KATHMANDU: Nearly 30,000 Nepali children die yearly in their first month of life, the third highest rate in the world. Yet, the battered country is on track to slash under-five mortality by two-thirds within a decade, says the United Nations. Other improvements are also under way, in a nation where the bleeding sometimes never seems to stop, according to the world body. “It seems baffling,” says Sriram Raj Pande, who heads the UNDP’s pro-poor policies initiative in Nepal. “Yet the (results) are based on the national statistical surveys they do show there has been improvement in many areas.” The child death target is one of eight Millennium Development Goals (MDGs) set by the global community in 2000. A UN report released recently documents Nepal’s steps in reaching those targets.
“Nepal has made significant progress over the past 15 years in reducing poverty, improving access to education, health services and drinking water...however, some serious challenges remain in addressing inequality and exclusion, which is a critical factor hindering the equitable distribution of the results of development efforts across all geographical regions and social groups,” says the foreword. Even a massive drop in the country’s poverty rate in the past eight years, reported earlier this year, was tempered by the finding that the gap between rich and poor is widening.
The report outlines steps the government has taken to achieve the MDGs — such as incorporating the goals into its five-year national plans, developing a poverty-monitoring system and initiating fiscal reforms like privatising public banks. But, concludes the introduction, “intensifying violence and political instability have been hampering the effective utilisation of aid. Restoring peace and democracy in the country, therefore, is of utmost priority to put development efforts back on track”.
According to the report, by 2015 Nepal is likely to meet the MDG goal of halving the proportion of people living below the national poverty line. Cutting in half the fraction of people who do not have access to safe drinking water is another target “likely” to be met, it adds.
“Some extra efforts from the side of the government and the donor partners may help in achieving three goals: gender and equality , improving maternal health and ensuring environmental sustainability ,” says a statement released by the UN Development Programme (UNDP) in Nepal. But “the report strongly states that the goal of achieving universal primary education is unlikely to be met.” Similarly, efforts will likely fail to halt and reverse the spread of HIV/AIDS by 2015, despite some improvements.
Development in Nepal, one of South Asia’s poorest countries where nearly four out of 10 people lives on less than a dollar a day, has been stunted by a Maoist uprising that has spread across most of the countryside. In the past decade, 12,000 people have died, thousands more have crossed into southern neighbour India for security and countless others have been displaced within the tiny country.
On Feb. 1 King Gyanendra fired the government for failing to defeat the Maoists, who say they aim to establish a system that will guarantee justice for the country’s disadvantaged groups, especially Dalits (so-called untouchables) and indigenous people, who together make up more than half of Nepal’s 25 million people.
While Nepal graduated in 2002 to being classified a country of “medium” development, that progress has been limited by many “constraints”, the MDG report says. These include: rugged terrain and inadequate infrastructure, high transport and investment costs, weak governance and high population growth. But for children, developments such as better control of diarrhoea, improved immunisation, nation-wide Vitamin A supplements and better management of acute respiratory illnesses, especially pneumonia, are likely causes for the “remarkable reduction” in Nepal’s child mortality in the last 30 years, says the report. If that progress continues, the country will probably attain the MDG child mortality goal despite the conflict’s destructive impact on rural life.
With an HIV/Aids prevalence rate of 0.5 per cent in the 15-49 age group, the disease would not seem to be a big health threat. However, “data suggests that Nepal has entered the stage of a concentrated epidemic,” says the report. “This means that HIV/Aids prevalence consistently exceeds five percent in some sub-populations such as female sex workers and injecting drug users.”
If the disease follows trends elsewhere it will move from those sub- groups to the general population, warns the report. This “has the potential to cause an explosive epidemic”. One study estimates Aids could be the leading cause of death in the 15- 49 age group by the end of the decade.—Dawn/The Inter-Press News Service