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

Sonia Awale

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Vaccines too little, too late for Nepal?

<figure><img width="765" height="510" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3579c7e80680e096649jpeg.jpg" alt=""/><figcaption>The first consignment of 348,000 doses of AstraZeneca Covishielf vaccines under the COVAX initiative arrives in Kathmandu on 7 March. The rest of the 1.92 million doses promised is expected at end-May.</figcaption></figure>As the world’s biggest vaccine producer, India was first off the mark with <a href="https://www.nepalitimes.com/latest/jabs-and-jab-nots/" target="_blank" rel="noopener noreferrer">vaccine diplomacy</a> in January by shipping millions of doses to neighbouring countries in South Asia.At the time, China was making forays with gifts for South American and African countries. It also made bulk sales of its Sinovac or Sinopharm vaccines – more than 150 million doses to Indonesia, 100 million to Turkey and 85 million to Mexico.New Delhi used its AstraZeneca Covishield brand for Prime Minister Narendra Modi’s ‘Neighbourhood First’ diplomacy with high-profile gifts to Bangladesh, Bhutan, Nepal and Sri Lanka. In fact, Sri Lanka rejected the Chinese donation, and Bangladesh was refused vaccines by China because it did not agree to trials.However, the second wave is now surging in India with the daily infection rate exceeding 82,000, which is nearing the peak in September of 99,000 per day. The Indian government came under criticism for shipping out more vaccines than it was giving its own citizens, and last month banned the export of Covishield made by Serum Institute of India and its other Covaxin brand manufactured by Bharat Biotech.This has left countries like Nepal in a lurch. It had already used the 1 million Covishield gifted by India in January for the first phase of inoculation of about 460,000 in high-risk groups. Although Nepal has enough in stock for their second dose starting 22 April, it has put its vaccine drive on hold because of the Indian ban. Another 300,000 people above 65 who got Covishield will have to wait for future shipment for their second dose.Nepal is yet to receive a further million doses it has already paid for from the Serum Institute of India. The Indian export ban has also delayed the next batch of Covishield shots under <a href="https://www.nepalitimes.com/opinion/glimmers-of-hope-for-nepal-on-vaccine/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/glimmers-of-hope-for-nepal-on-vaccine/&amp;source=gmail&amp;ust=1617427107762000&amp;usg=AFQjCNFBEk3TZV7gE1BtmBi5FrPnaJBSNQ">the COVAX initiative</a>, which is now not expected till May. Nepal received its first batch of 348,000 doses of Covishield under COVAX on 7 March, and is supposed to get another 1.92 million by May.The COVAX Facility is funded by the governments of Australia, Finland, France, Germany, Japan, Korea, Norway, Qatar, Saudi Arabia, Switzerland, the United Kingdom, the United States and the European Union as well as foundations and corporations, and is targeted for poorer countries in Africa and Asia. It sources its AstraZeneca shots from Serum Institute of India.<a href="https://www.nepalitimes.com/banner/nepal-fights-infodemic-to-push-vaccine/">Nepal fights infodemic to push vaccine</a>, Sonia AwaleMeanwhile, India announced on Thursday that anyone above 45 would be eligible for vaccines, as it diverted all domestic production to counter the second wave. Indian officials have said they will continue to supply vaccines under the COVAX commitment, but that the volume would be “recalibrated”. India is getting urgent requests from Canada, EU and UK for AtraZeneca, but export has dropped from 30 million a week in February to less than 6 million by late March.Meanwhile, China has now become the top exporter of Covid-19 vaccines as it has its domestic coronavirus spread under control through aggressive enforcement of precautions, testing and tracing.China first promised a gift of 500,000 doses of Sinopharm, and increased this to 800,000 in March. A Nepal Airlines plane brought those doses from Beijing on 30 March, and the government says it will use them to inoculate those between 45-59 years. <figure><img width="640" height="427" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3599c7e80680e09664ajpeg.jpg" alt=""><figcaption>Chinese Ambassador Hou Yanqi with Nepal's Health Minister Hridayesh Tripathi at Kathmandu airport on 30 March.</figcaption></figure><figure><img width="550" height="371" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce35c9c7e80680e09664bjpeg.jpg" alt=""><figcaption>Chinese Ambassador Hou Yanqi hands over 800,000 doses of China’s Sinopharm vaccines after they were flown from Beijing to Kathmandu on a Nepal Airlines plane on 30 March.</figcaption></figure>Chinese Ambassador Hou Yanqi handed over the 800,000 doses to Health and Population Minister Hridayesh Tripathi on Tuesday at a ceremony at Kathmandu Airport. Ambassador Hou said: "This batch of vaccines is not only an implementation of the solemn commitment of China to make Chinese COVID vaccine a global public good, but also a vivid manifestation of our two countries' joint construction of a community with a shared future."India made another donation of 100,000 doses of Covishield last week, but it was a goodwill gift from the Indian Army to the Nepal Army. The doses were handed over to Nepal Army Chief Purna Chandra Thapa by Indian Ambassdor Vinay Mohan Kwatra on 30 March during a video conference with the Indian Army Chief M M Naravane. <figure><img width="1280" height="853" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce35e9c7e80680e09664cjpeg.jpg" alt=""><figcaption>Indian Ambassador Vinay Mohan Kwatra hands over 100,000 doses of Covishield vaccine to Nepal Army Chief Purna Chandra Thapa on 30 March in Kathmandu.</figcaption></figure>So far, <a href="https://www.nepalitimes.com/latest/1-6-million-vaccinated-20-million-to-go/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/1-6-million-vaccinated-20-million-to-go/&amp;source=gmail&amp;ust=1617427107763000&amp;usg=AFQjCNGbfYYCoTsnvHjJ6ceHKk8ZkMLIJQ">Nepal has inoculated 1.6 million people</a> and needs to vaccinate 20 million more under its target to immunise 70% of its population. For this alone, the government needs to look into other certified vaccines in the market such as Russian Sputnik V, Bharat Biotech’s Covaxin and Chinese vaccines.With government-to-government deals in jeopardy, the Ministry of Health is now trying to get private importers involved to import doses. Suppliers of India’s Covaxin and <a href="https://www.nepalitimes.com/latest/sputnik-v-vaccine-mystery-in-nepal/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/sputnik-v-vaccine-mystery-in-nepal/&amp;source=gmail&amp;ust=1617427107763000&amp;usg=AFQjCNEqnSW3L-QsMCfzOkE9geLUdn2yDg">the Russian Sputnik</a> are said to be interested, and the government has approved Covaxin for emergency use.

The gift of the jab

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111156/636cd8cf9c7e80680e092e62jpeg.jpg" alt="" width="4096" height="2731"/><figcaption>A health worker in Jumla administers Covidshield AstraZeneca vaccine to an elderly this week. Photo: LAXMI NGAKHUSI/UNICEF NEPAL</figcaption></figure>Over 1.6 million Nepalis have so far been inoculated against the coronavirus, all of them with the AstraZeneca vaccine that several <a href="http://‘The damage is done’: Europe’s caution over AstraZeneca vaccine could have far-reaching consequences" target="_blank" rel="noopener noreferrer">European countries have suspended</a> because of fears of blood clots.With a turnout of 65% of frontline workers, vulnerable groups and people over the age of 65, Nepal has completed the <a href="https://www.nepalitimes.com/banner/nepal-fights-infodemic-to-push-vaccine/" target="_blank" rel="noopener noreferrer">second phase of its Covid-19 vaccination</a> rollout with the Covishield vaccine either donated or bought from the Serum Insitute of India.“We have managed to protect the groups most vulnerable to Covid-19 from the possible second wave,” Shyam Raj Upreti, head of the Government Covid Vaccine Strategy told Nepali Times. “The fact that there have been no serious side effects has increased the acceptance level of the vaccine among the masses and health practitioners themselves.”Read also: <a href="https://www.nepalitimes.com/editorial/its-not-over-yet/" target="_blank" rel="noopener noreferrer">It's not over yet</a>, EditorialHowever, reports of some EU nations, Thailand and other countries suspending the use of the AstraZeneca Oxford vaccine because of serious blood clots among some recipients may result in <a href="https://www.nepalitimes.com/banner/why-is-there-vaccine-hesitancy-in-nepal/" target="_blank" rel="noopener noreferrer">vaccine hesitancy</a> among the remaining population. Covishield is the brand name of the Indian-made version of AstraZeneca.Germany, France, Italy and Spain suspended the vaccine program , following in the footsteps of by Ireland, the Netherlands, Denmark, Norway, Sweden and Latvia discontinuing the vaccine earlier this week. Austria has temporarily paused the use of certain batches. Thailand is the first country in Asian nation to halt AstraZeneca shots.The <a href="https://edition.cnn.com/2021/03/16/europe/who-astrazeneca-europe-coronavirus-tuesday-intl/index.html" target="_blank" rel="noopener noreferrer">suspensions have baffled public health experts</a> who warn that there is neither enough data to justify the decision, nor evidence to blame the blood clots on the vaccine. It is especially worrisome because some European countries suffering their third wave of Covid-19 desperately need the vaccines.“To date, the vaccine has been safe in this part of the world, so its benefits far outweigh the risk,” said epidemiologist Lhamo Yangchen Sherpa, while cautioning that serious side effects should be monitored and their underlying causes studied.The suspensions in Europe, however, may be a blessing in disguise for countries like Nepal which have faced delays in shipments of AstraZeneca from India because of the rise in global demand. The price of the 2.2 million doses that Nepal had ordered from the Serum Institute also went up to $5 because of the shortage. It bought the first lot for $4 per dose.Nepal has approved two coronavirus vaccines for emergency use, Covishield AstraZeneca and China’s Sinopharm. So far, the government has only administered Covidshield and Nepali experts see no reason to discontinue the vaccine without a real causal link between AstraZeneca and the blood clots.With only about 600,000 doses in stock, Nepal needs to procure another 1.5 million shots if it wants to provide second doses starting from 20 April for those who inoculated in the first and second phases. Vaccine availability will also determine when the third phase aimed at people in the age group 55-64 age group will begin.“There is every likelihood that politics is involved in this decision to suspend AstraZeneca in the EU. We know that this vaccine is very safe, but it protects us from Covid and its more serious symptoms,” says Buddha Basnyat of the Patan Academy of Medical Sciences.Nepal has yet to receive another 1 million doses of Covidshield it ordered last month. Serum Institute of India was unable to deliver it on 15 March as expected. Similarly, Nepal received only 348,000 doses of Covishield vaccine under the COVAX initiative on 7 March of the promised 2.2 million doses. The next batch was not expected before May, but it could now be shipped earlier because of the suspensions.China, on the other hand, has increased its gift of Sinopharm vaccines to Nepal from 500,000 to 800,000 but there is a delay in procurement with Beijing insisting that Nepal send a plane to collect it .The shortfall in supply and procurement challenges have forced the Health Ministry to allow private companies to import other vaccines, including the Covaxin manufactured by Bharat Biotech in India.The <a href="https://www.nepalitimes.com/latest/nepal-braces-for-new-wave-with-vaccine-drive/" target="_blank" rel="noopener noreferrer">vaccination drive</a> and fewer daily positive cases have given Nepalis a false sense of security. Youth are out and about, shopping malls, cinema halls and dance bars are crowded, schools and offices have stopped maintaining physical distance.At a time when neighbouring <a href="https://www.nepalitimes.com/editorial/its-not-over-yet/" target="_blank" rel="noopener noreferrer">India is experiencing a possible second wave</a>, public health experts say the public has to be even more vigilant and follow safety precautions. Even those who have been vaccinated must remember that they can still be a carrier.Lhamo Yangchen Sherpa’s advice is: “The pandemic is not over, we can’t let our guard down. Vaccinate if possible, increase testing and continue to mask up, wash hands and maintain distance.”

Despite doubts, Nepal sticks with AstraZeneca jabs

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111011114/636cccff9c7e80680e08bc51jpeg.jpg" alt="" width="960" height="640"/><figcaption>Nepal took delivery of one million doses of Covishield vaccine ordered from the Serum Institute of India, on Sunday. Photo: AMIT MACHAMASI</figcaption></figure>Amidst the pandemic, Covid-19 vaccines have become a means for countries to exert influence over others. This has seen global powers flex their manufacturing prowess to reap geopolitical gains.As a landlocked country perched between China and India, the world’s two most populous countries and the largest global vaccine manufacturers, Nepal has <a href="https://www.nepalitimes.com/opinion/glimmers-of-hope-for-nepal-on-vaccine/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/glimmers-of-hope-for-nepal-on-vaccine/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFMX8c41M-XBr18zmXA9q450CrOjw">benefited from them. </a>Attempts by both Beijing and Delhi to distribute vaccines to Nepal signify the Himalayan state’s growing strategic value to both.India made the first move. In January, New Delhi <a href="https://www.reuters.com/article/us-health-coronavirus-nepal-vaccine-idUSKBN29W0VJ" data-saferedirecturl="https://www.google.com/url?q=https://www.reuters.com/article/us-health-coronavirus-nepal-vaccine-idUSKBN29W0VJ&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHvA5Q2Hq3IlOSW_YRiVLKoHZsimg">pledged to inoculate</a> Nepal’s frontline workers before any other country, and promptly dispatched one million doses of the Covishield vaccine manufactured by its <a href="https://www.seruminstitute.com/" data-saferedirecturl="https://www.google.com/url?q=https://www.seruminstitute.com/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFeCK6lMJ0mEMwnhe5ZlUkRhkq83g">Serum Institute of India.</a>“Nepal is getting the vaccines within a week after India rolled out its vaccination drive, which signifies the friendship between India and Nepal and the importance India attaches to Nepal,” India’s ambassador to Nepal Vinay Mohan Kwatra said, as the <a href="https://www.nepalitimes.com/latest/jabs-and-jab-nots/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/jabs-and-jab-nots/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFGat2xjZpiPoxjEjZIquz-r4fqSw">first shipment of the Oxford AstraZeneca vaccine arrived at Kathmandu airport.</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111011114/636ccd029c7e80680e08bc52jpeg.jpg" alt="" width="2839" height="2092"><figcaption> </figcaption></figure>Such rosy optics masked recent complications in relations between the two neighbours. India’s ties with Nepal have been strained in recent years by the Kalapani border <a href="https://www.brookings.edu/blog/up-front/2020/06/11/interpreting-the-india-nepal-border-dispute/" data-saferedirecturl="https://www.google.com/url?q=https://www.brookings.edu/blog/up-front/2020/06/11/interpreting-the-india-nepal-border-dispute/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHENUQx_suOCbeya69_G1M1t9-8ZQ">dispute</a>. In May 2020, India’s Defence Ministry opened a new 80 km-long road in the Himalaya to the Chinese border that passed through territory claimed by Nepal. In response, Kathmandu changed its own official map, and set up new border posts.There had been concerns in New Delhi that Nepal has become increasingly ‘Sinified’, especially since its six-month blockade of the border in 2015. China was the architect of the alliance of Nepal’s Maoist and UML parties, which swept the 2017 elections and united to form the Nepal Communist Party (NCP).Since 2018, Prime Minister K P Oli has signed off on numerous projects that are part of Beijing’s Belt and Road Initiative. The NCP and the Chinese Communist Party forged fraternal ties, with various workshops on ‘Xi Jinping Thought’ held in Kathmandu.After infighting among members of the Maoist coalition, Oli was forced to dissolve Parliament in December, presenting an opportunity for New Delhi to jostle for influence. While India will need to present more robust measures of support to Nepal than vaccines to cement its influence, India has a head start in the case of vaccine diplomacy.Evidently, Beijing has grown increasingly frustrated with the NCP leadership, and has voiced its displeasure by not opening its two border checkpoints, citing the pandemic. <a href="https://www.nepalitimes.com/banner/chinese-tourist-influx-to-nepal-in-2020/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/chinese-tourist-influx-to-nepal-in-2020/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNGmlmUxbFQO-w3a9zFkseqhfdPvxg">China’s Ambassador in Nepal Hou Yanqi</a> failed after repeated attempts to get the NCP leadership to <a href="https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFWPcQGwn4P8cJlsujB-h5uxm4tew">patch up their differences</a>, Beijing sent its <a href="https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFWPcQGwn4P8cJlsujB-h5uxm4tew">Army Chief Wei Wengfe</a> to Kathmandu in November just after India’s <a href="https://www.nepalitimes.com/latest/indias-multi-pronged-line-to-right-nepal-ties/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/indias-multi-pronged-line-to-right-nepal-ties/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHLEaB38PgM99Dyx6gKRNEM6v1gSg">Chief of Army Staff M M Navarane</a> himself paid a visit to Nepal.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111011114/636ccd069c7e80680e08bc53jpeg.jpg" alt="" width="1500" height="1080"><figcaption> </figcaption></figure>Not to be outdone in vaccine geopolitics, Chinese Foreign Minister Wang Yi called Foreign Minister Pradeep Gyawali on 5 February, and <a href="https://www.fmprc.gov.cn/mfa_eng/zxxx_662805/t1852133.shtml" data-saferedirecturl="https://www.google.com/url?q=https://www.fmprc.gov.cn/mfa_eng/zxxx_662805/t1852133.shtml&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNGy-kYDmw6qDY0hOU4alm8LtlGWKw">pledged </a>500,000 doses of its Sinopharm vaccine. After a long delay, the Chinese vaccine finally got approval from Nepal’s Department of Drug Administration last week for emergency use.The delay in the approval process for the Sinopharm vaccine, which has not been approved by the WHO yet, appears to have miffed Beijing. The Indian media played up supposed pressure by the Chinese Embassy in Kathmandu to fast-track the approval process.Beyond the Himalaya, vaccine geopolitics is playing out elsewhere in South Asia. Attempts by China to distribute vaccines to Bangladesh were thwarted after the government there refused to contribute to the development costs of the Sinopharm vaccine.After India donated two million doses of Covishield to Bangladesh, Dhaka struck a deal to <a href="https://www.thehindubusinessline.com/news/bangladesh-to-buy-indian-covid-19-vaccines-after-china-asks-to-share-vaccine-trials-cost-report/article33648633.ece" data-saferedirecturl="https://www.google.com/url?q=https://www.thehindubusinessline.com/news/bangladesh-to-buy-indian-covid-19-vaccines-after-china-asks-to-share-vaccine-trials-cost-report/article33648633.ece&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNG9b3i3OdybiKzX5Vufug5v02OGGw">purchase 30 million</a> doses of the vaccine for the country, snubbing Beijing. Chinese state media accused <a href="https://www.globaltimes.cn/page/202101/1214041.shtml" data-saferedirecturl="https://www.google.com/url?q=https://www.globaltimes.cn/page/202101/1214041.shtml&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNEoix9h2tMalRVwO7rZWBx2DMco2w">Delhi of meddling</a> with its  attempt to distribute vaccines in Bangladesh.China’s closest ally in the region, Pakistan, became the first country to receive donated shipments of China’s Sinopharm vaccine, with Beijing <a href="https://thediplomat.com/2021/02/china-gifts-pakistan-1-2-million-covid-19-vaccine-doses/" data-saferedirecturl="https://www.google.com/url?q=https://thediplomat.com/2021/02/china-gifts-pakistan-1-2-million-covid-19-vaccine-doses/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNGfbpJhrMSFm9ugwe0zMnssbFpZbw">pledging to send over</a> 1.2 million doses to Islamabad.Along with Nepal and Bangladesh, New Delhi also gifted Covishield to Afghanistan, Sri Lanka, Bhutan, Seychelles, Mauritius and Burma as part of its ‘Neighbourhood First’ policy.Nepal also took delivery of <a href="https://www.nepalitimes.com/latest/nepal-braces-for-new-wave-with-vaccine-drive/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-braces-for-new-wave-with-vaccine-drive/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFOkIKOTq_lBwSlRkb9icdh4NEBhA">1 million more Covishield vaccines</a> that it ordered from the Serum Institute of India on Sunday, and another 2.2 million doses purchased by Britain under the <a href="https://www.who.int/initiatives/act-accelerator/covax" data-saferedirecturl="https://www.google.com/url?q=https://www.who.int/initiatives/act-accelerator/covax&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFCmy6JvaMqdagVd7fzazTMUZePEA">WHO’s GAVI-COVAX initiative</a> are arriving next week.China has made strategic gains in the region in recent years to India’s detriment. Through its Belt and Road Initiative, China has poured investment into Sri Lanka, Pakistan, Nepal and the Maldives. Funded by Chinese money, massive ports, highways and other infrastructure projects have been built. With its muddled bureaucracy and weaker spending power, Delhi had not been able to keep up with Beijing’s soft power expansion.Now, India is using vaccines as the vanguard of its response. The Serum Institute has <a href="https://www.nytimes.com/2021/02/11/world/asia/vaccine-diplomacy-india-china.html" data-saferedirecturl="https://www.google.com/url?q=https://www.nytimes.com/2021/02/11/world/asia/vaccine-diplomacy-india-china.html&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNE0Xe33J3K0BozaLao6fO5i6bcnag">been producing</a> vaccine supplies at a much faster rate than the Indian government’s inoculation program can distribute them, making it easy for Delhi to send them abroad without suffering political backlash at home.This has given India a new edge for its soft power ambitions in the South Asian and Indian Ocean regions. Given that most of the developing world will not be vaccinated <a href="https://www.eiu.com/n/85-poor-countries-will-not-have-access-to-coronavirus-vaccines/" data-saferedirecturl="https://www.google.com/url?q=https://www.eiu.com/n/85-poor-countries-will-not-have-access-to-coronavirus-vaccines/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFRvEEUYnAtYJl-4suTFC2JfUJFhQ">until 2023</a>, demand for vaccines will only rise. While China’s manufacturing prowess means that it is likely to keep up with demand, regional resistance to its largely un-trialed vaccines will complicate efforts to gain approval by government agencies.What happens in Nepal over the coming months will be a microcosm of regional vaccine geopolitics. The erosion of Chinese influence with its inability to keep the NCP together, gives an opening for New Delhi to reassert itself in Kathmandu.While China may have promised Nepal its continued support to help <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHVHDy7dKQmiyzWk-iPKWg82NOhBw">overcome the pandemic</a>, its assistance may not be needed or welcomed if India already fulfils this role.

South Asia’s vaccine geopolitics

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110101152/636cca6b9c7e80680e08bb66jpeg.jpg" alt="health workers receive covid vaccine" width="2048" height="1364"/><figcaption>The first frontline health workers being inoculated with Covishield last week in Kathmandu from the 1 million doses of the AstraZeneca vaccine donated by India. Photo: MONIKA DEUPALA</figcaption></figure>The Ministry of Health has assured the public that there will be enough free Covid-19 vaccines for everyone above 18, after the first phase of inoculating frontline workers is complete.Nearly 150,000 of the 430,000 health workers and other high-risk groups in the first phase have already been vaccinated with the Astra Zeneca Covishield made by the <a href="https://www.seruminstitute.com" target="_blank" rel="noopener noreferrer">Serum Institute of India</a>.  However, that is only half of the people on the government’s priority list.The ministry is now waiting for more than 2.25 million more Covishield vaccines to arrive under the World Health Organization (WHO) and the <a href="https://www.gavi.org">Global Vaccine Alliance (GAVI) COVAX initiative</a>.The first lot of 1 million vaccines was gifted by the Indian government on 21 January, but the rest of the doses will be needed for the booster shots in two weeks. That is expected to coincide with the new Covishield consignment under COVAZ that will arrive by the end of the month.The Chinese government has also promised to gift 300,000 doses of its own Sinopharm vaccine, but the timetable for that is also unknown. Nepal has not ordered vaccines from any other private company or country.“We will administer the vaccines that are already here, and give the jabs as new COVAX vaccines arrive,” Health Ministry spokesperson Jageshwar Gautam said, “but they will not be coming all at once, we have to depend on the international supply chain, and have to adhere to our guidelines on which vaccines are affordable and available.”Gautam confirmed that the COVAX doses should arrive later this month, and immediately dispatched for inoculation of remaining frontline workers after which it will be the turn of citizens above 60.British Ambassador to Nepal Nicola Pollitt expressed happiness via a Twitter post in Nepali on Thursday that COVAX doses would be arriving soon: ‘The UK government assisted COVAX with 550 million pounds, and I am very glad that more than 2 million doses of this vaccine will be arriving next month. We will be cooperating with the Ministry of Health, WHO and UNICEF to make the vaccines available.’Frontline health workers, ambulance drivers, <a href="https://www.nepalitimes.com/latest/enlisting-female-health-volunteers-to-fight-covid-19/" target="_blank" rel="noopener noreferrer">female community health volunteers</a>, those working in senior citizens’ homes, security officials and prisoners were the first priority, but they make up only 3% of the population that need to be vaccinated.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110101152/636cca6e9c7e80680e08bb67jpeg.jpg" alt="" width="536" height="694">Covishield is being administered from 143 centres in all 77 districts, and there will not be enough for everyone in the first phase since there are 911,000 people on the Ministry of Health’s priority list of those eligible.The ministry is readying to vaccinate 5.154 million people in the second phase, which is 17% of the target population. The priority will be those above 55 years of age, and those in the 40-54 age group with chronic diseases.In the third phase it will be the rest of those aged 40-54 who total 2.9 million, which is 9.55% of the population. Then it will be the turn of all 12.78 million in the 18-39 age group who will get their jabs next, and they form 42% of the population. Those under 18 will not get the vaccine until safety issues are cleared up.Gautam says that completing all four phases may take as long as late 2022, because the timetable for inoculations will depend on the availability of various vaccines in the world market. He added that all vaccines will be free to Nepali citizens will be procured through  government-to-government agreements, or through the WHO-GAVI’s COVAX program.One government sources hinted that the second phase may be complemented by an additional Indian grant of 1 million doses of the <a href="https://www.bharatbiotech.com" target="_blank" rel="noopener noreferrer">Bharat Biotech Covaxin</a> which has been approved for restricted emergency use in India.Just to be sure, the Ministry of Health is said to be also trying to buy 1 million doses of the vaccines from India at a discounted rate, even though Covaxin has not yet completed third phase trials and has not been approved by the WHO.The Chinese Embassy has confirmed that the 300,000 doses of its Sinopharm vaccines will be a gift, but has not given a specific time frame. Although the Sinopharm has regulator approval for emergency use in China, Nepali authorities have not yet done so.Covaxin is India’s first locally produced vaccine and can be stored at normal refrigeration temperature of 2-8 Celsius, which makes it even more ideal for Nepal’s conditions. The Ministry is said to be sourcing 20% of vaccines in Nepal to from Bharat Biotech. This week the Indian company signed an agreement with Ocugen to co-develop and market the vaccine in the United States.Because of the ‘<a href="https://www.nepalitimes.com/latest/the-global-vaccine-divide/" target="_blank" rel="noopener noreferrer">vaccine divide</a>’ with rich countries hoarding or reserving most of the available supply, poor countries like <a href="https://www.nepalitimes.com/latest/vax-populi/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/vax-populi/&amp;source=gmail&amp;ust=1612582425459000&amp;usg=AFQjCNHdOOtR76bQRV735TToZmGPlS1SyQ">Nepal will need to coordinate closely</a> with the <a href="https://www.who.int/initiatives/act-accelerator/covax" data-saferedirecturl="https://www.google.com/url?q=https://www.who.int/initiatives/act-accelerator/covax&amp;source=gmail&amp;ust=1612582425459000&amp;usg=AFQjCNHvKxOI3Sbxj88Q9UhBeYrw3GfoIA">World Health Organization-initiated COVAX</a>, the only global inter-governmental initiative working with manufacturers to ensure Covid-19 vaccines are available to developing countries. Under COVAX, Nepal is expected to get 2.25 million Covishield vaccines from India.The limiting factor for Nepal is that the vaccines should be available, affordable, of the kind that do not need extreme refrigeration, and a cold chain not less than 20 Celsius. The government has also asked those who can afford to buy vaccines to do so, and the money will be used to buy doses for people who cannot afford the injections.Meanwhile, there were only 171 cases of coronavirus among 2,550 that were tested on Tuesday – 78 of them in Kathmandu Valley. There are now fewer than 2,300 active cases in Nepal, and number of patients in ICU has dropped to 61, with 14 of them on ventilator support. There were two days with no fatalities this week, and two patients died from coronavirus on Thursday – bringing the total so far to 2,033.Overseas, three more Nepalis died of Covid-19 this week, bringing the total number of reported deaths in the <a href="https://www.nepalitimes.com/latest/nepali-diaspora-hit-by-covid-surge/" target="_blank" rel="noopener noreferrer">diaspora</a> to 330. According to Sanjiv Sapkota of the Non-resident Nepalese Association (NRNA) 58,695 Nepalis in 50 countries had tested positive for coronavirus as of 30 January.As a new strain of Covid-19 sweeps Europe, the NRNA has issued guidelines on safety precautions, vaccines and also its side-effects. Sapkota, who heads NRNA’s Health Committee warned Nepalis abroad that even those who have been vaccinated can still transmit the disease, so continued precaution was necessary.The new fatalities and infections among Nepalis were reported this week from the UK, Malaysia, Saudi Arabia, Portugal, Nigeria. This comes even as the Covid-19 cases in Nepal continued to drop.Read also:<a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/"> A shot in the arm for vaccines in Nepal</a>, Sonia Awale

Next up for vaccines: elderly Nepalis

<figure><img width="2048" height="1282" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181120/636be1af9c7e80680e083e61jpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>With the <a href="https://www.nepalitimes.com/latest/double-whammy-air-pollution-and-covid-19/">pre-winter resurgence of Covid-19</a> around the world and in Nepal, pressure is mounting on governments to procure vaccines to protect their populations.
Last week, the <a href="https://www.nepalitimes.com/latest/vax-populi/" target="_blank" rel="noopener noreferrer">Nepal government set up a committee</a> of secretaries of the Finance, Home, Health and Foreign Affairs ministries to study vaccines under development as well as procedures to procure them. But Nepal is far behind other countries, which have already ‘booked’ their future supplies.
On Wednesday President Bidya Devi Bhandari signed an ordinance empowering the government to import Covid-19 vaccines from international pharmaceutical companies, and to use them even if they are authorised only for emergency use.
<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/vax-populi/" target="_blank" rel="noopener noreferrer">VAX POPULI</a>, Sonia Awale
However, there is no effective strategy to ensure vaccines for all as distribution in Nepal comes with the challenge of taking it to poor and remote corners of the country. Experts fear that even when the vaccines become available, the campaign will be plagued by the same socio-economic inequities that afflict the medical sector.
“We need to immediately start identifying vulnerable groups like <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" target="_blank" rel="noopener noreferrer">frontline health workers</a>, <a href="https://www.nepalitimes.com/here-now/spared-at-first-elderly-hit-hard-by-covid-19/" target="_blank" rel="noopener noreferrer">the elderly</a> or those with comorbidities to prioritise for immunisation,” says Bikash Gauchan, a physician at Bayalpata Hospital in the under-served western district of Achham.
“We also need to set up proper cold chain facilities across the country as soon as possible and have a well thought out distribution plan so that when the vaccine does arrive, we can hit the ground running,” he adds.
The silver lining is that Nepal already has a successful <a href="https://www.nepalitimes.com/banner/polio-hunt/" target="_blank" rel="noopener noreferrer">childhood immunisation</a> network that has successfully mobilised <a href="https://www.nepalitimes.com/latest/enlisting-female-health-volunteers-to-fight-covid-19/" target="_blank" rel="noopener noreferrer">Female Community Health Volunteers</a>, and they can deliver vaccines to the homes of the elderly who cannot make it to clinics. Monitoring the follow-up second dose for some of the vaccines will be crucial, although Nepal’s health system has experience with maintaining a cold chain for other campaigns.
<a href="https://www.nepalitimes.com/latest/nepali-diaspora-hit-by-covid-surge/">Nepali diaspora hit by Covid surge</a>, Nepali Times
Despite recent breakthroughs in trials (see box) public health experts stress the importance of exploring vaccine supply options closer to home. As of now, 11 vaccines developed in several parts of the world are in the third phase of <a href="https://www.nepalitimes.com/opinion/countries-cooperating-to-find-covid-19-cure/" target="_blank" rel="noopener noreferrer">clinical trials</a> with many of them expected to be as effective.
Neighbouring China and India are at the forefront. And Nepal should have begun its ‘vaccine diplomacy’ much before this to secure its supply of shots.
There is also the uncertainty of vaccine efficacy depending on the strain: the same vaccine could be highly effective against people in the West but not as much in South Asia where people suffer from chronic malnutrition and multiple infections.
“For a working vaccine to be made within a year is an amazing victory for science but we also need to know that these vaccines are designed for their population. So I’d want to know more about the vaccines in India and China,” says Sameer Mani Dixit of the Centre for Molecular Dynamics Nepal. “Particularly China, as it was where the pandemic started but <a href="https://www.nepalitimes.com/latest/what-nepal-can-learn-from-china-about-covid-19/" target="_blank" rel="noopener noreferrer">has since controlled it effectively</a> unlike rest of the world.”
<a href="https://www.nepalitimes.com/opinion/the-truth-about-the-chloroquine-scam/" target="_blank" style="font-size: 15px; letter-spacing: 0.01em;" rel="noopener noreferrer">Buddha Basnyat</a> of the Patan Academy of Health Sciences agrees. He says: “China looks at the reality in our backyard. So a more suitable vaccine for us could come from the Chinese, particularly because they have a track record of having developed better vaccine for this part of the world.”
Indeed, the JEVAX made by the researchers in Chengdu is now the most widely used jab against Japanese Encephalitis because it’s more cost effective compared to its western vaccines.
Nepal Health Research Council is once again considering conducting Phase III clinical trial of Coronavac by China’s Sinovac Biotech after an initial divided opinion over its safety. The vaccine has shown quick immune response in mid-stage trials in South America and parts of Asia.
In India, The Serum Institute has anticipated demand by already manufacturing 40 million doses of AstraZeneca’s potential Covid-19 vaccine. It will also soon manufacture Novavax.
Similarly, researchers at the Indian Institute of Science have designed a protein-based heat-tolerant vaccine that can stay stable for a month at 37°C, and could endure temperatures as high as 100°C if freeze dried, a feature that could be a game changer for mass vaccination campaigns in lower and middle income countries in Asia and Africa.
The other factor to consider will be the duration of the immunity after each vaccine shot, as well reinfection groups and if antibodies developed in the first episode helps fight the mutated forms of the virus.
With Covid-19 crisis continuing to spread rapidly across Nepal and at 10 fatalities per million population (same as Pakistan and much higher than China’s 3), it is not too early to start dialogue with Gavi, the vaccine alliance, COVAX and agencies like the World Bank and World Health Organisation to help procure the most cost effective approach to vaccines most suitable to Nepal’s conditions.
Alternatively, many pharmaceutical companies will want to play the field in order to boost their profile. In fact, embassies and foreign donors are already hard at work pushing for trails and deals.
“There is bound to be vaccine politics and it will mostly likely be ugly,” predicts Sher Bahadur Pun of the Health Ministry. “But we should not lose track of two things: efficacy of the vaccine against our population and its economic viability. If we do that we should be on the right path, more or less.”
In all this excitement, Nepal’s health authorities must also keep an eye on the plight of infected people and many more to come as <a href="https://www.nepalitimes.com/opinion/prevention-while-searching-for-a-cure/" target="_blank" rel="noopener noreferrer">they wait for a vaccine</a>. The results of current treatment regimens ranging from plasma therapy to administering Remdesivir have been patchy. And as scientists study the long-term impact of Covid-19 on patients even after they recover, making an optimal use of resources becomes even more significant.
So far, the government has been faulted for squandering months of lockdown, not carrying out sufficient tests and contact tracing, not increasing hospital capacity and equipment, and letting the people fend for themselves.  
The result is that Nepal is <a href="https://www.nepalitimes.com/banner/heat-map-of-nepals-covid-19-hotspots/" target="_blank" rel="noopener noreferrer">suffering a sustained surge</a>, with more than 1,400 new cases a day, over 60% of them in Kathmandu Valley alone and a quarter of those tested coming out positive. There is also a surge in symptomatic patients, even among those without pre-existing conditions, and those sick enough to require ICU and ventilator.
Even when the government does act, the <a href="https://www.nepalitimes.com/latest/coronavirus-coordination-committee-doesnt-coordinate/" target="_blank" rel="noopener noreferrer">priorities seem to be misplaced</a>. For instance, health experts say the emphasis in the past months should have been on high flow oxygen therapy or High Dependency Units rather than Intensive Care Units in hospitals.
“It would have been cheaper, it does not require highly trained staff or sophisticated equipment, and it would have freed up the ICUs for the really critical patients,” adds Pun, who himself is at the Health Ministry, and this possibly means his advice is not being taken.
Insiders say it will likely take upwards of six months for the first vaccines to arrive in Nepal, and there will be a rush by the rich, the powerful and those with political connections to get their shots. The marginalised, poor, those in remote areas will be the last to get their injections, unless the government has fair and effective rules in place and implements them.
Till then, there is little else to do than <a href="https://www.nepalitimes.com/opinion/silver-linings-in-the-covid-cloud/" target="_blank" rel="noopener noreferrer">keep masking up this winter, avoid large gatherings, keep distance and wash hands regularly</a>.
Says <a href="https://www.nepalitimes.com/opinion/a-covid-19-exit-strategy-for-nepal/" target="_blank" rel="noopener noreferrer">Buddha Basnyat</a>: “The mask is the best vaccine we have at the moment. These safety measures have largely reduced hospitalisation due to other infections in 2020, masks in particular will also protect us from winter pollution in the coming months.”<h2>The Vaccine Race</h2>The global resurgence of Covid-19 in the northern winter has coincided with breaking news every day of successful new vaccine trials.First the Russians announced a vaccine in September that is 92% potent against SARS-CoV-2.  Last week Pfizer unveiled a 90% effective vaccine, which on Wednesday was upgraded to 95% efficacy without side effects. Moderna was next with an efficacy of 95%, and not needing extreme refrigeration. More companies in China, India and Europe are conducting their own trials.Public health experts have hailed the developments, but warn that vaccines will not be universally available till late 2021 and even so will not provide full protection. They suggest continuing with masking up, keeping distance and avoiding crowded indoor places.Pfizer and its German partner BioNTech’s mRNA-based vaccine came out declaring over 90% effectiveness but only at -70°C ultra cold chain which will be a challenge even for countries with the best health facilities in the world.Massachusetts-based Moderna’s RNA shot has 94.5% efficacy, seems to also prevent severe infections and remains stable in medical and home refrigerators for up to 30 days, in freezers (-20°C) for up to six months, and at room temperature for up to 12 hours.Even so, poorer countries are unlikely to get coronavirus vaccine any time soon. Even the biggest pharmaceutical multinationals can only manufacture a limited quantity of the vaccine over the next year.Pfizer has capped its production at 1.4 billion for 2021, 80% of which has already been booked through advance purchase agreement by the US, UK, EU, Canada and Japan. Moderna expects to manufacture 20 million doses this year and up to one billion in 2021.On the other hand, <a href="https://www.nepalitimes.com/latest/sputnik-v-vaccine-mystery-in-nepal/" target="_blank" rel="noopener noreferrer">Russian’s Sputnik V</a> has been overshadowed by new developments, and due to lack of sufficient data to back up its claim of 92% efficacy. Although geopolitical rivalry with the West has given it negative publicity, some health agencies have not ruled it out.

When will Nepal’s Covid vaccine turn come?

Fenerbahçe Beko won the Turkish Airlines EuroLeague finals in Abu Dhabi, held 23-25 May, defeating Monaco 81-70 in the final. Olympiacos, who defeated Panathinaikos 97-93, finished the series in third place. The Most Valuable Player (MVP) of the final match, Nigel Hayes-Davis from Fenerbahçe Beko, received a prize of 1,000,000 Miles&amp;Smiles from Turkish Airlines’ Chief Commercial Officer Ahmet Olmuştur. The carrier has been the title sponsor of the Turkish Airlines EuroLeague, a top tier tournament, since 2010.

Turkish Basketball

In the black and white photograph, General Wangdu smiles broadly in front of the dusty cactus garden in Kathmandu’s Annapurna Hotel. With an ill-fitting jacket and shaggy hair he looks benign enough, but this was the last leader of the Tibetan freedom fighters who led the resistance against the Chinese from their remote mountain hideouts in <a href="https://nepalitimes.com/here-now/comings-and-goings-in-mustang">Mustang</a>. Five months later, Wangdu was dead. Snapped in March 1974, I had only recently arrived in Nepal. How did I meet this legendary fighter? Possibly with his devoted camp follower, Lynne Klapecki, and probably in the Om Restaurant near Freak Street which was the preferred <a href="https://nepalitimes.com/banner/hippie-trail-nostalgia-in-kathmandu">hippie hang-out</a>. Om Lobsang and his brother Yeshe were <a href="https://archive.nepalitimes.com/page/earthquake-brings-back-memories-of-camps-for-tibetan-refugees">refugees from East Tibet </a>whose cafe offered a friendly welcome and<a href="https://nepalitimes.com/multimedia/momo-loco"> the best momos</a> - they became my in-laws after I married their eldest brother Tenzin, but that was a decade later.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025052403054_4573b34282b0f5395c007243d6bef12c7ba76bfd520419e994cdcea048d795a1.jpg" data-media-id="editor_4" data-image-id="2025052403054_4573b34282b0f5395c007243d6bef12c7ba76bfd520419e994cdcea048d795a1" data-rendition-name="original" width="1000" height="1583" loading="lazy" alt="The last days of the Khampa NT"> <figcaption>Photo: LISA CHOEGYAL</figcaption> </figure>  Wangdu’s English was enthusiastically rudimentary, but even riding around town with him on the back of an aging <a href="https://nepalitimes.com/here-now/kathmandu-s-new-motorbike-museum">motorbike</a>, he was a commanding presence. Always flanked by armed outriders, impressive scars marked his forearms and a pistol hung from the cord around his neck. A charismatic guerrilla leader, Wangdu was celebrated by his followers for his tough commitment and respected for his measured pragmatism. He seemed so young to have shouldered such a responsibility of command, leading hundreds of hardened <a href="https://archive.nepalitimes.com/article/nation/50-years-after-the%20raid-into-Tibet,1012#google_vignette">Khampa combatants </a>through what had been a particularly <a href="https://nepalitimes.com/news/heavy-snowfall-over-nepal-himalaya">brutal winter in Mustang</a>, the last bastion to hold out against the Chinese invasion of their Tibetan homeland.&nbsp; The freedom fighters of Tibet, known as the Chushi-Gangdruk, had emerged to resist the <a href="https://nepalitimes.com/editorial/territorialism">Chinese takeover</a> of Tibet during the 1950s. Estimated to be 80,000-strong at the time of <a href="https://nepalitimes.com/here-now/what-or-who-after-the-dalai-lama">the Dalai Lama</a>’s final escape to India in 1959, the sheer number of Chinese deployed into Tibet eventually forced the Chushi-Gangdruk to retreat to Mustang, From this high Himalayan stronghold, they continued cross-border raids on the Chinese People’s Liberation Army (PLA) throughout the 1960s.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025052403054_8a4a935ba25ae79dc3a63bb5c14626927020e5ec098093c45ccb9a5982e009fd.jpg" data-media-id="editor_10" data-image-id="2025052403054_8a4a935ba25ae79dc3a63bb5c14626927020e5ec098093c45ccb9a5982e009fd" data-rendition-name="original" width="1114" height="676" loading="lazy" alt="The last days of the Khampa NT"> <figcaption>Guerrillas known as the Chushi-Gangdruk emerged to resist the Chinese annexation of Tibet during the 1950s. Photo courtesy: MIKEL DUNHAM</figcaption> </figure>  Their Kathmandu base was a small discreet lodge in a back lane near Rani Pokhari. Sipping sweet tea from a blue mug with a chipped lid, I sat bemused in a corner of the Mustang Hotel room whilst Wangdu and his cohorts received a battered brown suitcase from their CIA connection, a tousle-haired American in a leather jacket. Heaved onto the dingy bedspread that covered the thin mattress, it was clicked open to reveal piles of neatly stacked dollar bills.&nbsp; I cannot think why Wangdu allowed me to witness this handover but I was clearly no threat, a newly arrived world traveller with no understanding of the stakes nor any Nepali or <a href="https://nepalitimes.com/multimedia/tibetan-music-in-nepals-sacred-valley">Tibetan language</a>. Despite armed guards in the corridor,Wangdu radiated confidence and bravado, and there was a practiced familiarity to the tense transaction. This deadly dance for many years had been funded by the Americans, tolerated by <a href="https://nepalitimes.com/here-now/the-kingdom-within-a-republic">Mustang’s residents</a>, and permitted by King Mahendra and the Nepali authorities who it suited to turn a blind eye.&nbsp; But Mahendra died in 1972, and times were changing. Richard Nixon’s ping-pong diplomacy thawed the cold war and signalled a fresh entente with China. Nepal’s yet-to-be-crowned <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">King Birendra </a>was under pressure to curb the irritating incursions against the PLA launched from the Nepali territory of Mustang. Keen to appease his northern neighbour, on several occasions the King summoned Wangdu for peace talks but, despite increasingly overwhelming odds, Wangdu refused to surrender.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025052403054_a8efd5cfb92cd997bd7cb74296a936fef46e2f7428f9cd642b03f1ac4ea11ecb.jpg" data-media-id="editor_14" data-image-id="2025052403054_a8efd5cfb92cd997bd7cb74296a936fef46e2f7428f9cd642b03f1ac4ea11ecb" data-rendition-name="original" width="1055" height="885" loading="lazy" alt="The last days of the Khampa NT"> <figcaption>General Wangdu flanked by two Tibetan resistance fighters in Mustang in the 1970s. Photo courtesy: MIKEL DUNHAM</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025052403054_75969125a745847a2ef82b6fe8b9106c0b21a116d85b8efdf5d2ee89a347bb31.jpg" data-media-id="editor_15" data-image-id="2025052403054_75969125a745847a2ef82b6fe8b9106c0b21a116d85b8efdf5d2ee89a347bb31" data-rendition-name="original" width="1044" height="792" loading="lazy" alt="The last days of the Khampa NT"> <figcaption>King Birendra with General Wangdu (right in dark glasses) taken in 1974 possibly in Mustang after one of their few attempts at negotiation. Photo courtesy: RAJRNDRA KUNWAR</figcaption> </figure>  While I naively rode pillion around Kathmandu in the spring sunshine, Wangdu was in the midst of what turned out to be his final round of negotiations with the Nepal government. Refusing to cease hostilities with the Chinese, Wangdu must have suspected the cost of his decision, making his cheerful smile in the photograph all the more poignant and brave. It was only much later that I appreciated the significance of the moment. Wangdu had been sent to replace the first resistance leader in Mustang, Baba Gen Yeshe, a much derided corrupt character who stole money meant for his troops and exploited fleeing refugees by seizing their treasures. Baba Gen Yeshe never forgave Wangdu,and sought revenge in May 1974 by betraying him and his commanders to the Nepal authorities. Renewed Chinese incursions from the north, active PLA collusion with the Nepali forces under the new King, and treachery from within the Chushi-Gangdrukranks combined to seal their fate.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025052403054_e0987a7c90d76431b0d7d5e6115ebfe3dbda7ab939e5941e079c18d722e884c0.jpg" data-media-id="editor_16" data-image-id="2025052403054_e0987a7c90d76431b0d7d5e6115ebfe3dbda7ab939e5941e079c18d722e884c0" data-rendition-name="original" width="1400" height="769" loading="lazy" alt="The last days of the Khampa NT"> <figcaption>British television journalists George Patterson and Adrian Cowell embedded themselves with Khampa guerrillas and accompanied them from Tsum Valley on a cross border raid on a Chinese Army convoy in 1964. Photo: ESSAYS ON NEPAL / SAM COWAN</figcaption> </figure>  Mikel Dunham, renowned author of Buddha’s Warriors, writes: ‘It is possible that Wangdu was waiting for some cue from the Dalai Lama’s government-in-exile in Dharamsala, India. It is equally possible – during that last, <a href="https://nepalitimes.com/multimedia/the-human-cost-of-nepal-s-yarsa-gold-rush?fbclid=IwZXh0bgNhZW0CMTEAAR31-Cqw8oyIwMPzf_35e4Skr0ululJvLf3_vDkzHn-AYG2h8uPw2rqqErg_aem_tGVn5coY1-jA7fze_xqhew">desolate winter </a>– that he made the decision to go out in glory rather than admit defeat. Over the last fifteen years, Wangdu had experienced Tibet’s organized resistance being squeezed and shoved around by every conceivable outside force.&nbsp; First they had been pushed out of their own country by the PLA; then they had been refused sanction while on <a href="https://nepalitimes.com/opinion/borderlines/nepal-india-trans-boundary-bonds?fbclid=IwAR0PpJ5zUEbwdug3g_U3ar6FUugngRY0S8Tl2v_7wqzrsHmXWcXsKjvL4t4">Indian soil</a>; then they were abandoned by the Americans because, apparently, Nixon wanted to make friends with Wangdu’s mortal enemies, the communists; then they had been betrayed by the vampiric Baba Gen Yeshe – a Tibetan and, even worse, a fellow Khampa; and now, finally Wangdu’s army was being evicted by the Nepalis. One thing was certain: Wangdu was a warrior. To imagine Wangdu simply giving up and settling down in the pacific squalor of a <a href="https://nepalitimes.com/here-now/elderly-left-in-bhutan-refugee-camp">refugee camp </a>was unthinkable.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025052403054_8fc1ffef4ae751628b90ae781b66e11e51e4fdde2787207c9042efbee345ce49.jpg" data-media-id="editor_20" data-image-id="2025052403054_8fc1ffef4ae751628b90ae781b66e11e51e4fdde2787207c9042efbee345ce49" data-rendition-name="original" width="500" height="746" loading="lazy" alt="The last days of the Khampa NT"> <figcaption>The much derided Baba Gen Yeshe, the first Tibetan resistance leader in Mustang, who betrayed Wangdu for personal gain. Photo courtesy: MIKEL DUNHAM</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025052403054_b1d833cdb00d3ac4416b844d8730475cd88c238caaaf8da69889a584eea229a3.jpg" data-media-id="editor_21" data-image-id="2025052403054_b1d833cdb00d3ac4416b844d8730475cd88c238caaaf8da69889a584eea229a3" data-rendition-name="original" width="500" height="656" loading="lazy" alt="The last days of the Khampa NT"> <figcaption>Aditya SJB Rana of the Royal Nepal Army whose team ambushed Wangdu and his cohorts at the top of Tinker Pass in Darchula, West Nepal. Photo courtesy: GAUTAM SJB RANA</figcaption> </figure>  By August 1974 the game was up. Wangdu and six of his exhausted party were killed on their horses by <a href="https://archive.nepalitimes.com/news.php?id=7270">the Royal Nepal Army</a> on the brink of escape. The officer in charge, Aditya SJB Rana, cleverly predicted their route into India after they failed to silence a police radio in Yari. A carefully laid ambush trapped them near the summit of the Tinker Pass in Darchula,at 5,000 meters the highest military operation of its time. Wangdu’s body was helicoptered to Kathmandu, and a big show made of the royal Nepal victory.&nbsp; The Tibetan armed insurgency against China had reached its end.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250524030520_3ff9c6fc85a65bc9a2c3afe9736d9f5f9413de752e790a5d9dca0981ea94f9b4.jpg" data-media-id="editor_23" data-image-id="20250524030520_3ff9c6fc85a65bc9a2c3afe9736d9f5f9413de752e790a5d9dca0981ea94f9b4" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="The last days of the Khampa NT"> </figure>

The Last Days of the Khampa

Starting 17 September Turkish Airlines will fly daily to Seville, one of Spain’s major tourist draws. This is Turkish’s sixth destination in Spain after Madrid, Barcelona, Valencia, Malaga, and Bilbao. Seville is in the Andalusia region on Spain’s south coast with a rich Moor history. There are approximately 30,000 Nepalis living in Spain.&nbsp;

Turkish to Seville

The newly-formed Himalayan Art Council is set to launch Nepal’s National Art Protection Platform that seeks to preserve <a href="https://nepalitimes.com/banner/the-history-of-heritage">Nepal’s unique cultural heritage </a>using<a href="https://nepalitimes.com/here-now/artificial-censorship"> AI-powered tools</a>. The Council seeks to safeguard <a href="https://nepalitimes.com/banner/nepali-art-going-places">Nepali art works</a> from neglect, theft and counterfeiting as well as preserve existing artwork and celebrate living masters by giving them a cultural space to continue the <a href="https://nepalitimes.com/banner/sacred-survival">sacred art traditions</a>. "We are introducing a new digital platform designed to preserve, verify and elevate <a href="https://nepalitimes.com/banner/nepals-new-generation-of-alternative-artists">Nepal’s art for generations to come,</a>” says a statement from the Council, adding that the digital platform will use AI told for authentication and blockchain to keep track of works of art. Artists can now be protected by <a href="https://nepalitimes.com/multimedia/ayo-ai?fbclid=IwAR1uwmTVq4gUB70ljfRezjzukD9ArWXPuMnUikopeQ8PoiZMjicToPSwhKE&amp;=1">AI tools</a> that detect forgeries, identify their work even when unsigned, and ensure they receive proper recognition and credit. The archives will be searchable with translated inscription and interactive guides. Says curator Meena Lama: “AI and blockchains are tools that give us the power to detect fakes and identify unsigned paintings and track every piece. With these tools we can restore trust, secure authorship and give artists the dignity they deserve.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250514170544_2ab58f6313c0458f75114a692b0016bd9efb3b59d5f8f07f0da72e1e37b82f53.jpg" data-media-id="editor_6" data-image-id="20250514170544_2ab58f6313c0458f75114a692b0016bd9efb3b59d5f8f07f0da72e1e37b82f53" data-rendition-name="original" width="1300" height="1000" loading="lazy" alt="Artwork at the Traditional Art Exhibition at Patan Museum."> <figcaption>Artwork at the Traditional Art Exhibition at Patan Museum.</figcaption> </figure>  The Council is also holding an exhibition of Nepali cultural masterpieces with 50 historical <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Buzz-the-art,671">thangka and paubha </a>by past masters and <a href="https://nepalitimes.com/review/between-the-sacred-and-everyday">contemporary works by current artists</a>. This curated collection is a living tribute to <a href="https://nepalitimes.com/here-now/when-yaks-go-so-does-culture">Himalayan culture</a> with economic depictions of deities, mandala and sacred narratives. The exhibition at <a href="https://nepalitimes.com/multimedia/a-portal-into-patan-s-past-and-present">Patan Museum</a> also provides an opportunity to meet painters and custodians of art and culture. Read also: <a href="https://nepalitimes.com/review/golden-deities">Golden deities</a>, Sewa Bhattarai ‘The exhibition is only the first step in a long journey to ensure that Nepali art is no just seen but fully understood, <a href="https://archive.nepalitimes.com/article/nation/Narratives-of-Faith-and-Memory-Remembering-the-Lost-Sculptures-of-Kathmandu-exhibition,987">protected and remembered</a>,’ the Council says. Artist Kailash K Shrestha of Artudio has spent decades promoting thankha and paubha traditions because of their beauty and devotional meaning. But he also says artists are underpaid, exploited and ignored. He adds, “AI and blockchain are not just buzzwords, they are powerful tools that can protect Nepal’s artists from fraud, verify authenticity and build a permanent record of provenance.” Traditional Art Exhibition Till 17 May Patan Museum

vaccine-diplomacy