Rupak D Sharma

Kathmandu, May 28

Nepal’s Covid-19 vaccination drive, which started with a bang, has sputtered to an uneasy close, stoking fears of a rapid rise in infection -- including in rural areas that were largely untouched by the first wave -- and heavy loss of lives.

The commitments expressed by various countries as well as development partners, such as the Asian Development Bank (ABD) and the World Bank (WB), to support Nepal to restart its vaccination campaign are consoling. But the nature of coronavirus is such that it spreads rapidly. And delays of even a few days can wreak havoc. Just look at how rapidly the death toll has jumped. It stood at around 3,200 until a month ago and has since more than doubled to over 7,000.

“When it comes to vaccines, Nepal cannot and should not wait.... The World Bank and ADB commit to funding Nepal’s eligible vaccines that have WHO listing. We will do this today if the contracts between the government and eligible providers are ready. We are ready and on standby,” Faris Hadad-Zervos, World Bank Country Director, said in a written statement made available to the New Business Age.

The WB has provided US$75 million and the ADB an additional US$165 million to the government for procurement of safe and effective vaccines. China recently said it is ready to offer 1 million additional doses. Other countries, including the US, the UK and those in the European Union, too have said they would support Nepal to rollout vaccines.

Nepal, which has a population of about 30 million, was among the first in Asia to receive Covid-19 vaccines. It has administered around 2.74 million doses so far, which include vaccines provided in the form of grants by India and China. Early vaccine rollout in Nepal was seen as a feat by many. Then, the drive went into a tailspin. This was not because the country lacked financial resources but because of the choices it made.

Initially, the government was too focused on getting the vaccines for free. Later initiatives were taken to purchase them and one million doses were even bought from India. Then the health minister made statements saying some of the people, who were seeing the vaccination drive as a gravy train, were creating obstructions in the procurement process. This controversy dragged on for some period and by the time it subsided, India, one of the world’s largest vaccine suppliers, was in the grips of the second wave of the pandemic. This left India with no choice but to stop exports of vaccines.

The second wave of pandemic that hit India entered Nepal in no time. Soon hospitals started coming under intense pressure and the demand for oxygen and other critical medical equipment such as ventilators surged. The EU and its member states, the US, the United Nations, Switzerland, and the UK, for example, have supplied oxygen equipment, ventilators, personal protective equipment (PPE) and other medical equipment.

“We are also quickly mobilising emergency support with an initial 2 million euros towards the UN’s COVID appeal. We stand ready to provide further assistance,” said Janez Lenarčič, European Commissioner for Crisis Management in a statement provided to the New Business Age, thanking Finland, Spain, France, Germany and Belgium “for their quick and generous offers of assistance via the Civil Protection Mechanism”.

The development partners have also formed the Health Working Group to respond to Nepal’s needs in a coordinated manner through a single window. This is expected to maximize the efficiency in meeting Nepal’s Covid-related needs and streamline support. Several development partners have also immediately deployed their technical expertise to inform a fast-tracked response.

“The UK has had a technical team working in the Ministry of Health and Population for some years. The team has proved to be invaluable in being able to support the government in shaping the response to COVID-19. They have advised on the Rapid Response Plan, the specifications for equipment, design of treatment facilities, epidemiology, analysis, data and much more,” said Lisa Honan, British Embassy’s Development Director in a statement provided to the New Business Age.

The government has formed a high-level body, called Covid-19 Crisis Management Centre (CCMC), to take the lead in managing and coordinating the fight against the pandemic. Although many have supported formation of such a body, its image has been tarnished to some extent because of allegations of corruption levelled against it. Many are expecting the body to operate more professionally and in a transparent manner as the government has recently appointed former Nepal Army Lieutenant General Balananda Sharma as its CEO. But it has been suggested that it rope in more technical and public health experts who can help the body make streamlined, scientific, evidence-based and practical decisions to minimise health, social and economic impacts of the pandemic.

Nepal is facing a host of problems in dealing with the pandemic largely because it has failed to make adequate investment in public health infrastructure. Of course, the healthcare system of even the developed countries came under severe pressure during the pandemic. But, globally, lessons are being learnt and preparations are simultaneously being made to tackle such problems effectively and efficiently. In Nepal too calls are being made to strengthen public health infrastructure by engaging local governments. This should be supplemented by countrywide expansion of universal health insurance scheme, as many of the Covid-19 infected hesitated to visit hospitals because of the costs involved in the medical treatment. Germany, which provides one of the world’s best universal health insurance schemes using private and quasi-private agencies, is already supporting Nepal on this front. The country needs an affordable universal health insurance plan to build human capital.

“Several years of common effort to build a universal health insurance, together with GIZ and other partners, provide excellent experience and the first building blocks for fulfilling this task,” said Ambassador of Germany to Nepal Roland Schäfer in a statement provided to the New Business Age.

Had mechanisms like universal health insurance and a good public health infrastructure been in place, Nepal perhaps would not have had to impose one of the severest lockdowns in the world to contain the spread of the disease. During the first wave of the pandemic, entire Nepal was shut down for almost four months from March 24, 2020. The restrictions in movement brought the economy to a standstill, as almost all of the enterprises remained closed, supply chains were disrupted and many employees were relieved of their duties or were asked to take sharp pay cuts. This is expected to have made 1.6 million jobless and pushed 1.2 million into the poverty trap.

Nepal has not imposed a nationwide lockdown to tackle the second wave of pandemic, but almost all the districts have issued prohibitive orders since the end of April, severely restricting movements. Although an official study on the impact of the second round of lockdown has not been conducted, a survey done by the General Federation of Nepalese Trade Unions (GEFONT) in 60 districts showed that 3.65 million people have lost their jobs so far. Effect on livelihood of daily wage earners, persons with disabilities and people from disadvantaged groups with no access to formal social safety net is not immediately known. But impact is likely to be greater this time as infection rate has not gone down even after a month of lockdown and the virus has penetrated rural areas as well which largely remained safe during the first wave of pandemic.

The only government mechanism that can provide a safety net at times like these is the Prime Minister Employment Programme (PMEP), but it has not been able to provide relief to the most vulnerable. Around 187 countries around the world are already providing emergency cash transfers, mainly by expanding existing programmes, according to the World Bank. But Nepal has not been able to make use of its social protection programme, although the PMEP guideline allows distribution of subsistence allowance equivalent to 50 percent of wages of unworked days to registered beneficiaries.

Earlier, the government had introduced the Business Continuity Loan Scheme -- under which credit of up to Rs 100 million was pledged for a minimum of two years at five percent (first year) to six percent (second year) interest -- to save jobs as well as enterprises. But there were very few takers of this credit, as the scheme came with conditions that many businesses could not meet. Many are demanding that a similar scheme with fewer conditions be introduced to aid enterprises that are on the verge of bankruptcy. There are also calls for increasing the size of the refinance fund at the central bank -- and donors have expressed commitment to contribute to it -- to continue providing subsidised funding to priority sectors, particularly small and medium enterprises affected by the pandemic.

“Supporting the recovery of enterprises and investment growth is a crucial part of post-Covid recovery,” said Swiss Ambassador to Nepal Elisabeth von Capeller in a statement provided to the New Business Age, adding, “Switzerland, in partnership with the World Bank, is supporting the Government of Nepal to drive forward much needed reforms and help MSMEs [micro, small and medium enterprises] recover and rebound.”

Going forward, Nepal needs to prepare a coherent plan to revive the businesses and the economy, as growth contracted by two percent in the last fiscal year and the central bank has already ruled out the possibility of attaining four percent growth rate projected by the Central Bureau of Statistics for this year.

But for now Nepalis want one thing: vaccine.

“Vaccination program is the urgent need of the hour and the World Bank and ADB are working closely with the government and all partners in procuring and delivering COVID-19 vaccines safely and effectively. Vaccination not only saves lives and but also mitigates the negative economic impacts of the pandemic by restoring people’s ability to work and travel safely,” said Rudi Van Dael, Unit Head, Portfolio Management, of the Asian Development Bank Nepal Resident Mission, in a statement provided to the New Business Age.

(Based on views expressed by Asian Development Bank, British Embassy, European Union, German Embassy, Embassy of Switzerland, and World Bank)