Dr. Balmukunda Regmi

Despite of all her measures, Nepal is still struggling to control the COVID-19 pandemic. Just 14 months back, with the confirmation of the second case of coronavirus in Nepal, the government had imposed nationwide lockdown to break the spread of virus chain.
Despite the country’s weak health infrastructure, porous, open and unregulated border with India and inexperience in dealing with a pandemic like coronavirus, it was successful in not letting the virus go out of control. Nepal was forced to make a warlike response to the situation. It lacked a single PCR test facility but now it conducts over twenty thousand PCR tests per day. Now there are 47 laboratories in the public sector and 35 in the private sector that can carry out the tests.
One year ago, there were roughly a total of 480 ICU beds with around 260 ventilators. Of the total ICU beds, the government-owned hospitals had only 150, the rest were in the private sector. Now, there are a total of 1,171 ICU beds and 493 ventilators. The country has made an impressive progress in expanding the vital health facilities, but it is far from meeting the healthcare need of the day.
Negligence
Unfortunately, Nepal has now plunged into the devastating second wave of pandemic owing to utter negligence as reflected in the power-show demonstrations by both the governing and opposition political parties, social or religious gatherings, crowded buses, opening of elementary-level schools, hotels, tourism and other economic activities. Even the vaccination centres were careless when it comes to maintaining physical distance among the people who came to get the vaccine shots.
Notwithstanding how we missed the golden opportunity immediately after achieving a relative success in containing the first wave, now the focus should be put on immediate management of coronavirus crisis, including healthcare of the non-COVID-19 patients and supply of food and basic livelihood needs to the people at large.
To contain the current coronavirus crisis, besides the restriction on the social gatherings, the practice of wearing masks outside private homes, washing hands with soap water, and maintaining at least two-metre physical distance from other people, we need a prompt mass vaccination, sufficient oxygen and medicines supply, provision of enough ICUs with ventilators.
For a least developed country like Nepal that was badly affected by the 2015 earthquake, followed by economic blockade and political conflict over the promulgation of new constitution in the same year, it is next to impossible financially and technologically to solve the above listed problems before it is too late.
The gravity of difficulty has been expressed by Prime Minister KP Sharma Oli in his article published in the prestigious British newspaper, The Guardian on May 10. Citing the constraints of resources and infrastructure, Oli has appealed to the international community to help Nepal with vaccines, diagnostic tools, oxygen kits, critical care medicines and equipment, to support her efforts to save lives. He has requested the UK, both as the current chair of G7 and the host of Cop26, to play an important role in generating international support.
The frequently occurring epidemics in some countries and regions indicate that the fight against the virus is long and difficult. In the current globalised world, the virus can spread from one place to another any time. The virus has become a common enemy of mankind, and unity and cooperation are essential to defeat it.
Most of our donor countries are themselves hit hard by the COVID-19. Our southern neighbour India is herself seeking international assistance to cope with the worst pandemic since its independence in 1947. Japan is forced to accept the shutdowns. The US, the UK, Russia and most of the EU are still struggling to control the pandemic. At the moment only countries capable of helping Nepal are China, Australia, New Zealand and South Korea. Being our neighbouring country, the second largest world economy, the proponent of the Belt and Road Initiative (BRI) of which Nepal is a member, and a country Nepal has established strategic partnership during 2019 Nepal visit by its President, China is best suited for Nepal to approach for help.
China has assisted over 80 countries, including more than 50 African nations, Italy, Pakistan, and Nepal. China has also offered to support India in her endeavour to overcome the dreadful corona crisis. Nepal has received COVID-19 vaccine, oxygen cylinders, ventilators, oxygen concentrators, personal protection equipment and related assistance from China.
More than once, the Chinese government and her diplomats have expressed commitments to support Nepal. Many organisations and individuals have expressed willingness to support Nepal at the people-to-people level. This is high time that Nepal made explicit request to China for sufficient support aimed at completely containing the virus and ensuring the overall health security of Nepali people.

Areas of assistance
The Chinese COVID-19 vaccine, Vero Cell, has already been registered and used in Nepal. The use of other brands of the Chinese COVID-19 vaccines is also underway. As can be seen from the Chinese capacity of mass production, China is capable of providing the vaccine to cover whole need of Nepal. Supply of oxygen cylinders, oxygen concentrators, oximeters and setting up oxygen plants could save thousands of lives in Nepal, even without ICUs and ventilators. China has already declared to provide twenty thousand empty oxygen cylinders. Reaching an early understanding for the sufficient supply of these items by land route would ensure their timely availability without a need of expensive airlifting.
With the deterioration of the situation, rise in infection and death rate, the health infrastructure is becoming unable to respond to the healthcare needs of infected people with symptoms. Immediate construction of COVID-19 designated hospitals is an urgent need. Prompt and efficient response of Chinese medical teams was demonstrated in Nepal during 2015 earthquake and in Wuhan during corona outbreak in 2020. Bilateral collaboration for such operation would save thousands of Nepali lives.
And one more area where Chinese assistance would be fruitful is in situation analysis and integrated management of the corona crisis as practiced in China. Through appropriate mechanism, Chinese experts could provide important advice to the Ministry of Health and Population in optimal management of overall health services.
Meanwhile, altogether 86 Nepali citizens, including journalists, writers, artistes, professors, social workers and businessmen have called upon Chinese ambassador to Nepal Hou Yanqi to assist Nepal to provide vaccines and other crucial medical equipment to fight the pandemic in the country. This shows Nepalis’ trust in the Chinese ability to rescue them from scourge of killer virus disease.
Such a bilateral cooperation between Nepal and China not only serves current Nepali health interests, it also gives a justification to the creation of community with shared future for mankind, as proposed by the Chinese President Xi Jinping.

(Dr. Regmi is a professor at Tribhuvan University. bmregmi@gmail.com)