Strengthening Nepal’s Health Sector through Institutional Leadership and Innovation
Background
Nepal has identified health services as a national priority. Despite this, the country faces an escalating healthcare crisis marked by a severe shortage of qualified doctors and health professionals and Continuous outmigration of competent medical talent due to limited resources and opportunities. There is growing dependence on foreign countries for basic and advanced healthcare services. Families are burdened with high healthcare costs, including expensive overseas treatments. There is a mismatch between national ambitions for health tourism and the ground reality of inadequate domestic healthcare infrastructure.
Key Challenges
Nepal’s brightest medical professionals are migrating abroad due to limited research opportunities, weak institutional support, and lack of competitive incentives. Premier institutions like the Institute of Medicine (IOM) and other medical research bodies operate under severe resource constraints, limiting their capacity for innovation and excellence. The shortage of skilled professionals and under-resourced health institutions has left many citizens without reliable, quality healthcare services. While Nepal aspires to attract international patients, it struggles to provide basic healthcare for its own citizens, undermining credibility and feasibility.
Policy Recommendations
Declare Premier Health Institutions as Institutions of National Importance (INIs). Enact a Special Act of Parliament to grant INI status to key institutions such as the Institute of Medicine (IOM), Nepal Academy of Medical Sciences, and other comparable entities. This will ensure stable, long-term funding insulated from political cycles allowing academic and administrative autonomy to pursue innovation enhancing institutional reputation and global collaboration opportunities.
Create a dedicated funding mechanism to support research and development in medical sciences and health technology. THere should be incubation of health startups and innovation hubs within premier institutions supported by government and private sector. Public-private partnerships model should be implemented to accelerate health sector innovation.
Talent Retention and Development Programs
Introduce targeted programs to provide competitive incentives and career development pathways for doctors and health professionals within Nepal. Expand opportunities for international collaboration, training, and research without requiring long-term migration. Promote returnee programs for Nepali health professionals abroad. Realign Health Tourism Policy with Domestic Health Priorities
Health tourism can only be credible if built on a strong domestic health foundation. The government should prioritize strengthening healthcare for Nepali citizens. Invest in infrastructure and service quality that benefits both local populations and international patients. Market health tourism only after achieving demonstrable improvements in domestic healthcare delivery.
Expected Outcomes should be improved quality and accessibility of healthcare for Nepali citizens and reduced financial burden on families seeking treatment abroad. Increased retention of medical talent within the country. Elevated global reputation of Nepal’s health institutions. Creation of a realistic, credible foundation for health tourism in Nepal.
Conclusion
The health of a nation is its foundation for development, prosperity, and global competitiveness. Nepal must move beyond rhetoric and adopt bold, structural reforms that empower its health institutions, invest in innovation, and ensure healthcare excellence for all.
Elevating Nepal’s Premier Institutes to National Importance
Honorable Speaker and esteemed Members of Parliament, I rise today to speak on a matter of national destiny. Nepal stands at a pivotal moment – poised between the path of innovation-driven progress and the constraints of our current limitations . Our premier academies – the Institute of Engineering (IOE), the Institute of Medicine (IOM), the Nepal Academy of Science and Technology (NAST), and similar institutions – embody the talent and potential of our nation. Yet they have not been empowered to lead our scientific and
technological leap. We need bold vision and decisive action. I urge this House to follow India’s post-independence model: by declaring these institutions as “Institutions of National Importance” through a Special Act of Parliament, we can catalyze Nepal’s transformation.
Learning from India’s Visionary Model
Our neighbor India recognized early that a nation’s progress depends on premier institutes of learning. In fact, in 1946 the Sarkar Committee recommended creating world-class institutions (the IITs and IIMs) aligned with national development . These became engines of innovation, STEM leadership and global influence. For example, the Indian Institutes of Technology (IITs) and Indian Institutes of Management (IIMs), once established as Institutes of National Importance, have produced countless innovators and leaders. They have founded hundreds of high-tech companies and startups – including household names like Flipkart, InMobi, Ola, and Zomato – and even contributed an estimated 300–400 billion dollars to the world economy from
just the original six IITs . IIM graduates include global figures such as Indra Nooyi (former CEO of PepsiCo) and Ajay Banga (President of the World Bank Group) . And the All India Institute of Medical Sciences (AIIMS, New Delhi) now consistently ranks among the top medical schools worldwide, clinching 127th in the 2024 QS global medicine rankings . These successes show that special national status can turn technical and medical colleges into fountains of excellence. Nepal too has institutes of similar pedigree. IOE Pulchowk and Thapathali, IOM Maharajgunj, NAST Satdobato, among others, are the bedrock of our engineering, health, and science education. They educated generations of our doctors, engineers, and scientists. With proper
support, they could drive breakthroughs in health, technology and industry. We can replicate the strategic foresight of India: take our institutions and make them national anchors of innovation.
Transformative Benefits of National Recognition
Declaring an institute as one of national importance is not mere symbolism; it unlocks concrete benefits that modernize and sustain excellence. Most importantly, it guarantees long-term funding and institutional autonomy . Instead of wrestling year to year with budget constraints, these institutions would receive assured, multi-year funding. They could hire and retain top faculty without bureaucratic delays, and plan multi-year research agendas. As the advocacy group Digital Nepal Framework notes, such a designation “would guarantee long-term funding and institutional autonomy”, enabling global faculty and research exchange programs . In practical terms, this means our institutes could build cutting-edge labs and libraries, update
curricula with the latest technology, and reduce dependence on short-term grants. A Special Act would also empower them to collaborate internationally. Freed from restrictive rules, our universities could partner with foreign labs, host visiting scholars, and win grants from global agencies. We have seen that attracting external funding is currently a struggle: Nepal’s science organizations face chronic underfunding and limited global engagement . In fact, a 2021 survey of Nepali research institutions found all respondents complaining of “poor infrastructure and lack of budget” for research . With national-importance status, these institutes could tap philanthropy and multilateral programs. Donors and sister institutions are far more willing to invest in a formally recognized national priority. In short, the transformation would include:
● Dedicated Funding and Autonomy: Legal status would insulate these institutions from the uncertainty of annual budget cycles, allowing long-term planning. Autonomous governance (within national oversight) means boards can make academic decisions without political delay .
● Global Collaboration: Official backing brings prestige that attracts international partners.Institutes could more easily host faculty exchanges, joint PhD programs, and donor-funded research hubs .
● Infrastructure Growth: Prioritized capital spending builds modern labs, hospitals, and innovation parks. Just as NIH or the Wellcome Trust fund research in top US and UK universities, our premier campuses could become centers of R&D.
● Human Capital & Equity: With strong support, top students from all over Nepal (including rural areas) could access world-class education. Nepali talent would stay home instead of emigrating for better training.
These benefits are not hypothetical. Consider how India’s Institutes of National Importance have changed the game. Today every IIT is globally visible: they consistently rank among the world’s top engineering schools and IIT Ropar even leads the world in research citations . IIT alumni found scores of startups – IIT Bombay alone counts over 200 startups by its graduates .AIIMS Delhi’s international ranking shows how institutional focus on excellence pays off . We seek the same for IOE, IOM and NAST: institutes that not only admit top students but retain and reward top teachers.
Addressing Concerns and Skepticism
Some may ask: Can Nepal afford this? Is it realistic to give special status to institutions when many needs compete for our limited budget? These are valid concerns, but we must consider the return on investment. As one IIM director has noted, the “primary returns” of such institutes are not merely monetary gains but “the economic and cultural values our graduates bring to industry and society, [and] contributions to policymaking” . In other words, these universities will pay dividends in innovation, public health, and economic growth for decades. That same director emphasized that “financial resources are essential” to achieve these long-term returns . If we want Nepal’s economy and social well-being to thrive, we must provide the means. Others might worry about equity or control: will a few campuses be left out, or politicized? The Special Act can be crafted with transparency and oversight. Only a handful of institutes – those with national significance and track records – would be selected, not dozens of colleges. India’s example shows a phased expansion of national institutes; we can do likewise, ensuring it remains merit-based. And accountability measures (public audits, academic councils) can accompany autonomy to prevent misuse.
Meanwhile, the status quo already proves unsustainable. For example, IoE Pulchowk recently plunged into crisis: it carried a debt of Rs 90 million in one year and was forced to raise student fees by 177% just to operate . As one former principal warned, without new investment technical colleges may have to close . The institute’s assistant dean bluntly reported that the government “does not pay for their infrastructure, services, electricity... [or] salaries” for support staff . How long can our finest engineers be trained amidst such neglect? Similarly, the Auditor General found that NAST spent more on administration than on research, largely because the academy’s budget was too small to cover basic salaries . These stories illustrate the harsh
truth: we are already paying a price in lost opportunities and wasted talent. By formally prioritizing these institutions, we prevent such crises rather than react to them.
A Vision for the Future
In closing, honorable members, let us not be parochial or short-sighted. Declaring IOE, IOM, NAST and indred institutions as national priorities is a strategic investment in Nepal’s future. It aligns with our goals in the Digital Nepal and health policies, and with global SDGs for education and innovation. It tells every young Nepali engineer, doctor, and scientist that their work matters – that the nation will back them unconditionally. This is not a partisan issue; it transcends politics. It requires consensus and political will. The history of nations reminds us that greatness often follows foresight in education. Japan and South Korea built their economies by empowering universities; the United States committed over 0.6% of GDP to research after WWII and reaped the benefits in technology leadership. Nepal’s GDP allocation to science and technology is currently only about 0.39% – well below the world average of 1.2%. If we love our children’s future, we must choose to transform these figures.
By passing a Special Act for Institutions of National Importance, we can ignite a renaissance in Nepali education, research, and innovation. I urge you to lend your voice, to build consensus across party lines, and to make this bold declaration of confidence in our nation’s talent. The road will be long, but the destination – a
prosperous, self-reliant Nepal driven by knowledge and creativity – is worth every effort.