It will not be an exaggeration to say that Nepal’s health sector is in dire straits. The country faces an acute shortage of doctors and health officials, as hundreds of hospitals and health posts in remote districts continue to operate without trained manpower. Likewise, many of the pathology labs that have sprouted just about everywhere in urban settlements are being run by those with little or no expertise in laboratory science and without proper equipment. Questions have also been raised over the quality of drugs produced in the country as news of use of sub-standard material in drug manufacture continues to make headlines.
But perhaps no single case lays bare the sorry state of our health sector than the fact that there are just 13 drug inspectors to monitor over the 13,500 legally operating pharmacies across the country. Hundreds more might be operating illegally in the hinterlands, according to the estimates of the Department of Drug Administration (DDA), the sole body responsible for the supervision of pharmacies in Nepal.
Severe manpower crunch has meant that the laws governing sale and storage of medicine are also being openly flouted. In the absence of proper supervision, DDA has found free medicines supplied by the government being sold in the market, vaccines being stored in improper temperatures, and unauthorized people selling drugs. Yes, the DDA is responsible for keeping a tab on the pharmacies to rein in these illegal practices. But it can hardly be faulted for its ineffectiveness given that its hands have been tied, by the same government that has given it such an enormous responsibility. Besides monitoring thousands of pharmacies around the country, the skeletal DDA staff 13 drug inspectors has also been saddled with the responsibility of visiting pharmaceutical companies, both inside and outside the country, to monitor for the quality of their drugs.
Last year, DDA officials could cover only 1,500 of the nearly 14,000 pharmacies in the country. It does not have a clue about how the remaining ones are being operated. Given such a severe manpower shortage, it defies belief that no new DDA post has been created for the last 33 years. When the government did decide to act, instead of adding muscle to DDA, it inexplicably removed 14 drug inspectors from their posts 19 years ago. The demand of 150 additional employees, a demand which DDA has been making for the last 17 years, is yet to be met.
Apparently, the government-prepared master plan towards this goal was shelved. No one knows the reason for sure. Like we said, the DDA manpower crunch is only the tip of the iceberg of the malaise that afflicts Nepal’s health sector. Corruption in our healthcare system is equally rife. Last year, the National Vigilance Center reported that at least Rs 50 million was unaccounted for in the books of Bir Hospital. Dr Govinda KC had to resort to fast-onto-death to stop political meddling at Tribhuvan University Teaching Hospital (TUTH).
Transition or not, the sheer scale of neglect of healthcare sector in Nepal is unjustifiable. People may be able to wait for some more years to cast their ballots in the next CA polls, but thousands upon thousands of Nepalis whose very lives are on the line owing to government neglect surely can’t