Since Nepal promulgated a new Constitution in September, there has been a blockade at the India–Nepal border at transit points.
The blockade is leading to another humanitarian crisis only 6 months after the massive April earthquake. The blockade has consequences on transportation, production, and distribution of medicines, and other essentials, limiting provision of basic health and emergency services, leading to decreased quality of care, and putting patients at risk of increased morbidity and mortality.Limited supply of fuels is directly impacting transportation and cold chain of essential vaccines and drugs, putting disease control, elimination, and eradication efforts at risk.
Nepal has made substantial progress in health goals such as for maternal and child health, which is now at stake because of limitation on basic and essential services. This situation increases the vulnerability of the people, there is a risk of increase of maternal and child mortality, more low birthweight babies, and in the long run decreasing life expectancy.
The April earthquakes have damaged many health infrastructures and while the reconstruction has just begun, this blockade is impeding health infrastructure reconstruction.
There is also a financial cost: for the earthquakes, the loss is estimated at US$7 billion, and the blockade is estimated to cost more than $5 billion. Although these are immediate consequences, long-term impact could be expected for Nepal but also for other countries.
First, in Nepal, this blockade could lead to catastrophic effects on the economy, putting at risk universal health coverage and health system strengthening.
Second, while Nepal has made progress in controlling vaccine preventable diseases due to its immunisation coverage, any challenges on coverage and compromise on quality of vaccination are a threat to elimination of diseases such as polio and measles. This increased the risk of resurgence of polio and threaten the endgame strategy at regional level and global level. This could affect health security globally (emerging and re-emerging diseases). Any haemorrhagic fevers, cholera, or any outbreaks would have catastrophic consequences, not only in Nepal. Nepal has had a number of avian influenza outbreaks in poultry, but not in humans; however, the current situation could lead to an outbreak in humans putting other countries at risk because of decreased response capacity and increased vulnerability of people.
Any blockade in this globalised world not only challenges the country “blocked”, but also challenges other countries