No Medicine Means No Treatment
Editorial
A patient reaches a hospital, doctors identify the illness and prescribe a course of treatment, yet the required medicine is unavailable. This increasingly visible problem in Nepal’s health system cannot be treated as a routine supply issue. When life-saving medicines and vaccines are not available on time, citizens are effectively denied their right to treatment. This is particularly serious in cases such as cancer, where timely medication is critical, or rabies, where delays can directly endanger life.
When medicines are unavailable in government hospitals, patients are forced to search for them in private pharmacies. In many cases, they may have to pay substantially higher prices. The burden becomes even heavier for low-income families. When a household must choose between buying essential medicine and meeting basic daily expenses, the failure of the health system becomes painfully clear. A government hospital cannot be defined merely by its buildings, doctors and beds. The medicines required to complete the treatment prescribed there must also be reliably available within the system.
Controlling medicine prices is a responsibility of the state. But price regulation should not create a situation in which medicines disappear from the market altogether. At the same time, shortages must never become an excuse for charging patients arbitrary prices. A balanced policy must take into account regulated prices, import costs, production costs, international market conditions and the purchasing capacity of patients. Keeping outdated price structures for years and blaming importers when supplies stop is not a solution. Nor is transferring the entire financial burden onto patients whenever suppliers demand higher prices.
Nepal needs a clearly defined national list of essential medicines, minimum stock requirements and an early-warning mechanism capable of identifying potential shortages before they become crises. Responsible authorities should know on a daily basis which medicines are available in which hospitals, how much stock remains, how many patients may require them and when the next shipment is expected. An integrated digital information system connecting government hospitals, the Department of Drug Administration, the Ministry of Health, importers and suppliers could help end the practice of holding emergency meetings only after medicines have already run out.
Ordinary procurement delays cannot be accepted when life-saving medicines are involved. The government should maintain strategic reserves of medicines used for cancer, rabies, heart disease, kidney disease, intensive care and other serious medical conditions. Where necessary, a central procurement system should ensure minimum stocks for a fixed period. If expiry dates, quality standards and consumption forecasts are professionally managed, maintaining such reserves should not be seen as an unnecessary expense but as an investment in national health security.
Market monitoring must also become more effective. If a medicine is unavailable in public hospitals but easily available in the private market, authorities must determine where the supply chain has failed. The state should be able to establish quickly whether the shortage is genuine, the result of poor distribution, a pricing dispute or deliberate market manipulation. If anyone is found to be exploiting the desperation of patients for commercial gain, strict action should follow.
Healthcare is not a favor granted by the state. It is a fundamental right of citizens. Having doctors without medicines, hospitals without essential treatment materials, or officially fixed prices without medicines actually being available at those prices reflects a serious failure of management. The success of government health policy should not be measured by the publication of price lists or official directives, but by a simple question: can patients obtain the medicines they need, when they need them, at a fair price? As long as treatment is interrupted because essential medicines are unavailable, the right to healthcare may exist on paper, but it cannot be said to exist securely in the lives of citizens.
