HNAP implementation and integration into the NAP in Nepal

Nepal is highly vulnerable to the impacts of climate change although its contribution to global GHG emissions is non-significant. The health impacts of climate change in Nepal are complex due to the country's diverse ecological zones, which range from the low-lying Terai region to the highest peaks in the world. There is increasing evidence on the health risks of climate change in Nepal, including that disease vectors that were previously limited to low-lying regions are now observed in mountain regions, such as for Dengue and other vector-borne diseases.

In order to address the health impacts of climate change, the Ministry of Health and Population (MoHP) prepared and is implementing the Health National Adaptation Plan (HNAP) (2017-2021).

The Ministry of Forests and Environment (MoFE) prepared the National Adaptation Plan (2021-50) in 2021 and it features Health, Drinking Water, and Sanitation (HDWS) as one of the nine key thematic areas. It identified seven priority adaptation programs with a total proposed budget of $4.75 billion to address climate vulnerabilities and risks in the short (2025), medium (2030), and long-term (2050). The MoFE is continues to collaborate with the health sector to advance the NAP.

As a part of ongoing efforts to build a climate resilient health system in the country, the Ministry made health commitments at COP26. These include updating the Vulnerability and Adaptation Assessment (VAA) and preparation of a new HNAP based on the VAA results. Nepal updated the VAA of climate sensitive diseases and health risks in Nepal in 2022 and is working on the updated HNAP.

In line with the NAP which has a sectoral focus for adaptation measures, the MoHP has been developing the updated HNAP. The inception workshop and write-shop for the HNAP update were held and it is expected to finalise by  2023. In order to develop sectoral National Adaptation Plans (NAP), coordination is crucial. To achieve this a Thematic Group has been established under the MoHP for the NAP. MoFE and MoHP conducted a joint workshop, and MoFE has been actively participating in the Steering Committee and Technical Working Group for updating the HNAP.

The challenge:

Nepal's commitment to implementing the HNAP as part of its NAP has been hindered by several challenges that have slowed down progress in addressing climate change and health risks. These challenges include:

• Limited awareness and capacity: A significant hurdle in integrating the HNAP into the NAP is the insufficient awareness and capacity among relevant stakeholders, which includes policymakers, health professionals, and civil society organizations. These stakeholders have a limited understanding of the connection between climate change and health and the potential of the HNAP to enhance the country's resilience to climate change impacts.
• Limited funding and resources: A major obstacle to integrating HNAP into NAP is the inadequate funding and resources allocated to its implementation. To perform vulnerability and adaptation assessments, establish adaptation strategies, and execute adaptation measures, significant financial and technical resources are required. However, the health sector in Nepal has limited funding and resources, which has hindered the implementation of the HNAP.
• Fragmentation and coordination: Coordination and collaboration among various sectors and stakeholders, including health, environment, WASH, disaster risk management, amongst others, are crucial for the integration of the HNAP into the NAP. However, Nepal is facing significant fragmentation and coordination challenges, which are hindering effective integration.
• Limited data and evidence: A further challenge is the inadequacy of data and evidence of the health effects of climate change in Nepal. The absence of comprehensive and reliable information on the health risks linked to climate change has obstructed the recognition of adaptation priorities and the creation of evidence-based adaptation strategies. Moreover, this has also limited the monitoring and evaluation of the effectiveness of the adaptation measures implemented.

The solution:

Some interventions that Nepal could implement to address the challenges it faces in integrating the HNAP into the NAP include:

• Enhancing awareness and capacity: To improve the integration of the HNAP into the NAP, Nepal will focus on enhancing awareness and building capacity among relevant stakeholders, such as policymakers, health professionals, and civil society organizations, regarding the interconnection between climate change and health, and the significance of integrating the HNAP into the NAP. Raising awareness, advocacy programs at different levels, conducting workshops, and implementing training programs could be effective ways to achieve this.
• Mobilizing additional funding and resource: Nepal could engage with development partners, including multilateral and bilateral agencies, Green Climate Funds to mobilize additional funding and resources for implementing the HNAP. The country could also explore innovative financing mechanisms, such as public-private partnerships, to leverage private sector resources for HNAP implementation.
• Strengthening coordination and collaboration: Nepal needs to strengthen coordination and collaboration among the relevant sectors and stakeholders to ensure a coherent and effective implementation of the HNAP. This can be achieved by establishing clear mandates and roles, strengthening communication and information-sharing mechanisms, and effective operationalization of multi-stakeholder mechanism.
• Improving data and evidence: Nepal needs to improve data and evidence on the health impacts of climate change to facilitate evidence-based decision-making and adaptation planning. This can be achieved by investing in research and data collection and strengthening climate informed surveillance and evaluation systems.

Nepal faces several challenges in implementing the HNAP as part of overall NAP implementation, which has slowed down progress in addressing climate change and health risks. However, by enhancing awareness and capacity, mobilizing additional funding and resources, strengthening coordination and collaboration, and improving data and evidence, Nepal can overcome these challenges and advance the implementation of the HNAP.

Lessons learned:

Nepal has learned several important lessons in integrating the HNAP into the NAP. These include:

• The importance of stakeholder engagement: Nepal has realized the importance of engaging all relevant stakeholders in the integration of the HNAP into the NAP. This includes policymakers, health professionals, civil society organizations, and the private sector. Effective stakeholder engagement helps to build support for the integration of the HNAP into the NAP and ensures that all perspectives and viewpoints are considered.
• The need for capacity building: Nepal has recognized the need for capacity building among all relevant stakeholders to enhance their understanding of the linkages between climate change and health and the importance of HNAP. This includes training, workshops, and awareness-raising campaigns.
• The importance of data and evidence: One lesson Nepal has learned is the significance of collecting and analyzing comprehensive and reliable data on the health impacts of climate change in real-time and in a digital format. This helps to identify adaptation priorities and develop evidence-based adaptation strategies.
• The need for coordination and collaboration: Nepal has realized the importance of coordination and collaboration among various sectors and stakeholders in integrating the HNAP into the NAP. This includes health, environment, WASH, disaster risk management and many bother sectors. Clear mandates and roles among the relevant stakeholders are necessary to avoid duplication of efforts and ensure coherence in the implementation of adaptation measures.
• The importance of financing and resource mobilization: Nepal has learned the importance of mobilizing additional funding and resources for implementing the HNAP. This can be achieved by engaging with development partners and exploring innovative financing mechanisms, such as public-private partnerships.