Nepal needs urgent American vaccine support

20 May 2021

Nepal has a history with vaccination that goes back to 1816, after King Girvana Yuddha Bikram Shah died from exposure to smallpox. Desperate for help, Nepal’s ruling class lobbied the East India Company for vaccine doses, something it happily complied with as the British saw an opportunity to increase influence in the region.

In the 200 years that have passed since, Nepal’s youth and global diaspora have taken matters into their own hands. They have registered a desperate plea for vaccine aid from the US government, which has recently announced plans to share up to 80 million Covid-19 vaccines with countries across the world.

This is Nepal’s only opportunity for rapid and cost-free aid that can end the deadly waves of the virus that have destroyed the country’s economy and, in only one year, has resulted in nearly half as many deaths as the brutal ten-year conflict, or the devastating earthquakes in 2015. Nepal’s need for American aid is more acute today than possibly at any other point in our shared history.

The provision of immediate vaccine aid to Nepal will amplify the generous support already pledged for Covid-19 relief and ongoing development projects, increase US influence and relevance across the region, and -- most importantly -- save an untold number of lives.

It is often said that the greatest export from America is democracy. We have seen this play out in the past few weeks as this group of Nepali and American citizens penned an open letter to the US Ambassador to Nepal, Randy Berry. This letter spurred an online petition that has gathered nearly 40,000 signatures to date.

Another group of Nepalis living in America submitted a similar formal request directly to the Biden Administration which, in turn, inspired members of the diaspora across the country to call their elected representatives to advocate for Nepal. Thanks to even the potential of vaccine aid to Nepal, tens of thousands of citizens of Nepal and America have found one voice -- which is a desperate plea for help.

Through USAID’s critical support in immunisation, safe motherhood, community management of childhood illness and much more, Nepal has made remarkable strides in improving the lives of women and children in every corner of the country. The long-term support provided by the American people has been instrumental in reducing the number of maternal deaths by 75% since 1990.

Mortality for children under the age of five has also dropped more than 66% over the past 20 years. There have also been successful campaigns to control malaria, create better health infrastructure and mobilise community health workers in every single tole across the country. There is also the $130 million pledged after the 2015 earthquake, support for democracy and governance, improving the power grid, and bold programs that target conservation and mitigating the amplified impacts of climate change unique to the Himalayan region.

Altogether, USAID has empowered the Nepal Government to double life expectancy in the country since 1960. Current USAID programming, especially within the Suahaara II project, has also increased the already significant capacity of Nepal to effectively distribute vaccines to people across the country.

The fundamental approach of this program has mobilised agricultural extension workers and community health volunteers to promote early childhood nutrition, while supporting their work with effective behaviour change communications: precisely the tools Nepal will utilise to effectively distribute vaccines. Further support may be needed to strengthen Nepal’s cold chain for vaccine transportation but, again, this is something that USAID and its partners are uniquely positioned to do.

We argue that the US now has an opportunity to save the world. Nepal’s critical crisis is unique. This week, the Serum Institute of India announced that they would only be able to supply 1 million doses of the AstraZeneca Covishield vaccine (that Nepal has already paid for) at the end of 2021. With this, 1.7 million people are left without any hope of receiving a full vaccination. We will cross the deadline for the 12-week maximum recommended gap between doses next week.

This leaves Nepal unwillingly in the middle of an uncontrolled public health disaster. The people who have only received one dose of the vaccine are almost exclusively in the most vulnerable 65+ demographic. Defaulting on the vaccine leaves them completely exposed.

Perhaps even more concerning is that this may push the virus to more quickly create vaccine-resistant mutations that would then spread with a devastating effect across the globe. Heartbreaking as it is, by no fault of our own, what is happening in Nepal is a global liability that only the US can mitigate.

It would also look good, which is something (no offence) that the US could use right now. Supporting Nepal with a generous injection of AstraZeneca vaccine doses will position the US again as a beacon of support for health and democracy, and it may heal some of the wounds inflicted when the Millenium Compact Corporation (MCC) grant was tarred by misinformation and used as a punching bag for political gain by Nepal’s political class.

It may not be socially prudent to openly ask, or even beg, for support in this forum. But these are desperate times. We are facing one of the most severe Covid-19 epidemics on the globe. Our most vulnerable population is completely exposed to infection and death. We make this plea on humanitarian grounds. This time around, only the US can help Nepal turn the tide from fear and chaos to hope for the future.

In the past 200 years, in many ways, very little has changed as well. Last month our former King and Queen nearly died from Covid-19. With this in mind, we once again must ask our international partners for support.

We ask this for the benefit of everyone in the country -- especially those who are most vulnerable. We ask it because we could not have predicted this year, and we cannot predict the future. This is for the benefit of the world, too. Please.

Please continue to provide life-saving support – including, and especially vaccine aid, right now -- when it is needed the most.

Sushil Koirala is a public health expert based in Bangkok, Thailand.

Ben Ayers is an American citizen based in Nepal for over 20 years.