Nepali government pledges free cancer treatment for children, experts flag critical gaps

Most of these initiatives—reducing hospital wait times, increasing government health insurance coverage to Rs500,000, and providing outpatient care on public holidays—are yet to be implemented.

Arjun Poudel

Arjun Poudel

The Kathmandu Post

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File photo of the Ministry of Health and Population. The move is the latest in a series of populist announcements made by Minister for Health and Population Pradip Paudel since taking office around three months ago. PHOTO: THE KATHMANDU POST

October 30, 2024

KATHMANDU – Minister for Health and Population Pradip Paudel announced on Sunday that the government would provide free treatment to children under 14 years of age suffering from various types of cancer.

The move is the latest in a series of populist announcements made by Paudel since taking office around three months ago.

While most of these initiatives—reducing hospital wait times, increasing government health insurance coverage to Rs500,000, and providing outpatient care on public holidays—are yet to be implemented, Paudel continues to announce new free programmes.

According to a press statement issued by Paudel’s secretariat, free cancer treatment will be provided by Kanti Children’s Hospital, Bhaktapur Cancer Hospital, and Chitwan-based BP Koirala Memorial Cancer Hospital, starting November 16.

The federal government has already been providing Rs100,000 in relief to each cancer patient, including children, while the provincial government provides another Rs100,000. Officials said that the Health Ministry will cover any additional amount required for the treatment of children under 14 years with cancer from its internal sources.

A few days ago, Paudel also promised free care for impoverished burn victims who cannot afford treatment costs.

However, most health facilities that offer burn care provide only basic treatment, which often do not ensure patient safety.

Experts have welcomed the government’s decisions. However, they questioned the effectiveness and sustainability of the programmes announced by Paudel. They say that previous ministers and governments would have made similar decisions if there were simple solutions.

“Most programmes announced by the current health minister cannot be implemented due to various limitations,” said Dr Sagar Rajbhandari, a health expert. “Those who are unaware of the limitations and working style of our health system could be impressed by these populist announcements, but the reality is quite different.”

Due to the lack of positron emission tomography (PET) scans, immunohistochemistry, bone marrow transplants, and other tests available for children, patients are often compelled to travel to India for treatment. Health facilities providing cancer care for children said that they lacked support staff, including trained nurses and paramedics.

“Along with the decision to provide free care to children with cancer, we hope the government will invest in improving health facilities with the necessary equipment and trained human resources, which will help ensure quality care within the country,” said Dr Sudhir Sapkota, a pediatric oncologist at the Kanti Children’s Hospital. “Many patients cannot afford to go to India for these tests.”

According to doctors, PET scans are essential for determining the stage of cancer. This test provides more accurate reports than any other in identifying local or metastatic tumours (which spread to other areas of the body).

Immunohistochemistry (IHC) is commonly used to diagnose cancer, predict response, and determine likely disease outcomes. It also helps distinguish between different types of cancer.

Likewise, bone marrow replacement is necessary when existing bone marrow fails to work properly with new stem cells. Bone marrow transplantation provides new stem cells, which help kill cancer cells directly.

“‘If we can start offering the aforementioned services within the country, patients do not have to go India or other countries for treatment,” said Sapkota. “I hope the government will also work to address these shortcomings in the coming days.”

It is estimated that every year in Nepal, around 1,500 children under 14 years of age suffer from various types of cancer. Of them, around 200 seek treatment at the Kanti Children’s Hospital. Doctors at the hospital said that around 50 percent of the patients suffer from blood cancer.

Those seeking care at the first and second stages of cancer have a chance of full recovery. However, due to a lack of diagnosis facilities in most parts of the country, many patients seek treatment at the third and fourth stages.

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