If things had gone according to plan, Nepal would have received an additional one million doses of Covishield vaccine from Serum Institute of India in early March, allowing the government to continue the country’s vaccination campaign that began in January.

But there is uncertainty over when they will be delivered.

With cases soaring in India, the government there has put restrictions on the export of Covid vaccines although Nepal had made down payment for two million doses of Covishield but received only one million.

“We are not in a position to say anything about the supply of vaccines from the Serum Institute of India,” Dr Tara Nath Pokhrel, director at the Family Welfare Division of the Ministry of Health and Population, told the Post.

But despite the uncertainty, the government is yet to take any meaningful steps towards procuring alternative vaccines amid surging coronavirus cases in the country, officials admitted.

On Tuesday, Nepal reported 4,364 new cases from polymerase chain reaction tests and 160 from antigen tests. In the last 24 hours 18 deaths have been recorded pushing the total toll to 3,194. Active cases stand at 26,225.

Of the total infected in the last 24 hours 1,966 are from the Kathmandu Valley.

This is the first time since October 23 the single-day Covid infections surpassed the 4,000 mark. It is also the third highest single-day tally ever.

All Health Ministry officials, meanwhile, can say about procuring vaccines from other countries is “efforts are underway.”

“Diplomatic efforts are currently underway to see if we can get Chinese and Russian vaccines,” said Jageshwar Gautam, spokesperson for the ministry.

But these will not be of any use for the 1.3 million people over the age of 65 who have received the first dose of Covishield between March 7 and 15.

Besides Covishield, developed by the University of Oxford and pharmaceutical giant AstraZeneca, the Department of Drug Administration has also granted emergency use authorization to Covaxin developed by India’s Bharat Bioshield, BBIBP-CorV developed by China’s Sinopharm and Sputnik V vaccine developed by Russia’s Gamaleya National Center of Epidemiology and Microbiology.

Nepalis are being inoculated with 800,000 doses of Chinese BBIBP-CorV that Nepal received as a grant besides Covishield.

With its failure to procure vaccines the government is now pinning its hopes on vaccines from the COVAX facility which is providing vaccines to poor countries. So far it has received 348,000 doses of Covishield from the facility.

“We are told that additional doses will be supplied between May-end and June,” said Pokhrel. “We are expecting that the COVAX facility will provide sufficient vaccines to administer the second dose to those above 65.”

The government is also trying to procure the Oxford-AstraZeneca vaccine from other sources.

“We have sent diplomatic notes to various vaccine-producing countries including South Korea, which produces the Oxford-AstraZeneca vaccine,” Dr Roshan Pokhrel, chief specialist at the Health Ministry, told the Post.

As far as the Chinese vaccine is concerned, spokesman Gautam said, the Chinese vaccine was not procured at an earlier date as it was not feasible to procure the vaccine by fulfilling the conditions set by the Cabinet for procurement of Covid-19 vaccine.

The Cabinet had set conditions such as the vaccine to be procured should have been approved by the World Health Organization for emergency use, one that can be stored at temperatures between 2-8 degrees as far as possible, one that can be supplied as demanded by Nepal, and the price should be reasonable, according to Gautam.

He refused to divulge whether diplomatic efforts to procure Chinese and Russian vaccines were centred on price.

Nepal had bought 2 million doses of Covishield from Serum Institute of India at $4 per dose.

“Chinese and Russian vaccines are more expensive than the Covishield vaccine,” Dr. Dipendra Raman Singh, director general at the Department of Health Services said. “Therefore we are currently discussing whether to buy those.”

The Chinese and Russian companies, however, are yet to make an official statement about the pricing of their vaccines. But, The New York Times reported on March 12 that Hungary agreed to buy five million doses of the Sinopharm vaccine, priced at 30 euros ($36) per dose which makes the Sinopharm shot among the most expensive in the world. This price far surpasses what the European Union has agreed to pay for vaccines from Western manufacturers.

According to The Express Tribune, a Pakistan-based news outlet, the Pakistan government capped the maximum selling price at Pakistani Rs8,449 (equivalent to $55) for two doses of the Russian Sputnik V vaccine.

But by admission of Nepal’s Health Ministry officials money should not be an issue while procuring vaccines.

“We don’t lack resources to purchase vaccines,” said Pokhrel, director at the Family Welfare Division. “The World Bank and the Asian Development Bank have assured us to provide funds for procuring vaccines but we haven’t been able to procure due to an acute shortage.”

The Health Ministry has also decided to allow private suppliers to import the jabs but none of the suppliers have been able to do so. Officials at the Department of Health Services said they are also interested in purchasing Johnson & Johnson’s vaccine but their attempts haven’t been successful.

Bangladesh, which is waiting for delivery of Covishield vaccines from Serum Institute of India, is also working to procure vaccines from China and Russia. Russia has even asked Bangladesh to produce the Sputnik V vaccine, according to reports.

Bangladesh had signed a deal with India on December 13 last year to purchase 30 million doses of Covishield on an installment basis. But until now, Dhaka has received only 7 million doses in two installments while Delhi sent another 3.2 million doses as a gift.

With the number of Covid cases soaring rapidly in the country, experts have warned that the worst has yet to come.

Nepal’s R, or reproduction number, defined as how easily it spreads in the population, is 2 while that of India is 1, which is battling one of the biggest humanitarian crises, according to Dr Krishna Prasad Paudel, director of the Epidemiology and Disease Control Division.

Public health experts say as there is no known cure for Covid-19, vaccination is the only hope to contain the spread of the virus.

“We have to explore all options to inoculate our people as there is no other way to fight Covid,” Dr Shyam Raj Upreti, former director general at the Department of Health Services, told the Post. “Authorities must explore all available options.”