The pandemic exposed Nepal’s fragile health system primarily due to the government’s lack of foresight in the upkeep and preservation of a much-needed facility. Especially in the rural hinterlands, where the people have always faced either lack of doctors, medicine or proper care. And for the few who can access medical attention in the nearby district headquarters or the capital, flying in and out in a helicopter doesn’t come cheap. For the multitudes, it is just hoping against hope for a miracle.

With the effects of Omicron on the wane, people have only recently begun to sense some relief from the constant threat of contracting the dreaded virus. But no sooner had the pandemic started to wane than we witnessed a surge in various communicable and non-communicable diseases. Instead of increasing the overall budget of the health sector to better combat the ills of both Covid-19 and other diseases, in an odd twist, the Ministry of Health and Population decided to curb the budget for non-communicable medicines by almost two-thirds despite non-communicable diseases being responsible for nearly 66 percent of the total deaths in Nepal.

Another worrying statistic is the rising number of cases of vector-borne diseases which somehow has an inter-connected link with climate change. A recent report of the United Nations states that at least six major vector-borne diseases (VBDs) such as Kala-azar and dengue have recently emerged in the Himalayan republic and are now considered endemic. Ironically, out of the approximately 219 cases reported in 2020-21, about 21 were reported from Kalikot district where the elevation ranges from 738 to 4,790 metres above sea level. The fact that increasing incidences have been reported from mountainous regions such as Mugu, Jajarkot, Humla, Jumla and Salyan indicates warmer temperatures creating a fertile ground for spreading VBDs.

And since the host in these regions is immunologically unprepared, this leaves the host with severe illness. VBDs is not a recent phenomenon in Nepal, but their emergence in areas considered non-endemic in the past will eventually pose a significant health challenge. If the authorities are not careful enough, we could see a repeat of the situation the capital faced in 2019, when a dengue outbreak left more than 8,000 people hospitalised; thus exposing the fragility of the healthcare system in Nepal and the authorities’ incompetence and unpreparedness in handling an emergency.

We have witnessed a callous approach to maintaining hygienic living standards from the authorities and at the citizenry level; the waste heaped at street corners reflects the poor level of civic awareness in Nepal. And since VBDs arise primarily from inadequately maintained living conditions such as poorly designed water management systems, poor waste disposal and water storage, it is of utmost importance for the authorities to tackle the problem of civic unawareness head-on. Unless there is a proactive approach, the issue at hand is not if but when.