Investing in children means investing in the future, but Nepal is going the opposite way. We are only halfway through this fiscal year, and the yearly budget of Rs120 million set aside for free cardiac care of 500 children under 15 years of age at the Shahid Gangalal National Heart Centre—the national referral centre—has already been used up. If the government doesn’t approve additional funds, countless children and their poor parents will suffer. Unfortunately, following the information that no more funds would be available, the hospital has already begun charging parents of children with severe heart conditions.

Be it congenital or acquired, heart disease in children has become a global burden, and Nepal is no exception. Out of the country’s children population, 1 percent has congenital heart problems. According to pediatric cardiologists, for every 1,000 children born alive, eight to 10 suffer from this condition. The mortality rate among those with severe congenital heart conditions is also high.

In 2023 alone, the hospital did 905 free surgeries for needy children. At times, the surgery costs can even surge up to a million rupees for a single child. However, the amount currently allocated for free treatment is far from sufficient. What’s more, reportedly, the government has yet to reimburse millions of rupees to the hospital for services provided under a health insurance programme. The hospital also awaits Rs480 million in unpaid dues from last fiscal year’s free social service programmes with no assurance on reimbursement.

Nepal has only a few pediatric hospitals equipped for both congenital and acquired heart disease. The Shahid Gangalal National Heart Centre has set a precedent by caring for those families and children who cannot pay for treatment through its charity funds. Yet the government has not been able to support such initiatives. This has again highlighted the importance of allocating enough budget to the country’s health sector. But for this fiscal year, the government has allocated only Rs86.24 billion—which represents 2.5 percent increase from last year. This fund crunch affected crucial healthcare programmes like maternal health, immunisation, nutrition and child health.

This comes at a time when the Minister for Health and Population has been making tall promises about improving the country’s healthcare system. He had a chance to avert the crisis at the national heart centre, a problem which became evident much before he took office. But it seems to have escaped his notice, or was not a priority. Cardiac care is one of the costliest medical treatments and is a huge burden for many poor families. Understanding this, the government of Nepal, in collaboration with heart surgeons, introduced free or subsidised heart care (including surgery) for children under 15. This programme needs urgent expansion.

Access to adequate healthcare is the right of every Nepali child, regardless of their family’s station in life. In what is a matter of life and death for hundreds of young children, the government must not hesitate to give all the monetary help the hospital needs. What, one wonders, could be a bigger health priority than saving the untimely deaths of these children?