One in every three Nepalis carries the <a href="https://nepalitimes.com/editorial/tb-or-not-tb">tuberculosis</a> bacillus. There may be no active symptoms, but they can at any point progree into a full blown infection. TB kills up to 47 Nepalis daily. If so many people died every day in road traffic accidents, it would make headlines every day. But they do not because tuberculosis afflicts the poorest people in the poorest parts of Nepal.&nbsp; The annual 17,000 fatalities from <a href="https://nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control">tuberculosis in Nepal</a> are preventable with cost-effective treatment. A new pilot study in Chitwan and Piuthan in the past two years showed that 1,160 (out of 1,173 household contacts) completed the Tuberculin Skin Test (Mantoux Test) of whom 542 (45%) were positive. After doing a chest x-ray, 509 met the eligibility criteria for TB preventive therapy. 500 (97%) gave consent to the treatment.&nbsp; Researchers were pleasantly surprised. As in other countries in the region, they were expecting very few to agree to take preventive therapy medicines because they did not have TB symptoms, so a 95% agreeing to the treatment was exceptionally high. “People in Chitwan and Piuthan who participated in the study were not sick, they were just carrying the TB bacteria, but they agreed to take the preventive drugs because they have all known of relatives who had died of TB,” explains Buddha Basnyat, a physician who advised the Birat Nepal Medical Trust (BNMT) that conducted the research.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240325030340_43b4bc93b22c3964ee021a9dc9df40f9da783917b2ebfbe798a03a82276421a7.jpg" data-media-id="editor_2" data-image-id="20240325030340_43b4bc93b22c3964ee021a9dc9df40f9da783917b2ebfbe798a03a82276421a7" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="Tuberculosis preventive therapy in Nepal"> <figcaption>Health care volunteers during an outreach screening program in Dhanusha as part of active case-finding for tuberculosis in local communities.</figcaption> </figure>  BNMT is now extending the study to Nawalparasi and Rupandehi with the National Tuberculosis Control Centre. Latent TB is more prevalent in the Tarai districts because of their higher population density. With Nepal suffering such an <a href="https://nepalitimes.com/here-now/nepal-tb-cases-grossly-underestimated">enormous disease burden from tuberculosis</a>, one would have thought World TB Day on Sunday 25 March would have got more attention. But it was overshadowed by Holi celebrations. It would have been interesting to see how many in the crowds attending the concert at Darbar Marg would test positive. Scientists worry that the World Health Organisation’s END TB strategy of reducing global tuberculosis incidence by 90% and deaths by 95% in the next ten years is too ambitious unless latent tuberculosis cases are also treated.&nbsp; What makes this failure all the more tragic is that tuberculosis is a completely preventable and treatable infection. Every $1 invested in TB gives a $39 return, yet there is little investment and advocacy to combat this biblical illness. South Asia accounts for some 40% of all TB cases and 38% of all TB deaths — most of them occurring in the thickly-populated states across the Nepal border in India. The region also has a high burden of multi-drug resistant TB, one-third of global cases. In the past, Directly Observed Therapy Short Course (DOTS) drug therapy in which patients were administered medicines at health posts was considered a cure-all for tuberculosis. <a href="https://archive.nepalitimes.com/news.php?id=294">Nepal had a high success rate for DOTS</a>, but there were loopholes in the program: latent cases remained hidden and only the cases that came to the health system were treated. DOTS also added to the pre-existing stigma so that patients travelling to the health posts would be identified as having tuberculosis. In one instance, a patient in Bardia chose to take a dangerous tiger-infested jungle route to reach the health post. &nbsp; Meanwhile, BNMT had been setting up a strong community network of health volunteers, and was <a href="https://nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy">tracking active TB cases</a>. Unlike DOTS, it involved meeting family and friends of patients, allowing more case detection and treatment. Even so, they were not looking for latent infections.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240325030340_39b79cbd0799bee83a8ae67fd8016d9c75b539d89679e5a4328a7b8540bbca01.jpg" data-media-id="editor_6" data-image-id="20240325030340_39b79cbd0799bee83a8ae67fd8016d9c75b539d89679e5a4328a7b8540bbca01" data-rendition-name="original" width="1687" height="1125" loading="lazy" alt="Tuberculosis preventive therapy in Nepal"> <figcaption>Female Community Health Volunteers (FCHVs) have played a significant role in active case finding.</figcaption> </figure>  Latent cases can progress to active tuberculosis especially when a patient's immune system is weak because of malnutrition, illnesses like HIV, or age. In fact, half of TB worldwide can be attributed to undernourishment. Latent TB can be confirmed in two simple steps: a Mantoux test with an above 10 score and a clear chest x-ray. If positive, the patient is given the 3HP preventive therapy — a once-weekly treatment with isoniazid-rifapentine for 12 weeks. This treatment can prevent reinfection for as long as six years, and is not to be confused with the one for active cases which requires daily treatment for six months. “On an individual level, you can still get reinfected if you are living in a house with active cases. But if you treat the community at large with preventive therapy, you drive down the prevalence of TB and in turn, people won't get reinfected,” explains Maxine Caws of BNMT. She adds: “If we can use preventive therapy to push down the reservoirs of infection then we extend the amount of time people are protected as is the case in Europe for example where people don't get TB anymore because they are not exposed to the bacteria at all. We have to eradicate that reservoir.” The traditional BCG vaccine given within 28 days of birth is effective against childhood tuberculous meningitis and miliary disease, but does not prevent TB in adults. Efforts are underway to develop a new effective vaccine but there are many challenges.&nbsp; TB vaccine development is difficult because exposure to the tuberculosis bacillus does not seem to induce sufficient protective immunity. A new viable vaccine could take a decade, but in that time 13 million more people would die.&nbsp; “We cannot wait and do nothing until a new effective vaccine is developed. Preventive therapy is a vaccine until we have one,” adds Basnyat. Indeed, the 3HP preventive therapy after diagnosis costs only $5 per regimen. So, Nepal’s strategy should be a simultaneous focus on 3HP preventive therapy and case finding.&nbsp; The problem has been a lack of priority for preventive therapy at national and international levels because it does not involve costly research and interventions, and the patients are poor. Explains Caws: “On paper, we have very strong policies but the commitment in terms of funding from the governments has not materialised, essentially because it is not affecting the rich unlike with Covid when we threw everything at it to have a vaccine developed in a year.” TB’s main problem, <a href="https://nepalitimes.com/opinion/comment/pandemic-eclipses-nepals-tb-epidemic">unlike Covid</a> and HIV/AIDS is that it is a disease of the poor.&nbsp;

Sonia Awale

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Ending TB is possible, and cost-effective

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e899c7e80680e0b7923jpeg.jpg" alt="" width="1400" height="933"/><figcaption>Photo: ANTONIO BELTRÁN RODRÍGUEZ</figcaption></figure>Daily wage labourers Dharma and Gita lost their jobs during the pandemic. The young couple exhausted their meagre savings in less than a month, after which they started to buy food on credit. Still unable to repay loans, they limited their diet to one small meal a day.Soon, Gita started feeling weak. She often had a fever and cough. As the lockdown extended, her health deteriorated and the medicines were of little help. The couple even took a PCR test which came out negative. They visited five different health centers and bought bags full of medicines. The treatment was so expensive they had to sell their two cows. A month later, and heavily in debt, she was diagnosed with tuberculosis.Tuberculosis mainly afflicts the poorest. The numbers are staggering: one in every three people globally is infected by Mycobacterium tuberculosis, and even if they carry the bacteria most people do not get sick unless their immune system is weakened due to disease or malnutrition.And yet, this easily preventable and curable biblical disease thrives in Nepal and the Subcontinent due to inadequate measures taken to prevent, diagnose and treat the infection.A 2020 National TB Program report revealed that over 100,000 people are living with tuberculosis in Nepal. This figure is much higher than previously estimated but has most likely increased since as many patients have been unable to access treatment during the pandemic.Of these cases, 40,000 patients were not diagnosed or treated at government centres, which means nearly one in every two people were not diagnosed. Oftentimes, people reach standard TB treatment and care after months or even years. Their pathway to cure is complex, long and include misdiagnosis leading to unnecessary prescriptions. This in turn could lead to unnecessary death and suffering. Patients are also ostracised by friends and families, resulting in self-isolation from communities.These challenges are exacerbated by Nepal’s limited health infrastructure. Health care centres are understaffed and poorly managed, maintenance of laboratory equipment, as well as supply of quality chemicals for tests, are erratic.Across Nepal’s Tarai, settlements are overcrowded, people live in extreme poverty, hygiene and sanitation are at a bare minimum. In the hills and the mountains, difficult geographical terrain and poor road networks pose obstacles for people seeking health care.These deeply-rooted structural inequities collectively resulted in magnified impact on TB service delivery during the pandemic. As a result, we observed increased deaths from the disease.In 2018, global leaders committed to reducing TB by 2022. To meet this goal, we need comprehensive intervention programs with sufficient investment for prevention, early diagnosis and treatment. There are four key areas that require increased funding to decrease TB fatalities:1 PreventionWe saw how the world community got together to rapidly develop vaccines for Covid-19 with unprecedented funding and resources. TB on the other hand has only one vaccine and a very weak one at that. Developed over a century ago, BCG does not prevent adults from developing TB disease.UnderNepal's national TB program, young children living with adults who have TB are provided medicines to kill any TB bacteria they have inhaled and prevent the development of the disease. The Birat Nepal Medical Trust for the first time in Nepal is providing a shorter 12-dose course of TB preventative medicine to adults infected with the bacteria to stop them from getting sick and spreading the disease.In 2020, only $684 million of the estimated $2.16 billion needed globally for TB research and development was available from donors. Covid-19 on the other hand received over $100 billion in just two years to develop vaccines. The pandemic exposed this global inequity, and is proof of what sufficient funding and political commitment can achieve.If funding for the global TB prevention program is increased by 3-4 fold, we could design better community-based services, develop a more effective vaccine and promote shorter treatment regimens, all of which will achieve a TB-free Nepal sooner.TB awareness and health promotion messages also do not get as much coverage in the media as they used to. World TB Day, observed every year on 24 March, should serve as a reminder that TB is an epidemic and needs accelerated efforts for elimination.2 Diagnosis and InnovationGovernment health centres provide TB diagnosis and treatment free of cost. Yet, people spend a lot of money and time before they are correctly diagnosed and enrolled in treatment. This is because symptoms of the disease are common to many infections. People develop cough and fever and immediately resort to taking paracetamol and general antibiotics before realising that they have TB.Moreover, Nepal needs to quickly adopt GeneXpert machines which use PCR testing, and chest X-ray that diagnoses early-stage TB effectively and efficiently. Investment should be concentrated to expand, strengthen and maintain these diagnostic tools at health centers all over the country. Health care providers should be similarly trained to operate these machines.GeneXpert technology should be deployed with active case finding where community health workers make home visits to screen and identify TB patients. This method also commonly known as contact tracing was applied in containing the spread of the Covid-19 virus, and has been used in TB programs for decades.Although proven to be effective, new diagnostic technologies are expensive and active case-finding strategies require large and sustained financial commitments. One might question if a country like Nepal can afford such investments. But the question we should be asking is, can we afford not to?The costs of the continued TB epidemic are far greater than the investments required to reduce it. Investing in better  tools including tax waivers on the import of TB diagnostic machines and test kits, and increased global funding for implementation of active case finding strategies for low and middle-income countries like Nepal are urgently needed.3 Community-based Treatment and Care Incomplete or delayed treatment can cause drug resistant TB and even death. Therefore, the treatment of tuberculosis should be patient-centred.TB programs have been implemented in Nepal for over half a century, we now have plenty of experience to employ the best strategies and  to eliminate the scourge.One of the challenges to eradicating TB is the long duration of treatment. Under the DOTS program, tuberculosis patients have to visit health centres daily for medication to be taken in the presence of care providers. But this could expose them to other TB patients, and resulting stigma. It is also time-consuming and comes with additional transport expenses.Investment in research and development of shorter course treatment regimens, and scaling up telemedicine is a priority area.4 Social Protection TB and poverty form a vicious cycle, each fuelling the other. It is mainly the neediest in society who are most affected. Having TB increases financial strain in their families with far-reaching socio-economic consequences. Children may have to forgo education and seek employment to compensate for the loss of income in families with an infected adult. Providing cash to families after the diagnosis will alleviate the financial burden.TB also causes malnutrition making people more vulnerable. Providing diversified food packages with appropriate nutritional value will be a big support, it will also help reduce the mental stress of fulfilling family needs.But these are just a few recommendations, a study to identify feasible and acceptable support for people with TB will enable us to design an improved tuberculosis support program. These should incorporate health education to people with TB and their families to better understand the disease, cope with its treatment and overcome stigma.Ultimately, it is the government’s responsibility to protect the lives of its people. Therefore, investing in and incorporating locally appropriate social protection schemes within the TB program should be the key agenda and priority of policymakers.The slogan this World TB Day today on 24 March is ‘Invest to End TB. Save Lives’, which reiterates the need to increase funding to prevent, diagnose and treat TB. Without substantial investments that will accelerate collective efforts of the community, country and the world, it is unlikely we will win the fight against TB, reverse the huge setback caused by the pandemic or save lives.Kritika Dixit is the Research Manager at Birat Nepal Medical Trust (BNMT) and a doctoral student at Karolinska Institutet, Sweden. Rajan Paudel is the Research Associate at BNMT.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e8c9c7e80680e0b7924jpeg.jpg" alt="" width="80" height="109"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e8d9c7e80680e0b7925jpeg.jpg" alt="" width="82" height="109">Read also: <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/">For Nepal, a game-changer in TB control</a>, Buddha Basnyat and Maxine Caws

Pandemic eclipses Nepal's TB epidemic

The Himalayan mountains are also known as the Third Pole because it is the largest repository of water stored as ice outside the two polar regions. However, it is divided by political boundaries that nature does not recognise – be it the air pollutants that flow or migratory birds that fly over the peaks. The Himalaya is also a geopolitical and climate change hot spot. In these geopolitically and environmentally challenging times, it becomes even more important to create oases of conversations, where candid and future-oriented discussions can take place at a people-to-people level. Platforms dominated by inter-governmental agencies have been able to do little. The Himalayan Future Forum (HFF) aims to be a platform that stands at the crossroads of climate, community, and connectivity, fostering dialogue and promoting citizen-led action. Growing up in the Indian Himalayan town of Kalimpong and spending the nascent stages of my career helping in setting up offices of the award-winning Annapurna Conservation Area Project (ACAP) that fostered community involvement in conservation, I have witnessed transformations both good and bad.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205070244_6e2087b11fff0cc6704eebaee6f169848a9cfd57c4a02d7d1fd45db2526d2f67.jpg" data-media-id="editor_0" data-image-id="20260205070244_6e2087b11fff0cc6704eebaee6f169848a9cfd57c4a02d7d1fd45db2526d2f67" data-rendition-name="original" width="5559" height="3711" loading="lazy" alt="HFF 2026"></figure>  There are initiatives like Nepal’s forest cover doubling in 30 years, or Bhutan’s drive for high-end sustainable tourism. At the same time, I have seen landscapes destroyed by bulldozers and tall buildings competing for air and sunlight in expanding cities. From crony capitalists patronised by political leaders engaged in plundering natural resources to citizen-led initiatives on cleanliness drives and waste management, the Himalayan region is full of stories from both ends of the spectrum of disappointment and hope. Life is about observing and, in one’s little sphere of influence, taking baby steps towards catalysing positive transformation. This is why, Nepal Economic Forum (NEF) had been hosting the Himalayan Consensus Summit in Nepal from 2014 to 2020 following which the Himalayan Future Forum (HFF) was incubated since 2023. HFF is an initiative to encourage multi-faceted dialogues on the topics of climate, community, and connectivity in the Himalayan region by bringing together leaders, experts, institutions, and practitioners from different countries and sectors.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205070244_a7e673507dcdb6e265cb6f76f2890f17af36f17006a7f6d0f2f0e1a288c89a09.jpg" data-media-id="editor_1" data-image-id="20260205070244_a7e673507dcdb6e265cb6f76f2890f17af36f17006a7f6d0f2f0e1a288c89a09" data-rendition-name="original" width="5364" height="3581" loading="lazy" alt="HFF 2026"></figure>  In this year’s edition, there are a series of sessions on 6 February with 34 speakers including ten international panelists. On day two the Himalayan Haat aims to showcase a variety of local, indigenous, and sustainable products. As in 2024, it is believed that the conversations and interactions at the HFF will lead to more partnerships and collaborations from climate financing to managing disasters to taking Himalayan brands global. YOUNG FELLOWS Beyond this, there are sessions on topics such as geopolitics and the Himalaya, as well as on migration which are especially relevant considering the past few years that have seen many events which impacted the global world order. One of the key features of HFF, guided by our ethos of bringing together experts, experiences, and enthusiasm, is also to ensure stronger youth representation through the HFF Youth Fellowship. This year, following a rigorous screening process, youth fellows were selected out of an overwhelming response. Those chosen will be able to attend the events as well as collaborate in future research and publications. Selected fellows will also be provided with full scholarships to the public policy program at Takshashila Institution, an independent centre for research and education in public policy in Bangalore. In a region where half of the population is under 25 years, it is important to get the future generations also in the room.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205070244_3416bd14d5249afeb357b11f760f49b0cd1d77feeac71d820406b2d9e86696bc.jpg" data-media-id="editor_2" data-image-id="20260205070244_3416bd14d5249afeb357b11f760f49b0cd1d77feeac71d820406b2d9e86696bc" data-rendition-name="original" width="5273" height="3520" loading="lazy" alt="HFF 2026"></figure>  Nepal presents an ideal location to hold meetings such as this, where no-holds-barred conversations can take place face-to-face. The country has good air connectivity and one of the most liberal visa policies in Asia. And while Davos is a good example to follow for convening global voices, we need not have so many private planes burning fossil fuel, as we can have participants take scheduled commercial flights or have regional participants simply take a road trip. Ultimately, the Himalayan region is also about festivities. No exchange of ideas is complete without immersing in art, culture, culinary experiences, and music. This is why HFF envisages graduating to a Himalayan Jatra, rooted in a region where people smile from the heart, and teach the world to smile with them. Join us at HFF 2026 as we move closer to this vision. See the schedule <a href="file:///Z:/%231297%20February%206/pix/page%209/HFF%202026%20Program%20Schedule%20(1)_compressed.pdf">here</a>. Sujeev Shakya is Chair of Nepal Economic Forum and Convenor of the Himalayan Future Forum.

Himalayan Futures Forum 2026

Kathmandu Valley alone now has over 700 cafes serving mugs made from freshly ground beans. ‘Americano double shot’, ‘Cappuccino’ and ‘Mocha’ have entered the Nepali language. It has also become a cash crop for thousands of farmers with near-perfect growing conditions along the Himalayan foothills.&nbsp; Yet, annual coffee production has declined by 15% to only 550 tons in the past years, and this meets only a fraction of the domestic demand of 6,000 tons.&nbsp; Nepali coffee fetches $22 per kg in the international market, but Nepal only exports 3% of its crop. If cleverly promoted, the international demand for Nepali coffee can be 8,000 tons. “Coffee is all about story-telling,” explains <a href="https://archive.nepalitimes.com/article/business/Gagan-Pradhan-and-Himalayan-Java,1076">Gagan Pradhan, founder of Himalayan Java Coffee</a>. “Nepali coffee has brand value because it is grown in the highest elevations on earth and is a cash crop for cooperatives and small farmers. There is tremendous potential for growth.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_1f366d8a85cc133fedee0ee72d7768d3a23bf51f8d43edbdadf98443bc0c01ba.jpg" data-media-id="editor_1" data-image-id="20260205100216_1f366d8a85cc133fedee0ee72d7768d3a23bf51f8d43edbdadf98443bc0c01ba" data-rendition-name="original" width="2000" height="1518" loading="lazy" alt="coffee culture in Nepal"> </figure>  The reason for the decline in coffee production lately is attributed to erratic weather caused by climate change, but mostly it is because it is manual-intensive, needing initial capital and patience for a return on investment. The strategy that makes most sense for <a href="https://nepalitimes.com/here-now/make-way-for-makalu-coffee">Nepal’s coffee industry</a> is to sell it as a rare, specialty product.&nbsp; Says Raj Kumar Banjara, master trainer at Nepal Coffee Academy and originator of the Himalayan Arabica brand: “There is no better crop for Nepal because we have the ideal soil and weather to grow specialty coffee, which can be exported to third countries directly instead of sending it through India like with ginger, cardamom, or tea.” These favorable conditions are at altitudes between 800m to 1,600m along the mid-mountains and temperature not exceeding 22°C, which allows cherries to &nbsp;develop slower, giving it a denser taste with complex flavours of fruits and nuts.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_35e470381d258d9598d30165d0dbb6b4294c389c61695bf8c47d72d2273b4629.jpg" data-media-id="editor_3" data-image-id="20260205100216_35e470381d258d9598d30165d0dbb6b4294c389c61695bf8c47d72d2273b4629" data-rendition-name="original" width="3872" height="2592" loading="lazy" alt="coffee culture in Nepal"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_f7ccb42d7a7fb656dadc7ba5132a6243b8f99a28f7877875172411b7a4c96bc0.jpg" data-media-id="editor_4" data-image-id="20260205100216_f7ccb42d7a7fb656dadc7ba5132a6243b8f99a28f7877875172411b7a4c96bc0" data-rendition-name="original" width="1024" height="768" loading="lazy" alt="coffee culture in Nepal"> </figure>  This is ‘Arabica’ coffee, and it is also considered ‘organic by default’ because farmers have limited access to chemical pesticides and fertilisers, adding to its premium. All of Nepal’s coffee is grown in only 4,300 hectares total, and this is just 0.36% of the area suitable for coffee farming. Still 31,000 households across 44 districts depend on this cash crop.&nbsp; Challenges include out-migration, limits on land ownership, and climate breakdown leading to colder, drier winters, droughts and heat stress. Shreeyanch Shrestha is the founder of Samparka Cloud Loyalty, a startup that helps businesses retain customers by giving them insights about customer behaviour. Among the services offered is a digital loyalty card for coffee shops, one of his biggest clientele.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_c80e17ac78016ae5a90f4b27105e16af6c39d1422665f9f9c9b1d8404e5e7d54.jpg" data-media-id="editor_5" data-image-id="20260205100216_c80e17ac78016ae5a90f4b27105e16af6c39d1422665f9f9c9b1d8404e5e7d54" data-rendition-name="original" width="1280" height="960" loading="lazy" alt="coffee culture in Nepal"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100212_968c5b264ec2fb65014dc3ebc2777f0bf19f596a4152c59f9cad9d99dee79df7.jpg" data-media-id="editor_6" data-image-id="20260205100212_968c5b264ec2fb65014dc3ebc2777f0bf19f596a4152c59f9cad9d99dee79df7" data-rendition-name="original" width="1200" height="900" loading="lazy" alt="coffee beans"> </figure>  Shrestha is also a coffee enthusiast, and recently collaborated with Baato Maps on the playfully designed ‘Kathmandu Coffee Map’.&nbsp; “This was a marketing campaign but also a way to pay tribute to cafe owners we worked with,” he says. “A new generation of coffee farmers, processors, roasters and consumers seem to want to invest in upgrading their coffee experience.” COFFEE CULTURE Operators such as Raj Kumar Banjara have been in that game for over 30 years, even earning a PhD in Coffee Agriculture, running farms and teaching roasting and barista courses. Now, he makes short how-to videos on social media. Banjara’s Academy is run by Specialty Coffee Association certified Q Graders and Authorised Trainers.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_22433d3a8b71224cd8cb38105b9eb5502a104e03ccec2e3864c8b23efc9f3fc6.png" data-media-id="editor_7" data-image-id="20260205100216_22433d3a8b71224cd8cb38105b9eb5502a104e03ccec2e3864c8b23efc9f3fc6" data-rendition-name="original" width="3612" height="2028" loading="lazy" alt="coffee culture in Nepal"> </figure>  Also promoting a coffee culture through social media is Santosh Shah of Bariko Coffee. He documents his process on Instagram, from hand picking and processing coffee cherries to brewing.&nbsp; Nepal appears to be riding the Third Wave of Coffee (see box) as the beverage moves away from the café chain culture to one that values knowledge of the cherries, beans, the roasting process and brewing -- right from the plant to the cup.&nbsp; Along the way, there are tales to be told about where the coffee is grown, who grows it, and how farmers get a fair price for the product. Coffee then becomes a shared social experience that directly connects the consumer to the producer. Nima Tenzing Sherpa returned to Nepal from the United States to start Lekali Coffee Estate in 2018, and produces fine single origin coffee beans so that the quality of the product improves the quality of life of the growers.&nbsp; He told Nepali Times: “Specialty-grade beans are the only future for Nepal’s coffee industry. I am continuously hunting for the best coffee origins in Nepal.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100212_e08ba44d6396eb75da868404dd8cf2a26b71cd6d90ab3afaf7175790c111d21e.jpg" data-media-id="editor_8" data-image-id="20260205100212_e08ba44d6396eb75da868404dd8cf2a26b71cd6d90ab3afaf7175790c111d21e" data-rendition-name="original" width="3000" height="4000" loading="lazy" alt="coffee beans"> <figcaption>Photo: LEKALI COFFEE ESTATE </figcaption> </figure>  HISTORY OF COFFEE Human consumption of coffee began in Ethiopia when herders found their goats became perky after eating beans from a wild Arabica bush. The first commercial cultivation of the brew began in Yemen 600 years ago. &nbsp;&nbsp; Nepal’s coffee history is much younger. A holy man is said to have brought coffee seeds from Burma in 1938, and planted them in Gulmi, the district in the mid-mountains where the first coffee nursery was set up in 1981. The Nepal Coffee Company was founded in 1983 by Krishna Ghimire in Manigram near Butwal which educated farmers about the crop and recruited them to cultivate it. He then roasted the beans, and convinced the BhatBhateni stores, which had just opened, to sell it. The company still supplies coffee to cafes and has its own brands and farm. It supplies green beans to those who want to self-roast, or build a brand. In the 1990s, the National Tea and Coffee Development Board was established, and Himalayan Java Coffee (Nepal Made, right) opened its first shop in Kamaladi before moving to Thamel. Itr now has nearly 100 franchises across Nepal and overseas.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260207030236_1908f4a4246d373f51affa8ac48be90129e888f1222b8f10e5cd25421e931dd8.jpg" data-media-id="editor_9" data-image-id="20260207030236_1908f4a4246d373f51affa8ac48be90129e888f1222b8f10e5cd25421e931dd8" data-rendition-name="original" width="2052" height="1455" loading="lazy" alt="coffee map"> </figure>  What is the Third Wave? First Wave: Profit-driven, mass marketing, air tight containers and instant coffee. Consumption of coffee worldwide starts growing.&nbsp; Second Wave: Artisan-driven, origin and roasting style become important, epitomised by Starbucks and espresso. &nbsp; <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Nepali-specialty-coffee,4106">Third Wave</a>: Characteristics of the beverage take centre stage: origin of the beans, consistent processing techniques, and roasting style. Independent coffee shops demonstrate craftsmanship and knowledge of coffee beans from plant to the cup, promoting ethics and transparency.&nbsp; Coffee Districts Coffee is grown in over 44 districts of Nepal (see map, above). In the last fiscal year, Nepal produced 550 tonnes of Bourbon, Typica and Yellow Caturra varieties of Arabica coffee. The total plantation area in Nepal is 4,300 hectares, a fraction of the total suitable land. &nbsp;

Caffeine buzz

When I landed in Kathmandu last November, I arrived with a Diwali hangover. Not the festive kind, but the coughing, dust-coated, throat-scratching kind gifted by North India’s winter air. After a decade of breathing in Delhi’s seasonal gas chamber, my lungs were in an open revolt. But within days of landing in Kathmandu, my cough vanished. It felt almost miraculous. The air was crisper. The Air Quality Index was kinder, and the Himalayan peaks rose on the horizon.&nbsp;
But by the third week, the familiar grey veil returned. First as a faint blur, then peak by peak the Himalaya began to disappear. Locals said it had been getting worse every year.&nbsp;
Much of this haze is not Kathmandu’s doing. What drifts into Nepal each winter is a toxic spillover from the plains of North India and Pakistan: black carbon, brown clouds, and fine particulate matter carried across borders by seasonal winds. Kathmandu’s bowl-shaped valley simply traps what the region exhales.
Abid Omar, founder of the <a href="https://pakairquality.com/" target="_blank">Pakistan Air Quality Initiative</a>, put it bluntly: “We often view air pollution and climate change as separate silos, but in the Himalaya, they are one and the same.”
Black carbon is essentially soot from diesel emissions, brick kilns, and crop burning. It may be short-lived in the atmosphere, but when ash settles on snow and ice, it reduces reflectivity and accelerates melting.&nbsp;
Omar adds, “Black carbon is a threat to the water security of the entire Indus and Ganges basins.”
What burns on both sides of Punjab do not stay in Punjab. It ends up on glaciers that feed rivers, sustaining hundreds of millions of people downstream.
In November 2024, AQI levels in New Delhi hovered near 500 and about the same time Lahore briefly became the world’s most polluted city, with the AQI count crossing 1,100. These numbers are not abstract.
According to the <a href="https://www.stateofglobalair.org/resources/archived/state-global-air-report-2024" target="_blank">State of Global Air 2024 report</a>, India recorded more than 2 million deaths attributable to air pollution in 2023. Bangladesh and Pakistan each saw over 200,000 deaths. Air pollution is now one of the leading causes of premature death across South Asia.
Nepal, often imagined as cleaner by default, tells a sobering story of its own. Air pollution in Nepal led to an estimated <a href="https://www.worldbank.org/en/news/press-release/2025/06/17/air-pollution-is-the-number-one-health-risk-factor-in-nepal#:~:text=Vehicle%20Emissions:%20Continuing%20to%20electrify,airflows%20carry%20pollutants%20across%20borders." target="_blank">48,500 premature deaths</a>, with the loss of more than 1.4 million disability-adjusted life years. The University of Chicago’s <a href="https://aqli.epic.uchicago.edu/post/nepal-capital-chokes-as-wildfires-rage-en" target="_blank">Air Quality Life Index</a> estimates that particulate pollution cuts 3.4 years off the life of the average Nepali. In the Tarai region, life expectancy drops by nearly five years. In Kathmandu, residents lose 2.6 years.
Says infectious disease specialist Anup Subedee: “Air pollution is killing at a far higher rate than Covid-19 did during its worst years in Nepal. People are dying in their twenties of cancer, or having heart attacks and strokes in their thirties and forties.”
Nearly <a href="https://www.icimod.org/press-release/kathmandu-choked-on-polluted-air-for-75-of-the-last-90-days/?utm_source=chatgpt.com" target="_blank">40 per cent of winter particulate pollution in the Kathmandu</a> valley originates outside Nepal. Black carbon carried from Punjab, Haryana, and Uttar Pradesh in India, besides parts of Pakistan, rides the winds north, settles on Himalayan snow, and accelerates glacier melt by absorbing heat.
“The pollutants travel across borders within shared airsheds, creating one gigantic plume of polluted air over India, Nepal, Bangladesh, and Pakistan several times a year,” says Subedee.
In some Himalayan regions, <a href="https://www.icimod.org/success-stories/chapter-2/black-carbon-and-glacier-melt/" target="_blank">scientists estimate</a> that black carbon can increase localised melt rates by up to 30%. Yet global climate negotiations continue to treat glacial loss primarily as a carbon dioxide problem.&nbsp;
CHINA’S APPROACH
The South Asian story is transboundary, and more immediate as well as more preventable. This is not only about emissions. It is about coordination, and China offers an instructive contrast.
Since 2013, China has dramatically improved its air quality by declaring a '<a href="https://www.aljazeera.com/opinions/2025/12/12/what-new-delhi-can-learn-from-chinas-war-on-air-pollution#:~:text=In%20the%20following%20years%2C%20Beijing,29.3%CE%BCg%2Fm%C2%B3%20in%202024." target="_blank">war on pollution</a>'. A major air pollutant, suspended PM2.5 levels fell sharply through strict controls on coal, vehicles, and industry, massive investment in renewables, and legally binding national action plans.
Crucially, China shifted from city-by-city firefighting to a regional airshed approach. Provinces shared data, coordinated emergency responses, enforced unified standards, and tied environmental performance to political accountability. South Asian countries have done none of this.
Isolated national actions are insufficient when pollution itself ignores borders. India, Nepal, Bangladesh, and Pakistan share the same airshed. Without cooperation, each country keeps breathing its neighbour’s mistakes.
“As the government representing the largest population affected by air pollution, India should lead this effort. Instead, the region has drifted away from cooperation, and the cost is becoming catastrophic,” Subedee says.
The haze over Kathmandu is not only Nepal’s burden. It is a <a href="https://sapannews.com/2024/12/27/could-climate-diplomacy-be-the-googly-a-gamechanger-for-regional-cooperation/" target="_blank">regional failure</a>. The melting of South Asia’s glaciers is not just a global warming story. It is also a local one, written in the smoke rising from our own fields, factories, and highways.
If we keep ignoring black carbon, the Himalayas will keep losing time, snow, and stability. The disappearing peaks of Kathmandu are not a metaphor. They are a warning.
And like the air itself, that warning is already crossing borders. ©Sapan News
Pragyan Srivastava is an Indian journalist and associate editor at <a href="http://www.sapannews.com/" target="_blank">Sapan News</a>. <a href="mailto:pragyan@sapannews.com" target="_blank">pragyan@sapannews.com</a>

Cleaning up the Himalayan airshed

This is the 82nd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. In September, under pressure from GenZ activists, Home Minister Om Prakash Aryal pledged to ensure that overseas Nepalis would be able to vote in the March election. The analysis from experts, election officials, and much of the public was that the Election Commission was not prepared to ensure out-of-country voting in such a short time.&nbsp; But just because the diaspora cannot exercise its franchise does not mean Nepalis abroad cannot influence the election outcome. The 2021 census said 2.1 million Nepalis lived abroad, but realistically three times more live, work and study overseas.&nbsp; Being breadwinners also makes them decision makers for families back home. Most have left because they could not get meaningful jobs and sought opportunities abroad, which means they are not happy with the way Nepal has been governed by the established parties and leaders.&nbsp; The diaspora is therefore mostly an anti-incumbent vote bank, which was one reason the political leadership blocked out-of-country voting for so long – despite a Supreme Court ruling that all citizens had a constitutional right to vote, wherever they lived. &nbsp; In the 2022 polls, overseas Nepalis had already shown considerable influence by backing newer and alternative candidates like Balendra Shah for Kathmandu mayor, and parties like the RSP. In the four years since, and especially since the GenZ movement, support for a political shakeup has grown even stronger. So has technological reach that enables the diaspora to politically organise from overseas. &nbsp;‘Technology has reduced the distance in communication, but has also lowered the barrier in a way that allows overseas Nepalis to pressure family members,’ author Narayan Wagle wrote in an op-ed on Setopati this week. Indeed, all it takes for family members to be convinced whom to vote for is an ultimatum that relatives will stop sending money. With less than a month to go for the 5 March election, many Nepalis overseas are campaigning remotely for preferred candidates, even if they cannot themselves cast ballots.&nbsp; The overwhelming feeling seems to be that younger candidates should be given a chance. &nbsp;&nbsp; Read what some Nepalis abroad have to say. NEPAL'S NON-VOTING MIGRANTS <h2>My Respected Parents</h2> Anil Gole, Romania [This letter is a letter to my parents ahead of the election. They are UML supporters, my uncle is for the Nepali Congress (NC), and my grandfather supports the Nepali Communist Party (NCP).] My Respected Parents, I hear that election fever has picked up in the village. New faces with new ways of thinking have emerged this time. I don’t really understand politics, so what I say may feel bitter. But Father, when I see the flag with the sun in your hands, I remember the heat of Qatar from 12 years ago, your sunburnt skin and mother’s cheeks wrinkled with worry. Perhaps Uncle, too, found the Saudi heat so intolerable that he returned home. That may be why while seeking shade, he found the NC tree symbol endearing. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Great uncle spent his whole life back home in the village, which is perhaps why he identifies with symbols like the plough, the sickle, and the hoe.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040236_669402ff85bdbd58360c12e10d23900ad99596b7a8dc196b8db1bcfe7e81e80e.jpg" data-media-id="editor_0" data-image-id="20260206040236_669402ff85bdbd58360c12e10d23900ad99596b7a8dc196b8db1bcfe7e81e80e" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Anil Gole</figcaption> </figure>  Even then, at any cost, vote for the same politicians. Vote for the same politicians who have not developed the country, who have not fed the poor, whose sons have not been shot.&nbsp; What if the country does not change? I have changed my country. When homesick, I have learnt what it feels like to suffocate in tears under a blanket. Now my younger brother is old enough. Send him here as well. We brothers will earn together. We will marry off our sister in a grand way. So what if the country does not develop? We will build a small, cute house with a big yard. You can play with the grandchildren there. And when they grow up, they too can migrate. But if you vote for the right people and the country gets good leaders, future generations will not have to sweat in foreign lands. They will not have to leave the comfort of a mother’s lap to spend nights abroad in unknown cities. No matter how hard things get, they will not have to lie in letters to their mothers,saying, “I’m doing fine, Mother.” I have not lost courage because of your blessings. My body is here, but my mind is always back home in Nepal. Your children are here, but my children’s future is in your hands. That is why vote for the same politicians whose hearts did not bleed even when the young were killed, the same politicians whose children have not come home in a box. Mother and Father, please take care of each other. Yours truly, Your fortunate migrant son <h2>Algorithm versus vision</h2> Ambika Paudel, Qatar I have been in Qatar for 18 years, and work in the facilities management, engineering, shipping and logistics &nbsp;industry. I get to interact with people from across the world, and they are closely connected with their embassies through online systems and communities. I lead the Nepal Expatriate Community that has multidisciplinary professionals and have observed the need to revise the narrative around migrants. We are here for our families. The sacrifices we make are for them. We are working for our own career growth and families because there were no opportunities back home. Many of us have achieved a good standard of living through our hard work and merit. When I send money to Nepal, it is for my family and the benefit to the government is a byproduct. It would have been good if we got to vote, too. That possibility and promise got lost somewhere in the policy confusion and lack of technical capacity. Overseas Nepalis are also deeply invested in the election, but it is largely algorithm based. We are not questioning the vision of the candidates.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040236_dc05b31d3abcf126360d923615a785a36de5b62a8695af9cbff000b586d0336d.jpg" data-media-id="editor_1" data-image-id="20260206040236_dc05b31d3abcf126360d923615a785a36de5b62a8695af9cbff000b586d0336d" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Ambika Paudel</figcaption> </figure>  Our parents back home are the actual voters, and those overseas &nbsp;are talking to them. I don’t think they will be swayed just based on calls, and they shouldn’t be either. We are prioritising algorithms and words and social media boosts over vision, experience, and concrete plans. I am for the NC but I am not a blind supporter. Despite being at the forefront of every significant democratic change in Nepal’s history, the party has had lapses but it is currently on a new trajectory. Not all candidates of all parties are good so we have to elect competent leaders and question them. Whatever promises they make need to be examined for delivery and vision.&nbsp; There are also Congress loyalists who are swayed and influenced by the new, but I let it be — it is their right, their choice. Change requires vision and experience, it should not be based on hype, I remind them. Over online conversations, I tell them to vote wisely so they don’t regret it later. I returned from my break just recently so I cannot come home to vote as it will be too expensive. There are good human resources back in Nepal and in the diaspora which can be used. There are people in decision-making positions in their companies who are very capable and intelligent who could contribute to Nepal. These are missed opportunities in our policymaking and governance: Nepal needs to create opportunities for capable Nepalis.&nbsp; The new government can make the investment climate better through a one-door system so that services are accessible, quick and there is no need to go to multiple offices to start a company or pay taxes. This would also stop unnecessary bribes and other hassles. I don’t have plans to return in the near future. I have a good job and am earning well. I came to Nepal between 2016 and 2019 and remigrated again after things did not work out. <h2>The young need convincing</h2> Jeevan Kumar Dewan, Malaysia I have been living in Malaysia since 2001, and am an active member of the UML wing here. There is excitement about the upcoming election, but we are bound by contracts so cannot go home to vote.&nbsp; There was hope that we would be able to vote from overseas, but there were questions of security. Even though we won’t be able to vote, people are actively participating online and using social media to show their support to their candidates and parties of choice.&nbsp; Political parties prioritise organisational expansion overseas but there is no direct campaigning during elections. It is through conversations and social media engagement that people are participating, debating and expressing their support and loyalty.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_2ed54377199b995f0a19b7be98fff79004c13787c7a07185a47427467237277a.jpg" data-media-id="editor_2" data-image-id="20260206040240_2ed54377199b995f0a19b7be98fff79004c13787c7a07185a47427467237277a" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Jeevan Kumar Dewan</figcaption> </figure>  &nbsp;As a UML supporter, it is my duty to remind people to cut through the noise and to separate facts and truth. While elderly voters don’t need much convincing as they are loyal to the party, I do engage a fair amount with the young voters. I have to remind them not to get distracted by the videos shared in social media platforms. All new is not good just because it is new if there is no real political agenda. There is no doubt that we need change but being new is not enough nor can we overlook the contributions and experience of the old parties. All we can do is talk to the voters and try to get our message across. It is important to prioritise better managed migration and also to ensure migrants have proper guidance on how to invest their hard-earned money in productive sectors, even when it is not much, so they have something to fall back on after returning. I don’t have plans to return immediately, I go back and forth quite frequently. I have a stable job and I have seen how my friends who left secure jobs to return home ended up remigrating after their investment failed. I will stay here and continue with my job which I am happy with. <h2>The old need convincing</h2> Prajwal Poudel, Saudi Arabia I work as a data entry analyst in Saudi Arabia. People overseas have seen development, but have also experienced challenges of being away from home. Politicians are aware of this and didn’t want us to vote.&nbsp; When I was in Nepal, I did not care much about politics. It was not for me. But overseas we care about Nepal even more. Perhaps you don’t know the value of something unless you lose it. Perhaps distance makes hearts grow fonder. I am definitely more invested in Nepali politics after leaving.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_43ea30dfb58b873760e40177d84dca4bb34f1c9cdffdbc9a7c5a0c26b15e78b9.jpg" data-media-id="editor_3" data-image-id="20260206040240_43ea30dfb58b873760e40177d84dca4bb34f1c9cdffdbc9a7c5a0c26b15e78b9" data-rendition-name="original" width="738" height="1600" loading="lazy" alt="Overseas vote bank NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_dfbc2302411e1ae32a4ab048fa34d940147942c00845d82d9cf59574f5c2e0fe.jpg" data-media-id="editor_4" data-image-id="20260206040240_dfbc2302411e1ae32a4ab048fa34d940147942c00845d82d9cf59574f5c2e0fe" data-rendition-name="original" width="1080" height="1200" loading="lazy" alt="Overseas Nepali vote bank NT"> </figure>  So I have to make sure that family members back home make the right decision this election. My cousin is also with me in Saudi Arabia and I was talking to his parents and telling them to vote correctly. They have voted for the same faces for two decades. I said that if there had been changes we would not have had to migrate. That this time they should accept the masu-bhat and alcohol, say UML-Congress jindaawaad, take the money offered but finally stamp on Ghanti.&nbsp; My cousin posted a recording of that call spontaneously on Tiktok. It went viral perhaps because it resonated with the youth. We cannot vote but we have to make sure at least our close family members vote correctly. My mother also seems ready for a change despite her loyalty to the UML, but I tell her she does not need to change her party just change her vote this year.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_0234dfec6f97a726f67120124833bb3fdc84cbf794eee910736649c5624e7576.jpg" data-media-id="editor_5" data-image-id="20260206040240_0234dfec6f97a726f67120124833bb3fdc84cbf794eee910736649c5624e7576" data-rendition-name="original" width="1168" height="1556" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Prajwal Poudel</figcaption> </figure>  We need to give the new ones a chance. But it’s also true that the new will not bring dramatic changes overnight. Conversations here are all about the election back home. We talk about who is getting elected from their areas. Who they think will win. But the hottest topic of conversation is of course Jhapa. For those of us abroad, the government should make our embassies stronger. Back home, I hope corruption will be curbed and that good roads will reach all corners of the country. This will allow people to develop the country themselves.&nbsp; I am the son of a Malaysia returnee. I even worked as a teacher in Nepal. I could not even afford decent clothes so I left everything and came here. I don’t know when I will return.

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