To drive real change, WHO in Nepal must develop the diplomatic skills to engage the Ministry of Finance and the highest levels of government – not just health bureaucrats
Nepal stands at a crossroads. Despite decades of donor support and public health campaigns, the nation remains haunted by the twin spectres of rampant malnutrition and rising childhood obesity – two faces of the same broken food system. While policymakers and international agencies have long treated these crises as the exclusive domain of the Ministry of Health, the real levers of change – taxes, subsidies and regulation – rest with Nepal's Ministry of Finance. If Nepal is to break the cycle of poverty, poor nutrition and stunted development, it is time for a bold, finance-led approach that puts child health at the centre of economic policy.
Nepal's economic status is fragile. Nearly one in five Nepalis lives below the poverty line, and the country's Human Development Index ranks among the lowest in South Asia.
Yet, the actual cost of poverty is most visible on the faces of Nepal's children. Malnutrition rates remain stubbornly high: nearly 36 per cent of children under five are stunted, and 10 per cent are wasted, according to the latest Demographic and Health Survey. At the same time, urbanisation and aggressive marketing by food companies have led to a surge in childhood overweight and obesity, especially in Kathmandu and other urban centres. The poorest children suffer the most – malnourished in early life and then exposed to cheap, unhealthy foods as they grow older.
The global record is clear: fiscal policy works. Countries that have taxed sugary drinks and junk food have seen dramatic reductions in consumption and improved public health, all while raising revenue for essential services. Mexico's sugar tax cut consumption by up to 12 per cent in its first year, with the steepest declines among the poorest households. South Africa's Health Promotion Levy led to a 29 per cent drop in purchases of sugary drinks. Thailand's excise taxes, public education and school-based nutrition programmes have begun to shift consumption patterns among children.
Nepal, however, has lagged. The Ministry of Finance, wary of industry backlash and the myth that such taxes hurt economic growth, has hesitated to enact robust fiscal policies. Yet, the evidence is overwhelming: sugar and junk food taxes do not stifle economies – they strengthen them. The World Health Organisation and UNICEF have documented that sugar taxes generate billions in revenue globally, with no evidence of net job losses or GDP decline. Instead, these revenues can be earmarked for child nutrition, school meals and clean water – investments that pay dividends in health, education and future productivity.
Nepal's struggle with corruption is well-known. From procurement scandals to the misuse of donor funds, public trust in government is low. This corruption has crippled the delivery of nutrition programmes and allowed vested interests to block reforms. The food and beverage industry, emboldened by weak regulation, aggressively markets ultra-processed foods to children, often violating advertising codes. Meanwhile, the Ministry of Health, under-resourced and politically marginalized, lacks the clout to push back.
This is where the Ministry of Finance must step in. By leading on nutrition policy, the Finance Ministry can ensure that fiscal measures – taxes on sugary drinks and junk food, subsidies for fruits and vegetables – are designed and implemented transparently and effectively. These policies can be tied to measurable outcomes: reduced malnutrition, lower obesity rates and improved school performance. Crucially, revenue from these taxes should be ring-fenced for nutrition and health programmes, with independent oversight to prevent misuse.
Nepal need not reinvent the wheel. Countries like Singapore and Japan have shown that the results are transformative when finance ministries work hand-in-hand with health, education and agriculture. Singapore's Ministry of Finance has used fiscal incentives and regulatory nudges to make healthy food the easy, profitable choice for vendors and consumers. Japan's "Shokuiku" food education programme, coordinated across ministries, has produced some of the healthiest children in the world.
Thailand's "Miracle of 1000 Days" policy – crafted by a coalition of ministries, with finance at the table from the outset – demonstrates that high-level coordination is not only possible but essential. These countries have improved child health and strengthened their economies, proving that nutrition is not a cost but an investment.
International organisations like WHO and UNICEF must also adapt. In Nepal, WHO has often functioned as an extension of the Ministry of Health, mirroring its priorities and limitations. To drive real change, WHO in Nepal must develop the diplomatic skills to engage the Ministry of Finance and the highest levels of government – not just health bureaucrats. This means speaking the language of economics: showing how better nutrition reduces health care costs, boosts productivity and fuels economic growth.
Nepal's future depends on its children. The time for fragmented, health-led campaigns is over. What is needed is a coherent fiscal strategy: a well-designed sugar and junk food tax, robust regulation of food marketing to children and targeted subsidies for healthy foods. The Ministry of Finance must be brought to the centre of this agenda – not as a reluctant gatekeeper, but as a proactive champion. The Prime Minister's Office should convene and coordinate the relevant ministries – Finance, Health, Education, Agriculture, and Women and Children – so that policy is aligned, communication is consistent and implementation is monitored.
The stakes could not be higher. Without decisive fiscal action, the economic and health costs of malnutrition and childhood obesity will continue to rise, undermining Nepal's development goals and burdening future generations. But with courageous leadership from the Ministry of Finance – supported by skilled, strategic engagement from partners – Nepal can turn the tide. The world has shown what is possible. It is time for Nepal's finance ministry to lead from the front.
Verma is the Honorary President of The Himalayan Dialogues and an international expert in leadership & strategic communication and global health diplomacy. More on www.sunoor.net
