<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161144/636d1d159c7e80680e0af392jpeg.jpg" alt="" width="1920" height="1080"/>I nternational tourist arrivals increased by 58% in July-September, compared to the same period of 2020. This is still 64% below average 2019 levels and 76% below pre-pandemic levels, according to the UN World Tourism Organisation. The figure will stay at 70-75% below average 2019 levels for the remainder of 2021. Mobility restrictions, vaccinations, and traveler confidence have meant improvement in parts of Europe and the Americas during the third quarter of 2021, but arrivals in Asia-Pacific were down almost 95%. The tourism sector could lose $2 trillion this year, the same as in 2020.

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Tourism picks up

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111016110/636d12099c7e80680e0a98b5jpeg.jpg" alt="" width="1124" height="786"/>Nepal’s Sangya Malla has been announced Woman Police Officer of the Year 2021 by the United Nations Department of Peace Operations. Malla is currently serving in the UN Organisation Stabilisation Mission in the Democratic Republic of the Congo (MONUSCO).Malla currently serves as the Chief of the MONUSCO Police Health and Environment Unit, which she helped establish in the country’s capital, Kinshasa. The unit is responsible for implementing policies and procedures concerning the health and well-being of personnel as well as United Nations Police environmental initiatives.Malla’s contributions during the ongoing Covid-19 pandemic and past outbreaks of Ebola virus disease have had a significant impact in the Democratic Republic of the Congo. During the volcanic eruption in Gola last May, her unit alerted the local population and UN staff of precautionary measures, preventing further losses.“She helped establish and now leads MONUSCO’s Health and Environment Unit, enhancing the safety and welfare of our peacekeepers by mitigating the risks from Covid and other threats,” says United Nations Secretary-General António Guterres, who will be presenting the award virtually on 9 November.He adds: “And she represents something far larger — the many contributions of women police officers in advancing peace and security around the world. Through her work, Superintendent Malla embodies the best of the United Nations.”Malla is a medical professional by training and has helped develop guidelines to control the spread of the novel coronavirus in the region. In 2021, she organised over 300 awareness sessions on Covid prevention as well as environmental protection for the public, government officials and UN staff in Congo. As the MONUSCO Police’s focal point on Covid-19, she has also been actively disseminating information about the vaccines and promoting the vaccination drive.Malla was previously with the United Nations Stabilisation Mission in Haiti (MINUSTAH) from 2016 to 2017, where she was a member of the Formed Police Unit’s medical team. Before this, she got started by joining the Nepal Police in 2008 as an inspector.“I am honoured to receive this award, and I hope it will encourage more young women in my country and around the world to pursue careers in policing, which is still too often viewed as “man’s work’,” said Malla.The United Nations Woman Police Officer of the Year award was set up ten years ago in 2011 to empower women and recognise the contribution of women police officers to UN peace operations.Of some 7,300 UN police officers, 27% are women and are presently deployed in 14 different United Nations peace operations around the world. Through their work, they are enhancing international peace and security by supporting host countries in conflict, post-conflict and other crises.“Like many peacekeepers during this challenging time amid the pandemic, Superintendent Malla has gone above and beyond the call of duty to serve local communities,” said United Nations Police Adviser Luis Carrilho. “Together with her team, her efforts to raise awareness about public health and natural risks have ultimately made her colleagues and the Congolese people safer—a core function of policing.”Nepal, which began deploying peacekeepers from 1958 with a modest five military observers in Lebanon is now the second-largest troops contributing country to UN Missions. Over 135,000 personnel have since participated in the peacekeeping missions.Of the total 5,717 Nepali blue helmets currently serving in 12 countries and territories including Congo, South Sudan, Western Sahara, Israel, Lebanon, Mali, Syria, Central African Republic, Iraq, Libya and Yemen, 1,555 are women.

Nepal’s UN Policewoman of the Year

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141152/636d02be9c7e80680e0a3699jpeg.jpg" alt="" width="640" height="427"/><figcaption>Photo: UNITED NATIONS</figcaption></figure>The United Nations General Assembly has started its 76th annual session, as 100 world leaders gather in-person after last year’s virtual meeting of the world body. This is an opportunity for the international community to act as a community for once to tackle the two big global crises of our times: Covid-19 and climate, both of which are <a href="https://www.nepalitimes.com/banner/un-climate-report-declares-planetary-emergency/" target="_blank" rel="noopener noreferrer">impacting Nepal</a>.For the General Assembly this year, the UN flew in the Korean boy band sensation, BTS. It was an effort to make sure that the annual sessions in New York, which are known mostly for their long boring speeches, go viral. And it is vital that the message this year needs to get out.<blockquote>The <a href="https://twitter.com/hashtag/GlobalGoals?src=hash&amp;ref_src=twsrc%5Etfw">#GlobalGoals</a> are the world’s roadmap to create a better future for all.See how world leaders &amp; influencers joined <a href="https://twitter.com/antonioguterres?ref_src=twsrc%5Etfw">@antonioguterres</a> on Monday to inspire action for the future of our planet, and all its people. <a href="https://t.co/9JItAr3Xp3">https://t.co/9JItAr3Xp3</a>— United Nations (@UN) <a href="https://twitter.com/UN/status/1440141984132370432?ref_src=twsrc%5Etfw">September 21, 2021</a></blockquote>Even as the international media focuses on the ‘vaccine gap’ between vaccinated and unvaccinated world leaders turning the General Assembly into a super-spreader event, the real issue is <a href="https://www.nepalitimes.com/opinion/covid-19-and-human-freedom/" target="_blank" rel="noopener noreferrer">the global vaccine gap</a>. The emphasis should have been not on vaccine deniers, like Brazilian President Jair Bolsanaro, but on a summit of world leaders happening at the right place at the right time to discuss global vaccine inequity.The global gap between the jabbed and jab-nots is not just unjust, but there is increased risk of the emergence of <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">deadlier variants like Delta</a> since such a large section of the world’s population is not yet vaccinated. It also means that more people in poorer countries are at risk of losing their livelihoods as the pandemic surges there.The attempt to promote <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">the COVAX facility</a> to distribute vaccines to the developing world was a noble gesture, but it ended up being largely just that: a gesture. Rich countries circled their wagons, fighting tooth and nail among themselves to stockpile several times more vaccines than was needed by their populations. Team Europe tried to pick up the slack, but this just ended up putting brakes on individual members trying to pass on surplus doses to countries most in need.We now know that vaccines are the most effective tool we have to defeat this scourge. But like all disasters, Covid-19 has also exposed structural inequality in the world. So far, 73% of the 5.7 million vaccine doses administered so far have been in just 10 of the better off countries.The World Health Organisation (WHO) wants to vaccinate at least 40% of the population of every country by the end of this year, and will need the pledges made at the UN this week to reach 70% by next year. It has called on richer countries to <a href="https://www.nepalitimes.com/opinion/to-boost-or-not-to-boost/" target="_blank" rel="noopener noreferrer">postpone third dose boosters</a> to their populations and ship those doses to people around the world who are not yet vaccinated. But going by the vaccine nationalism we have seen so far, that is unlikely to happen.Nearer home, Nepal was <a href="https://www.nepalitimes.com/latest/too-early-for-nepal-to-let-its-guard-down/" target="_blank" rel="noopener noreferrer">one of the first countries in the region to start its vaccination</a> drive in March – thanks to us being next door to India which gifted 1 million doses right away and had just started supplying more Astra Zeneca Covishield vaccines indirectly via COVAX when the Delta struck with brutal force. Because of our open border, the strain swept through Nepal as well, but by then India had stopped the export of Covishield.On Wednesday, US President Joe Biden hosts a virtual summit to discuss concrete steps the world can take collectively to combat the contagion. He is calling for 1 billion more vaccines to be shipped out so that 70% of the world population can be inoculated by 2022, this in addition to the 2 billion already pledged.

Covid and climate at the UN

<figure><img width="1142" height="787" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111128/636cd31d9c7e80680e08f94ejpeg.jpg" alt=""/><figcaption>Manoj Basnyat in his New York office with MP Man Bahadur Gurung (left) and Hum Gurung (right) in 2014.</figcaption></figure>To be posted in regions of political instability seems to have been the calling of Manoj Basnyat’s life. As a United Nations representative, he was sent to all the major hotspots: Sri Lanka, Afghanistan, Ukraine.After serving the UN in Nepal from 1994-99 he left just as the country itself was turning into a hotspot. Manoj travelled and lived as a citizen of the world, working for the United Nations Development Programme (UNDP) for more than 27 years.He died in New York on 12 January, his sudden demise leaving his friends, colleagues and relatives, in shock. Many will remember him for being a catalyst for conservation in Nepal, and for development and peace-building around the world. He changed many lives for the better, and inspired a new generation of those working to balance economic progress and ecological protection.  As Assistant Resident Representative of UNDP in Kathmandu, Manoj’s focus was on governance, infrastructure and natural resources. He believed in the Japanese way of nemawashi 根回し, an informal process of convincing and gaining the support of communities for positive change. He used this approach for change, wherever he went. <img width="536" height="586" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111132/636cd3209c7e80680e08f94fjpeg.jpg" alt="">As a conservationist trying to convince communities to take ownership and participate, Manoj's mentorship in Nepal was a lifelong gift for me. He was generous with sharing practical tips on communicating with politicians and bureaucrats, which is perhaps one of the most essential skills at senior management positions. For many like me he was a role model ‘adviser’, with the ability to influence decision-makers, thereby impacting policies at all levels. The relationship he maintained with senior politicians in Kathmandu ran a parallel at the grassroots. He maintained excellent relations with village leaders, locally elected representatives and listened to them intently during meetings, which made them seek his advice on major development activities.My connection with Manoj Basnyat started in December 1996 when I joined UNDP in Kathmandu as Senior Policy Adviser. It was impossible to not be touched by Manoj Basnyat’s optimism and can-do attitude. <figure><img width="2032" height="1337" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111132/636cd3249c7e80680e08f950jpeg.jpg" alt=""><figcaption>UNDP Resident Representative to Nepal Carroll Long on a field visit to Butwal in 1996 with Manoj Basnyat.</figcaption></figure>He took this positive, practical approach to ideas and their execution to the countries he was assigned to for UNDP. Between 2001-2005, Manoj was the Deputy Resident Representative of UNDP in the Ukraine and assisted in the delivery of development assistance as its Country Programme Director. His fluency in Russian helped him in his Eastern Europe postings.Prior to that, he served as the Policy Specialist and Deputy Regional Manager for the Sub-regional Resource Facility in UNDP’s Regional Center in Bratislava (1999 – 2001). This was a crucial time to be in Slovakia, as the country was having presidential elections  for the first time following a constitutional amendment in 1998.He also served with UNDP’s Regional Centre in Colombo from 2005– 2006 at a time of the fiercest fighting between the Sri Lankan military and Tamil separatists. He went on to Dhaka to serve as UNDP Resident Coordinator from 2006 to 2008, planning and delivering strategies built around successful partnerships.Then, it was to another hotspot: Afghanistan, where he served as UNDP’s Country Director (2008-2012), working to help the country recover from decades of war. Attacks were frequent, and Manoj had to often duck into bunker safe rooms in between meetings about development projects. <figure><img width="636" height="420" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111132/636cd3279c7e80680e08f951jpeg.jpg" alt=""><figcaption>Former President of Afghanistan Professor Rabbani and Minister Masoom Stanikzai with Manoj Basnyat in Kabul.</figcaption></figure>From his childhood at St Xavier's School in Kathmandu to college at the Kuban State Technological University in Russia where he did his science Masters, Manoj lived like an explorer—of life and places. He went on to attend Universität Dortmund in Germany to do a post-graduate in Regional Development Planning and Management. He also spent time at the Asian Institute of Technology in  Thailand and the John F. Kennedy School of Government at Harvard where he did a degree in leadership. My last meeting with Manoj was in September 2014 at his office in New York in the company of our acquaintance Man Bahadur Gurung, the erstwhile Chair of the Conservation Area Management Committee of Parche in Kaski. The Gurung community from Sikles had just won the internationally renowned UNDP Equator Prize for nature conservation and sustainable local development.  We presented Manoj with the coffee table book, <a href="http://archive.nepalitimes.com/news.php?id=18160#.YAj4BnYzaUk" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/news.php?id%3D18160%23.YAj4BnYzaUk&amp;source=gmail&amp;ust=1611287597946000&amp;usg=AFQjCNGiA5owFh8gA6yJm9O6poulRIDe9w">Our Village, Our Life: Sikles in Focus</a>, by  Sara Parker. As he flipped through the pages of the book, he said: “I really miss our mountains and plains, our new forests, and the hopes and potentials of rural Nepal.”  Hum Gurung, PhD, is Regional Project Manager for BirdLife International-led Forest Governance in Southeast Asia and Pacific.

A Nepali on a UN mission

<figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109151116/636bb6769c7e80680e07bc63jpeg.jpg" alt=""/><figcaption></figcaption></figure>Nepal’s Prime Minister K P Oli and heads of state and governments from over 64 countries have committed to reverse nature loss by the end of the decade to fulfil the United Nation’s Sustainable Development Goals (SDGs). Countries endorsing the pledge represent more than 1.3 billion people and more than a quarter of global GDP, and comes after the <a href="https://www.nepalitimes.com/latest/world-lost-2-3-of-its-animals-in-50-years-wwf-report/" target="_blank" rel="noopener noreferrer">World Wildlife Fund Living Planet Report 2020</a> released earlier this month. That report revealed that there has been a two-thirds decline in the global populations of mammals, birds, amphibians, reptiles and fish in the past 50 years. Nepal has been praised internationally as <a href="https://www.nepalitimes.com/banner/in-conservation-nepal-is-not-out-of-the-woods-yet/" target="_blank" rel="noopener noreferrer">a model for nature conservation</a>, and its ability to manage people and parks relatively well despite problems of poverty, population growth and pressure on land. But despite past achievements, experts say Nepal cannot afford to be complacent and the government commitment will renew conservation efforts, especially to curb recent surge in <a href="https://www.nepalitimes.com/banner/lax-laws-make-nepal-haven-for-tiger-poachers/" target="_blank" rel="noopener noreferrer">wildlife poaching</a> during of Covid-19 lockdown. <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/7-musk-deer-killed-by-poachers-during-lockdown/" target="_blank" rel="noopener noreferrer">Six musk deer</a> were found killed in traps in Sagarmatha National Park in April. There was a <a href="https://www.nepalitimes.com/latest/wildlife-smuggler-caught-in-kathmandu-after-15-years/" target="_blank" rel="noopener noreferrer">seizure of tiger and leopard pelts</a> as well as bones this week in western Nepal from poachers who were taking them to China. Earlier this month in Chitwan National park, a dead rhino was found with a bullet hole in its head, and a tiger was found dead in Bardia on Saturday. Nepal had marked its fourth year with zero rhino poaching recently. Announced just few days ahead of the UN Summit on Biodiversity, The Leaders’ Pledge for Nature: United to reverse biodiversity loss by 2030 for Sustainable Development will send a united signal that the world must step up ambition to halt and reverse nature loss for the benefit of people and nature and to help tackle climate change. “Pandemics, wildfires, wildlife decline and climate change are all symptoms of our dangerously unbalanced relationship with the natural world. We can’t ignore it any longer, and we must act decisively,” says Marco Lambertini, Director General of WWF-International. <figure><img width="1400" height="1051" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109151116/636bb6799c7e80680e07bc64jpeg.jpg" alt=""><figcaption></figcaption></figure>Conservationists said the pledge at last demonstrated leadership from the highest political level of governments for <a href="https://www.nepalitimes.com/banner/between-existence-and-extinction-in-nepal/" target="_blank" rel="noopener noreferrer">protecting the planet’s biodiversity</a> from the effects of the climate crisis and destructive land management by countries.In the past year, a series of major reports have focused global attention on the biodiversity crisis, with nature currently declining globally at rates <a href="https://ipbes.net/news/Media-Release-Global-Assessment" data-saferedirecturl="https://www.google.com/url?q=https://ipbes.net/news/Media-Release-Global-Assessment&amp;source=gmail&amp;ust=1601378297829000&amp;usg=AFQjCNFm681spRqm7cDGRkc2D-pehkLf1w">unprecedented</a> in human history.This is causing irreversible harm to our life support systems, aggravating poverty and inequalities, increasing risk of future zoonotic pandemics and contributing significantly to climate change.Key commitments in the pledge include:<ol><li>The development and full implementation of an ambitious and transformational post-2020 global biodiversity framework to be adopted in Kunming, China, next year;</li></ol><ol start="2"><li>Transitioning to sustainable patterns of production and consumption and sustainable food systems that meet people’s needs while remaining within planetary boundaries. Including by switching to deforestation-free regenerative agriculture;</li></ol><ol start="3"><li>Reducing pollution on land and in the air, including eliminating ocean plastic waste;</li></ol><ol start="4"><li>Sustainably managing our ocean and conclude the negotiations under the United Nations Convention on the Law of the Sea;</li></ol><ol start="5"><li>A green and just response to the current health and economic crisis, integrating a One Health* approach and putting biodiversity, climate and the environment as a whole at the heart of recovery strategies, investments and decisions and actions across the whole of government;</li></ol><ol start="6"><li>Investing more money in biodiversity and nature-based solutions and also committing to eliminating or repurposing harmful investments and subsidies and aligning financial flows to environmental commitments and the Sustainable Development Goals to achieve the wellbeing of people and safeguard the planet.</li></ol><a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/in-conservation-nepal-is-not-out-of-the-woods-yet/" target="_blank" rel="noopener noreferrer">In conservation, Nepal is not out of the woods yet</a>, Sonia Awale

Nepal part of UN campaign to reverse nature loss

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141112/636ba75d9c7e80680e07377bjpeg.jpg" alt="" width="2048" height="1364"/><figcaption>Photo: BIKRAM RAI</figcaption></figure>The Covid-19 pandemic hit Nepal much later than the rest of the world, and now the country is being battered by a surge of positive cases. Hospitals are <a href="https://www.nepalitimes.com/banner/nepals-virus-vortex/" target="_blank" rel="noopener noreferrer">running out of beds for the seriously sick</a>.The crisis comes even as the country was hit by the <a href="https://www.nepalitimes.com/latest/nepals-deadliest-monsoon-in-recent-times/" target="_blank" rel="noopener noreferrer">worst monsoon-related lanlslides and floods in recent years</a> that have killed more thna 200 people.To augment the Nepal’s government’s efforts, the United Nations in Nepal and the UK’s Department for International Development (DFID) have put their resources together to support its Covid-19 response and disaster preparedness.The partnership aims to provide essential support with Covid-19 contact tracing, health screening, telemedicine, and personal protective equipment for frontline healthcare workers. The agencies also seek to support over 35,000 <a href="https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/" target="_blank" rel="noopener noreferrer">children</a> and pregnant and lactating <a href="https://www.nepalitimes.com/here-now/birth-and-death-during-a-pandemic/" target="_blank" rel="noopener noreferrer">women</a> to prevent malnutrition as well as ensure continued sexual and reproductive health services, psychosocial support to survivors of gender based violence, and water and sanitation in health and quarantine facilities.As of 22 August, Nepal has a total of 31,117 confirmed Covid-19 cases with 146 fatalities. Likewise, floods and landslides triggered by the monsoon rain have so far killed 241 people with 88 missing.“This is a welcome step towards the commitments made by members states, including by Nepal to deliver collective responses to the national needs and priorities by bringing the UN system together,” said Valerie Julliand, United Nations Resident Coordinator in Kathmandu. “As the UK joins forces with the UN, together we are working on responding to the crisis and also addressing the inequalities and vulnerabilities in social, political and economic systems in Nepal.”Beyond supporting Nepal government’s response to both Covid-19 and <a href="https://www.nepalitimes.com/here-now/in-nepal-either-too-much-or-too-little-water/" target="_blank" rel="noopener noreferrer">monsoon-related crises</a>  the UN is also working to develop national and local disaster management capacity through its cluster co-leadership role. The world body said it is committed to jointly plan and prepare for emergency response in Nepal this year and beyond.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/uk-support-to-help-strengthen-nepals-response-to-covid-19/" target="_blank" rel="noopener noreferrer">The UK</a> will provide financial and technical support to tackle Covid-19 outbreak and scale up the UN’s ability to prepare effectively for future emergencies.The UK also endorsed the role of the UN Resident Coordinator to take a lead in planning emergency preparedness and response on behalf of the international community with the government of Nepal. This includes humanitarian advisory capacity, coordination, data analysis and a common service for accountability to affected populations.Lisa Honan, Country Director for DFID Nepal said, “Nepal has suffered a great deal because of natural hazards including the coronavirus. We are confident that our support to the UN will help improve the response to the pandemic in Nepal as well as improve preparedness for future natural hazards.”

UN and DFID join hands for Nepal Covid fight

Paul Nunn and Bhim Singh Thakuri<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814110/636a52f19c7e80680e052324jpeg.jpg" alt="" width="1400" height="933"/><figcaption>Pic: NT ARCHIVE</figcaption></figure>Tuberculosis remains <a href="https://www.nepalitimes.com/editorial/tb-or-not-tb/" target="_blank" rel="noopener">a major public health problem in Nepal</a>, with over 32,000 notified cases and an estimated 7,000 deaths per year.Nepal participated at the United Nations High Level Meeting on TB in September 2018 and, with all the other nations of the world, committed to end TB as a public health problem by 2035.In June, a team of international TB experts reviewed the country’s progress against the disease, visiting five provinces. Their findings: Nepal is not on track to meet the 2035 commitment.  What is more, cases of TB in the country are much higher than we previously estimated.There had been concern that notified cases were just the tip of the iceberg, as there was evidence that many TB cases were being missed.  The Ministry of Health and Population (MOHP) supported by the Global Fund against AIDS, TB and Malaria and the World Health Organisation, conducted a survey to measure for the first time the amount of <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB in Nepal</a>.Read also:<a href="https://www.nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy/" target="_blank" rel="noopener">Nepal tests and treats TB with a flying pharmacy</a>, Ramu Sapkota<a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB</a>, Sonia AwaleDespite the terrain, this was one of the most thorough surveys ever done. Final results will be published at the end of the year, but preliminary findings show there is about two-thirds more TB than was previously estimated.How could this be? For over 20 years, Nepal has had a National TB Programme (NTP), which provided nationwide coverage of basic services for drug sensitive TB and, more recently, for drug resistant TB. Treatment results compare favourably with other countries.The NTP has successfully introduced modern rapid diagnostic technology (GeneXpert) and electronic reporting of cases, started a collaboration with the private sector to ensure proper management of patients, and begun a program to find and treat children with TB.Read also: <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener">For Nepal, a game-changer in TB control</a>, Buddha Basnyat and Maxine Caws<a href="https://www.nepalitimes.com/editorial/tb-or-not-tb/" target="_blank" rel="noopener">TB or not TB</a>, Editorial<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814110/636a52f59c7e80680e052325jpeg.jpg" alt="" width="1000" height="639"><figcaption>A lab technician at National Tuberculosis Centre in Thimi, Bhaktapur. Photo: NATIONAL TUBERCULOSIS CENTRE</figcaption></figure>But long-standing weaknesses in management and organisation, compounded now by the federalisation process, have allowed some of the essential functions of the NTP to disintegrate, and others are at serious risk. The laboratory network for diagnosing TB and the system of supportive supervision that ensures standards are maintained through all levels of government should be restored immediately.This is because district centres, key to TB control strategies, were abolished — and then reinstated — but with far fewer staff than previously.Accurate surveillance of the cases notified and the flow of information to the centre is endangered. Federalisation has so far not created clear mechanisms that will ensure these essential functions continue. If decentralised procurement of drugs continues, it will increase procurement costs significantly and risk the purchase of poor quality drugs.Successive governments have allowed the technical staff of the National TB Centre to be hollowed out, eroding its capacity to develop policies and lead their implementation. The National Strategic Plan, written three years ago, is underfunded and only partially implemented. Most staff responsible for TB activities are now not trained to carry out the work.Diagnosis is mostly by outdated and insensitive sputum microscopy.  <a href="https://www.nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy/" target="_blank" rel="noopener">Transport of specimens to laboratories</a> is still inadequate. Consequently, GeneXpert utilisation has been slow to increase.The private health sector is massive and growing. Over 70% of people with TB first go to private clinics, yet diagnosis and treatment are of variable quality, leading to drug resistance.The joint monitoring mission recommended the following:Stop the collapse of the NTP by engaging the MOHP in discussions on federalisation to ensure that the essential functions of TB control are preserved, with clear roles and responsibilities for the newly appointed staff.Increase investment to provide technical support to all levels of the NTP through teams of staff at central and provincial levels. Let a partner employ these staff if the government cannot do so immediately.Use these teams to address the massive training gap that hypermobility of staff and federalisation have created.Phase out sputum microscopy for diagnosis and move to GeneXpert testing, and make sure contracted organisations achieve case-finding targets. If they do not, stop the activities and redirect the resources to more effective areas.Fully engage with the private sector to ensure patients there are diagnosed and treated according to national guidelines.Similarly engage with community-based organisations to help find cases and ensure they finish treatment.Nepal must act on all these recommendations without delay to get back on track to meet its commitments.Paul Nunn was Team Leader of the international mission and Bhim Singh Tinkari is a recent Director of the National Tuberculosis Centre<h2>Communities against a communicable disease</h2>TB testing by and for communities can free Nepal from its biggest infectious killerOlivia Biermann<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814110/636a52f79c7e80680e052326jpeg.jpg" alt="" width="1400" height="1194"><figcaption>Photos: Birat Nepal Medical Trust</figcaption></figure>Ram, 65, from Makwanpur was nothing but skin and bones. He had lost his appetite and was coughing. His back pain made it difficult for him to walk and care for his chickens and buffalos, which were his main source of income. Ram was very sick, but his disease remained undiagnosed.Over the course of a year, he had visited several private and public health facilities, and spent over Rs69,000 for different treatments. Nothing helped. Ram had given up hope of being healthy.A partner organisation of the national TB program was targeting high-risk areas like Makwanpur for the disease by setting up neighbourhood camps to test people. Ram met volunteer Sangita, who collected his sputum sample and tested it. Ram had TB. He started treatment immediately. Six months later, the treatment completed, he was cured.There are about 10,000 Nepalis like Ram, sick with TB but never diagnosed and treated. They continue to unknowingly transmit the disease to their families, friends and colleagues — fuelling the epidemic. Poverty increases the likelihood that a person will get sick with TB. In turn, TB can make people and their families a lot poorer.Worldwide, TB is the number one infectious killer. The World Health Organization (WHO) estimates 3.7 million people have TB, but do not even know it.One strategy to find these ‘missing’ TB patients is community-based screening (active case-finding). Setting up a camp, as in Ram’s neighbourhood, is only one of many examples of how this type of outreach screening can be done. It could also mean testing friends and family members of a TB patient or offering screening to high-risk groups, such as persons with HIV or diabetes, or people living in a homeless shelter.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814110/636a52fb9c7e80680e052327jpeg.jpg" alt="" width="1400" height="1116"><figcaption>PROACTIVE MEASURES: Health care volunteers during an outreach screening program in Dhanusha as part of active case-finding for tuberculosis in local communities.</figcaption></figure><a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener">Active case-finding</a> is not a silver bullet to end TB. There are no silver bullets, in fact. Consequently, in countries with many TB patients like Nepal, community-based TB screening is a necessary but potentially double-edged sword in the global TB emergency.Community screening can waste resources or increase stigma, but it can also decrease suffering and transmission – it all depends on how it has been tailored and put into practice. That is to say that this ‘sword’ should be used carefully, and by those who know when, where and how to mobilise the community.Tailoring outreach screening approaches means considering a) global and local data and evidence, which are limited but steadily growing, and b) using the most accurate diagnostic tools, such as the molecular <a href="http://archive.nepalitimes.com/news.php?id=17747#.XUwPT_IzaUl" target="_blank" rel="noopener">GeneXpert test</a> not widely available in Nepal yet. (See article above)Active case-finding is a balancing act. Tailoring and integrating outreach screening approaches implies that we must consider and strike a balance between:Focusing on transmission versus individual health outcomesPublic health versus risk of harm for individualsEmploying the necessary human resources versus relying on volunteersAchieving long-term success versus containing costs in the short-termProactive prevention versus reactive medical interventions.What Nepal needs to meet its 2030 TB target, contained in the Sustainable Development Goals, is a person-centred public health and sustainability mindset. This is not an oxymoron. We need to keep the big picture in mind so that the 10,000 missing Nepali TB patients like Ram can be identified and treated. Only then can we work towards ending the TB epidemic.Olivia Biermann of the Karolinska Institutet in Stockholm used to work for the WHO and is researching health systems and policy in low- and middle-income countries.  Read also:<a href="http://archive.nepalitimes.com/news.php?id=17747#.XUwP8_IzaUl" target="_blank" rel="noopener">Game change in Tuberculosis</a>, Buddha Basnyat<a href="https://archive.nepalitimes.com/page/resistance-to-live-saving-drugs-threatens-to-set-back-progress-in-nepal" target="_blank" rel="noopener">The return of microbes</a>, Sunir Pandey

Nepal TB cases grossly underestimated

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107161120/636922289c7e80680e03a112jpeg.jpg" alt="" width="1400" height="1051"/><figcaption>DREAM COME TRUE: Capt Pradeep Shrestha in the cockpit of a Boeing 787 Dreamliner (left) says there is no reason Nepal airlines cannot replicate Ethiopian’s success. Pic: Kunda Dixit</figcaption></figure>Nepal and Ethiopia have travelled similar trajectories as nations. Both are ancient landlocked <a href="http://archive.nepalitimes.com/article/nation/nepal-from-royal-to-republic,3736" target="_blank" rel="noopener">former monarchies</a>, both suffered ruinous wars, both struggle with governance and <a href="https://archive.nepalitimes.com/article/editorial/trickledown-corruption,4176" target="_blank" rel="noopener">corruption</a>, both are now vibrant democracies, but poverty and disease are persistent and endemic in the two countries.Compared with Ethiopia, however, Nepal has a much higher GDP per capita, is ahead in the ease of doing business, and Nepal has made much more progress in <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">improving health indicators</a>.There is one area in which Ethiopia is far ahead of Nepal, however: running a global airline. While Nepal Airlines is mired in government <a href="http://archive.nepalitimes.com/blogs/kundadixit/2015/11/02/prepared-for-takeoff/" target="_blank" rel="noopener">interference and mismanagement</a>, state-owned Ethiopian Airlines is a reputed award-winning airline.“What has allowed Ethiopian Airlines to fly high is that from the time of [former emporer] Haile Selassie, the carrier has been insulated from government interference. It is state-owned, but does not depend on the state,” explains Pradeep Shrestha, a Nepali captain who flies for Ethiopian.Having flown for Nepal Airlines for nearly four decades, Shrestha has a unique perspective for comparing the two countries and their airlines. He credits Ethiopia’s former rulers, who saw the national airline as a global ambassador flying the country’s flag, whereas in Nepal, <a href="https://archive.nepalitimes.com/article/business/saving-nepal-airlines-with-fleet-route-expansion-drives,1983" target="_blank" rel="noopener">politicians interfered with the national airline</a>.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107161120/6369222b9c7e80680e03a113jpeg.jpg" alt="" width="1400" height="1150"><figcaption> </figcaption></figure>Ethiopian Airlines was voted Best Airline in Africa last year and is the most profitable carrier in the region. The airline is the envy of other African nations because of the full autonomy it enjoys, despite being owned by the government. The airline has a fleet of 103 aircraft, including the latest model Boeing 777 and 787, and Airbus 350s, one of which is named Mt Everest. It has its own state-of-the-art maintenance hangar, and an advanced crew training school.From the beginning, Ethiopian has set its sights on being a global airline and accomplished it with a deep sense of nationalism, commitment, and transparency. There was a time Royal Nepal Airlines also had vision, and was regarded as one of the best airlines in the region for its service and equipment. It was one of the first carriers in Asia to buy state-of-the-art Boeing 757s in 1985, which today would be like acquiring brand new Dreamliners.“Actually, I believe we have as much potential as Ethiopian,” Capt Shrestha told Nepali Times. “Ethiopian is leveraging the country’s location, while Nepal can promote its destination.”Indeed, Ethiopian Airlines has pivoted its Addis Ababa hub as the gateway to Africa, offering connections to nearly 30 destinations in the continent for its flights from China, South Asia, Europe and the Americas.Shrestha returned to Nepal after getting his pilot’s license in Canada in 1982, flew Twin Otters, then Boeing 757s. He went back to flying STOLs for Kasthamandap to remote area airports.But when Ethiopian Airlines announced vacancies for pilots, he applied because his “dream was to fly Dreamliners”. At first he flew Ethiopian 767s chartered to the U.N., and often flew Nepali peacekeeping forces from Sudan, Haiti and East Timor to a familiar Kathmandu airport.Shrestha says he often wonders what Nepal Airlines would need to take off again. He thinks adding wide bodies would be the first step, but much more important would be visionary leadership, elimination of government interference, discipline, and a merit-based management.He adds: “There is no reason why Nepal cannot do what Ethiopian has accomplished. I am positive about it.”

What can Nepal learn from Ethiopia?

<figure><img width="678" height="509" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107141112/6369044e9c7e80680e037d16jpeg.jpg" alt=""/><figcaption>UN Nepali Diplomat Kul Gautam accepts Harris Wofford Global Citizenship Award from National Peace Corps Association President Glenn Blumhorst.</figcaption></figure>Retired Assistant Secretary-General of the United Nations and peace activist Kul Chandra Gautam received the highest honor bestowed to a global leader by National Peace Corps Association (NPCA) in Shawnee of Pennsylvania on Friday.The annual award is named for the former U.S. Senator who was instrumental in the formation of the Peace Corps in 1961 as a special  assistant to President John F. Kennedy. NPCA is the largest non-profit organization representing Returned Peace Corps Volunteers.Born in a small village without running water or electricity, Gautam’s ties to the Peace Corps date back to 1962 when he attended a school in Tansen, about a three-day walk from his home.Read also: <a href="https://www.nepalitimes.com/featured-videos/kul-chandra-gautams-long-journey-home/" target="_blank" rel="noopener">Kul Chandra Gautam's long journey home</a>, Kunda DixitRecognizing Gautam’s talents, Peace Corps volunteers encouraged Gautam to seek a college scholarship in the United States. Gautam eventually graduated with degrees from Dartmouth College and Princeton University and then worked for UNICEF over three decades, rising to become Deputy Executive Director of UNICEF and Assistant Secretary-General of the United Nations in the early 2000s.After retiring from the UN, Gautam was briefly Special Adviser to the Prime Minister of Nepal on International Affairs and the Peace Process. He continues informally to advise his country’s senior political and civil society leadership on the peace process, consolidation of democracy, human rights, and socio-economic development. "I am thrilled and most grateful for this honour,” said Gautam. “My experience with the Peace Corps has been a source of great inspiration for me from my early student days in Nepal and throughout my long career with the United Nations in the service of the world's poor and disadvantaged, particularly women and children. This prestigious award will further motivate me to continue to dedicate the rest of my life to pursue the core Peace Corps values of service, peace, development, human rights and global human solidarity.”In describing the award, NPCA CEO Glenn Blumhorst noted: “This award honors an outstanding global leader who grew up in a country where Peace Corps Volunteers served, whose life was influenced by the Peace Corps, and whose career contributed significantly to their nation and the world in ways that reflect shared values in human dignity and economic, social, and political development.”Gautam was nominated by RPCV Doug Hall of New Hampshire. After serving in the Peace Corps in Nepal in the late 1960s, Hall first met Gautam as an undergraduate at Dartmouth College in 1971.“I am so happy that NPCA has selected Kul Gautam for this year's Wofford award,” said Hall.  “Kul's long career in the UN and subsequent activity back in Nepal exemplify his dedication to global and national leadership and commitment to goals that all Peace Corps Volunteers have shared over the years: international understanding and peace. Throughout his life, he has not been hesitant to praise President Kennedy's vision in establishing the unique institution that is the US Peace Corps."To learn more about NPCA, go to: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.peacecorpsconnect.org/cpages/home" target="_blank" rel="noopener">www.peacecorpsconnect.org</a>To learn more about Kul Chandra Gautam, go to: <a href="http://www.kulgautam.org" target="_blank" rel="noopener">www.kulgautam.org</a>

Kul Chandra Gautam awarded

The United Nations office in Nepal, on Friday issued a statement reiterating its support for the government, saying it ‘values highly’ its partnership with the country.The short statement appeared to be in response to media reports in Kathmandu on Friday saying the UN was carrying out a study of political developments in Nepal without consulting with the host government.‘The UN closely consults and partners with the Government in planning and implementing development activities, with the shared objective of a peaceful and prosperous federal Nepal as laid out in the Constitution, and the achievement of the 2030 Agenda on Sustainable Development,’ the statement read.The statement was issued by the office of the UN Resident Coordinator in Nepal, Valerie Julliand, and added: ‘Nepal is a respected member of the United Nations and the UN highly values the long and trusting partnership with the Government in addressing global challenges on peace and security, human rights and the Sustainable Development Goals.’This follows high on the heels of a run-in between the government of Nepal and the European Union Election Observation Mission statement last week that recommended scrapping electoral quotas for Nepal’s dominant caste groups. The Foreign Ministry reacted sharply to the report after a storm of angry posts against the EU on social media.The media reports quoted unnamed sources as saying that the UN office in Kathmandu had started an exercise to study Nepal’s foray into federalism and identity politics allegedly without clearing it with the government.

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