Nepal has demonstrated commendable progress on a range of health indices, despite myriads of challenges. Nepal is among the least developed countries currently, but due to its sustained and growing progress on a range of sustainable development indices, it is all set to do away with this tag in 2026.

Dr Bikash Devkota, Secretary, Department of Health and Population, Government of Nepal, shared some of the milestones “that we believe are not only national successes but maybe the global exemplars.”

“Nepal has witnessed one of the most dramatic health transformations. Life expectancy at birth has increased almost three-fold, from 28 years in 1954 to 72 years in 2021. Nepali story is remarkable in efforts to reduce maternal deaths. Over the last three decades, we have reduced maternal mortality ratio by more than 70%. This means that tens of thousands of Nepali mothers who might once have been lost during childbirth are now alive raising their children, nourishing them and contributing to their community. The neonatal mortality rate reduced by more than half, declining from 50 deaths to 21 deaths per 1,000 live births over the same period,” said Dr Devkota.

Dr Devkota was the opening keynote speaker at SHE & Rights (Sexual Health with Equity & Rights) session on the theme: “United Nations General Assembly (UNGA 2025): Only 64 months left to deliver on SDG-3 and SDG-5: It is time for Accountability.” SHE & Rights is hosted together by Global Center for Health Diplomacy and Inclusion (CeHDI), International Conference on Family Planning (ICFP) 2025, Family Planning News Network (FPNN), International Planned Parenthood Federation (IPPF), Asian-Pacific Resource and Research Centre for Women (ARROW), Women’s Global Network for Reproductive Rights (WGNRR), Asia Pacific Media Alliance for Health and Development (APCAT Media) and CNS.

Clock is ticking as 64 months left to deliver on SDGs

Globally, progress on SDG-3 (health and wellbeing) and SDG-5 (gender equality) has been at best, patchy and fragile – and far from being satisfactory. Anti-rights and anti-gender pushes are threatening to reverse some gains made on health and gender equality.

Dr Devkota echoes the sense of urgency that should drive spirited action to keep the promises enshrined in the SDGs. “The clock is ticking, and the urgency is real for Nepal. This moment is not only about reflecting our progress but also about reaffirming commitments, embracing accountability and inspiring collective global action. If we see Nepal's public health journey, then it is from fragility to the leadership over the past decades. Nepal has travelled an extraordinary journey in public health despite limited resources, complex geography, frequent crisis from political transitions to devastating earthquake and the COVID-19 pandemic.”

“Nepal has demonstrated that determined policies, community ownership and global solidarity can drive remarkable change. Access to sexual and reproductive health and rights in Nepal has expanded significantly supported by progressive legislation such as the Safe Motherhood and Reproductive Health Rights Act which was enacted by the federal parliament of Nepal to respect, protect and fulfill women's constitutional rights to safe motherhood and reproductive health by ensuring the provision of safe, quality, affordable and accessible maternal and reproductive health services,” said Dr Devkota, who has served Government of Nepal in various leadership roles and currently leads Ministry of Health and Population as its Secretary.

Nepal’s Aama programme is another sterling example

A cornerstone of Nepal's maternal health progress has been the “Aama” (translates to mother in Nepalese language) programme, which stands as a flagship policy model of equity in maternal health, eliminating financial barriers so that no person in Nepal has to pay for maternity services.

“Aama programme provides financial incentives that empower women to choose safe institutional delivery and reinforcing the capacity of our health workers and institutions. It is not only saving lives but also setting a powerful example on how investment in equity transforms maternal health outcomes. Behind these achievements is the quiet but powerful contribution of nearly 52,000 female community health volunteers - the backbone of Nepal's health system - ensuring that every woman and child, even in the remotest village, can access life-saving care,” shared Dr Bikash Devkota.

No one should suffer from vaccine-preventable diseases

“Another area of pride is our progress in immunisation and disease elimination. Nepal has maintained over 90% of immunisation coverage under national immunisation programme for several years,” said Dr Devkota.

“Nepal conducted a nationwide campaign in 2024, reaching over 6.3 million children with measles and rubella vaccination. As a result of these sustained efforts, the World Health Organization (WHO) officially declared Nepal for having eliminated Rubella on 18th August 2025 and we are on track of eliminating measles, kala azar (visceral leishmaniasis), and malaria. These are not merely statistics, but these are lives saved, disabilities averted, and futures served. This progress is a testimony of our ability to deliver results when communities, governments and partners work together,” shared Dr Devkota.

Golden thousand days initiative of Nepal

"Sunaula Hazar Din" (this phrase is in Nepalese and means Golden Thousand Days) is a campaign run by Government of Nepal. 1000 days refer to the period from conception to the child's second birthday, encompassing approximately 270 days of pregnancy and 730 days after birth. This campaign, launched in 2014, aims to help protect newly born child and mother from malnutrition.

“Remarkable decline in malnutrition has been achieved through integrated multi-sectoral action among health, agriculture, sanitation, education and social protection programmes that are working together. Our celebrated campaign, the Golden Thousand Days Initiative (Sunaula Hazar Din) has mobilized communities to prioritise maternal and child nutrition during the most critical period for lifelong development. These efforts have improved growth, learning potential and productivity for millions of children across Nepal,” said Dr Devkota.

Nepal is the only Asia Pacific country to reduce new HIV infections by 75%

According to the latest UNAIDS Global AIDS Update 2025 released last month, Nepal is the only country in Asia and the Pacific region to show a decline of over 75% in new HIV infections between 2010-2024. There are only 4 countries globally to reduce HIV infections by 75% or more during the same period: Nepal, Kenya, Zimbabwe and Malawi.

Global goal is to achieve that 95% of people who know their HIV status should be on lifesaving antiretroviral treatment by 2025. ⁠Antiretroviral therapy coverage for people living with HIV reached over 80% in only 4 countries in Asia and the Pacific region: Cambodia (89%), Nepal (82%), New Zealand (90%) and Thailand (82%) by 2023.

TB is the deadliest infectious disease worldwide. Even during COVID-19, TB killed more people in many high TB burden countries than COVID-19. “Nepal has also improved TB notification rates and strengthened community-based direct observation treatment services ensuring early diagnosis and treatment. TB-free communities’ initiatives have hugely contributed to our commitment to aligning with WHO’s End TB Strategy and accelerating progress towards TB elimination,” said Dr Devkota.

Over 68,000 people get active TB disease in Nepal in 2023 but 36,900 of them were notified to the national programme, as per the WHO Global TB Report 2024. Every person with active TB disease must get early and accurate TB diagnosis, universal drug susceptibility test (to ensure that the medicines used to treat the person are effective against TB bacteria and not resistant), and support to finish the therapy – in a person-centred, rights-based and gender transformative manner.

More worrying is that only 52% of those with active TB disease were tested with WHO recommended molecular test. Microscopy underperforms and misses over half of TB disease. That is why Nepal government along with all other world leaders at United Nations General Assembly High-Level Meeting on TB in 2023 committed to replace microscopy with molecular test completely by 2027.

After malnutrition, tobacco use is the largest TB risk factor in Nepal

According to the WHO Global TB Report 2024, number of people who got active TB disease due to top 5 risk factors were as follows:

- Malnutrition caused TB in over 5,900 people

- Tobacco use caused TB in over 5,300 people

- Diabetes caused TB in over 3,100 people

- Alcohol caused TB in over 2,500 people

- And HIV caused TB in over 380 people.

Nepal government has demonstrated strong and deepening commitment to tobacco control since past several years. Most recently, despite reported tobacco industry opposition, Nepal stood steadfast with science, evidence and public health – and went ahead to implement world’s largest (100%) graphic pictorial warnings on all tobacco packs.

Agrees Dr Devkota: “Nepal is also proud to be a global leader on tobacco control. We are the only country in the world to implement 100% pictorial health warnings on all tobacco products. This bold initiative has earned Nepal international recognition and awards, demonstrating that even small nations can lead the way in advancing global public health.”

Over 70% of deaths due to non-communicable diseases

World leaders from all countries including Nepal would meet at the 80th United Nations General Assembly (UNGA) and UN High-Level Meeting (UNHLM) on Non-Communicable Diseases and mental health soon in September 2025.

The zero draft of Political Declaration that will be up for discussion for world leaders at UNHLM on non-communicable diseases (NCDs) is in public domain. It emphasises that the burden of NCDs, including cardiovascular diseases (such as heart disease and stroke), cancers, diabetes, and chronic respiratory diseases, which together account for more than 43 million deaths each year, 18 million of which occur prematurely (before the age of 70 years), with cardiovascular diseases accounting for the largest share of these deaths.

Tobacco use is among the common major NCD risk factors

“If we talk about the NCDs, climate change and antimicrobial resistance (AMR), we are not only fighting yesterday's battle but also preparing for tomorrow's challenge. Nepal has adopted a national action plan on AMR applying the One Health approach across human health, animal health, food and agriculture and environment sectors. We are addressing the rising burden of NCDs and mental health which account for more than two-third of total deaths in the country,” said Dr Bikash Devkota.

He added: “Recognising the threats of climate change, we are investing in vector-born disease control and prevention programmes, heat-related health risks and resilient health systems. These all achievements are anchored in a strong policy foundation. The Public Health Act guarantees health as a right. The gender equality and social inclusion strategy ensures that no one is left behind especially women and other marginalised groups. And most importantly, Nepal has in its constitution the right of every citizen to free basic services. The constitution guarantees and guides every action we take.”

Progress is possible with accountability

"With just 64 months left to 2030, the message is clear. Progress is possible, but only if we hold ourselves accountable. Nepal is committed in these priorities, equity and universal coverage, ensuring service reach the last mile and marginalised groups, sustaining gains, consolidating disease elimination efforts while tackling NCDs and climate sensitive diseases, strengthening accountability through digital health information system, citizen engagement and parliamentary oversight and empowering women and youth in health leadership because SDG-3 and SDG-5 are inseparable and must go together," said Dr Bikas Devkota of Nepal government.

"But we also know that challenges remain. Health inequities persist. NCDs are on the rise. Climate change is reshaping health risk and financing gaps threaten sustainability. Therefore, as world leaders would meet at the upcoming United Nations General Assembly next month, Nepal calls upon the global community, let us turn promises into action and action into measurable results. Let us ensure accountability at every level, local, national, regional, and global. Together we can still deliver on the 2030 promise," concluded Dr Devkota.

Shobha Shukla – CNS (Citizen News Service)