Working across sectors to combat the burden of NCDs in Nepal

The impact of noncommunicable diseases (NCDs) in Nepal is overwhelming. An estimated 71% of total deaths in the country were due to NCDs. Inclusive of deaths due to injuries, the figure staggers to 80%.

Implementation of a multisectoral approach is key to effectively addressing the rising burden of noncommunicable diseases. Aligned with this principle, the Government of Nepal endorsed the second Multisectoral Action Plan (MSAP) on prevention and control of NCDs in 2021. WHO Country Office for Nepal supported in drafting the plan and has been working closely with the Ministry of Health and Population and other stakeholders to implement the plan.

"Although the Country Office had been conducting multisectoral advocacy and engagement in the past, it was in a limited capacity, primarily due to lack of clarity about WHO's working modality with sectors beyond health. Through enhanced delegation of authority (DOA) to WHO representatives which allow quick decision making, and prioritization of working across sectors, the Country Office Strengthening Action Plan has empowered the staff and the country office to accelerate and strengthen multisectoral collaboration and deliver impact, particularly in NCDs," said Dr Rajesh Pandav, WHO Representative to Nepal.

"In the past two years, we have initiated several collaborations that have effectively contributed to aligning efforts across sectors to prevent and control NCDs and seen some great results. These partnerships have informed how we work across sectors to deliver results in tackling alcohol control, helmet use promotion and mainstreaming actions to curb use of e-cigarettes," said Dr Gampo Dorji, Team Lead for NCDs at WCO Nepal.

Traffic personnel in Kathmandu, Nepal is using a speedometer to check speed of an oncoming vehicle. Credit: WHO Nepal

For instance, WCO Nepal's engagement with the Ministry of Physical Infrastructure and Transportation, Nepal Road Safety Council, Nepal Police and civil society groups on road safety culminated into a development of a strategy for enforcement of helmet use among two wheelers in the country and expansion of drink driving counter measures beyond Kathmandu, the capital city. More than 33 000 breath tests have been conducted in Madhesh Province in 2024 after WHO supported codesigning of breath tests to check for drink driving with Nepal Police.

"WHO has been an important partner, supporting to conduct capacity building activities, providing us guidance on preparing significant strategic documents and sharing valuable inputs on designing interventions to improve the road safety situation in Nepal. We look forward to continuing and strengthening this collaboration, particularly in the areas of introducing international best practices in Nepal, bench marking by participating in national and international events, and in conducting research activities," said Saroj Kumar Pradhan, National Road Safety Council.

Similarly, WCO Nepal's partnership with the Ministry of Health and Population and a civil society group, in regulating and curbing alcohol advertising and sponsorship promotion, led to a landmark ruling by the Supreme Court of Nepal in 2023 which upheld the ban on any form of alcohol advertisement throughout the country.

And most recently, WCO's collaboration with the Department of Food Technology and Quality Control under the Ministry of Agriculture and Livestock on trans fat regulation led to the passage of a legislation limiting use of toxic trans-fatty acids for the first time, contributing to WHO's goal of global trans fat elimination by 2025.

Building on these successful multisectoral partnerships, WCO Nepal will continue to engage and work across sectors to fight the burden of NCDs in the country. Advocacy for the adoption of universal helmet use, strengthening enforcement for ban on e-cigarettes, capacity building for implementation of trans fat regulation and strengthening health promoting school environments are some of the immediate priorities of WHO. These partnerships built beyond the health sector in Nepal, are clear demonstration of strategic role WHO can leverage to make health-in- all policies a reality as reflected in the WHO General Programme of Work.