In 2019, as many as 6,241 people throughout the country commited suicide. The number rose by 14 percent in 2020 to 7,117. Data show that Nepal’s suicide mortality rate was 23.7 per 100,000 people in 2020.

In 2015, this rate was 16.5 per 100,000 population.

Suicide data is one of major indicators of mental health problems prevalent in the country. It is the second major cause of death among people between 15 and 29 years of age and the main cause of death among women aged between 15 and 45. What is more concerning is not only mental health problems, the burden [death and loss of health due to diseases] of noncommunicable diseases too has increased of late in the country.

A 2019 study on the prevalence of noncommunicable diseases by the Nepal Health Research Council found that noncommunicable diseases accounted for 71 percent of the deaths in the country.

Public health experts say the report of a rise in the burden of non-communicable diseases, or NCDs, amidst the pandemic is concerning, as the entire state machinery has been diverted to contain the spread of the ongoing Covid-19 pandemic.

“While focusing on containing the spread of the coronavirus, authorities should not ignore non-communicable diseases,” said Dr Megnath Dhimal, chief researcher at the Nepal Health Research Council. “The rising cases of non-communicable diseases is a serious problem, which should not be underestimated.”

After the country was hit by the second wave of the coronavirus pandemic, most of the state-run health facilities as well as private and community hospitals have been converted into Covid-19 dedicated hospitals. This led to a disruption in regular health care services, preventing people with chronic conditions from getting treatment.

The study by the Nepal Health Research Council primarily focused on behavioural risk factors like tobacco and alcohol consumption and biological risk factors like high blood pressure, overweight, obesity, abnormal lipid prevalence, coronary artery disease, chronic obstructive pulmonary disease and diabetes, among others.

The findings showed that the leading risk factor of deaths in 2019 was smoking, responsible for 17.7 percent, followed by high systolic blood pressure (12.3 percent), household air pollution (11.2 percent), ambient air pollution (9.3 percent), diabetes (8 percent), and high cholesterol and kidney dysfunction.

Another study titled Nepal Burden of Disease, conducted in 2017 found that two in every three deaths (66 percent) in the country are caused by noncommunicable diseases—heart disease, chronic obstructive pulmonary disease, lower respiratory infection and stroke.

“Burden of noncommunicable diseases has been increasing alarmingly of late in our country,”said Dr Krishna Prasad Paudel, spokesperson for the Ministry of Health and Population. “The government has been working to increase the budget for buying medicines for noncommunicable disease, recruiting trained human resources and working to ensure availability of free essential medicines.”

A 2019 joint study by the WHO, Health Ministry and the Nepal Health Research Council says changing age structure and lifestyles—increasing sedentary behaviour, tobacco and alcohol use, and unhealthy diets—are the main risk factors for deaths and disabilities.

Experts say various other studies carried out in the country have also indicated that noncommunicable diseases have been emerging as serious health problems and that authorities concerned have failed to pay attention.

“Non-communicable diseases including mental health issues should not be overlooked, as thousands of people die by suicide every year,” said Dr Basudev Karki, a consultant psychiatric, serving at Nepal Mental Hospital. “Besides increasing the budget for medication, authorities should also focus on launching awareness drives and recruiting trained human resources.”

Meanwhile, amidst reports that the burden of noncommunicable diseases has surpassed that of communicable diseases, the Ministry of Health and Population has allocated Rs15 million to each province to purchase medicines for non-communicable diseases. These include medicines for mental health problems, cardiovascular diseases, high blood pressure, diabetes and curable cancer, which the provincial governments have to purchase and distribute free of cost to the patients from state-run health facilities.

“Rs15 milion has been allocated to each province to purchase medicines for noncommunicable disease this fiscal year,” said Dr Phanindra Prasad Baral, chief of mental health section at the Epidemiology and Disease Control Division. “Rs10 million has been allocated to purchase medicines for cardiovascular diseases, chronic obstructive pulmonary diseases, diabetes, blood pressure and curable cancer and an additional Rs5 million has been allocated for mental health medicines.”

Nepal has committed to reducing suicide rate to 4.7 per 100,000 people by 2030 to meet the Sustainable Development Goals target.

The Health Ministry provides more than 70 types of medicines for communicable and noncommunicable diseases to all district hospitals having at least 25 beds. Patients get more than 60 types of essential medicines from primary healthcare centres and 35 types of drugs from health posts free of cost.