Can Nepal not make its own vaccine?

 Can Nepal not make its own vaccine?


At that time, the demand for the vaccine against Covid was very high, while India did not have enough vaccine for its own citizens.



It is said that although there was a need for vaccine production in Nepal, policymakers ignored it and a vaccine production company should be established.


The context is during the Covid-19 pandemic. Nepal was importing 2 million Covid-19 vaccines from India. After sending the first batch of 1 million, the second 1 million vials could not arrive. The import of the vaccine to Nepal was stopped due to a court order there.


The main reason for this is that there was not enough vaccine for their country. After this, Delta, which is considered the most deadly of the Covid variants, badly affected Nepal after India. If the second 1 million vaccines had arrived at that time, perhaps many deaths could have been saved.


Similarly, the recent resurgence of Japanese encephalitis has seen an increase in the number of infected deaths in the last few years. Nepal must rely on imports for this vaccine as well. Apart from these, vaccines are considered the surest way to prevent the outbreak of many other infectious diseases.


Past and present experiences of these studies also show that as we enter the 21st century, vaccines are the only solution for new (like Covid) and previously controlled and resurgent diseases (like Japanese encephalitis).


Although some medicines are currently being produced domestically, there is no vaccine production. It seems that policymakers have almost ignored the need for vaccine production.


Is it that Nepal itself cannot produce a vaccine for use in humans? Or has the health sector not yet realized the need for it, been unable to do it, or is not interested?


There are not enough health centers or hospitals in Nepal. Moreover, health centers equipped with the necessary physical infrastructure and resources are even more limited. In such a situation, if any infection spreads or takes the form of an epidemic, there will be a shortage of hospital beds, resources, and health workers.


This increases the risk of patient death. When I was working at Teku Hospital two and a half decades ago, dozens of patients with diarrhea and cholera were admitted every hour during the rainy season.


Similarly, Japanese encephalitis has a high mortality rate, so dozens of people were admitted every week during the mosquito season. Most of those admitted had to die because they arrived at the hospital late.


Generally, the impact of Japanese encephalitis is greater in the Terai. Due to the lack of sufficient hospital beds and manpower there, they were forced to come to Kathmandu.


But later, after the vaccine against Japanese encephalitis was used in Nepal, the mortality rate decreased sharply. At that time, support for the vaccine came from neighboring China. The support itself is not bad, but the question is for how long?


Nepal had expected foreign support for the vaccine during the Covid epidemic. At Nepal's request, India agreed to provide the Indian-made vaccine called Covoshield. However, when the second batch was to be sent, the vaccine could not reach Nepal because the court there had ordered to give priority to its citizens first and not to export it.


This decision is not surprising. Because at that time, the demand for the vaccine against Covid was very high, while India did not have enough vaccine for its own citizens. At that time, 'vaccine diplomacy' was also very popular.


There was a competition among developed countries to develop the vaccine against Covid the fastest. At that time, Covid was present as a great enemy against humanity, and the world was working day and night to develop a vaccine to protect itself from it.


After the Covid vaccine was stopped from India, another neighboring country, China, received the Covid vaccine as assistance. This also shows how important vaccines are during major epidemics.


The role played by the Serum Institute of India during the Covid pandemic is also an example of how much relief can be provided in an epidemic when a vaccine manufacturing company is available.


Although Covid itself is a new disease, scientists were able to develop a vaccine faster than expected due to their hard work day and night. Naturally, the possibility of developing a new vaccine is also greater in developed countries due to the presence of high-quality research laboratories and excellent scientists.


During an epidemic of a highly infectious and deadly disease that terrifies the world, only a limited number of vaccines are produced by limited production organizations in limited countries. In this case, the possibility of sending it to other countries or the rest of the world is also reduced.


But if the vaccine formula or the 'components' used in the vaccine can be obtained and a vaccine manufacturing company is available, India can be taken as an example that vaccine production can be continued. If there was a vaccine manufacturing company in Nepal during the Covid pandemic, human losses could have been prevented to a large extent. It was a situation where we had to sit and stare at foreigners.


It has only been a few years since the Covid pandemic ended. Those moments are still very tragic, especially for those who have lost their relatives to Covid or who have managed to survive severe Covid.


But it has also taught us some lessons. 

Use of AI in healthcare: How useful, how dangerous?

 Use of AI in healthcare: How useful, how dangerous?


Doctors use AI in conjunction with their knowledge, experience, and patient conditions, and the risk increases when patients base their decisions on that.



Use of AI in healthcare: How useful, how dangerous?


AI is not a replacement for doctors, but a tool to expand their capabilities, and its responsible use in the healthcare sector is necessary.

Some time ago, during the confusing time when the Medical Education Commission announced the PG results, I created a ‘seat predictor’ tool using available data and AI.


Recently, when the actual results of the government seat came out, this tool of mine seemed to be ‘conservatively’ very safe. The tool had ‘underestimated’ the actual rank somewhat, so that doctors did not have false expectations and could make safe decisions.


I have also included its detailed description and how to use it in the description of the MD/MS video of my Bimarsha Acharya YouTube channel. This small experiment made me realize one big thing, that AI is not an ‘enemy’ for the Nepali healthcare sector, but rather a powerful ‘co-pilot’ for those who know how to use it correctly.


In this context, I have been conducting clinical research training sessions, in which I have also been regularly covering the use of AI, its ethical aspects and its responsible integration into daily medical practice.


In the process, I have trained more than 700 doctors and medical students in Nepal. This experience has further highlighted the need to use AI not just as a tool, but also in a safe and responsible way with proper guidance.


AI has become like a companion to me while seeing patients daily in the hospital. I use it regularly to remember medication doses or precautions, compare different treatment methods, align my decisions with international guidelines and understand the results of the latest research and trials. In complex cases, comparing your initial clinical thinking with evidence-based information makes decisions clearer and more confident. In this way, AI is a powerful tool to augment the capabilities of doctors, not replace them.


AI for doctors: Which is more useful?


The various AI tools in use today, such as Grok, Gemnai, ChatGPT, Perplexity, and OpenEvidence, have their own roles. However, their use varies depending on the context. ChatGPT, Gemnai, or Grok can be useful for understanding general information, clarifying concepts, and facilitating quick clarification. Perplexity presents information with sources, making it easier to search and compare. However, evidence-based, contextual, and up-to-date information is extremely important for clinical decisions.


OpenEvidence is considered particularly useful in this regard. This platform focuses on providing evidence-based information based on international journals, clinical trials, and established guidelines. It shows doctors not just the answer, but also the scientific basis for it, which makes clinical decisions safe, reliable, and accountable.


Therefore, while various AI tools can be used for general understanding, OpenEvidence is considered one of the most suitable options in the current situation as an evidence-based platform for clinical practice and decision-making.


The danger of relying on AI's advice


Nowadays, many patients have started using AI like doctors. There is an increasing trend of seeking medical advice directly after experiencing common symptoms, which can be a serious danger.


For example, if someone has a stomach ache, AI can recommend a medicine to relieve common pain. But a serious problem like appendicitis may be hidden within that symptom. Even if the medicine provides relief for some time, the disease may become more complicated.


This is where the difference between AI used by doctors and patients becomes clear. Doctors use AI by combining their knowledge, experience, and patient's condition, while patients directly base their decisions on it, which increases the risk. Self-medication can sometimes even put lives at risk.


AI in Nepal's health sector


In a country with geographical challenges like Nepal, AI can bring about a major change in healthcare. In remote areas where there is a lack of specialist doctors, AI can help in decision-making at the primary level. Its use in X-rays, cardiac tests or emergency assessment can guide timely treatment.


Combining AI with telemedicine can reduce the distance between villages and cities. Patients can get specialist services nearby, while doctors can also provide better service with limited resources.


AI can also play a big role in the research sector. It can help increase participation in complex studies, data analysis and international publications. This has the potential to make Nepal’s health system knowledge-based and technology-friendly.


Our responsibility now


The future competition will not be between doctors and AI, but between doctors who know how to use AI and those who do not. A system that cannot adapt with time will fall behind.


Therefore, it is necessary for both the government and the private sector to work together to formulate a clear policy to integrate AI into the health system. It is imperative to provide training, resources and incentives to doctors.


If we fail to embrace this technology today, we will be unable to compete globally tomorrow. But if we move in the right direction, Nepali health care The sector can establish its identity on an international level.


The question now is clear: will we lead the change or lag behind it?

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