Nepal PM’s Top Aide Calls for Stronger Health Sovereignty Across South Asia

COLOMBO (News 1st); As the world continues to grapple with the lessons of COVID-19 and prepares for future pandemics, a key question is increasingly being asked across developing nations: who really controls access to healthcare, medicines and life-saving vaccines when a global crisis strikes?

For Prakriti Dhakal, Personal Under-Secretary to the Prime Minister of Nepal, the answer lies in a concept that is becoming more important than ever: health sovereignty.

Speaking to News 1st on the sidelines of the MSF Health and Humanity Summit in Colombo, Dhakal said discussions about health sovereignty must go beyond hospitals, medicines and funding, and begin with a deeper understanding of power itself.

According to her, power exists at multiple levels. There is the direct power to make policy decisions, the power to influence and shape policy agendas, and the power to drive ideas and values that ultimately influence decision-making.

She noted that while governments hold the primary authority to formulate policy at the national level, civil society groups, development partners and citizens also play critical roles in shaping priorities and demanding change.

However, the challenge becomes even more complex on the international stage.

"Countries operate within a system of treaties, conventions and international organisations where influence is not always equally distributed," Dhakal explained, adding that developing nations must better understand their place within these structures if they are to effectively protect their healthcare interests.

For Dhakal, health sovereignty should not be measured solely through economics.

She argued that while cost-efficiency is important, the real test is whether healthcare systems are equitable, accessible and capable of meeting people's needs.

"If large sections of the world's population are unable to access vaccines, medicines, diagnostics and treatments, then no country can truly consider itself secure," she said.

Drawing on the experience of the COVID-19 pandemic, Dhakal recalled how vaccine access became one of the defining examples of global inequality.

While wealthier countries were able to secure significant quantities of vaccines early, many lower-income nations struggled for months to obtain doses for their populations.

The experience, she said, demonstrated why developing countries must demand a stronger voice in global health governance.

"If pathogens or scientific data are shared by one country and contribute to vaccine development, then there must be guarantees that those countries will also receive fair access to those vaccines when they become available," she said.

Dhakal pointed to ongoing international discussions on pandemic preparedness and financing, including proposals requiring a portion of future vaccines and treatments to be allocated to lower-income nations.

She emphasized that such arrangements should not simply focus on sharing final products but also on building local capacity, strengthening national health systems and enabling countries to become more self-sufficient.

The Nepalese official noted that countries such as Nepal are now playing increasingly important roles in international health discussions, including within the World Health Organization, creating new opportunities to advocate for the interests of developing nations.

While acknowledging the growing influence of global institutions and development partners, Dhakal stressed that national governments must remain at the centre of decision-making.

"For me, each country's government is the supreme authority. Nothing else should be able to affect, influence or manipulate it. The Government of Sri Lanka should be in the topmost position for Sri Lanka. Development partners and international actors should listen to what governments identify as their needs and support those priorities accordingly. The same applies to Nepal and every other country," she said.