The World Health Organization (WHO) reports an estimated 300 million women have a Human Papillomavirus (HPV) infection worldwide, which is the primary cause of cervical cancer.

Cervical cancer is a growth of cells that starts in the cervix, the lower part of the uterus that connects to the vagina.

While universal access to the HPV vaccine is widely available, it has not been administered routinely and widely in Nepal.

Come 2025, around 1.7 million Nepali girls aged between 14 and 15 will be jabbed with HPV, which will provide substantial public health benefits. Health experts say the move is a sound investment of resources.

The HPV vaccine campaign will save daughters from preventable deaths from cervical cancer, the second-most common cancer in the developing world and a significant cause of death among Nepali women as well.

The vaccination campaign will begin on February 5. There is no national data, but according to the BP Koirala Memorial Cancer Hospital in Bharatpur, more than 700 women suffering from cervical cancer seek treatment at the hospital every year.

This is only the record kept by one hospital.

“All necessary preparations for the nationwide HPV vaccination drive, including ensuring vaccine doses, have been completed,” says Dr Abhiyan Gautam, chief of the Immunisation Section at the Family Welfare Division of the Department of Health Services.

In Nepal, social enterprise promises economic empowerment and social transformation and drives tremendous positive change in women's lives. According to health experts, the direct and indirect effects of vaccination on HPV in girls and women would not only save lives but also build healthy human capital in the future.

Furthermore, the Ministry of Health and Population has decided to incorporate the HPV vaccine into the routine immunisation schedule following the conclusion of the nationwide campaign. As part of this initiative, all girls aged ten will receive the HPV vaccine annually.

Experts say the HPV vaccine can prevent up to 80 percent of cervical cancer.

Meanwhile, in another commendable healthcare initiative, the ministry is preparing to launch a nationwide drive to screen non-communicable diseases, which have emerged as a major killer in recent years. Non-communicable diseases account for around 80 percent of total deaths.

According to a 2019 study on the prevalence of non-communicable diseases by the Nepal Health Research Council, 71 percent of total deaths at present are due to non-communicable diseases, and an additional 8 percent are caused by injuries.

Officials hope free screening for non-communicable diseases will raise awareness of risk factors and lessen the disease's burden.

“We are all set to launch the nationwide drive for screening non-communicable diseases,” said Dr Yadu Chandra Ghimire, director of the Epidemiology and Disease Control Division. “This campaign aims to make people aware of the emerging risk factors caused by our changing lifestyles, food habits, and stress level, among others.”

Several other healthcare programmes—screening for the mental health of jailbirds and pregnant women, promotion of open gyms, yoga, and fitness centres, and free cancer treatment for children—are planned for implementation in 2025.

Minister for Health and Population Pradip Paudel is on a spree, announcing populist programmes one after another.

Public health experts say the health minister’s commitments should be taken positively. There is nothing wrong with making commitments to improvement. The leadership should commit to betterment, and the minister is quite aware of his role.

“Incumbent leadership of the health ministry is aware of the problems and solutions,” said Dr Prabhat Adhikari, a health expert. “What needs to be done is effective implementation of the plans. We hope all plans go well.”

Health experts say more and more people have become aware of their health and have started taking measures to care for them, which is the most important achievement.

But problems are galore.

Hundreds of thousands of Nepalis have been deprived of basic healthcare services due to the lack of health facilities and funding. The unequal distribution of services is also a key obstacle to saving people from diseases.

Most healthcare facilities in the country lack adequate infrastructure and human resources. Cesarean delivery, minor operations, consulting, and immunisation services are scarce in most hospitals nationwide.

The demand for high-quality healthcare has surged with the significant increase in chronic (non-communicable) diseases.

The private sector has taken a great leap forward in the health sector, but affordability is another question.

“We hope that the government will accord healthcare facilities by allocating sufficient budget,” said Adhikari. “Much focus has been given to curative services, but we should not forget that prevention is always better than cure.”

There are also coordination problems among the three government tiers: federal, provincial, and local.

“Our policies, including those on health care, must be based on facts,” said Dr Mingmar Gyelgen Sherpa, former director general at the Department of Health Services. “Policymakers must try to understand our ground reality, formulate policies and allocate budget accordingly for better results.”

There is a lack of trained human resources, as Nepal has seen a mass exodus of skilled workers abroad.

The remuneration structure for health service officials ranges from Rs28,640 at the lower end to Rs66,860 at the upper end. On December 12, a secretary-level decision at the health ministry announced the provision of minimum wages and other services and facilities in line with the government's service for all nurses and other health workers.

Experts say the government is responsible for ensuring health care for all and making them educated and well-informed. They stress that investing in cost-effective preventive measures is the only thing the country can easily afford.

“Existing policy focusses on the curative services, meaning that the government provides incentives to patients suffering from serious ailments, such as kidney disease, cardiovascular disease, and cancer, among others,” said Sherpa.

“By providing incentives, we do not encourage people to change their behaviours—eating habits, physical exercises and lessening stress, among other things. Instead, we should invest in preventing such diseases. For that, people should be made aware of their health.”

Experts agree that disease prevention must be a priority. Critical resources, including budget and trained human resources, must be increased to ensure universal health coverage and achieve health targets.

“We all know what the problems are,” says Dr Bhagwan Koirala, a renowned cardiac surgeon. “What we need is to translate them into reality.”