<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

original

400x266

400x240

400x203

301x200

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">

674x448

610x380

500x500

1250x600

1084x550

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

the-lancet

The truth about the chloroquine scam

A Nepali in Beijing during coronavirus scare

A shot in the arm for vaccines in Nepal