Urgency of Pharmaceutical Sector Reform to Achieve Universal Health Coverage in Nepal

OBJECTIVES: The Constitution of Nepal 2015 has established health as a fundamental right of the citizens. Both the National Health Sector Strategy 2015–2022 (NHSS) and the National Health Policy 2019 (NHP) were developed to realize the constitutional aspirations and are anchored to Nepal’s commitment to Universal Health Coverage (UHC). The government cannot provide financial risk protection without equitable access to medicines. Quality medicines and pharmaceuticals are needed to expand health coverage and services. To fulfill the government's promise to improve public health, key policy reforms are required to unleash this potential.

METHODS: To discuss critical issues facing Nepal’s pharmaceutical sector, including the regulatory environment and domestic manufacturing, a high-level multisectoral policy dialogue was organized in November 2021, and a series of intensive focus group discussions were carried out to encapsulate a vision for Nepal’s pharmaceutical sector, outline the building blocks for pharmaceutical sector reform, and propose key reform priorities. The paper aims to provide a holistic view of the reform agenda and is mainly intended for the consumption of policymakers, development partners, and stakeholders directly or indirectly associated with Nepal’s pharmaceutical sector.

RESULTS: To unleash the full potential of Nepal’s pharmaceutical sector, several critical challenges need to be addressed. The main buckets of issues and challenges are self-reliance, regulation, quality assurance, institutional restructuring, innovation, and strategic positioning of the pharmaceutical sector. The building blocks of the pharmaceutical sector fall under seven domains: policy coherence and harmonization, regulatory stewardship, local manufacturing promotion, institutional governance, pharmaceutical services, and technology and innovation.

CONCLUSIONS: As Nepal transitions to federalism and the government shoulders the mandate of safeguarding the health of the citizens by espousing the principles of equality, prosperity, and social justice, the question “What should be new vision for the pharmaceutical sector?” needs to be answered from the perspective of both consumers and providers.