99f0c64b90a9110e8b0855d944bfa93" data-rendition-name="original" width="1500" height="998" loading="lazy" alt="Divine chariot"> </figure>  Another welcome change is the focus on safety. Builders climbing the chariot’s tower now wear harnesses and there are efforts in crowd control. The most visible change in recent years has been the involvement of Patan’s enthusiastic youth in the festival — the tradition is now passing to a new generation. Says Matsyendranath expert Vidhu Kayastha: “There is more energy, the young people in red t-shirts this year were very organised, these modern touches aren’t diluting our culture, they’re keeping it alive in new forms.” He adds, “We are <a href="https://nepalitimes.com/here-now/searching-for-a-homeland-away-from-home">reconnecting with our roots</a>, we have more resources, more awareness than ever before. We must not be swept away by western values that may not serve us, and in some ways, cause more harm than good. We must revive our own culture.”&nbsp;

Divine chariot

In 2025, two seemingly disconnected acts of violence shattered the illusion of stability in the region. In March, <a href="https://www.ft.com/content/16f7f947-1e96-4206-9844-891378adc683" target="_blank">militants hijacked a passenger train</a> near the Bolan Pass in Balochistan, executing soldiers in cold blood. A month later, <a href="https://www.nytimes.com/2025/04/22/world/asia/kashmir-terrorist-attack.html" target="_blank">gunmen in Kashmir’s</a> Pahalgam Valley massacred tourists. 
In both Islamabad and New Delhi, <a href="https://www.aljazeera.com/news/2025/4/25/were-cursed-kashmiris-under-attack-across-india-after-pahalgam-killings" target="_blank">the reaction was reflexive:</a> condemn the violence, <a href="https://www.economist.com/asia/2025/04/22/india-and-pakistan-could-come-to-blows-over-kashmir" target="_blank">blame external enemies</a>, declare the situation contained. But South Asia’s leaders are not fighting terrorists alone. They are fighting the consequences of their own betrayals.
Across <a href="https://www.bbc.com/news/world-asia-26272897" target="_blank">Balochistan</a>, <a href="https://www.bbc.com/news/world-south-asia-11693674" target="_blank">Kashmir</a>, <a href="https://www.crisisgroup.org/asia/south-asia/india/346-finding-way-out-festering-conflict-indias-manipur" target="_blank">Manipur</a>, and beyond, decades of <a href="https://www.amnesty.org/en/projects/enforced-disappearance-in-south-asia/" target="_blank">enforced disappearances</a>, broken promises, and brute militarisation have hollowed out the social contracts meant to hold these nations together. The grievances that drove rebellions from the 1940s through the 1990s – demands for dignity, recognition, and political agency – were never meaningfully addressed. They were buried beneath asphalt and propaganda, paved over by development projects and security checkpoints.
States may claim victory. But their victories are mirages, dissolving the moment anyone looks too closely. South Asia’s unfinished wars are not relics of a violent past. They are live ammunition, loaded into the future.
<a href="https://www.theguardian.com/world/2025/mar/24/he-only-wanted-revenge-the-bloody-insurgency-in-balochistan-gaining-lethal-momentum" target="_blank">Balochistan</a> has been at war with Pakistan for most of its modern history. Rich in gas, minerals, and coastline, the province has been plundered for decades under the language of national development. 
Projects like the <a href="https://eastasiaforum.org/2020/11/26/pakistans-three-evils-cpec-and-good-governance/" target="_blank">China-Pakistan Economic Corridor (CPEC)</a> promise progress but deliver exclusion: minerals are mined, ports are secured, but Baloch homes are raided. 
The insurgency endures not because of foreign conspiracies, as Islamabad endlessly insists, but because the Pakistani state remains incapable of seeing its <a href="https://thebalochistanpost.net/2025/01/enforced-disappearances-in-balochistan-in-december-2024-tbp-report/" target="_blank">Baloch citizens</a> as anything other than a security problem to be managed.
In <a href="https://www.forbes.com/sites/ranisingh/2016/07/12/kashmir-in-the-worlds-most-militarized-zone-violence-after-years-of-comparative-calm/" target="_blank">Kashmir</a>, the Indian government claims to have <a href="https://www.nytimes.com/2023/03/08/world/asia/kashmir-village-defense-committees.html" target="_blank">“normalised” the valley</a> after revoking its autonomy in 2019. It <a href="https://www.cfr.org/global-conflict-tracker/conflict/conflict-between-india-and-pakistan" target="_blank">looks a lot like occupation</a>. Soldiers outnumber local leaders, dissent is criminalised, internet shutdowns suffocate public life. Tourism campaigns and investment summits cannot erase a generation raised under curfew and surveillance.
<a href="https://www.bbc.com/news/world-asia-india-66260730" target="_blank">Manipur’s descent into ethnic bloodshed</a> in 2023 exposed another fault line Delhi prefers to ignore. Long-simmering tensions between the Meitei and Kuki communities erupted into violence that shattered any illusions of northeastern integration. The central government’s delayed, politicised response made clear what many Manipuris had always suspected: they are citizens of India only when convenient.
Even the <a href="https://msf.org.au/rohingya-worlds-largest-stateless-population" target="_blank">Rohingya, stateless and exiled from Myanmar</a>, find themselves entangled in South Asia’s ethnonationalist calculus. Fleeing genocide, they are criminalised anew in Bangladesh and India – trapped between the countries that reject them and the memories that refuse to let them go.
South Asia’s states have excelled at suppressing rebellion. But failed at extinguishing the reasons rebellions rise in the first place. And the wars South Asia tries to forget at home have found new life abroad.
Across <a href="https://www.abc.net.au/news/2024-06-17/modis-indian-government-accused-of-spying-silencing-critics/103974414" target="_blank">Canada, Australia, Britain, and the United States</a>, diasporic communities have become memory-keepers and, increasingly, <a href="https://www.business-standard.com/world-news/khalistan-supporters-hold-protest-outside-indian-consulate-in-vancouver-123092600087_1.html" target="_blank">the agitators</a> for the struggles their home states would rather erase.
Khalistan flags fly outside Indian consulates in Vancouver and <a href="https://www.tribuneindia.com/news/punjab/perturbed-over-waving-of-khalistani-flags-at-an-event-in-melbourne-india-warns-australia-of-khalistan-separatists-and-their-links-with-terror-groups-458320/" target="_blank">Melbourne</a>. Tamil activists march through London, demanding accountability for the <a href="https://www.aljazeera.com/news/2024/5/19/grim-reminder-sri-lankas-tamils-mark-15-years-since-end-of-civil-war" target="_blank">massacres in Mullivaikkal</a>. Kashmiri protests in Washington and New York refuse to let India’s crackdown slip into diplomatic amnesia.
For host countries, these movements pose uncomfortable questions. Freedom of expression collides with fears of extremism. Clashes erupt between communities carrying wounds that their new homelands.
Meanwhile, South Asian states pursue their adversaries across borders. India faces allegations of <a href="https://www.nbcnews.com/news/world/canada-says-india-home-minister-ordered-campaign-against-sikh-activist-rcna177972" target="_blank">targeting Sikh activists for assassination in Canada</a> and the <a href="https://www.npr.org/2024/10/27/g-s1-29561/sikh-separatist-assassination-india" target="_blank">United States</a>. Pakistan continues to court Kashmiri separatists abroad while crushing Baloch dissent at home. <a href="https://apnews.com/article/sri-lanka-tamils-civil-war-dead-5b372b0bba567837c5a4d94250040e7d" target="_blank">Sri Lanka</a> lobbies furiously to brand Tamil diaspora organisations as fronts for terrorism, even as it stonewalls investigations into its own wartime atrocities.
The old insurgencies have not been defeated. They have been globalised. South Asia’s governments have long mistaken silence for stability.
In Punjab, India broke the back of the <a href="https://www.cnn.com/2023/10/06/india/india-canada-sikh-khalistan-analysis-intl-hnk/index.html" target="_blank">Khalistan insurgency</a> through brute force. The fields grew green again, the trains ran on time. But the wounds were never closed, the <a href="https://www.dw.com/en/why-is-indias-khalistan-separatist-movement-on-the-rise/a-65081729" target="_blank">movement’s heart beats</a> not in Amritsar but in Brampton and Surrey.
In Sri Lanka, the <a href="https://www.academia.edu/4738983/The_Man_Who_Destroyed_Eelam" target="_blank">military crushed the Tamil Tigers</a> with <a href="https://www.newyorker.com/magazine/2011/01/17/death-of-the-tiger" target="_blank">overwhelming brutality in 2009</a>. <a href="https://www.scmp.com/week-asia/politics/article/3264148/we-want-our-children-back-sri-lankan-families-still-demanding-justice-their-missing-loved-ones" target="_blank">Tamil families still search for their missing</a>, still mourn their dead – and still organise across the diaspora for justice that remains undelivered.
In Kashmir, Delhi boasts of new <a href="https://www.aljazeera.com/opinions/2023/2/4/kashmir-is-bleeding-its-economy" target="_blank">highways and investment corridors</a>, showcasing the region as a trophy of unity. But when the visitors leave and the cameras are packed away, <a href="https://harvardlawreview.org/print/vol-134/from-domicile-to-dominion-indias-settler-colonial-agenda-in-kashmir/" target="_blank">the checkpoints, the raids, and the quiet despair remain.</a>
Victory parades fade. Grievance endures. Suppressing insurgency may end battles. It does not end the ideas that fueled them. In a region where <a href="https://www.nytimes.com/2025/04/23/world/asia/kashmir-attack-india-pakistan.html" target="_blank">history is rarely past</a>, and memory is rarely voluntary, states that rule through repression are only ever buying time. And often, not very much.
South Asia’s unfinished wars are not accidents. They are the inevitable consequences of states that confuse conquest with consent, and erasure with reconciliation. They cannot legislate memory out of existence.
Every <a href="https://www.bbc.com/news/articles/c15qyyzz89lo" target="_blank">disappeared son in Balochistan</a>, every <a href="https://medium.com/the-wvoice/the-half-widows-in-kashmir-fef80c6b88e9" target="_blank">half-widow in Kashmir</a>, every <a href="https://www.doctorswithoutborders.org/what-we-do/focus/rohingya-refugee-crisis" target="_blank">refugee child born stateless in a Rohingya camp</a> carries forward the memory of betrayal – a memory that outlives soldiers, politicians, and peace accords alike.
The region’s future will not be decided by GDP figures or infrastructure projects alone. It will be decided by whether its governments can summon the political courage to face the truths they have long suppressed – or whether they will continue down a path <a href="https://theconversation.com/india-is-using-the-g20-summit-to-further-its-settler-colonial-ambitions-in-kashmir-205166" target="_blank">where forgetting is demanded</a>, and rebellion becomes inevitable.
Shyam Tekwani is a professor at the Daniel K. Inouye Asia-Pacific Center for Security Studies in Hawaii. This <a href="https://dkiapcss.edu/nexus_articles/ghosts-at-the-border-south-asias-unfinished-wars/" target="_blank">article</a> was originally published on <a href="https://dkiapcss.edu/security-nexus/" target="_blank">DKI APCSS Security Nexus.</a> The views expressed in this article are those of the author and do not reflect the official policy or position of DKI APCSS, the Department of Defense, or the US Government. The appearance of external hyperlinks does not constitute endorsement by the United States Department of Defense (DoD) of the linked websites, or the information, products, or services contained therein. DoD does not exercise any editorial, security, or other control over the information you may find at these sites.

Balochistan to Kashmir

The discourse around <a href="https://nepalitimes.com/editorial/nepal-s-corruption-carousel">corruption in Nepal</a> is mainly about politicians and bureaucrats accepting bribes and kickbacks. The private sector usually does not get as much blame.
But the prevalent <a href="https://nepalitimes.com/here-now/nepal-s-crony-communism-exposed">climate of cronyism</a> in Nepal means that the politicians and businesses are often hand in glove. The private sector is generally considered to be in favour of free market competition to encourage <a href="https://nepalitimes.com/here-now/nepal-has-to-curb-corruption-before-wooing-investors">investment</a> and innovation so that wealth is generated.
But insider trading, cartelling, and conflict of interest have become a given in Nepal’s private sector, and it all happens with the blessings of the government. In fact, <a href="https://nepalitimes.com/news/the-business-of-politics-in-nepal">tycoons have become legislators and politicians have become businessmen</a>.
“Such collusion kills the free market, and does not allow entrepreneurship and innovation to flourish,” says Kush Kumar Joshi, former president of the Federation of Nepal Chamber of Commerce and Industries (FNCCI).
An example of this is the Dangote Group of Nigeria, which was planning for a cement factory in Nepal. A Dangote executive told us that Nepal’s cement cartel got the government to sabotage their plans.&nbsp;
Earlier, the same cartel tried to do the same thing to the Chinese companies Hongxi and Huaxin, arguing that Nepal’s cement industry was capable of meeting domestic demand and did not require foreign investment. Ultimately, Hongxi partnered with Nepal’s Shivam and Huaxin with former FNCCI president Suraj Vaidya.
In 2019, industrialists successfully lobbied lawmakers to prevent foreign investment in agriculture by amending the Foreign Investment and Technology Transfer Act. Two years later,<a href="https://nepalitimes.com/news/aid-rarely-aids-agriculture-in-nepal"> foreign investment in agriculture</a> was opened, but only if 75% of the products were exported.
There is a long history of local lobbyists obstructing the entry of multinationals, like J Walter Thompson advertising agency and the international shipping company Maersk. Microbreweries, which can be operated by restaurants, have been prohibited at the behest of larger beer companies. The <a href="https://archive.nepalitimes.com/news.php?id=1292">private dairy sector </a>opposed the government-owned Dairy Development Corporation when it tried to begin production in Pokhara a decade ago.
“The<a href="https://nepalitimes.com/news/business-as-unusual?fbclid=IwAR3qEnUrVu9pRhZU669FR1F4zF95uPJKBpbQbq-q1Bm26p7OMVw-8JBP7FU"> business sector</a> is a reflection of Nepali society and government which do not care about <a href="https://archive.nepalitimes.com/news.php?id=6725">ethical business practices</a>,” says former CNI president Hari Bhakta Sharma. “The environment is not conducive to the few businessmen who are honest.”
Lobbying by businesses is not unusual in a democracy, but its basic character should be for the collective good, not individual greed.
“This kind of profit-over-everything mindset is fatal for businesses. Entrepreneurs must prioritise social, worker, and customer welfare,” adds Sharma.
Industrialists have actively lobbied for the removal of policies that prevent loan misuse and require bank loans in specific areas. They have partially reversed such directives.
Until the economic slowdown, Nepal’s fastest growing industry was construction. But even there, cement and steel rod manufacturers colluded by price-fixing. Banker Parshuram Kunwar Chhetri says Nepal’s corporates just do not believe in free market principles, adding: “Their ideas go against competition benefiting consumers. It is all about price fixing, cartels and monopolies.”
Read also:<a href="https://nepalitimes.com/news/poor-cash-rich-nepal"> Poor cash-rich Nepal</a>, Sonia Awale
Ideologically, Nepal’s Communist parties are supposed to be against the neoliberal free market, globalisation and the ‘imperialism’ of international financial institutions like the World Bank and the IMF. But cronyism is rife there, too.
Two years ago, the FNCCI and the Confederation of Nepalese Industries (CNI) accused the IMF of interfering in Nepal's domestic economic policy after the Fund demanded economic reforms as conditions for its Extended Credit Facility.
Says economic analyst Sujeev Shakya: “How can we expect an honest and ethical business sector when we as a society tend to laud those who earn money through illicit and corrupt means rather than lament their <a href="https://archive.nepalitimes.com/article/editorial/Editorial-moral,667">moral bankruptcy</a>?”
In October 2012, the Chaudhary Group’s CG Electronics warehouse in Kathmandu caught fire. A surveyor certified that the company had suffered Rs580 million damage, which was paid out by United Insurance Company.
The Commission for the Investigation of Abuse of Authority (CIAA) directed the Nepal Insurance Authority to investigate suspected insurance fraud, and found that the fire damage was actually Rs340 million.
The Patan High Court ordered Chaudhary Group to return the excess amount, a decision the company challenged in the Supreme Court. But in March, the apex court also found the Chaudhary Group guilty of insurance fraud.
Chaudhary Group's Binod Chaudhary, Nepal's only known dollar billionaire, is a Nepali Congress central committee member and MP, former president of FNCCI and founder of the CNI.
Then last February, the Central Investigation Bureau questioned Binod Chaudhary and arrested his brother Arun Chaudhary of CG Holdings over their alleged involvement in the illegal acquisition of the state-run shoe factory, following an investigative report by Ukaalo Online.
In 2021, Chaudhary and his family’s offshore business dealings landed them <a href="https://nepalitimes.com/here-now/nepal-s-richest-man-in-the-pandora-papers">in the Pandora Papers list</a> by the International Consortium of Investigative Journalists (ICIJ) for hidden assets in Panama.
Says Krishna Khanal, assistant professor of business ethics at King’s College: “Cronyism, political collusion, and anti-competitive cartelling are routine in the private sector. There is no other objective than to make money at any cost.”
Conflict of interest is rife in Nepal’s share market. In 2023, Ghorahi Cement owned by Triveni Group issued primary shares at a premium price. There is also evidence that a river was diverted for the construction of its business tycoon Upendra Mahato’s Mediciti Hospital. Bhatbhateni owner Min Bahadur Gurung is also involved in Lalita Niwas land grab scam in Baluwatar.
Meanwhile, Shankar Group Vice President Sulabh Agrawal, former honorary consul of Kyrgyzstan, was arrested by the police during the <a href="https://nepalitimes.com/news/nepal-s-uneven-covid-19-deaths">Covid-19 pandemic </a>after he was found selling 67 infrared thermometers from a vehicle with diplomatic credentials. He was later acquitted by the court for price-gouging.
Nepal’s most influential corporates were accused of evading billions in VAT by forcing invoices. Freedom Forum invoked the Right to Information to collect evidence of the involvement of CG Foods, Him Electronics of Shekhar Golchha, Morang Auto Works of Bishnu Agarwal, Sulabh Agarwal’s Jagdamba Steels, United Builders of Shakuntalal Hirachan, United Traders of Anuj Agarwal, and Min Bahadur Gurung’s Bhatbhateni Supermarket.
Most of these businessmen have held leadership positions in the FNCCI. Former FNCCI presidents Shekhar Golchha, Pashupati Murarka and Pradeep Jung Pandey, along with members of the federation's governing council Birendra Kumar Shanghai, Shashikant Agrawal, and others all have unpaid dues of Rs22 billion to Nepal Electricity Authority.&nbsp;
Former FNCCI president Chandiraj Dhakal was blacklisted by the Credit Information Bureau Nepal for non-payment of bank loans.
He had previously obtained permission to use 36 hectares of government forest land in Chandragiri for 40 years without competition, and had received an exemption to build a ropeway there. The 54th report of the Auditor General, stating that Nepal had suffered as a result of these decisions, had suggested that the state be investigated for leasing land at low rates allowing large revenue exemptions.
Another ex-FNCCI president Pradeep Jung Pandey was sentenced to prison in 2014 following a corruption case spanning three decades. Former FNCCI treasurer Gyanendra Lal Pradhan is currently facing charges of <a href="https://nepalitimes.com/news/black-white-and-grey">money laundering </a>through insider trading.&nbsp;
Former FNCCI president Pashupati Murarka was acquitted by the special court in a corruption case, but it is still pending in the Supreme Court. His cement company was found to have exploited the environment by over-mining limestone at various times.&nbsp;
His Siddhartha Minerals was also found to have encroached forests in Palpa, following which the District Forest Office registered a criminal case against him and co-investor Manoj Kedia. Arrest warrants were issued for six people, including Murarka and Kedia, but Muraka was released on bail, while Kedia is on the run.
Current FNCCI president Chandra Prasad Dhakal during his tenure as a member of the Securities Board of Nepal (SEBON) was accused of conflict of interest in being a regulator in the sale of shares in a company that his family had invested in.&nbsp;
Dhakal is the chair of the IME Group, which owns banks, insurance, remittance companies, several cable cars and hotels, and has been embroiled in numerous ropeway-related controversies — most recently for allegedly using political connections to suppress local opposition to a<a href="https://nepalitimes.com/editorial/progress-and-or-preservation"> cable car project in Pathibhara</a>.
Another example of fraud committed in collusion with political leadership is Himalayan Reinsurance, the investors of which include prominent businessmen who have led FNCCI and CNI in the past, including Shekhar Golchha, Pashupati Murarka, Bhawani Rana, Rajesh Kumar Agrawa, Rohit Gupta, Amit Mor, Satish Mor, Shashikant Agrawal, and Sulabh Agrawal.
During <a href="https://nepalitimes.com/here-now/lessons-not-learned-from-the-pandemic">the Covid-19 pandemic</a>, the Nepal Insurance Authority requested approval for a reinsurance company through an emergency notice, even though such a government-operated company already existed. But Himalayan Re-insurance was granted permission without any explanation as to why another reinsurance company was needed, or how it was selected out of the five companies that submitted proposals.
It was found that the Securities Registration and Issue Regulation was amended to allow this company to issue shares at a premium price, allowing the shares priced at Rs100 to be sold for Rs206. Himalayan Re-insurance raised Rs6 billion. The Companies Act stipulates that primary shares can be issued at a premium price only after three years of operation, a criteria Himalayan Re-insurance did not fulfil.
Open competition, consumer protection, worker welfare, environmental consciousness, anti-corruption, and tax responsibility are the foundations of a country’s healthy business world. But most captains of Nepal’s industry themselves do not uphold those principles.
The business community here is instead actively engaged in lobbying and colluding with the political leadership, and forcing the appointment of their candidates to lead various regulatory bodies.&nbsp;
“While the <a href="https://nepalitimes.com/multimedia/reviving-nepal-s-craft">new generation of entrepreneurs</a> operating in sectors linked to external markets such as IT seem sensitive to and compliant with professional codes, ethics, professionalism, and honesty are sorely lacking in Nepal’s business sector in general,” says Rameshore Khanal, former Secretary of the Ministry of Finance.
He adds: “Even those following ethical practices have been forced to seek political favours for fear of being left behind. There will thus be<a href="https://nepalitimes.com/banner/it-does-not-pay-to-have-integrity"> no integrity in the private sector </a>until there is honesty in politics.”
Following the publication of this report in Himalkhabar, a Supreme Court judge on the condition of anonymity said: “Businessmen do not adhere to the principles of judicial independence, <a href="https://nepalitimes.com/opinion/federalism-rule-of-law-and-the-judiciary">rule of law </a>and <a href="https://archive.nepalitimes.com/article/editorial/government-to-governance-editorial,4200">good governance</a>. They use intermediaries and political connections to approach judges and win cases. Meanwhile, nobody raises these issues in public.” &nbsp;