Dispatch

Nepal’s Vaccine Disaster Has Left Millions Unprotected

Alleged corruption and geopolitical worries have created a deadly shortage.

Street artists paint a mural depicting COVID-19 front-line workers in Nepal.
Street artists paint a mural depicting COVID-19 front-line workers in Kathmandu, Nepal, on June 10. Prakash Mathema/AFP via Getty Images

KATHMANDU, Nepal—Nepal was on the right track to defeat the pandemic with the launch of its vaccination campaign on Jan. 27, even as several Western countries lagged behind in the vaccination race.

But the euphoria that saw a decline in COVID-19 cases and a successful rollout of vaccines didn’t last long. Lockdown was eased in the following months, and political rallies and protests, religious festivals, and public movements turned into superspreader events. The result was tragically predictable: Nepal was hit hard by a deadlier second wave.

KATHMANDU, Nepal—Nepal was on the right track to defeat the pandemic with the launch of its vaccination campaign on Jan. 27, even as several Western countries lagged behind in the vaccination race.

But the euphoria that saw a decline in COVID-19 cases and a successful rollout of vaccines didn’t last long. Lockdown was eased in the following months, and political rallies and protests, religious festivals, and public movements turned into superspreader events. The result was tragically predictable: Nepal was hit hard by a deadlier second wave.

Yet Nepal’s failure goes deeper. A corruption scandal has led to the effective halt of the vaccination program—leaving many people unable to get the important second shot and even more without even their first.

According to Our World in Data, so far 2.9 million doses have been administered and around 700,000 people have been fully vaccinated, only 2.5 percent of the total population. The small country has witnessed nearly 600,000 infections and over 8,000 coronavirus-related deaths.

The number of cases started to skyrocket in March and peaked in mid-May. Nepal has rivaled India’s rates of infection. The COVID-19 numbers in Nepal could, according to one estimate, reach around 800,000 cases and 35,000 deaths by mid-July.

Earlier this year, India was already suffering from the delta variant, and a porous border with Nepal meant the delta virus was bound to enter India’s mountain neighbor. The Nepali government continued to encourage flights to and from India and had to manage returning Nepali migrant workers while failing to properly impose border exit, entry, and quarantine. The need for vaccines was urgent—but the system had collapsed.

In February, Minister for Health and Population Hridayesh Tripathi indirectly informed the public that a local contractor might be obstructing the procuring of AstraZeneca vaccines from India’s Serum Institute. That comment led to a series of investigations by the local press.

The agents involved in the procurement of the AstraZeneca vaccines had close ties with Nepali Prime Minister K.P. Sharma Oli. The Serum Institute had already been in touch with the agents and had promised to deliver the AstraZeneca vaccine. The Nepali government signed a deal to procure 2 million vaccines from the Serum Institute for $4 per dose. One million doses arrived in Nepal on Feb. 21, and the government was willing to pay up to $5.50 for additional doses.

But the Serum Institute’s local agent in Nepal, Hukam Distribution & Logistics Private Ltd., was hoping to cash on the pandemic.

The whole program was halted after the agents demanded a 10 percent commission, pushing the price to $6.05 per dose.

Even if the government had wanted to pay what was, in effect, a coercive demand by a middleman, Nepal’s public procurement law has no provisions that would allow the government to pay a commission to agents under a government-to-government deal. But the Serum Institute had informed the Nepali government that it would only sell the vaccines through Hukam. On March 3, the Serum Institute wrote a letter to the Department of Health that it could no longer provide vaccines as promised earlier. The commission agents, Vijay Dugar and Ritu Singh Vaidya, partners at the distribution firm, are under scrutiny, as Dugar lives in Mumbai—putting him beyond the reach of Nepali authorities—and Vaidya’s husband, Suraj Vaidya, is close to the incumbent prime minister’s Unified Marxist-Leninist party.

The local agents are alleged to have prevented the export of the 5 million AstraZeneca vaccines if the commission wasn’t provided. They are accused of manipulating Indian bureaucracy to prevent the deal from moving forward.

Dugar refuted the claims by Tripathi, the health minister, and said that the government was trying to shift blame onto the agency. In a bizarre series of events, an under-construction facility of the Serum Institute in Pune, India, caught fire in January. The institute’s CEO, Adar Poonawalla, fled to the United Kingdom in recent months, citing security reasons.

The Health Ministry had put out a press release saying the vaccines couldn’t be procured from India because of the fire and rising COVID-19 cases in India. The Serum Institute later clarified that the fire wouldn’t affect its exports.

However, the government of India later banned the export of vaccines, citing the pandemic disaster at home, and Nepal never received the remaining doses. Nepalis were abandoned.

All this has played out against a background of Nepal’s uncertain political position between Nepal and China. The Nepali government had refused to accept Chinese vaccines, hoping that India would fill the gap.

Bindesh Dahal, a foreign analyst and diplomatic editor at the news site Lokantar, told Foreign Policy, “Nepal depended on India alone for vaccines. But India punched above its weight. Vaccine diplomacy of India went only so far. We should have diversified vaccine procurement. China was willing to send vaccines. Russia too. But we didn’t care. When India stopped exporting vaccines, we panicked and started pleading with different countries. India-dependence is the root cause of current vaccine procurement failure.”

After a reversal of policy, Nepal received an additional 1 million Sinopharm vaccines from China this week. It needs 43 million more doses to inoculate enough people to provide a strong communal immunity.

“The Oli government is trying to cozy up to India for immediate political gains,” Dahal added. “It seems that Oli and [the Rashtriya Swayamsevak Sangh/Bharatiya Janata Party] establishment has made rapport to keep Oli in power. Indian establishment fears the Chinese bogey. Therefore, it appears that Oli didn’t want to spook them with an overture to China. But now that situation is dire; the Oli government has taken vaccines from China as well.”

Although foreign countries are reaching out to Nepal with medical help, around 1.4 million elderly Nepalis are still waiting for the second dose of AstraZeneca, after initially receiving the first. The COVAX initiative is supposed to supply 13 million more doses, but only a fraction have arrived so far.

U.S. President Joe Biden’s administration announced on Thursday that it is unveiling a plan to share at least 80 million vaccines with the rest of the world, including Nepal—but time is running out for the Himalayan nation as the pandemic rages.

Arun Budhathoki is a Nepalese journalist and poet.

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