Kathmandu, April 9

The private sector has called on the government to provide necessary incentives to start the process of manufacturing personal protective equipment in the country in a bid to deal with the shortage of the gear that is crucial to safeguard lives of people on the frontline of the fight against coronavirus disease and create employment opportunities at a time when the shutdown has rendered many jobless.

The call comes at a time when the World Health Organisation has said the global stockpile of PPE is insufficient because of surging global demand driven not only by the number of COVID-19 cases, but also by misinformation, panic buying and stockpiling. “This will result in further shortages of PPE globally.”

This has prompted the WHO to ask governments worldwide to provide incentives to industry to ramp up PPE production. But Nepal has not taken any initiative on this front so far.

The government had earlier promised to provide PPE to all hospitals, including public and private, and had initiated the process of importing these gears over two months ago. The government finally received the first consignment of medical goods on March 30, which included 100,000 sets of PPE.

But even hospitals like Seti Provincial Hospital and Dhaulagiri Zonal Hospital, which have been designated for treatment of COVID-19 patients, have said their stock of PPE will last only a few days. Seti Provincial Hospital is treating four COVID-19 patients, while Dhaulagiri Zonal Hospital is treating two. Other public and private hospitals are also facing acute shortage of the protective gear.

“Amidst this scenario, domestic firms can undoubtedly produce PPE on a mass scale if the government provides incentives, such as subsidies, and ensures the availability of raw materials and human resources,” said Hari Bhakta Sharma, executive director of Deurali Janata Pharmaceuticals Ltd.

Domestic firms can produce PPE on a mass scale if  subsidies are provided and raw materials and human resources are ensured

Last week, when a 65-year old female from Baglung tested positive for COVID-19, she could not be immediately transported to Dhaulagiri Zonal Hospital, as the driver of the ambulance, which was supposed to pick her, fled because he did not have a PPE. Doctors of many private hospitals across the country are not attending to patients with symptoms akin to COVID-19 as they lack the protective gear. Nurses working in public and private hospitals also fear for their lives as their workplaces are short of PPE. These frontline medical workers, including ambulance drivers and cleaners, generally come into close contact with patients, exposing them to the risk of infection. If they get infected, chances of them passing on the disease to others, including family members, cannot be ruled out. It is, therefore, essential that medical workers attending COVID-19 patients put on PPE, which includes gowns, aprons, gloves, medical masks, respirators, goggles and face shields to prevent infection.

“It is time we start production of the equipment in the country rather than wait for the government to import the same. This will also help the country generate employment opportunities,” said Satish Kumar More, president of the Confederation of Nepalese Industries. “But since Nepali private sector does not have experience in PPE production, the government must provide incentives and extend support for importing raw materials and human resources.”

The government had earlier appointed Omni Group, a private firm, to import PPE and other medical equipment in three phases. The group delivered the first consignment in March-end. The government then terminated the contract with the group, stating the firm was not in a position to deliver the second consignment. The contract was terminated after it became public that the government had appointed the company flouting procurement rules. The firm was also said to have inflated the prices of medical equipment that it had supplied in the first phase.

Since then the government has asked the Nepali Army to hold negotiations with different countries to bring in medical equipment through government-to-government process. Although the Nepali Army is said to have initiated dialogue, it is not known when the equipment will arrive, as countries across the globe are facing shortage of PPE.

“In the wake of the shortage and the government’s failure to supply the gear on time, we have already started our own production. Four people are engaged in manufacturing and they produce up to 40 units of PPE a day,” said Bijaya Rimal, general manager of Mediciti Hospital, adding, “The hospital has 700 units of PPE in stock and is supplying the gear to others in case of emergency.”

It is time we start producing the equipment in the country. This will also help the country  generate employment  opportunities

Lately, few surgical material suppliers and garment firms have also started producing PPE in limited volume. Even National Innovation Centre run by Mahabir Pun has jumped on the bandwagon. But many say this piecemeal approach will not work and PPE should be produced on a mass scale as risks of contagion are unknown and it is better for a country like Nepal with fragile healthcare system to take all necessary precautions.

“The major problem behind mass production of PPE is lack of human resources and raw materials,” said Rimal.

Nepal so far has confirmed only nine COVID-19 cases. But what is worrying is the detection of the first locally transmitted case last week in the far west. Far west is the region where thousands of Nepali migrant workers have returned following a lockdown in India. Many of these returnees have neither self-quarantined nor undergone tests, causing jitters of an outbreak in Nepal as well. On Tuesday, Prime Minister KP Sharma Oli, in a nationally televised address, said the next two weeks would be crucial for the country because of the high risk of the disease spreading at the community level.

If the disease spreads at the community level and the government fails to maintain adequate stock of PPE, chances of health workers abandoning the workplace cannot be ruled out. This will create a disaster.

“We are discussing the matter of producing PPE on a mass scale with other government agencies and the private sector, as we are not sure when the coronavirus crisis will end,” said Bikash Devkota, spokesperson for the Ministry of Health and Population, adding, “Domestic production of PPE should be promoted.”

A version of this article appears in e-paper on April 10, 2020 of The Himalayan Times.