CONTENTS 1. INTRODUCTION 5 2. NEPAL COUNTRY RISK PROFILE 8 3. FINDINGS FROM THE CPGA 15 Overview of Cross-Sectoral Challenges in Promoting Crisis Preparedness 17 4. SUMMARY OF COMPONENT-SPECIFIC FINDINGS OF CPGA 18 4.1. Legal & Institutional 19 Legislative Frameworks and Strategic Plans and Policies for Crisis Preparedness 19 Institutional Framework for Crisis Preparedness 20 4.2. Understanding & Monitoring Risks 26 Risk Assessments 26 Risk Monitoring and Early Warnings 28 4.3. Financial Preparedness 32 Crisis Risk Financing 32 Public Financial Management 36 4.4. Primary Response 38 Public Health Systems 38 Critical Infrastructure 41 Civil Protection and Emergency Management Systems 42 4.5. Social & Livelihood Support 45 Coverage and Scalability of Social Protection 45 Food Security and Livelihoods 47 Continued Access to Education 48 Crisis Induced Displacement 50 5. SUMMARY AND CONCLUSION 52 6. APPENDIXES 58 Appendix A: List of individuals consulted 59 Appendix B: CPGA data collection process 61 Appendix C: Mapping of current WB portfolio and key DP engagement 62 Appendix D: References 65 2 ABBREVIATIONS ADB Asian Development Bank BIPAD Building Integrated Platform Against Disaster CAT-DDO Catastrophic Deferred Draw Down CCDR Country Climate and Development Report CPGA Crisis Preparedness Gap Analysis DHM Department of Hydrology and Meteorology DONIDCR Department of National ID and Civil Registration DRF Disaster-Risk Financing DRM Disaster-Risk Management DRR Disaster-Risk Reduction DRRM Disaster-Risk Reduction and Management EDCD Epidemiology and Disease Control Division EOC Emergency Operation Center EPR Emergency Preparedness and Response EWARS Early Warning and Reporting System EWS Early-Warning System FMTC Food Management and Trading Company GLOF Glacial Lake Outburst Flood GON Government of Nepal GP Global Practice HEOC Health Emergency Operation Center IHR International Health Regulation ISR Integrated Social Registry JEE Joint External Evaluation LG Local Government MHRA Multi-Hazard Risk Assessment MOALD Ministry of Agriculture and Livestock Development MOFE Ministry for Forests and Environment MOHA Ministry of Home Affairs MOLESS Ministry or Labor, Employment and Social Security MOHP Ministry of Health and Population MSNP Multi-Sector Nutrition Plan 3 NDRRMA National Disaster Risk Reduction and Management Authority NEKSAP Nepal Khadya Surakshya Pranali NEOC National Emergency Operation Center NGO Non-Governmental Organization NPHL National Public Health Laboratory NRA National Reconstruction Authority PAMS Public Asset Management System PMEP Prime Minister’s Employment Program SAR Search and Rescue SOP Standard Operating Procedure SPAR State Party Self-Assessment Annual Reporting SRSP Shock- Responsive Social Protection SSA Social Security Allowances UNICEF United Nations Children’s Fund VRA Vulnerability and Risk Assessments WFP World Food Program WHO World Health Organization 4 5 INTRODUCTION Crisis preparedness is crucial to preventing shocks from Livelihood Support. Components correspond to foundational becoming crises. Investments in ex ante preparedness are elements of crisis preparedness consistent with the World especially relevant in countries like Nepal that face high levels Bank’s mandate, building on sector-specific frameworks and of exposure and vulnerability to a range of risks.   on operational engagements in this space. Each component is further broken down into subcomponents and indicators, In seeking to identify opportunities to strengthen the resulting in a three-tiered system with maturity levels assigned Government of Nepal’s (GoN’s) capacity to prepare for crisis to each (see Table 2). Levels of maturity range from unmet events in an effective and timely manner, this Technical (little to nothing has been done to actively promote crisis Annex presents findings from the application of the Crisis preparedness) to advanced (typically for a regional leader in Preparedness Gap Analysis (CPGA) diagnostic in the crisis preparedness, with a comprehensive and multisectoral country. It provides details on findings and entry points across approach and with significant resources and capacity). See the five components of crisis preparedness. For a summary, Annex B for more details on maturity levels. The framework please refer to the accompanying CPGA Nepal Briefing Note. does not evaluate past performance or attempt to predict Following a brief description of the CPGA methodology, the how a country might fare in a crisis but serves as a baseline Technical Annex presents a summary of findings from each exercise to assess core preparedness capacities that are CPGA component alongside identification of entry points and relevant across a broad range of potential crises. Based on the opportunities to strengthen crisis preparedness in the country. findings, it identifies entry points for targeted technical and financial support to strengthen crisis preparedness across its Crisis preparedness requires a comprehensive and cross- five components. sectoral approach to risk management with targeted interventions across a range of sectors. While the scope The Nepal CPGA builds on and supplements a range of and effectiveness of preparedness activities are heavily sector- and crisis-specific diagnostics. These include, dependent on context—including exposure to hazards and the among others, the GoN’s series of climate change nature of underlying drivers of vulnerability—some elements vulnerability and risk assessments (VRAs) and Emergency of preparedness are generally considered as relevant in most Preparedness and Response Assessment 2022–2030 (based country contexts.   on the R2R framework), the World Bank’s Country Climate and Development Report (2022) and Assessment of Contingent A crisis is a situation in which a government is overwhelmed Liabilities from Natural Disasters in Nepal (2022), the ADB’s by a shock, or multiple shocks, requiring immediate action to Enabling Environment for Disaster Risk Financing in Nepal– address social, economic, and political consequences. Crises Country Diagnostics Assessment (2019), and the World Health tend to result from the interaction of multiple compounding Organization’s (WHO’s) Joint External Evaluation/International shocks. The CPGA looks at threats emanating from natural Health Regulations framework (2019). The CPGA does not hazards, health emergencies, and food-insecurity and replace or duplicate these in-depth assessments. Rather, it livelihood risks, in particular. Crisis preparedness is frequently offers a holistic, high-level perspective on key country systems referred to interchangeably with emergency preparedness and that contribute to crisis preparedness for different types of disaster preparedness. shocks and across sectors. These sector-specific diagnostics constitute the starting point of the CPGA in countries where they exist. To provide a holistic assessment of preparedness, the CPGA focuses on five core components of crisis preparedness. These are (i) Legal and Institutional Foundations, (ii) Crisis preparedness is generally a critical agenda for Nepal, Understanding and Monitoring Risks, (iii) Financial and the CPGA was conducted at a particularly important Preparedness, (iv) Primary Response, and (v) Social and juncture. Nepal’s geography puts it at high risk from natural 6 hazards, especially floods, landslides, and earthquakes. the focal agency to coordinate various government agencies. While chronic food insecurity and malnutrition are declining, Bilateral meetings with key government stakeholders provided structural vulnerability to production and trade shocks are inputs at an early stage. The key findings from the analysis increasing. Nepal is also a hotspot for various zoonotic were shared and validated at a joint meeting of stakeholders diseases with epidemic potential. The government’s fiscal convened by NDRRMA and were also presented to the country constraints and low-income levels across most of the office for inputs and validation. In addition, the team consulted population mean that structural vulnerability to these hazards with development partners (DPs), bilaterally and in joint is particularly acute. Many of the crisis risks the country faces workshops. are bound to intensify further with climate change. At the same time, the institutional landscape for disaster risk management The CPGA is aligned to the Green, Resilient and Inclusive (DRM) and preparedness is in flux with the establishment of Development (GRID) agenda that the GoN has adopted. the National Disaster Risk Reduction and Management Agency In assessing gaps in crisis preparedness, it contributes (NDRRMA) in 2019 against a background of ongoing transition to promoting resilience of households, communities, and to federalism. This poses both challenges and important country systems to prepare for and respond to crises. One opportunities to build on the significant experience and key recommendation of the CPGA is to institutionalize shock- progress in crisis preparedness that the government has built responsive social protection (SP), which will help improve the in recent decades. The CPGA aims to contribute to the policy efficiency and inclusiveness of the delivery of disaster relief dialogue in this context. and recovery by mobilizing existing SP programs and delivery systems. Finally, the CPGA recommendations support the The CPGA In Nepal was conducted by a multisector team federalism agenda. The proposed recommendations support through a consultative process. The team included staff and capacity building at local levels across the multiple aspects consultants from multiple practice groups including Social of crisis preparedness—institutional arrangements, risk Protection and Jobs, Disaster Risk Management, Health, and monitoring, financial preparedness, primary response, and SP Agriculture. NDRRMA welcomed the exercise and served as and livelihoods. 7 8 NEPAL: COUNTRY RISK PROFILE Nepal is a landlocked nation bordering China to the north and flanked by India on the other three sides. Nepal’s geography is divided into three distinct ecological zones running from east to west: the Terai with fertile, alluvial grasslands; a temperate hill region; and the mountain region.1 Table 1: Summary statistics related to key risks and vulnerabilities in Nepal NATURAL HAZARDS2 Extreme Heat High risk Urban flood High risk Landslide High risk Wildfire High risk Water scarcity / Drought risk High risk Earthquake 3 High risk Riverine flood Medium risk Cyclone Low risk FOOD Cereal import dependency ratio4 13.7% Prevalence of severe food insecurity 13.6% Proportion of children under 5 affected by stunting5 31.5% Food price inflation, average of monthly year-over-year inflation6 7.5% HEALTH Total expenditure on health, as a percentage of GDP 7 5.17% Physician density (per 1,000 people) 8 0.9 Nursing and midwifery personnel density (per 1000 population)9 3.4 Malaria incidence (per 1,000 people at risk)10 0.01 1 GON: Geography of Nepal. https://jp.nepalembassy.gov.np/geography-of-nepal/ 2 ThinkHazard! 2020. “Nepal” https://www.thinkhazard.org/en/report/175-nepal 3 Nepal ranks 11th in terms of earthquake risk globally. 4 FAO: Suite of Food Security Indicators. https://www.fao.org/faostat/en/#data/FS 5 World Bank. 2019. “Proportion of children under 5 affected by stunting - Nepal”. https://data.worldbank.org/indicator/SH.STA.STNT.ZS?locations=NP 6 World Bank. 2023. Nepal Development Update. https://thedocs.worldbank.org/en/doc/7c67a4b930b6e88250b4ff109449ee0a-0310062023/nepal-develop- ment-update-april-2023 7 World Health Organization Global Health Expenditure database, https://apps.who.int/nha/database. 8 WHO. 2021. “Density of Doctors (per 1,000 people) – Nepal”. https://data.who.int/indicators/i/217795A 9 WHO. 2021. “Nursing and midwifery personnel density (per 1000 population) - Nepal”. https://data.who.int/indicators/i/5C8435F 10 WHO. 2021. “Malaria Cases – Nepal”. https://data.who.int/indicators/i/442CEA8 9 MACRO-FISCAL GDP11 $36.3B GDP growth rate 12 4.2% Total external debt stock, as a percentage of GNI 13 24.3% SOCIOECONOMIC Poverty headcount ratio at $1.90/day14 15% VULNERABILITY Human Development Index Rank15 143/189 Human Capital Index Score 16 0.5 Population covered by at least one social protection benefit (2020) 17 16.9% Vulnerable persons covered by social assistance (2020) 18 17.1% Primary school completion 19 106% Number of refugees in country20 19554 FRAGILITY, CONFLICT Fragile and Conflict-Affected Situations (FCS) Status Not on FCS list 21 & VIOLENCE Conflict events (3 months)22 759 Reported fatalities (3 months) 15 Violence against civilians (3 months) 29 Note: Statistics are compiled from a range of external databases (see footnotes for citations; reference period for included data is from 2017 - 2021). Nepal’s population is approximately 30 million with an annual a quarter of the country’s GDP in 2020.25 Services are fast growth rate of 2.3 percent. Its socioeconomic landscape is growing and represent the largest sector, accounting for predominantly rural, although two-thirds of the population more than half of Nepal’s GDP (Figure 1), led by growth in the now live in urban municipalities per the 2021 census. 23 Around tourism, hospitality, and retail industries. Manufacturing in two-thirds of the population is engaged in agriculture, which Nepal is primarily small scale, covering handicrafts, textiles, contributes about one-third of the country’s GDP. 24 Many food processing, and light manufacturing. Nepal is highly Nepali citizens seek employment overseas, primarily in Gulf dependent on imports, including of food, medicine, petrol, and countries, and their remittances were equivalent to nearly other essential goods, overwhelmingly from India. 11 World Bank. 2021. “GDP (Current US$) – Nepal” https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=NP 12 World Bank. 2021. “GDP growth (annual %) – Nepal” https://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG?locations=NP 13 World Bank. 2021. “External debt stocks (% of GNI) - Nepal” https://data.worldbank.org/indicator/DT.DOD.DECT.GN.ZS?locations=NP 14 Asian Development Bank. 2022. “Poverty Data: Nepal” https://www.adb.org/countries/nepal/poverty#:~:text=In%20Nepal%2C%20the%20proportion%20 of,rate%20in%202017%20was%2010.7%25. 15 UNDP. 2022. “Nepal moves up one place in human development, ranks 143rd” https://www.undp.org/nepal/press-releases/nepal-moves-one-place-human-de- velopment-ranks-143rd 16 World Bank. 2020. “Human Capital Index (HCI) (scale 0-1) - Nepal” https://data.worldbank.org/indicator/HD.HCI.OVRL?locations=NP 17 ILO. 2020. “Population covered by at least one social protection benefit.” https://www.ilo.org/shinyapps/bulkexplorer52/?lang=en&segment=indicator&id=S- DG_0131_SEX_SOC_RT_A 18 ILO. 2020. “Vulnerable persons covered by social assistance.” https://www.ilo.org/shinyapps/bulkexplorer52/?lang=en&segment=indicator&id=SDG_0131_SEX_ SOC_RT_A 19 World Bank. 2017. “Primary completion rate, total (percent of relevant age group) – Nepal” https://data.worldbank.org/indicator/SE.PRM.CMPT.ZS?locations=NP 20 World Bank. 2021. “Refugee population by country or territory of asylum - Nepal” https://data.worldbank.org/indicator/SM.POP.REFG?locations=NP 21 World Bank. 2022. “Classification of Fragile and Conflict-Affected Situations.” https://www.worldbank.org/en/topic/fragilityconflictviolence/brief/harmo- nized-list-of-fragile-situations 22 ACLED. 2021. Dashboard. https://acleddata.com/dashboard/#/dashboard 23 GoN. 2022. National Population and Housing Census 2021. The increase in the share of urban population has more to do with reorganization of local govern- ments after federalization than with actual urbanization. 24 FAO. “Nepal at a glance” https://www.fao.org/nepal/fao-in-nepal/nepal-at-a-glance/en/ 25 Joshi, T., Mainali, R. P., Marasini, S., Acharya, K. P., & Adhikari, S. (2021). Nepal at the edge of sword with two edges: The COVID-19 pandemics and sustainable development goals. Journal of agriculture and food research, 4, 100138. 26 World Bank. 2023. Nepal Development Update 10 Figure 1: Gross Domestic Product by Industrial Classification Source: Nepal Development Update 2023 (World Bank) Nepal sits on the fault line between the Indian and Eurasian including intense heatwaves, flooding, and air pollution.30 tectonic plates, and unplanned urban settlements and The 191 events recorded between 2000 and 2019 caused infrastructural gaps add to the damage earthquakes can losses averaging 0.39 percent of GDP.31 While earthquakes cause. In the last five decades, Nepal has dealt with four major and floods have historically been the most destructive events, earthquakes over magnitude 6.5, including the 2015 Gorkha floods, storms, erosion, and landslides have seen a sharp earthquake. The 2015 earthquake killed almost 9,000 people, increase in the recent past.32 displaced over 2.6 million, 27 and caused widespread destruction of buildings, heritage sites, schools, health facilities, and critical These kinds of severe weather events regularly cause infrastructure, with total losses amounting to close to USD 7 extensive human and economic losses. Heavy rains, floods, billion, or about one-third of the country’s GDP in FY 2013–14.28 and landslides have claimed dozens of lives, destroyed crops In its aftermath an estimated 700,000 Nepalis (about 2.5 to 3.5 and hundreds of homes, and damaged infrastructure. For percent of the population) fell into poverty.29 example, in 2020, landsides and flooding in western Nepal left 300 dead and 223 injured, causing economic damage of over Due to its geography and environment, Nepal is among the USD 393,000.33 Because the rains were unseasonal, there was countries most highly affected by ongoing extreme climate significant loss of livestock, agricultural damage, and damage events, with four out of every five people at risk from hazards to houses and other infrastructure. 27 Internal Displacement Monitoring Centre and ADB. 2022. Disaster displacement: Nepal country briefing. https://reliefweb.int/report/nepal/disaster-displace- ment-nepal-country-briefing-december-2022 28 Post-Disaster Needs Assessment (PDNA) conducted by the National Planning Commission of Nepal 29 Gauchan, Devendra & Joshi, Bal & Ghimire, Krishna. (2017). Impact of 2015 Earthquake on Economy, Agriculture and Agrobiodiversity in Nepal. https://www. researchgate.net/publication/322364093_Impact_of_2015_Earthquake_on_Economy_Agriculture_and_Agrobiodiversity_in_Nepal 30 Nepal ranked 10th in average climate risk between 2000 and 2019. Eckstein, David, Vera Künzel, and Laura Schäfer. 2021. Global Climate Risk Index 2021: Who Suffers Most from Extreme Weather Events? Weather Related Loss Events in 2019 and 2000–2019. Berlin: Germanwatch, p. 13. Ibid. 31 32 World Bank Group. 2022. Nepal Country Climate and Development Report. CCDR Series. © World Bank, Washington, DC. 33 DCA. (2021). When Climate becomes a Threat, Evidence of Climate Change Induced Loss and Damage in Nepal. Similarly, in 2021, the Melamchi River experi- enced massive flooding because of heavy rains and the erosion of glacial deposits. This event caused at least 17 casualties and damaged more than 540 houses and critical infrastructures including bridges, roads, and schools. World Bank, GFDRR. 2022. “Melamchi Flood Disaster in Nepal: Damage and Risk Quantification with Drone Survey, Satellite-Based Land Displacement Analysis, and 2D Flood Modeling” https://www.gfdrr.org/en/publication/melamchi-flood-disaster-ne- pal-damage-and-risk-quantification-drone-survey-satellite 11 Risks associated with climate change and natural disasters increase in rainfall, while winters are predicted to be drier.35 are predicted to increase. Compared to the 1981–2010 By 2030, 350,000 people are expected to be affected by river reference period, temperature is expected to rise by 0.92–1.07 flooding brought on by climate change each year, up from degree Celsius in the medium term (2016–45) and by 1.3–1.8 157,000 in 2010.36 degree Celsius in the long term (2036–65).34 Similarly, it is anticipated that yearly precipitation would rise by 2–6 percent Figure 2 highlights the frequency and number of people to 8–12 percent over the medium and long term. Monsoon affected by specific hazards over the past four decades. summers are predicted to be wetter with up to a threefold Figure 2. Number of people affected by key natural-hazard in Nepal, 1980–2020 Source: Climate Change Knowledge Portal, https://climateknowledgeportal.worldbank.org/country/nepal/vulnerability Food insecurity risks are changing, with chronic food function of a steady decline in poverty. Meanwhile, investment insecurity and malnutrition declining but structural in the agricultural sector and its productivity remain very low, vulnerability to production and trade shocks increasing. limiting improvements to the livelihoods of the huge numbers Nepal’s score on the Global Hunger Index decreased from 36.8 of Nepalis working in agriculture, forgoing opportunities to in 2000 to 20.8 in 2019, outpacing other countries in South build resilience against increasing climatic shocks including Asia. Stunting in children under five years old decreased from drought, erratic rainfall, and excessive heat, and exacerbating 36 percent in 2016 to 24.8 percent in 2022. 37 However, these a reliance on food and input imports that renders Nepal are still high figures, and 29 percent of households in urban acutely vulnerable to global and regional price shocks and areas and 38 percent of rural households remain food insecure. supply chain disruptions.38 This is particularly critical in 2023– Chronic food insecurity is focused in the Mid-Western and Far 24, as erratic monsoon rainfall is expected to lead to a decline Western Mountains and the Central Mountain region, although in domestic production39 and Government of India imposed a pockets of the population in the Terai face high food insecurity ban on rice exports of non-basmati rice in July 2023 to control as well. Improvements over recent decades are mainly a rising prices. 34 MoFE (2019. Climate Change Scenarios for Nepal for National Adaptation Plan (NAP). Kathmandu: Ministry of Forests and Environment), Government of Nepal 35 Ibid 36 World Bank Group and Asian Development Bank 2021. Nepal Demographic Health Survey 2022 37 38 World Food Programme. 2022. Impact of Current Shocks on Household Food Security in Nepal: Sixth Round of Mobile Vulnerability Analysis and Mapping Household Livelihoods, Food Security and Vulnerability Survey June. https://reliefweb.int/report/nepal/impact-current-shocks-household-food-security-ne- pal-sixth-round-mvam-household-livelihoods-food-security-and-vulnerability-survey-june-2022 39 FAO. 2023. GIEWS Country Brief: Nepal 13-October-2023. https://reliefweb.int/report/nepal/giews-country-brief-nepal-13-october-2023 12 Pandemic risk is characterized by complex interactions fall within a geographical band that may be rendered virtually between human, animal, and environmental health. A large uninhabitable by the late 21st century because of wet-bulb part of the population working in agriculture and livestock sector temperatures that regularly exceed survivable levels. Extreme uses farming methods vulnerable to animal-to-human disease heat events have serious effects on human health, including transmission. This includes the close proximity between homes dehydration, renal failure, and heat strokes, and heatwaves and animal sheds and practices of animal waste disposal. Such have already led to increased morbidity and mortality across practices as well as incursion into forest areas and the poor South Asia. These risks particularly affect those with underlying implementation of vaccination drives 40 makes Nepal a hotspot health conditions, residents of informal settlements, and for various zoonotic diseases with epidemic potential. 41,42 To people whose livelihoods depend on working outdoors, such address these challenges, the Nepalese government has as agricultural and construction workers. Extreme heat events developed the One Health strategy. 43,44,45 also interact closely with infrastructure. Unplanned urban expansion, which is ongoing across the Terai, can exacerbate The COVID-19 pandemic was a reminder that pandemic risks heat stress through urban heat islands, and heat in turn affects disproportionately affect the vulnerable and have particularly infrastructure including electricity grids, threatening cooling negative impacts on women. Forty-one percent of women lost technology exactly when it is needed most. their jobs during lockdowns, compared to 28 percent of men, and the gender pay gap is likely to have been exacerbated Despite significant commitment and investment, the too. 46 Additionally, the pandemic disproportionately affected SP system does not adequately cover all the poor and children, increasing child poverty and deteriorating access to vulnerable.47 15 percent of the population lives on less than schools and health care facilities. $1.90 a day and and about 17.4 percent of Nepal’s population was multidimensionally poor in 2019.48 About one-third of the Many of these risks are bound to intensify with climate nation’s populace is covered by some form of SP, but only about change, and new ones are likely to emerge. A prominent 55 percent of those in the poorest quintile are covered by any example is extreme heat events, which have immense program.49 In FY 2021-22, only 23 percent of the population implications for human health, agricultural production, was enrolled in the national health insurance program.50 More productivity, and infrastructure. The GoN and the World importantly, the current SP programs are not designed to scale Bank classify the extreme-heat-hazard level for Nepal as up during crises to cover additional beneficiaries or provide high. Particularly at risk are Nepal’s southern Terai plains, additional benefits. Nepal often relies on the humanitarian where over half of the country’s population lives, and which system for support. 40 Ellwanger, Joel Henrique, and José Artur Bogo Chies. “Zoonotic spillover: Understanding basic aspects for better prevention.” Genetics and molecular biology vol. 44,1 Suppl 1 e20200355. 4 Jun. 2021, doi:10.1590/1678-4685-GMB-2020-0355 41 These include taeniasis, leptospirosis, hydatidosis, brucellosis, toxoplasmosis, rabies, dengue fever, and avian Influenza. 42 Ministry of Health and Population, Government of Nepal. Zoonotic Disease Control Programme. https://www.mohp.gov.np/program/zoonotic-disease-con- trol-programme/en 43 WHO. 2017. One Health. https://www.who.int/news-room/questions-and-answers/item/one-health 44 Krishna Prasad Acharya, Surendra Karki, Kshitiz Shrestha, Krishna Kaphle, One health approach in Nepal: Scope, opportunities and challenges, One Health, Vol- ume 8, 2019, 100101, ISSN 2352-7714, https://doi.org/10.1016/j.onehlt.2019.100101. 45 Paudel, S. (2020). Scope and challenges of one health approach in Nepal. International Journal of Infectious Diseases, 101, 404. 46 United Nations Development Program. 2020. Rapid Assessment of Socio-Economic Impact of COVID-19 In Nepal. https://www.undp.org/Nepal/Publications/ Rapid-Assessment-Socio-Economic-Impact-Covid-19-Nepal 47 The total expenditure on social-protection programs was roughly NPR 210 billion in 2021, which was 16.6 percent of total government expenditure. ILO. 2023. “Extending social protection for all in Nepal: An analysis of protection gaps”, https://www.ilo.org/wcmsp5/groups/public/---asia/---ro-bangkok/---ilo-kathman- du/documents/publication/wcms_882394.pdf; UNICEF. 2019. “Programme Guidance: Strengthening Shock Responsive Social Protection Systems” https://www. unicef.org/media/63846/file 48 World Bank. 2020. “Poverty and Equity Brief,” Nepal, October 2020. https://databankfiles.worldbank.org/public/ddpext_download/poverty/987B9C90-CB9F- 4D93-AE8C-750588BF00QA/SM2020/Global_POVEQ_NPL.pdf. 49 Central Bureau of Statistics. 2020. Nepal Multiple Indicator Cluster Survey 2019, Survey Findings Report. Kathmandu, Nepal: 50 Annual Report FY 2022, Health Insurance Board. While this number is low, it reflects rapid improvement, from 17.7 percent enrolled in FY 2021. 13 The unique geopolitical positioning of Nepal, situated impact on Nepal. The resulting shortage of fuel led to a crisis between India and China, has a profound impact on its in transportation, cooking, and heating, and it had knock-on trade dependencies, food security, and overall development effects on industries, hospitals, and schools. Given that Nepal strategies, and it can complicate other crisis risks. For was still recovering from the devastating Gorkha earthquake example, cross-border trade disruptions with India that of 2015, the trade disruptions later that year created an lasted from September 2015 to February 2016 had a severe unprecedented humanitarian and a diplomatic crisis.51 BBC News. 2015. UN: Nepal blockade puts millions of children at risk. https://www.bbc.com/news/world-asia-34968252 51 14 15 FINDINGS OF THE CPGA Findings from this CPGA illuminate the strengths and which summarizes the Technical Annex. The CPGA assigns challenges in crisis preparedness in Nepal. The CPGA draws maturity levels to the five preparedness components and their on information gathered through desk review and extensive subcomponents, based on the number and mix of affirmative interviews with sector experts from across World Bank Global responses to the pertinent guiding questions: unmet, nascent, Practices (GPs) and from consultations with government, basic, good, advanced. A description of steps taken in data external experts, and DPs (see Appendix A for a list of collection can be found in Annex C alongside further details individuals consulted). This report presents technical insights, on the CPGA methodology and the maturity levels. Table 2 both cross-cutting and sector specific, from the CPGA presents the maturity levels assigned to each module from the assessment. It complements the Nepal CPGA Briefing Note, assessment. Crisis Preparedness Gap Analysis Nepal Completed Table on 2: Maturity Sep-23 levels for components and subcomponents of the CPGA in Nepal Completed by Nepal CPGA team ComponentSummary Component Summary Unmet Nascent Unmet Na s cent Basic Ba s ic Good Good Advanced Adva nced Legal 1.Legal 1. && Institutional Institutional Foundations Foundations Basic Basic 2.7 2.7 1.1 1.1Legislative Legislativeframeworks, strategic frameworks, plans and strategic policies plans Advanced and policies Advanced 4.0 4.0 1.2 1.2Governance Governanceand institutions and institutions Basic Basic 2.0 2.0 2.Understanding 2. Understanding& Monitoring Risks Risks & Monitoring Basic Basic 2.0 2.0 2.1 2.1Risk Riskassessment assessment Basic Basic 2.0 2.0 2.2 2.2Risk Riskmonitoring monitoringandand early warnings early warnings Basic Basic 2.0 2.0 Financial 3.Financial 3. Preparedness Preparedness Nascent Nascent 1.3 1.3 3.1 3.1Crisis Crisisrisk financing risk financing Nascent Nascent 1.7 1.7 3.2 3.2Public PublicFinancial Management Financial Management Nascent Nascent 1.0 1.0 4.Primary 4. PrimaryResponse Response Nascent Nascent 1.7 1.7 4.1 4.1Public Public health systems health systems Basic Basic 2.0 2.0 4.2 4.2Critical Criticalinfrastructure infrastructure Nascent Nascent 1.5 1.5 4.3 4.3Civil Civilprotection protection Emergency and and Management Emergency Systems Systems Management Nascent Nascent 1.5 1.5 5.Social 5. Socialand andLivelihood Support Livelihood Support Nascent Nascent 1.0 1.0 5.1 5.1Coverage Coverageand scalability and of social scalability protection of social protection Nascent Nascent 1.0 1.0 5.2 5.2Food Foodsecurity livelihoods andand security livelihoods Unmet Unmet 0.5 0.5 5.3 5.3Continued Continuedaccess to education access to education Advanced Advanced 4.0 4.0 5.4 5.4Crisis Crisisinduced displacement induced displacement Unmet Unmet 0.0 0.0 16 OVERVIEW OF CROSS-SECTORAL CHALLENGES IN PROMOTING CRISIS PREPAREDNESS Nepal has laws, policies, and plans that lay out the legal, Nepal struggles to put in place sufficient financing both for regulatory, and policy foundation for crisis preparedness, essential public services that are also crucial for multihazard but implementation is weak and crisis preparedness is not preparedness—especially a strong public health system— established as a policy priority. One of the main issues is that and for contingent liabilities arising from high-impact risks. multiple institutions across sectors work on crisis preparedness Given the magnitude of Nepal’s development challenges and and response but often with unclear and conflicting mandates of the high and increasing crisis risks it is facing, this is unlikely and responsibilities, and cross-sectoral, interagency to change. Realistic and effective risk-financing strategies collaboration is limited. Furthermore, key line ministries see need to take this fact into account. their role primarily in organizing ex post responses to crises that affect their area of work. The NDRRMA, which is responsible Crisis preparedness in Nepal is largely donor driven and for cross-sectoral coordination of crisis preparedness, has project based. While the resulting analytical reports, planning limited autonomy, technical capacity, and resources (including documents, and pilot projects form important components of staff), and, across agencies, there are coordination gaps for Nepal’s crisis-preparedness mechanisms, they could often many important sector-preparedness activities. be better integrated with long-term government strategy, planning, processes, and budgets. Frequent challenges with Local governments (LGs) have an exclusive mandate and donor-driven initiatives include lack of coordination and should play a key role in implementing crisis-preparedness interoperability of frameworks and limited consideration for and crisis-response activities. However, most LGs have limited scalability and sustainability. financial and technical capacity, resources, and staffing. This affects not only preparedness planning but vertical processes Many of the key risks that Nepal faces are likely to increase such as the collection and aggregation of data for crisis-risk with climate change, but there is limited long-term planning monitoring. around climate change–induced risks. Nepal is among the countries most vulnerable to climate change, and rising Key institutions responsible for preparedness, processes, temperatures and changing weather patterns are likely to and activities are not adequately financed, and, where have significant adverse effects on living conditions and food funding is available, procurement and spending are often production across the country. For instance, the southern Terai slow and incomplete. An important reason why preparedness- plains, where over 50 percent of the population lives and most related laws and policies are not being implemented, and of Nepal’s food is grown, face increasing annual risks such preparedness institutions remain ineffectual, is the absence of as deadly heatwaves and dry spells requiring climate- and dedicated budget lines to pay for permanent staff, maintenance disaster-resilient infrastructure, settlement, and agriculture of equipment, costs for recurring activities such as risk development planning with multidecade horizons. assessments and preparedness plans, and operating costs for early-warning systems (EWSs). Slow budget execution and Overall, while the GoN is prepared to manage small, recurrent procurement processes are a long-standing issue with Nepal’s natural disasters, it is not prepared to deal with large, multi- development budget, which affects preparedness as well. sector crises. The CPGA analyzes the various gaps in the Reasons are complex and include challenges in procurement preparedness capacity. Chapter 4 presents a summary of governance. In crisis preparedness and response, this has component-specific findings on crisis preparedness. the effect of further tilting expenditures away from ex ante preparedness and toward comparatively simpler ex post response and relief activities. 17 18 SUMMARY OF COMPONENT-SPECIFIC FINDINGS ON CRISIS PREPAREDNESS LEGAL & INSTITUTIONAL FOUNDATIONS COMPONENT SUBCOMPONENT INDICATOR ML 1. Legal & 1.1 Legislative frame- 1.1.1 Dedicated crisis-preparedness laws and regulations are in place and institutional works, strategic enforced, with preparedness plans mainstreamed into policy frameworks ADVANCED foundations plans, and policies 1.2 Governance and 1.2.1 Governance and institutional arrangements are in place, with defined BASIC institutions mandates, roles, and responsibilities 1.2.2 Preparedness activities are coordinated across sectors and levels BASIC within government and with external stakeholders Overview: The legal and institutional architecture underpinning and an increasing prioritization of climate change and other Nepal’s crisis-preparedness framework is relatively new and drivers of risks. The legislative framework is adequate and is evolving, reflecting both the implementation of Nepal’s federal rated advanced, but the institutional framework for coordinating restructuring that was initiated with the 2015 constitution preparedness is less clear and fragmented and is rated as basic. LEGISLATIVE FRAMEWORKS AND STRATEGIC PLANS AND POLICIES FOR CRISIS PREPAREDNESS At the level of the constitution, disaster management is the The legal cornerstone of DRM is the Disaster Risk Reduction exclusive jurisdiction of the local levels (Schedule 8) but also and Management (DRRM) act of 2017. Unlike the Disaster Risk falls under the concurrent jurisdiction of the federal, provincial, Reduction Act 1982 that it replaces, the new act considers a and local levels (Schedule 9). Early preparedness for rescue, broad range of disasters, including public health emergencies relief, and rehabilitation, in contrast, is listed as being in the and food insecurity, and assigns significant power both to concurrent jurisdiction of federal and provincial levels (Schedule a new autonomous disaster-management authority, the 9). Other areas pertinent to crisis preparedness are distributed NDRRMA, and to LGs. Important subsidiary regulations and across the federal level (health policy and services, land use, policies are the Disaster Risk Reduction and Management social security), concurrent federal and provincial levels (water Regulations (2019) and the National Policy for Disaster Risk supply and sanitation, use of forests and mountains, and Reduction (2018), which provides overall policy guidance and forest conservation), and concurrent jurisdiction of all levels is supported by the National Strategic Action Plan for Disaster (electricity, water supply and irrigation, social security, and Risk Reduction, 2018–2030, which outlines an overall multi- poverty alleviation). Clarity of responsibilities based on the hazard DRM strategy. scale and the magnitude of disasters needs to be spelled out clearly for seamless actions during disasters and for effective In addition, a variety of other policies and plans address coordination across agencies and levels of government. preparedness and response. Some of these are hazard specific, 19 such as the National Pandemic Preparedness and Response balance between ex ante and ex post preparedness is also Plan, while others address specific, frequently occurring multi- apparent from allocation of crisis-related funding with the hazard scenarios such as the preparedness and response plan approval of the National Disaster Management (DM) Fund for monsoon disasters, which is prepared on an annual basis. Guideline of 2023, which governs DM funds at all tiers of Many recent sector-specific policies also contain a strong government: it allocated up to 70 percent for disaster-risk disaster-preparedness component. For example, the National reduction, response preparedness, reconstruction, and Climate Change Policy of 2019 has disaster-risk reduction rehabilitation (for details, see Module 3). and management (DRRM) as one of its eight thematic areas. In addition, a National Adaptation Plan has been formulated Across the board, disaster-preparedness and disaster- that identifies six high-priority adaptation programs for the response laws, regulations, plans, and policies explicitly DRRM sectors to help integrate and harmonize climate change state their commitment to considering the specific needs adaptation and DRRM at all levels of government. Among the of vulnerable groups. However, the approach to inclusion actions the National Adaptation Plan intends to promote are is not standardized across documents, and this general developing shock-responsive SP, multi-hazard EWSs, federal commitment is often not operationalized. Doing so would and provincial strategies and action plans on mitigation of require analysis of how specific groups are differentially climate-induced disasters, and a regulatory framework for affected by specific hazards and guidance for how these domestic and industrial fire control and mitigation as well as impacts and vulnerabilities should be addressed. To address building climate resilience through land-use planning. this, NDRRMA is in the process of finalizing the Gender, Equality, Disability, and Social Inclusion (GEDSI) strategy. Crisis-related laws and policies place significant emphasis on As of now, DRM policies, programs, and systems are ex ante preparedness. This is reflected in the establishment of also not linked to SP. The government is also currently a permanent institutional structure across tiers of government preparing shock-responsive social protection (SRSP) in the 2017 DRRM Act, which covers both preparing for and guidelines to establish this link, which if implemented will responding to crises, notably through risk assessments and contribute to operationalizing this commitment (for details, preparedness plans, again across tiers of government. The see Module 5). INSTITUTIONAL FRAMEWORK FOR CRISIS PREPAREDNESS The NDRRMA was established in 2019 per the 2017 DRRM At the federal level, the highest DRRM body is the DRRM Act to carry out disaster-management activities across the National Council. Chaired by the prime minister, the National broad array of crisis situations covered by the act. However, Council52 provides strategic oversight and strategy and the NDRRMA has yet to be fully empowered with adequate policy guidance including at the provincial and local levels. technical staff and financial resources to fully execute its An Executive Committee53 chaired by the minister of home functions and responsibilities. The ambiguities and disputed affairs is tasked with developing strategies and policies mandates between the Ministry of Home Affairs (MoHA) and and then implementing them once approved, including by the NDRRMA need to be clarified to avoid duplications and coordinating across government agencies.54 The central address gaps particularly in prioritizing crisis preparedness institution for developing and implementing DRR strategy and and recovery of livelihoods after disasters. policy is the NDRRMA, which is part of MoHA and operates 52 The Council comprises ministers of the federal government, chief ministers of all seven provinces, vice chairperson of NPC, chief secretary, leader of opposition party, heads of security agencies, three appointed experts with chief executive of NDRRMA as the member secretary. 53 The executive committee comprises ministers of MOHP, MOUD and MOFAGA, secretaries of GoN, representatives from security agencies, Nepal Rastra Bank, Nepal Telecommunications, Social Welfare Council, Nepal Red Cross Society, and Chamber of Commerce. 54 For the latter, see Disaster Risk Reduction and Management Regulation 2076, Paragraph 4 (2019). 20 under the supervision of the Executive Committee. Per the agencies concerned.55 In addition, it is tasked with DRRM Act, the NDRRMA has a broad array of duties. Apart implementing DRRM strategy and policy, acting as the central from serving as the secretariat of the National Council DRRM research and resource agency, providing financial and and Executive Committee, its roles include both crisis technical assistance to provincial and local bodies, providing preparedness and planning and response (including search DRRM recommendations across government agencies, and and rescue [SAR] and mobilization of security agencies), to maintaining the National Emergency Operations Center be carried out in close coordination with other government (NEOC). Figure 3: Coordination Mechanism for disaster risk management in Nepal National Council Office of the Prime Minister and Council of Ministers Executive Committee Ministry of Home Affairs and Line Ministries Provincial Governments NDRRM Authority (National Emergency Security Agencies, Operation Centre) Departments Provincial DM Committees (PEOCs) District DM Committees (DEOCs) District Administration Offices Local Governments Local DM Committees (LEOCs) At the provincial level, the DRRM Act prescribes a Provincial At the district level, the act establishes a District Disaster Disaster Management Council chaired by the chief minister Management Committee (DDMC) headed by the chief and a Provincial Disaster Management Executive Committee district officer (who works under MoHA), with the District (PDMEC) chaired by the interior minister for disaster Administration Office as its secretariat.56 Its roles includes management. Responsibilities and powers of the PDMEC supporting the implementation of national- and provincial- range from complementary (coordinating on SAR, establishing level policies, distributing relief materials, managing shelters, and implementing DRM policies and plans in line with national ensuring readiness of security agencies, providing essential policy) to exclusive (providing temporary shelters and essential supplies, coordinating NGO activities, and other activities that supplies, distributing relief materials and assistance provided overlap with the PDMEC’s and LGs’ mandates. by nongovernmental organizations (NGOs), destroying buildings declared unsafe). Disaster Risk Reduction and Management Act, 2074, Chapter 4 (2017) 55 56 Disaster Risk Reduction and Management Regulation, 2076, Paragraph 6.1 (2019) 21 Local Disaster Management Committees are chaired by LG on managing the response to natural disasters, including SAR chairs or mayors. Their mandate includes establishing DRRM and the distribution of relief. The NEOC, which falls under the plans in line with national and provincial provisions, conducting NDRRMA per the DRRM Act, continues to remain under the local risk assessments, establishing a local emergency operation DRM division.58 The Ministry of Health and Population (MoHP) center (EOC), maintaining a fire brigade, enforcing national asserts its lead role in pandemic response and in other public building codes, involving communities, developing early-warning health crises, but other agencies also have jurisdictions on structures, and identifying disaster-affected households. aspects of health emergency response.59 The mandate for climate change–related risks and food security is with the In sum, institutional structures for disaster preparedness Ministry of Agriculture and Livestock Development (MoALD), and response, as set by law, are quite strong, although not while the Food Management and Trading Company (FMTC) without some inconsistencies, ambiguities, and overlap. The is responsible for emergency food stocks and distribution. In main strength of the de jure framework is the establishment this context, the NDRRMA has so far mainly focused on natural of the NDRRMA and provincial- and local-level agencies disasters despite its broader mandate to work on all crises. with the explicit mandate to analyze risks and coordinate There is a need for the NDRRMA to engage and coordinate preparedness and response across sectors. However, the legal with relevant agencies to prepare for crises related to health framework has multiple weaknesses as well. The NDRRMA and food insecurity. was originally envisaged as an entity that is empowered and resourced in a manner similar to the post-earthquake National During the COVID-19 pandemic, the response was organized Reconstruction Authority (NRA). But while the NRA chair had 57 with the formation of an ad hoc COVID-19 Crisis Management the protocol rank of a state minister and reported directly to Coordination Committee (CCMC) co-led by the deputy Prime the prime minister, the NDRRMA is housed within MoHA. This Minister, reporting directly to the Office of Prime Minister means that the NDRRMA chief executive has limited convening and Council of Ministers, and with representatives from all power for coordinating across line ministries. In addition, the ministries including MoHP and, prominently, the Nepal Army. law leaves significant gaps in terms of downstream lines of Stakeholder consultations indicated that the CCMC may communication and command. Most significantly, these are provide the template for crisis response going forward, with not specified for national and subnational EOCs. an ongoing discussion about establishing an interministerial crisis coordination mechanism similar to CCMC that can be Actual processes diverge significantly from those prescribed activated in an emergency, with different ministries in the lead in the DRRM Act. Partly, this is because the new institutions are depending on the nature of the hazard involved. still being established amid an ongoing broader restructuring of the state and administration into a federal system. This is From a crisis preparedness perspective, this poses several a complex exercise that takes time. However, there are also challenges. First, the coexistence of two separate institutional systemic obstacles to the establishment of well-functioning frameworks for crisis response introduces a measure of institutions for preparedness. uncertainty about which framework should be followed every time a crisis occurs. Second, the idea behind a permanent, By law, the NDRRMA leads in both crisis preparedness cross-sectoral DRM authority is to both coordinate across and crisis response across sectors, but de facto, several institutions for preparedness and response and institutionalize ministries view it as their exclusive role to organize response an approach that can effectively evaluate and prepare for for hazards that fall within their purview. Disaster risk different dimensions of a crisis across sectoral boundaries. reduction (DRR) was previously managed by a dedicated DRM In contrast, preparedness and response mechanisms led by division at MoHA, headed by a joint secretary. This division individual ministries are less likely to have the capacity to continues to operate essentially as before and claims a mandate transcend sectoral silos. CPGA consultations, June 2023 57 58 CPGA consultations, June 2023 59 MoHP. (2022). Health Sector Response to COVID-19 Pandemic in Nepal. Ministry of Health and Population, Government of Nepal. 22 Third, preparedness is not prioritized by the line ministries. Also among its key tasks is coordination across sectors and Several documents allocate responsibilities for specific stakeholders—for example, through the National Platform for preparedness activities. The Disaster Risk Reduction National Disaster Risk Reduction, which is chaired by the NDRRMA Strategic Plan of Action (2018–30) contains lists of preparedness chief executive. The monsoon-preparedness plans of the last activities that specify the lead agency, usually one or several three years, developed with full buy-in from the Humanitarian ministries, responsible for carrying them out. However, there Cluster Team—cochaired by the NDRRMA chief executive and has not been an assessment of the implementation progress the UN resident coordinator—are a particular success here. of these activities, and inter-ministerial coordination is not With regard to recovery of livelihoods, the NDRRMA should assured. ensure that it is prioritized with financing from the disaster management (DM) fund and coordinate its delivery through Some cross-sector collaboration for preparedness is taking the relevant sectoral agencies. place, but it is not institutionalized. For example, National Agriculture Research Center under the MoALD works with However, the NDRRMA faces several institutional and the Department of Meteorology and Hydrology (DHM) to resource constraints. Institutionally, the NDRRMA has to devise forecast-based advice (agro-advisory bulletin) for operate via the DRM division, which limits its autonomy. It also farmers (see Module 2). The One Health strategy provides a lacks crucial human resources. The budget allocated to the platform for coordination across MoHP, Ministry of Forests and NDRRMA is far less than required for it to execute its functions. Environment, and MoALD (see Module 4). Crucially, although The technical assistance from the DPs has remained critical the MoHA secretary is a member of the One Health Steering for its functioning. The limited staffing and budget have also Committee, the NDRRMA is not. Consultations indicate that affected one of its most crucial functions, which is to provide coordination is generally difficult, not institutionalized, and training and technical assistance to LGs. One partial solution certainly not as effective as it could be. to the human resource constraint, which is already being practiced at a limited scale, is to request secondments of Response to food insecurity and recovery of livelihoods technical staff from relevant agencies. This has the added during and after crises is another area that receives advantage of strengthening lines of communication and insufficient attention. The mandate for food insecurity broader ownership of the NDRRMA across government.60 is fragmented across multiple agencies, with no agency prioritizing the preparedness for it. Regarding recovery, Local and provincial governments are relatively new the government tends to focus on immediate relief and institutions established in the transition to a federal structure reconstruction of damaged housing and does not consider and require significant technical and human resources to take recovery of livelihoods affected by disasters. Unlike with crisis over DRRM responsibilities. Broadly speaking, LGs currently response, this leaves the intersectoral analysis of risks and lack the staffing and capacity to meaningfully engage in coordination of preparedness measures, as well as the crucial preparedness activities. This is the case for core preparedness area of livelihood recovery, without a strong institutional functions and responsibilities such as devising disaster- champion. preparedness and disaster-response plans or enforcing the national building code. This is evident from assessments Cross-sectoral preparedness and livelihood recovery are, across three areas of preparedness: liaison with higher tiers of therefore, fields in which the NDRRMA can claim its mandate government, the state of EOCs, and preparedness plans. effectively and is already contributing significantly. The NDRRMA has undertaken several key pieces of strategic Disaster Management Committees (DMCs) and EOCs at all analytical work, including the crisis-response capacity levels, including the local level, have inadequate resources. mapping of GoN (using the Ready to Respond (R2R) A major recommendation of recent preparedness assessments framework), and it maintains a new disaster-information portal has been for the establishment, training, and equipment of (BIPAD; see Module 2) and is shepherding the SRSP agenda. ward-level, volunteer emergency preparedness and response CPGA consultations, June 2023 60 23 (EPR) teams and for the EOCs to have permanent staff.61 But ownership or are template-based and lack local specificity, local DMCs are not currently equipped to undertake this. The and only a few good examples indicate possible entry points functioning of local EOCs is also affected by unclear chain for improvements. Often disaster-preparedness and disaster- of command. Per the DRRM Act, NEOC would coordinate response plans mention available capacities but do not detail with and work through EOCs at the district and local levels capacity shortfalls. In turn, the national government allocates (the 2017 DRRMA does not provide for provincial EOCs),62 but funds that are often distributed based on the claims of various there has been no policy-level decision or standard operating authorities rather on evidence-based planning. procedure (SOP) specifying the chain of command between EOCs at different levels. Meanwhile, chief district officers The DRRM act empowers the government to seek international (CDOs) working under the direction of MoHA chair the District assistance if required. The central mechanism for coordination EOCs, the SOPs for which are based on the National Disaster between the government and international actors for disaster Response Framework from 2013, before the establishment preparedness and response is the humanitarian cluster of federal structures. This reflects the de facto direct system, which works on preparedness and planning and can coordination between the MoHA DRM division and CDOs and be scaled up in the event of a crisis at the request of GoN. therefore reinforces a parallel structure that does not allow for Each of the 11 clusters is led by a government agency and co- the supposedly central role of local bodies in preparedness led by representatives of the humanitarian sector, usually one and response. In addition, the coordination between NEOC or several UN agencies. The UN Resident Coordinator Office and health EOCs (HEOCs) under MoHP is weak. is tasked with coordinating international humanitarian actors in support of GoN’s crisis response, including through chairing The limited ability to generate preparedness data and the Humanitarian Cluster Team Principals, which consists of develop preparedness plans illustrate the challenges of the cluster co-leads and representatives of donors, the Red subnational-level crisis preparedness. Consultations with Cross, and international NGOs and serves as the central several ministries indicated that data collection and entry at decision-making and oversight body for the international the local level has emerged as a crucial bottleneck in compiling humanitarian community in Nepal.63 preparedness-relevant data, including on food security. Before federalism, the District Food Security Networks, collected This assessment does not cover the cluster system in detail data for the food-security monitoring system (Nepal Khadya but based on consultations, offers a few observations. Surakshya Pranali [NeKSAP]). With the dismantling of district- First, given Nepal’s limited fiscal space and the role that level administrative structures in 2017, this has been disrupted. international donors and humanitarian agencies have played Efforts are underway to realign food-security information in responding to some crises in the past, they should be centers at all tiers of government, under the institutional considered an integral part of response capacity. Second, in architecture of the Right to Food and Food Sovereignty Act the area of preparedness, the HCT has established in some of 2018. The National Strategic Plan of Action and Disaster areas contingency plans that are important instruments for Preparedness and Response Plan Directives of 2019 call for coordinating international assistance with the government, the development of disaster-preparedness and disaster- but this aspect could be strengthened. Examples are the UN’s response plans at the local, district, provincial, and federal Earthquake Contingency Plan and Pandemic Contingency levels. While most district and local DMCs do have these plans Plan. In the case of the former, there is neither government co- (they are called local disaster and climate resilience plans ownership nor a GoN document. In the case of the latter, the at the local level), the plans are often developed with input government has its own preparedness plan and the UN’s plan64 from donor-funded NGOs or projects with little government was subsequently revised to be aligned with the GoN plan.65 NDRRMA. (2022). Emergency Preparedness and Response Assessment 2022 – 2030: Ready 2 Respond Methodology. National Disaster Risk Reduction and Man- 61 agement Authority, Government of Nepal. 62 At the provincial, district, and local levels, the 2017 DRRMA provides for the formation of Disaster Management Councils, which then further establish emergency operations centers. 63 UN Nepal. (2021). Earthquake Contingency Plan Nepal, 2022. Kathmandu: United Nations Nepal 64 UN Nepal (2021). COVID-19 Nepal: Preparedness and Response Plan (CPRP), 2021. Kathmandu: United Nations Nepal 24 Finally, numerous small-scale, donor-funded pilot projects into government review and planning processes to ensure on preparedness have been undertaken across Nepal, but it effective knowledge management and seizing of opportunities is unclear whether these kinds of projects are well integrated for scaling up. Entry Points: Legal and Institutional Foundations 1. Clarify government agencies’ responsibilities for crisis preparedness and response: • Clarify the responsibilities of agencies working on preparedness and response at different levels of government, including by consolidating the currently fragmented chain of command and communication between the NEOC and EOCs at the district and local levels. • Establish SOPs that enable smooth communication and cooperation under a broad range of contingencies. 2. Strengthen the NDRRMA’s role and institutional capacity to enable it to liaise across and coordinate agencies to coordinate preparedness across crises including natural hazards, pandemics, and food insecurity, as well as post crisis livelihood recovery: • Engage in sustained high-level policy dialogue, advocating to strengthen the NDRRMA as a dedicated agency for cross- sectoral preparedness and for increasing its autonomy in this area—for example, through making chains of command clearer and streamlining fund flow. • Encourage secondments from important partner ministries to address shortages of sectoral expertise and build cross- institutional rapport. • Invest in preparedness activities to be implemented by the NDRRMA, including building a multi-hazard EWS and developing multi-hazard risk assessments at the all levels. • Integrate the NDRRMA in the One Health agenda and the food-security dialogue. 3. Strengthen the NDRRMA to enable it to support local level capacity building for key preparedness activities and engagement with communities: • Support NDRRMA to serve as the lead agency to deliver technical assistance to the LLs including by providing assistance to draft key preparedness documents, risk monitoring, as well as drills and simulation exercises, and to promote community engagement in all DRM activities, both to promote awareness and readiness for response. GoN (2020). Health Sector Emergency Response Plan: COVID-19 Pandemic, 2020. Ministry of Health and Population 65 25 UNDERSTANDING & MONITORING RISKS COMPONENT SUBCOMPONENT INDICATOR ML 2. Under- 2.1 Risk assessment 2.1.1 National cross-sectoral and sector-specific risk assessments have BASIC standing & been carried out, using current and historical data sets monitoring risks 2.1.2 Government is able to identify vulnerable people without BASIC discrimination 2.2 Risk monitoring 2.2.1 Government has the capacity to monitor and analyze active threats in BASIC and early warnings real time to inform national- and subnational-level decision-making 2.2.2 Risk information is communicated in accessible and relevant formats BASIC to all relevant groups Overview: Numerous sector-specific risk assessments of multiple hazards with effects that may compound and conducted over the last few years jointly build a broadly cut across sectors. Risk assessment is therefore rated as comprehensive risk profile suitable for planning, implementing, basic. Risk monitoring and early warnings is also rated basic. and monitoring sector-specific activities. However, there are The government operates effective systems for monitoring important gaps, especially in understanding new and emerging hazards in two sectors: flood early warning based on a risks with global or regional origins (for example, low-likelihood well-developed system for collecting and analyzing hydro- / high-impact risks such as deadly wet-bulb heatwaves in the meteorological data, and health risk, including pandemic, Terai plains or serious disruptions of remittances or trade in monitoring. Monitoring of food security is fragmented and essential goods) and in understanding possible interactions only partially functional. RISK ASSESSMENTS The last cross-sectoral risk assessment needs updating; a example, from flood-risk monitoring). An MHRA is underway new multi-hazard risk assessment (MHRA) should analyze with assistance from the World Bank and should be conducted compounding and cascading risks. A Nepal Hazard Risk at regular intervals. Assessment was undertaken in 2010. While this assessment covers a broad range of hazards and models, quantifies More recent assessments of climate change–related risks potential impacts, and offers district-level risk profiles, several are an important addition but exclude several key threats. A central elements require updating—among other reasons, to series of climate change VRAs66 for nine thematic areas and account for demographic and socioeconomic changes. A new one cross-cutting area conducted by the Ministry of Forests assessment would offer an opportunity to benefit from recent and Environment (MoFE) were published in 2021 including advances in risk management: it could be conducted as a in a consolidated VRA summary report. The thematic VRAs multi-hazard assessment analyzing how key risks interact with disaggregate levels of impact and vulnerability by district and one another, and it could avail itself of new data sources (for contain an element of long-term forecasting by modeling risk 66 The Environmental Protection Act specifies that climate change VRAs should be conducted every five years. 26 and impact levels across different sectors under a range events (to be vetted by police or LG officials if the reports of climate change scenarios. 50 districts of the 77 districts come from a member of the public). The aim is to have a are ranked high to very high in terms of climate change continuously updated database of disaster events, with a vulnerability. 67 The World Bank’s 2022 Country Climate and wide range of use cases for preparedness planning and Development Report for Nepal adds analysis on the economic response. The challenge to making BIPAD fully operational costs resulting from a range of climate change scenarios, is effective data entry given capacity constraints at the local considering aggregate-growth scenarios as well as damage level. A pilot for training municipalities for BIPAD data entry is to agricultural and labor productivity and infrastructure. currently underway. These assessments specifically focus on hazards and risks resulting from climate change, and although they effectively Risk assessments identify certain groups of people as cover a broad range of the hazards affecting Nepal, including vulnerable, but there is no consolidated database of the flood, landslide, extreme-weather, and pandemic risks, they vulnerable. Existing databases and assessments identify exclude others, such as earthquake risks and risks related to broad categories of vulnerable populations based on global political and economic dynamics. intersecting characteristics such as gender, age, ethnic and caste identity, and socioeconomic status. However, beyond Existing assessments have several shortcomings. Most databases of program beneficiaries, there is no integrated assessments are insufficiently fine-grained to allow for a database of the vulnerable. Efforts are currently underway to full understanding of geographical differences and facilitate establish an integrated social registry (ISR) with a database of subnational planning for province- or local-level specific all households that would help identify vulnerable households crisis preparedness and response. Some provinces and (for details, see Module 5). Such a consolidated database municipalities have conducted risk assessments (especially would open opportunities to scale up existing, local-scale on climate vulnerability), but there is no existing mechanism efforts to enable more targeted early warning, preparedness, for feeding data gathered at this level into national documents and response—for example, by overlaying data on vulnerable or data sets. Second, most risk assessments at the national households on flood hazard maps. An important remaining and provincial levels are still driven by development projects, concern is the risk of significant exclusion errors in SP which means they often follow different methodologies, are not databases—for instance, exclusion of populations without interoperable, and are not conducted at regular intervals, and citizenship certificates who are therefore unable to enroll. data are siloed in multiple government and partner institutions rather than being consolidated in federal-level databases. In addition, there are very few small-scale, group-specific analyses of the impacts of key threats on groups identified A digital platform for compiling and sharing risk-assessment as vulnerable. The existing analyses of vulnerability draw data and information does exist but is not yet fully effective. on the significant body of qualitative studies on social Building Integrated Platform Against Disaster (BIPAD), a exclusion and its socioeconomic consequences in Nepal. disaster-management information system, was developed The major gap in current efforts to account for group-specific after the 2015 earthquake and replaced earlier databases. vulnerabilities is that they are based on a priori assumptions The BIPAD portal includes multiple natural hazards, including rather than analysis of how different kinds of threats affect heavy rainfall, earthquakes, landslides, and hurricanes, different groups of people differently. Such analysis is crucial in all provinces, and it can be used to make disaster- for developing targeted and effective preparedness and related informed decisions by all three tiers of government. response measures. One well-established example is the BIPAD includes historical data and is conceptualized as a way the pandemic affected children through school closures, decentralized platform that allows users to report disaster requiring measures to ensure the continuity of education. 67 Even under the stabilizing climate change scenario i.e., Representative Concentration Pathways of 4.5, most of the districts in Nepal will be at high to very high- risk. 27 RISK MONITORING AND EARLY WARNINGS The flood EWS operated by the Department of Hydrology and assessment of possible impacts, including when, where, and Meteorology’s (DHM’s) flood-forecasting division monitors how likely the impacts are based on historical impact data 12 rivers in the Terai region through readings from a network and probabilistic modeling. It provides the information needed of manual and automated measurement stations. 68 Based to act before disasters to minimize the socioeconomic costs on its own flood hazard maps and predefined thresholds, the of weather and climate hazards. The key challenges here, DHM issues warnings of imminent floods. It also issues three- however, are inadequate expertise for modeling and lack of day flood warnings based on modeling using river gauge data clarity on how to collect the impact data to inform the models and satellite weather data. The warnings are disseminated and who will do so. This would ideally be done at the local through daily bulletins and geo-targeted SMS messages. The level, but LGs do not currently have the human resources for former is mainly addressed to LG agencies, the latter to end doing so. At present, the DHM lacks a policy and regulation to users. Built over the last decade, this is an advanced EWS, but streamline its services across the sectors and throughout the there are important gaps, especially in hydromet monitoring in country. A Hydromet Policy and Hydromet Master Plan is under mountain regions, which results in limitations in early-warning development that is expected to provide strategic guidance capacities for downstream flood risks, glacial lake outburst and an action plan for strengthening the institutional and floods (GLOFs), and potentially landslides (once a landslide technical capacity of the DHM for improved weather, water, EWS has been established). Several issues related to upkeep and climate services in the country. and evolution also need to be resolved. First, the DHM’s flood hazard maps are possibly outdated, and there is currently Health risks are monitored through the Early Warning and no system for updating them. Second, the maintenance of Reporting System (EWARS) operated by the Epidemiology and monitoring stations and the salaries of gauge readers are now Disease Control Division. EWARS serves as the early-warning LG responsibilities, and it is unclear whether the new system surveillance system in Nepal through sentinel sites at federal, works. 69 provincial, and local hospitals. EWARS data are entered into and reported through the electronic district health information The DHM also provides forecasting services that are highly system. Event-based surveillance is present but does not in demand, especially during the monsoon season, and currently function well at the national level. Laboratory provides the basis for limited agro-met advisory, but it lacks surveillance is also in place for influenza and SARS-CoV-2. sufficient staff to do so sustainably. During the monsoon Antimicrobial-resistance surveillance on 10 pathogens occurs season, the monsoon forecasting team provides 24/7 at 26 sites. During the COVID-19 pandemic, EWARS was forecasting, but this currently happens in an ad hoc manner. It bolstered by the very rapid expansion of laboratory capacity, is neither institutionalized nor properly budgeted for, and it puts which, if maintained, will provide important capacity for significant strain on the small team of meteorologists at the pandemic-risk monitoring going forward. DHM who work in shifts during this period. The hydromet data generated, furthermore, is not fully used, because it is not fully Elements of a food-security monitoring system exist but are tied into impact analysis and actionable early warnings. To the currently fragmented and only partially functional. NeKSAP, extent it is used, the DHM provides agro-met services to the the food-security monitoring system, was an established, National Agriculture Research Center and MoALD that provide nationwide, multisectoral monitoring system that collected, the Agro-Advisory Bulletin with recommended measures by analyzed, and presented district-level information on crop. These recommendations are shared with LGs. The DHM household food security, markets, and nutrition. The system is now planning to adopt impact-based forecasting, and a was initially established by the World Food Program (WFP) and pilot project has already started. Impact-based forecasting has been institutionalized within MoALD since 2016. NeKSAP’s combines a forecast of a weather or climate hazard and an operations have been disrupted during the transition to a 68 The rivers are Mahakali, Mohana, Karnali, Babai, West Rapti, Narayani, Reu, East Rapti, Bagmati, Kamala, Koshi, and Kankai. 69 Meechaiya, Chinaporn, Emily Wilkinson, Emma Lovell, Sarah Brown and Mirianna Budimir. (2019). The Governance of Nepal’s Flood Early Warning System Oppor- tunities Under Federalism, BRACED Working Paper. 28 federal structure, wherein LGs have the responsibility to monitor With respect to monitoring and analysis of malnutrition, food insecurity. The District Food Security Network, which the Nutrition Section of the Department of Health Services was the core part of NeKSAP geared toward data collection, at MoHP collects local-level data on nutrition indicators, analysis, and district-level planning on food security, no longer including incidence and progress of moderate acute exists. Until the local Food Security Information centers are malnutrition in children below 5 years of age. 74 In addition, operational, the WFP has supported monitoring of acute the Nepal Demographic and Health Survey and the National food-insecurity risks through rapid surveys, which during the Living Standard Survey provide periodic insight on the food- pandemic were funded by Australian aid. security situation and malnutrition data at the provincial level. However, these are only periodically updated, every 5 and 7 Efforts are underway to institutionalize Food Security years, respectively. Information Centers at all three tiers of the government as part of NeKSAP under the Right to Food and Food Sovereignty Act of Several key threats facing Nepal are not adequately covered 2018, facilitated by the proposed Food Systems Transformation by monitoring, forecasting, and EWSs. Some of these threats Strategic Plan (2022–2030) endorsed by the NPC. The WFP is cannot be reliably forecast with currently available technology, currently supporting pilots of these information centers in 16 as is the case for earthquakes. For other important threats, LGs.70 Localizing NeKSAP to all 753 LGs would ensure that it notably landslides, GLOFs, forest fires, and air pollution, has timely, reliable, accurate, and useful data, and risk-based however, forecasting would be possible by expanding or monitoring. 71 linking up existing monitoring systems. There is one GLOF EWS in Rolwaling-Tamakoshi, Dudh Koshi (Everest Region). Besides NeKSAP, there are few existing tools for monitoring Although landslides are one of the major hazards in the food security and prices. MoALD conducts periodic country and cause massive devastation every year, a proper monitoring and assessments, but these are mainly limited to landslide-based EWS has yet to be established. The NDRRMA monitoring production mainly based on weather forecasts is currently piloting impact-based forecasting for landslides in and agri-statistics. 72 There are problems with the accuracy of four districts and for floods in western Nepal. this data, and MoALD is collaborating with the WFP and the International Center for Integrated Mountain Development on A multi-hazard EWS is under development. The 2018–2030 a pilot project using satellite imaging to improve forecasts. National DRR Policy and Strategic Action Plan makes a The WFP and the Food and Agriculture Organization conduct policy commitment to establishing EWSs for natural hazards, periodic assessments and monitoring of food security through specifically through the development of a multi-hazard their respective tools, (i) Mobile Vulnerability Analysis and EWS. The NDRRMA is currently drafting a concept note and Mapping and (ii) Global Information and Early Warning Systems an action plan for its implementation with the cost of the (GIEWS). Mobile Vulnerability Analysis and Mapping surveys project estimated at USD 600 million until 2030. There are are conducted twice a year, capturing seasonality, and can also efforts to integrate EWSs regionally, with the NDRRMA provide food-security estimates at the provincial level.73 developing a Common Alerting Protocol in collaboration with GIEWS monitors food supply and demand and other key the Regional Integrated Multi-Hazard Early Warning System, indicators for assessing overall food security in all countries, an intergovernmental organization across Africa, Asia, and the issues regular analytical and objective reports on prevailing Pacific, under the World Bank–financed Climate Adaptation conditions, and provides early warnings of impending food and Resilience for South Asia Project crises at the country or regional level. Critically, monitoring food security usually feeds into response activities but is not For any expansion of hazard monitoring capacity to linked to preparedness activities. be effective, serious challenges in data analysis and 70 CPGA consultations, June 2023 71 NPC. (2018). Towards Zero Hunger in Nepal: A Strategic Review of Food Security and Nutrition. National Planning Commission, Government of Nepal 72 CPGA consultations, June 2023 73 Further, VAM exercises also include emergency data preparedness and rapid food-security assessments and thematic studies. 74 MoHP. (2021). Annual Report: Department of Health Services 2076/77 (2019/20). Ministry of Health and Population, Government of Nepal. 29 communication of actionable advice need to be addressed. flood warnings through the DHM bulletins, and end users The first constraint on raising EWSs’ effectiveness is the lack through SMS messages. However, as detailed in Module 1, of capacity for interpreting risk-monitoring data and generating subnational EOCs are not properly staffed and trained to actionable advice and warnings for impact forecasting. adequately interpret the bulletins and translate them into However, relevant expertise on this is often distributed effective preparedness and response measures. For them, across different agencies. The collaborations that do exist and for end users, a key issue is that warnings are not precisely are generally ad hoc and not institutionalized. To take agro- geo-targeted, so it is unclear who should act on them. While met advice as an example, the existing collaboration does not SMS has wide coverage, this measure also leaves important allow for developing advice that is sufficiently customized for gaps, excluding vulnerable populations who cannot read, do farmers—for instance, translating a monsoon forecast into not speak Nepali, or do not have mobile phones. Innovative advice on whether to push forward the harvesting of particular solutions to address these issues exist but are implemented crops in particular parts of the country. 75 in isolated and fragmented projects and would need to be systematized and scaled up. A second important constraint lies in the effective communication of warnings and advisory. In principle, Both on data interpretation and risk communication, the EWSs are supposed to disseminate warnings and other risk two most urgent improvements required are clarification of information through the network of EOCs at the national, roles (for example, between the DHM, the NDRRMA, and LGs) provincial, district, and local levels. In the case of flood through standard operating guidelines and strengthening of risks, which represent the most advanced area of risk relationships between data-generating and data-interpreting communication, LGs and civil society organizations receive institutions (for example, between the DHM and line ministries). Entry Points: Understanding and Communicating Risk 1. Support the NDRRMA to conduct an MHRA at the national and subnational levels: • A new MHRA is already underway with support from the World Bank, which will help establish a national analytical framework and regulate periodicity to ensure consistency and continuity. • Complement the national MHRA with systematic subnational multihazard risk assessments conforming to a common standard in order to generate risk profiles that are sufficiently granular and geographically specific that it enables effective preparedness planning and geographical prioritization of monitoring and EWS measures. 2. Strengthen hydromet forecasting by institutionalizing impact-based forecasting by DHM, which is particularly crucial for risk monitoring during the monsoon months. The hydromet law could be the instrument for its institutionalization. • Expand the network of hydromet monitoring stations and provide adequate resources for maintaining them. • Focus additional technical assistance on building DHM’s modeling expertise. 3. Support development of an inclusive multihazard EWS: • Expand the range of natural hazards monitored (such as for landslide forecasting and lightning detection) through technical investments. • Ensure budget lines for recurring expenditures on maintenance and staffing. 75 CPGA consultations, June 2023 30 • Enhance sectoral capacities for risk monitoring—for example, in agriculture (for lumpy skin disease), roads, and hydropower—and strengthen LG capacity for monitoring certain risks. • Strengthen monitoring of food insecurity by operationalizing the food-security information centers at the local level. • Strengthen communication of early warnings to the public. • Strengthen institutional collaboration: • Establish intersectoral forums to understand the implications of forecasting data for different sectors and to develop actionable advisories accordingly. • Develop interoperability with existing EWSs, including those in health. 4. Systematically identify vulnerable groups and assess group-specific risks and impacts of key hazards to inform preparedness and response: • Building on existing analyses, establish consistent analytical frameworks and processes for identifying differential impacts of key hazards on different groups. A periodic climate change VRA could use such a framework. • Future local-level analyses should be conducted through participatory methods and used to inform preparedness and response measures that respond to groups’ different needs. • Local analyses should be collated to inform preparedness and response planning at the provincial and national levels. 31 FINANCIAL PREPAREDNESS COMPONENT SUBCOMPONENT INDICATOR ML 3. Financial 3.1 Crisis-risk 3.1.1 Government has a dedicated strategy for delivering crisis- and BASIC preparedness financing disaster-risk financing 3.1.2 Government has access to a range of sovereign financing NASCENT instruments 3.1.3 Government ensures the environment for insurance and other risk- BASIC finance instruments is enabling 3.2 Public financial 3.2.1 Government has put in place crisis-related budget execution rules BASIC management and procedures 3.2.2 Anticorruption mechanisms are in place to ensure transparency, efficiency, and accountability in the provision of emergency services and NASCENT financing at the national and subnational levels 3.2.3 Government coordinates and engages closely with international- development and humanitarian stakeholders to manage postcrisis inflow BASIC of resources, among other things Overview: The financial-preparedness component looks a World Bank-financed Catastrophic Deferred Draw Down at provisions for crisis-risk financing and public financial (Cat-DDO). Data gaps in risk information pose a significant management to ensure effective and accountable fund flow challenge to expanding coverage of insurance. Financing for during crises. GoN has limited crisis-risk financing mechanisms, contingency plans for critical infrastructure is hampered by a and large-scale response and recovery are mainly financed lack of consolidated inventory of such infrastructure. Challenges through development-partner financing. The government is in public financial management such as poor budget execution now trying to put into place a risk-layered approach to financial and procurement contribute to significant gaps in financial preparedness. The DM funds are in place at the national, preparedness. The ratings for subcomponents under financial provincial, district, and local levels, and Nepal is renegotiating preparedness range from nascent to basic. CRISIS-RISK FINANCING Disasters, in particular earthquakes and floods, have the billion).76 The 2017 floods led to direct damages of USD 585 potential to cause economic losses at such a scale that they million (NPR 60,717 million) and recovery needs of USD 705 put Nepal at significant risk of fiscal stress. The 2015 Gorkha million (NPR 73,245 million).77 Although the climatological and earthquake was estimated to have caused USD 5.4 billion (NPR hydrological events are less severe, they happen much more 517 billion) in damage to assets, equating to approximately one- frequently than earthquakes and can have an extremely large fifth of GDP in 2015. In addition, the economic losses resulting impact. from this destruction totaled around USD 1.7 billion (NPR 166 76 World Bank. (2022). Assessment of Contingent Liabilities from Natural Disasters in Nepal. 77 Ibid. 32 GoN has limited crisis-risk financing mechanisms to finance reallocations for high-frequency, low-impact events. These crisis response, recovery, and reconstruction. GoN has events are often more predictable and involve a generally limited ex ante interventions, and in the case of major disasters, lower response cost. For low-frequency, high-impact events, GoN relies mainly on post-disaster budget reallocations government transfers risk to the market using instruments and humanitarian appeals. For example, following the 2015 such as sovereign-risk insurance and catastrophe bonds. earthquake and its aftershocks, pledges totaling USD 4.4 These instruments spread the cost of coverage over multiple billion were made. 78 years, offering certainty of financing should a qualifying (large) disaster event occur during the period. The image below shows A risk-layered approach to financial preparedness allows the current financing instruments available to GoN plotted governments to combine different instruments to protect against the ideal mix of financing instruments needed for more against events of different frequency and severity. Under effective DRM as outlined in the disaster-risk financing (DRF) this approach, government retains some risk, which it manages strategy. It illustrates the current state of DRF with its heavy through government reserves, contingency funds, or budget reliance on ex post budget reallocation and donor financing. Disaster-risk financing in Nepal FINANCING MECHANISMS High Donor assistance* Sovereign earthquake insurance Insurance of public assets RISK LEVEL Contingent credit* Index insurance Post-disaster budget reallocations* National contingency funds* Micro index insurance Low High FREQUENCY Low Note: * indicates existing disaster-risk financing mechanisms. The main DRF instruments in place so far are contingency preparedness, reconstruction, and rehabilitation. However, the funds in the form of DM funds at the national, provincial, challenge is to actually use this resource for preparedness. district, and local levels. Established through the DRRM The moneys in the DM fund are mobilized per decisions of the Act of 2017, the DM funds can receive resources from GoN, Executive Committee at the federal level and relevant DRRM individuals and organizations in Nepal as well as foreign committees at subnational levels. A coordination committee individuals, organization, and governments. The DM-fund comprising joint secretaries from MoHA and the NDRRMA, with operating guidelines of 2022 mandate the use of DM funds for the NDRRMA chief executive as the committee coordinator, risk reduction, preparedness, response, relief, reconstruction, facilitates coordination and monitoring. The guidelines (clause and rehabilitation. A minimum of 30 percent of the balance in 18.4) note that the federal DM fund can access funds from the the national DM fund is to be set aside for response, and up Prime Minister’s Disaster Relief Fund (PMDRF), a separate fund to 70 percent of the balance can be used for risk reduction, that collects funds solely for disaster relief. Ministry of Finance, 2015 78 33 The DM funds contain sufficient financial reserves for basic Response Component was activated during the COVID-19 preparedness activities and for responding to localized or pandemic. The Public Debt Management Office (PDMO) less severe crises. Balances and expenditures of subnational sees potential to mobilize domestic resources for DRM using DM funds are not reliably compiled and in the public domain, medium-term debt instruments. The PDMO, however, while but the federal DM fund and the PMDRF together held over recognizing disasters as an important fiscal risk, has yet to NPR 4.9 billion (around USD 37 million) as of FY 2022-23.79 fully assess disaster-related fiscal risks.83 The assessment A budget analysis conducted for GoN’s 2022 Emergency of disaster-related fiscal risks could be part of the fiscal-risk Preparedness and Response Report noted that the DM funds register to be developed by Ministry of Finance as part of the at all levels have accumulated significant amounts of funds, a International Monetary Fund program in Nepal. proportion of which should be spent on preparedness as noted above.80 In addition to the federal DM fund and the PMDRF, There is almost no sovereign-level insurance, and private there are DM funds established at all seven provinces, 77 insurance coverage remains very low. A policy for public asset districts, and all 753 LGs, with over NPR 500 million (around insurance through the Rastriya Beema Company exists, but USD 3.8 million), NPR 590 million (around USD 4.5 million), it is up to departments and ministries to purchase coverage. and NPR 2 billion (around USD 15 million), respectively.81 As of 2019, the only public asset insured was the Tribhuvan The DM Fund Operating Guidelines 2022 specifies minimum International Airport.84 There is no clear policy framework for thresholds to be maintained by the federal- and district-level insuring public assets. Thirty-nine insurance companies now DM funds.82 Minimum thresholds for the provincial- and local- have products offering indemnity-based insurance products level funds are defined per the directive of the respective in the agriculture, livestock, and health fields, among others. governments. Despite these provisions, there remains a need The uptake of agricultural insurance is low despite heavy for complementary financing for preparedness and response subsidies of up to 75 percent for crop and livestock insurance. activities given the scale of historical high-impact earthquakes Personal insurance for other risks, such as flooding, landslides, in Nepal along with seasonal flooding. or earthquake damage, is virtually nonexistent.85 The only sovereign-level ex ante financing instrument for With the 2020 Disaster Risk Financing Strategy and its medium-risk, medium-impact disaster events is a World implementation plan, DRF implementation plan 2021, GoN Bank Cat-DDO. In 2020, GoN signed a DRM Development plans to implement a risk-layered approach to reduce Policy Financing for USD 50 million with a Cat-DDO aimed its contingent liabilities. The strategy outlined in these at strengthening the government’s institutional and financial documents substantively follows the recommendations of capacity for multisectoral disaster- and climate-risk the ADB 2019 Country Diagnostic Assessment on Disaster management, of which USD 25 million was drawn for COVID-19 Risk Financing and reiterated in the World Bank’s DRFIP 2022 response. A new Cat-DDO operation is currently being Report including recommendations that GoN (i) consider prepared. The government is also discussing a Contingent taking out insurance on its assets that are exposed to more Disaster Financing with the Asian Development Bank (ADB). In intense and less frequent disaster events, (ii) adopt agri- addition, World Bank–financed projects allow for Contingent insurance solutions to offer greater access to risk finance to Emergency Response Components. These add flexibility in the smallholder farmers, (iii) pilot risk-layered DRF instruments event of disasters or other shocks by allowing the repurposing at the subnational level, and (iv) consider creating sovereign of unspent project funds. At least one Contingent Emergency insurance to cover earthquake risk. 79 NDRRMA, Monsoon Preparedness and Response National Action Plan, 2080, p. 6 80 Asian Development Bank. (2022). Nepal Disaster Risk Reduction and Management Public Expenditure and Institutional Review, p. 37 81 NDRRMA Monsoon Preparedness and Response Plan, 2080, p.6 (https://bipad.gov.np/np/587), and CPGA Consultation (MoFAGA, Environment and Disaster Management Division) 82 NPR 500 million (around USD 3.7 million) for the federal DM, and district-level DM funds to maintain at least NPR 2.5 million, NPR 2 million, and NPR 1.5 million for districts in the Terai, hills, and mountains, respectively. 83 Ibid. 84 Asian Development Bank. (2019). The Enabling Environment for Disaster Risk Financing in Nepal: Country Diagnostics Assessment, p. 19 85 Ibid. 34 However, implementation of these recommendations runs up Commercial insurance for public assets at high risk will help against significant structural challenges. One such challenge the government mitigate the burden of major hazards in the is lack of catastrophe models for Nepal. Catastrophe models future. The 2022 Country Climate and Development Report help quantify the level of risk and enable the analysis of different indicated that flood damages to infrastructure (buildings mitigation strategies across the full complement of DRF and roads) in Nepal are projected to be amplified because of instruments. These models are also required for the insurance increasing temperatures and increasingly intense precipitation. industry to price risk and provide the necessary protection. Simulations show a 3.5 percent reduction in GDP by the end One such model has been developed for earthquakes in Nepal. of 2050 as a result of projected flooding.86 The government A detailed action plan, along with a cost-benefit analysis and could purchase sovereign earthquake insurance or insurance projection of economic losses through an impact-forecasting for specific public assets based on an understanding of their earthquake-catastrophe-risk model, was completed for relevant risk and a rigorous cost-benefit analysis. Nepal. This model has also been used by the World Bank to develop national- and district-level analytics. The World Bank Despite incentives, there are both demand- and supply-side is currently supporting GoN to develop a flood-risk model from constraints that prevent widespread uptake of agricultural which flood-risk transfer products can be developed. Current insurance in the country. Existing studies on demand-side flood models available to Nepal are only suitable for DRM challenges find lack of awareness among many farmers and activities and not developing DRF products. find that access to the insurance products is limited in many remote areas that are beyond the reach of most insurance Lack of an inventory of critical assets and infrastructure is agents.87 On the supply side, one important challenge is a a key challenge. There is currently no inventory of critical lack of product diversification. Most crop-insurance products infrastructure to enable costed scenario planning, which is use the cost of inputs rather than yield value as the basis also required for DRM planning to ensure key infrastructure for indemnity, and there is often lack of transparency in continues providing services when a disaster event occurs. determining the sum insured.88 Given that the stand-alone There is a lack of sufficiently detailed catastrophe-risk crop-insurance product covers only a small share of the models for designing DRF products that would be accepted risks farmers face, ADB’s 2019 DRF diagnostic recommends by insurance providers (with the exception of earthquake-risk bundling crop insurance into a broader “total risk management models). The World Bank’s 2022 Assessment of Contingent solution,” which it argues will be more attractive to farmers Liabilities from Natural Disasters in Nepal report identified and in Nepal. Bundling livestock insurance with agricultural loans estimated the liabilities that may arise from natural disasters has, led to an increase in uptake of livestock insurance. In in Nepal, but this is a relatively coarse estimate based on past addition, resolution of insurance claims and disbursement of data and simplified modeling. To further support this work, subsidies often take very long. Plans to decentralize the claims the DRFIP 2022 report and ADB 2019 report recommended verification and payout to the LGs are a welcome initiative. developing a comprehensive register of all public assets. The The LGs could then play a substantive role in promoting the World Bank has been supporting GoN to develop a valuation insurance products to farmers. framework for public assets (schools and hospitals) set to be completed in September 2023. This will include updating Insurance-product diversification is hindered by lack of data the government’s Public Asset Management System (PAMS) and risk information and by insurers’ capacity constraints. with information on these assets using the new valuation Small-scale pilots of index-based insurance products framework. The World Bank is also working with the NDRRMA have been initiated. One example is an index-based flood- to ensure this information is also available in BIPAD, the insurance product for smallholder farmers in the lower Karnali disaster-information management system. region of western Nepal supported by the InsuResilience 86 World Bank. (2022). Nepal Country Climate and Development Reports. 87 Bima Samiti. (2017). Crop and Livestock Insurance Report 88 Ibid. 35 Solutions Fund; for this product, microfinance institutions and only one insurer offering a parametric insurance product cooperatives acted as policyholders on behalf of smallholder for crop cover in one district. For microinsurance products, farmers. 89 This pilot faced challenges: lack of hydrological microfinance/insurance institutions, given the size of their data and lack of records of extreme events. The product operations, would not be able to absorb losses and often do therefore initially covers communities in which sufficient data not have sufficient professional expertise to design insurance are available to model the indexes and develop the index- products. Some microfinance institutions unknowingly based flood insurance. In addition, the insurance is bundled assume a high contingent liability, thereby putting themselves with agricultural advisory services and will cover yield losses if at serious risk. Accordingly, arranging effective reinsurance there is a hazardous flood event. for these product lines in Nepal could be difficult, and placing them in the international market might not be commercially Insurance product design and pricing are often not viable. Overall, however, the ADB study recommends placing adequately informed by actuarial or long-term financial greater emphasis on the cooperative sector, which many rural analysis. Insurers frequently lack the necessary expertise Nepalis are familiar and comfortable with. For low-income to handle the underwriting of claims for crop and livestock households, it recommends expanding subsidy programs to risks and to model risks for flood insurance. The lack of risk- products such as home and life insurance. It also advocates modeling capacity and data—for instance, on crop prices insurance against dramatic demand fluctuations for the in informal markets—makes insurance more expensive and tourism sector, which could be paid for through an additional has prevented diversification of products. There is now levy. PUBLIC FINANCIAL MANAGEMENT Challenges in public financial management such as poor A major challenge in spending post disaster relief and budget execution contribute to significant gaps in financial reconstruction funds is the difficulty in procurement preparedness. This presents a monumental challenge to in times of disaster. The Public Procurement Act 2007 financial preparedness for crises, leading to underuse of and Public Procurement Regulation 2007 have special DM funds and delays in reconstruction. Following the 2015 procurement provisions for exceptional circumstances such earthquake, the government identified USD 7.7 billion (NPR as earthquake, flood, landslide, fire, drought, and war or 838 billion) in financing needs for recovery and reconstruction internal conflict. However, these are rarely used. Generally, and received donor pledges of USD 3.8 billion (NPR 410 billion). bureaucratic caution has discouraged use of emergency Combining that with USD 1.3 billion (NPR 135 billion) of its own procurement measures. In addition, there are weaknesses resources, the government had a total of USD 5 billion (NPR 545 in internal controls and oversight, and capacity constraints billion) in its on-budget fund. Although the amount committed further hamper GoN’s ability to spend allocated amounts for by donors reached around 95 percent of that pledged only 26 post-disaster recovery.91 percent had been disbursed at the end of FY 2020. Disbursing recovery and reconstruction funds in a timely manner was thus There is also a basic challenge in tracking post-disaster fund a challenge even for NRA, an institution dedicated to post- flow and expenditures. Identifying and tracking post-disaster earthquake reconstruction. expenditure is difficult. There is currently no budget code to tag expenditures on preparedness, response, reconstruction, Reasons for low spending capacity are complex and unlikely and recovery, especially where the expenditures are cross- to change in the short term. These include (i) confusion over sectoral. Discussions are ongoing to create such a budget concurrent responsibilities, (ii) limited human resources, (iii) code. External assistance commitments and inflows related a fragmented public financial management system, (iv) slow to crisis events are tracked through the Aid Management procurement services, and (v) lengthy budget reallocation Information System in the Ministry of Finance. processes. 90 89 Laux, L. and Shrestha, U. (2022). Nepal: Introducing index-based insurance for flood-prone communities, Case study 06, InsuResilience Global Partnership. 90 World Bank. (2022). Assessment of Contingent Liabilities from Natural Disasters in Nepal. Ibid. 91 36 A national DM fund has been established per the DRRM act Low spending capacity ultimately also limits opportunities and the guidelines for its operation were approved in 2022. to increase public borrowing despite relatively low levels Many subnational governments, however, have yet to establish of debt. Greater capacity to manage disaster reconstruction DM funds and guidelines. The NDRRMA is expected to play efforts would allow GoN to increase public borrowing to meet a coordinating role across the local, district, and provincial post-disaster spending requirements more rapidly, reducing the DRM committees in the use of DM funds. However, the DM social and economic consequences of recent disasters.92 Lack fund’s operating guidelines of 2022 instituted a cumbersome of business-continuity plans for public financial management authorization process for release of funds to LGs whereby the during crisis is another challenge to timely spending. For requests from LGs have to go through the DDMC and DRM example, there are no provisions for eSignatures, which means Division at MoHA before being submitted for authorization by transactions are held up when officials cannot be present in the Executive Committee. person in the office. Entry Points: Strengthening Financial Preparedness 1. Continue to use available contingent financing instruments such as the Cat-DDO. • This includes the World Bank’s Cat-DDO and ADB’s Contingent Disaster Financing. • Ensure that such financing can be mobilized to assist the most vulnerable during crises. 2. Invest further in national DRF catastrophe-risk models as a core element of risk management: • Expand catastrophe-risk modeling to cover other hazards such as floods (this has already been initiated with World Bank support). • Consider sovereign earthquake-risk insurance based on risk modeling of, and insurance for, public assets at high risk. • Develop earthquake- and flood-insurance products for households; they could be subsidized for low- and medium- income households. 3. Promote development of a domestic market for crisis-risk agricultural insurance: • Develop hybrid agri-insurance products with a combination of indemnity-based and index-based coverage that account for risks more effectively. • Promote awareness of agri-insurance products among low-income farmers and incentivize insurance agents to expand their coverage. • Expedite decentralization of administration of agri-insurance from MoALD to LGs. • Strengthen public-private partnerships to improve data collection, product development, and outreach to the insurance sector and to support capacity building. • Streamline and enhance procurement and public financial management during crises by improving internal controls and oversight of postcrisis expenditures. • Streamline LGs’ access to federal DM funds by simplifying the procedures in the federal DM fund’s operating guidelines. • Introduce dedicated budget codes for DRM expenditure for better tracking of these expenditures. • Support LGs to detail emergency procurement provisions in their procurement laws and regulations. 92 Asian Development Bank. (2019). The Enabling Environment for Disaster Risk Financing in Nepal: Country Diagnostics Assessment. 37 PRIMARY RESPONSE COMPONENT SUBCOMPONENT INDICATOR ML 4. Primary 4.1 Public health 4.1.1 The public health system has the capacity and resources to respond BASIC response systems to key health threats and function fully during crises 4.1.2 Government has the capacity to detect and carry out surveillance of BASIC emergent and ongoing health threats in real time 4.2 Critical 4.2.1 Government maintains an inventory of critical assets and NASCENT infrastructure infrastructure 4.2.2 Systems are in place to ensure infrastructure operation, BASIC maintenance, and post-incident response across infrastructure types 4.3 Civil-protection 4.3.1 Emergency-management legislation and related policy instruments and emergency- exist that allow the emergency-management services to function at the BASIC management national and subnational levels systems 4.3.2 Emergency-service systems are well resourced and maintained and NASCENT are sufficient to respond to major threats Overview: The primary-response component comprises system is rated as basic. Contingency planning for critical health systems, critical infrastructure, and civil-protection infrastructure is hampered by a lack of a consolidated and emergency management systems and is rated as nascent inventory of such infrastructure and limited provisions for overall. Nepal has made significant efforts to align its national financing their maintenance and repair. Emergency services public health policies, acts and regulations with International are equipped with specialized personnel and resources but Health Regulations (IHRs). However, operationalizing these face challenges in terms of adequacy and readiness to tackle policies, acts and regulations is a challenge, and there are large-scale disasters, accountability for equipment use and gaps in primary-response capacity across the fields of maintenance, and resilience of communication systems. health, emergency response, critical infrastructure and Ratings for the latter two subcomponents range from nascent services, and emergency management. The public health to basic. PUBLIC HEALTH SYSTEMS Nepal has made significant efforts to align its national health systems for purposes including emergency preparedness. policies, acts, and strategies with IHRs. As a signatory of the Nepal has taken legislative measures to address potential IHR of 2005, Nepal recognizes the importance of preventing, threats to public health, including the passage of the Infectious detecting, and responding to global public health risks. In Disease Act and the Public Health Service Act. These acts addition, Nepal is also committed to various global health provide a framework for the government to take necessary frameworks and commitments including the Sustainable actions in response to public health emergencies. As stipulated Development Goals, Sendai Framework for Disaster Risk in the Public Health Service Act and Regulations, the federal, Reduction 2015–2030, and Global Health Security Agenda, all provincial, and local levels are required to develop health of which demand an increased priority for strengthening health emergency plans and implement them effectively. Additionally, 38 the Public Health Service Act (Section 48, Subsection 1) Weak surveillance capacity is another key challenge. includes provisions for establishing a rapid response team Effective surveillance systems are vital for early detection, and emergency physician group to enable swift and timely monitoring, and response to outbreaks and pandemics. responses during health emergencies. Nepal scores 50 percent, against the regional average of 88 percent and global average of 83 percent, on surveillance per Despite legislative and policy arrangements, Nepal falls the 2022 SPAR. There are multiple arrangements for disease short of operationalizing these arrangements and performs surveillance, and they are not systematically connected to suboptimally with regard to IHR capacity. Per the 2023 IHR feed into the planning process in a synchronized manner. State Party Self-Assessment Annual Reporting (SPAR) on the While the country has made efforts to introduce an event- status of IHR capacity, Nepal scored an average of 47 percent based surveillance system, EWARS—a hospital/disease-based in comparison to the regional average93 of 68 percent and sentinel surveillance system—is the main surveillance system. the global average of 66 percent in 2022.94 Nepal performs EWARS is currently operational in 118 sentinel sites from across relatively well on policy, legal, and normative instruments the country. However, the reporting status of the hospitals is for implementing IHR (50 percent compared to the global poor, adversely affecting detection and response measures. average of 56 percent) but performs far below the regional The Department of Livestock Services actively monitors and global averages on indicators such as human resources, zoonotic influenza in poultry and pigs and surveys brucellosis, surveillance, health emergency management, coordination toxoplasmosis, leptospirosis, and tuberculosis periodically. and risk communication, and zoonotic diseases. A joint external However, structured official surveillance for relevant zoonotic evaluation (JEE) of IHR core capacities of Nepal conducted in diseases is limited to avian influenza. Antimicrobial-resistance 2022 validates these scores.95 surveillance has been recently established, and the key challenges concern analysis, interpretation, and reporting of The health system faces human resource gaps, which are the national antimicrobial-resistance surveillance system’s data particularly evident during times of crises. Nepal scores 30 together with data on antimicrobial consumption.98 Likewise, percent, against the regional average of 67 percent and global Nepal has limited capacity for advanced surveillance data average of 60 percent, on human resources per the 2022 SPAR. analysis to better inform preparedness and response. The One Unfulfilled vacancies, absenteeism, maldistribution, and lack of Health strategy recognizes the interconnectedness between up-to-date workforce data pose significant challenges to the human health, animals, and the environment, but collaboration accessibility and quality of public health services. The country and coordination between the Veterinary Epidemiology also falls far below the WHO’s recommended threshold of Centre under MoALD and the zoonosis-control program in health workers: Nepal has 9.77 doctors, 21.08 nurses, and 12.01 the Epidemiology and Disease Control Division (EDCD) under auxiliary nurse midwives per 10,000 population.96 In particular, MoHP remain limited, hindering effective preparedness for the 2022 JEE shows that the capacity for a workforce surge responding to zoonotic events. during a public health event is very limited.97 The civil servant adjustment process during the transition to a federal structure Laboratory capacity is a key aspect of disease surveillance has exacerbated these gaps. The National Strategy on HRH and diagnosis. National Public Health Laboratory (NPHL) is 2020–2030 aims to address these challenges. well equipped to perform testing for most pathogens of public 93 World Health Organization (WHO) South-East Asia Region. Countries include Indonesia, Bangladesh, Myanmar, Maldives, Thailand, Sri Lanka, Bhutan, India, Ne- pal, and Timor-Leste. 94 WHO. (2023). Electronic IHR States Parties Self-Assessment Annual Reporting Tool. Retrieved from https://extranet.who.int/e-spar/#capacity-score 95 WHO. (2023). Joint external evaluation of IHR core capacities of Nepal: Mission report, 28 November-2 December 2022. 96 The recommended density of doctors, nurses, and midwives per 1,000 population for operational routine services is 4.45 plus 30 percent surge capacity (Nation- al Strategy on Human Resources for Health 2020–2030). WHO. (2023). Joint external evaluation of IHR core capacities of Nepal: Mission report, 28 November-2 December 2022, Technical Area D3.4 (score 1). 97 98 Antimicrobial consumption (AMC) data refers to antimicrobial usage data collected from the community/outpatient and hospital inpatient setting. List of Anti- microbial include: Antibacterial, antibiotics, antifungals, antivirals, antimycobacterial for treatment of Tuberculosis, etc. GLASS methodology for surveillance of national antimicrobial consumption. Geneva: World Health Organization; 2020. 39 health importance. Although NPHL’s capacity was expanded the technical and managerial capacities of health service significantly during COVID-19, coordination between different providers. The challenge is to institutionalize these gains into tiers of human health laboratories is not effective. The Central routine health sector programming and sustain them. Veterinary Laboratory is the designated National Reference Laboratory for animal health. Both human and animal health Finally, resource allocation for outbreak and pandemic laboratories have limited capacity to detect exotic/imported preparedness remains limited. The pandemic preparedness- diseases that carry economic impact and pose epidemic threat. related allocation was estimated to be USD 0.73 per capita There are issues around referral and transport of specimens in Nepal in 2020,102 which is far below the globally accepted for diagnostics. NPHL, along with five other human-health level (USD 1.69 per capita) of investment for preparedness.103 laboratories, is accredited to ISO 15189 standards for laboratory Nepal increased its budgetary allocation to deploy a strong quality, but the Central Veterinary Laboratory is not accredited. emergency response to the pandemic. This explains the National quality standards are also not available for biomedical increase in Nepal’s IHR financing-capacity score from 60 equipment, reagents, and kits. While the human-health percent in 2021 to 70 percent in 2022, slightly lower than the laboratory performs better than the animal-health laboratory, regional average of 73 percent. The 2022 JEE P2.2 (financing the average laboratory score of Nepal per the 2022 SPAR is for IHR implementation) score stands at 3 (developed 48 percent compared to the regional average of 73 percent capacity). However, as the pandemic subsides, Nepal is likely and global average of 74 percent. The Global Health Security to see a decline in preparedness-related allocation for various Index also rates Nepal’s laboratory capacity as low, indicating related reasons, including slow economic growth and ongoing weaknesses in system strength, quality, and supply chains.99 inflation compounded by competing demands for public resources from other sectors. In this context, Nepal needs to Multiple health-system gains were made as a result of regularly conduct financing for preparedness-and-response- the COVID-19 pandemic response, including laboratory related activities to estimate potential gaps in financing and capacity. Following the pandemic, Nepal surged its health- prioritize domestic investment to fill in such gaps in health- sector capacity to meet the demands of the emergency and systems strengthening, including strengthening health EPR. made impressive progress in expanding its laboratories with molecular diagnostic capacity from one to over 100.100 During These challenges are acknowledged in the Nepal Health the pandemic, Nepal’s only national laboratory, the Biosafety Sector Strategic Plan 2023–2030 developed by MoHP. The Level-3 Laboratory, which was established at the NPHL in plan recognizes these gaps and aims to build on the successes Teku that was certified to meet the IHR, also added capacity and lessons learned from the pandemic. The National Health for pathogen genetic sequencing, leading to the establishment Financing Strategy 2023 also acknowledges the need for of a National Pathogen Genetic Sequencing Consortium. 101 increased investment in health-emergency and emergency- Additionally, various training programs were implemented, health services. Following the JEE conducted in 2022, Nepal including the Field Epidemiology and Training Program, notably will also formulate a National Action Plan for Health Security, with the support of Health DPs. These training programs, based on One Health approach and will adopt a whole-of- such as pilot testing for rapid response teams, aim to improve government approach.104 99 Global Health Security Index (2021). Country Profile for Nepal. Retrieved from https://www.ghsindex.org/country/nepal/ 100 MoHP. (2022). Health Sector Response to COVID-19 Pandemic in Nepal. 101 With the biotechnology department of Tribhuvan University, the Dhulikhel Hospital, Epidemiology and Disease Control Division, Central Veterinary Laboratory, Nepal Academy of Science and Technology, Walter Reed/AFRIMS Research Unit Nepal, and WHO Country Office for Nepal as members of the consortium. 102 In Nepal’s analysis, provincial and LGs’ own resources allocated to implement preparedness-related activities were not accounted for because of difficulty in tracking such data. The exercise did not include external financing (off budget). 103 World Bank. (2019). Pandemic Preparedness Financing Status Update. 104 WHO. National Action Plan for Health Security. Retrieved from https://extranet.who.int/sph/naphs 40 CRITICAL INFRASTRUCTURE Contingency planning for critical infrastructure105 faces inventory of critical infrastructure. Both the Disaster Risk two major challenges: lack of a consolidated inventory Reduction National Strategic Plan of Action 2018–2030 of such infrastructure, and provision for financing of and the National Strategy for Management of Disaster Risk their maintenance and repair. First, Nepal does not have a Financing 2078 (2021) note the need for an inventory of critical consolidated inventory of critical assets and infrastructure. infrastructure and a costed plan for repair and maintenance.107 Efforts to establish an inventory have been fragmented. The The World Bank’s Assessment of Contingent Liabilities from Financial Comptroller General Office manages the PAMS, Natural Disasters in Nepal also notes this gap. which is meant to be an inventory of all public assets including infrastructure such as buildings, hospitals, airports, highways, Nepal has limited provisions for financial resources and and telecommunication infrastructure and also including incentives to ensure critical infrastructure operation and equipment, furniture, and consumables such as stationery. maintenance during and after crises for service continuity, However, the PAMS has recorded only a limited set of assets and business-continuity and contingency plans do not including electronics and furniture so far. It is not complete exist for most critical services. While some resources are and not regularly updated. For many infrastructures, physical put toward maintenance and repair, they are used reactively verification needs to take place before the details can be and are deployed after disaster, through budget reallocations recorded in the PAMS. In addition, the PAMS information system or donor support, with a focus on short-term site clearance, is not yet customized to record different details that may vary immediate post-disaster works, and repair of damaged roads, from one infrastructure to another. The Department of Roads hydropower dams, telecommunications towers, and electricity has a management information system for road assets, but it poles. There is little mention of assurance of operations of has not done a critical path assessment of the road network. critical infrastructure or business continuity in government documents related to emergency preparedness. The Department of Health Services uses at least three parallel systems for critical-infrastructure inventory management: While the NDRF identifies responsibilities for service Health Infrastructure Information System, Planning and continuity for critical public service and infrastructure Management of Assets in Health Services, and electronic providers including electricity, drinking water, health, and Logistic Management Information System. MoHP, through telecommunications with clear roles for the respective its Quality Standards Regulation Division, is also piloting a sectoral ministries, strategic plans to support such biomedical equipment inventory. 106 More recently, the NDRRMA interventions are limited. For instance, while the NTA’s 10- has completed the Rapid Visual Screening survey of assets Year Master Plan 2011–2020 (Strategy 17) recognizes the need such as education and health facilities and public offices to for a “well-established Disaster Recovery Plan . . . to cope with create an inventory of over 1,000 facilities in 13 districts. The any disaster and/or natural calamity” both at the national level NDRRMA plans to scale this up nationally. These systems and the individual service providers’ level,108 such a plan does are not interoperable, lack a clear periodicity of inventory not exist. Other sectoral ministries, such as the Department of controls, and have uncertain resource allocation. A single Electricity Development, Department of Roads nor Department unified inventory is required for efficient management and of Water Supply, also do not have service-continuity plans. maintenance of public assets including digital infrastructure. Business-continuity planning in the event of climate-induced disasters mostly exists in hydropower projects and certain The fragmentation persists despite multiple plans and donor-supported critical infrastructure projects.109 Some strategies highlighting the need for establishing an integrated efforts can be seen in the aviation industry with initiatives 105 Critical infrastructure typically refers to energy, transport, water, information and communications technologies (ICT), health, and finance. 106 MoHP. Biomedical Equipment Management System. Ministry of Health and Population, Government of Nepal. Retrieved from https://bems.mohp.gov.np/ World Bank. (2022). Assessment of Contingent Liabilities from Natural Disasters in Nepal. 107 108 Ten Year Master Plan (2011–2020), Nepal Telecommunications Authority (NTA) - https://nta.gov.np/uploads/contents/10%20Year%20Master%20Plan%20-%20 Draft%201.pdf 109 CPGA Consultations 41 such as the Get Airports Ready for Disasters initiative to Strategic Plan of Action 2018–2030 has also highlighted the increase readiness of domestic airports for disaster response, need to establish a special fund and monitoring mechanism enable them to provide uninterrupted air service, and handle for retrofitting existing risky public service and physical increased traffic. The use of critical public infrastructure such infrastructures such as public and private buildings, hydraulic as schools, roads, hospitals, airports, and the communication structures, urban infrastructures, schools, hospitals, and system is featured in contingency plans. While it has occurred shopping malls. Some schools and hospitals are being in practice on an ad hoc basis, including during the COVID-19 retrofitted for earthquake resilience through donor-financed response, no specific ex ante preparedness or contingency projects. Finally, some infrastructure such as the holding plans have addressed coordination with private infrastructure. centers built during COVID-19 lies unused in the absence of clear guidelines on their use and management. The NDRF also prioritizes preparation of business-continuity plans for the private sector, which could ensure continuity The DRR National Strategic Plan of Action 2018–2030 in sectors that are mainly led by private providers such aims to substantially reduce disaster damage to critical as transportation, food supply, medical supplies, and infrastructure and disruption of basic services, including telecommunication. Most private sector businesses also through establishing a special fund, but this fund has lack business-continuity plans.110,111 In telecommunication, not yet been established. Existing funds, such as the Rural private providers, such as Ncell, have their internal Business- Telecommunications Development Fund, established in Continuity Management frameworks to act in case of any 1997 with private sector partnership to increase investments crisis. 112 Fuel is another sector that is largely affected during in and improve the country’s telecommunications crises, with heavy dependence on imports from India and infrastructure, coverage, and accessibility in rural areas, significant implications on supply and price. have failed to be fully used.113 The fund has been used to expand optical fiber networks and build broadband network The poor physical state of most public buildings is another and internet connectivity in earthquake-affected and other concern. Rapid visual screening of over 1,000 public buildings remote districts and municipalities including by expanding in 13 districts conducted by the NDRRMA shows that less services in local ward offices, health centers, and community than 3 percent are disaster resilient. The DRR National schools. CIVIL-PROTECTION AND EMERGENCY-MANAGEMENT SYSTEMS As noted in Chapter 1, GoN has a robust legislative and Administration (MoFAGA), and several other agencies have policy framework in place for emergency management. A roles in crisis management. multitude of institutions have a role in disaster preparedness and response. MoHA serves as the focal agency, primarily The NDRRMA conducted an assessment of national concentrating on disaster response, and oversees a network emergency-response capacity that looks at the federal, of EOCs. The NDRRMA has mandate to focus on disaster provincial, and local levels, based on the World Bank’s preparedness, prevention, and mitigation. In addition, DHM, Ready2Respond diagnostic in 2022.114 Findings from the MoHP, MoALD, Ministry of Federal Affairs and General assessment highlight that EPR systems in Nepal are weak. Nepal 110 NDRRMA. (2022). Emergency Preparedness and Response Assessment 2022 – 2030: Ready 2 Respond Methodology. National Disaster Risk Reduction and Man- agement Authority, Government of Nepal. MoHP. (2020). Health Sector Emergency Plan: COVID-19 Pandemic. Ministry of Health and Population, Government of Nepal. 111 112 CPGA Consultations 113 Per the provision in the Telecommunications Act of 1997 (Section 30, Subsection 4), the NTA collects 2 percent of the annual gross adjusted revenue from every telecom provider each year, which is deposited directly into the fund. 114 NDRRMA. (2022). Emergency Preparedness and Response Assessment 2022 – 2030: Ready 2 Respond Methodology. National Disaster Risk Reduction and Man- agement Authority, Government of Nepal. 42 scored 39.8 percent, which means that most of the attributes a feedback mechanism for improvement.117 The local and of the EPR systems in Nepal are currently weak or were not provincial governments also struggle because of insufficient in place at the time of the analysis. It notes that while Nepal’s capacity to understand and address emerging risks in their EPR systems can handle small-scale disasters fairly well, the area, hampered further by the lack of integrated plans, system is not adequately prepared to handle medium- to resources, and mechanisms to handle these risks. This calls large-scale disasters. The diagnostic highlights multiple for an urgent need to enhance interinstitutional collaboration gaps including severe lack of SAR equipment for different and streamline disaster-management processes.118 hazards, a dysfunctional EOC network, weak communication and IT system, over-reliance on DP-funded projects or Another challenge is the lack of SOPs for communication activities, and lack of funding from the government. during crisis. In multisector crises it is essential to clarify the role of each agency involved, in terms of both the operation Experiences with emergency response in the cases of the 2015 and who communicates what information to the public. There earthquakes, 2017 floods, and COVID-19 pandemic indicate are no clear SOPs for communication during crisis in Nepal. that the HEOCs and EOCs are not adequately prepared to respond effectively. The NEOC and the HEOC in Nepal serve Nepal’s emergency services, though equipped with some as central points of coordination and communication for specialized personnel and resources, face significant disaster information and response.115 These issues stem from challenges in terms of adequacy and readiness to tackle a range of challenges including limited resources, high staff large-scale disasters. While the Nepalese Army and Police turnover, and poor understanding of operational systems have Disaster Management Units and organizations like the within these organizations. Communication inefficiencies Red Cross contribute to emergency-management training, both within and between organizations such as national major disasters have necessitated international support. With and provincial HEOCs and NEOCs further exacerbate these regard to SAR, Nepal aspires to establish International Search problems. Furthermore, there is a conspicuous lack of a and Rescue Advisory Group (INSARAG)-accredited SAR teams harmonized information-management system and integrated in the Nepal Army, Armed Police Force, and Police.119 Provisions mechanisms to develop and disseminate risk information to for rapid deployment of resources during crises exist, yet they the public, media, and other relevant stakeholders.116 are largely hazard specific, being typically developed after disasters. Significant accountability issues persist with the The efficiency of these institutions is also hampered by a use and maintenance of emergency service equipment, as siloed approach, highlighting a pressing need for improved evidenced by the 2022 EPR Assessment, primarily because inter-institutional collaboration. Despite having a robust of a lack of proper inventory management. The emergency institutional structure, Nepal faces coordination challenges communication systems have some resilience but have both vertically and horizontally. This hinders the efficiency previously shown limitations in operating under extreme of entities like the NDRRMA, which relies on other agencies conditions, as in the 2015 earthquake. for risk information and cannot provide direct guidance to local and provincial DRM committees. Moreover, the reach Given the chronic challenges in the health sector, its of the DHM is limited, especially in relation to vulnerable and preparedness for crises is limited. Nepal scores 47 percent marginalized communities, and their communication lacks on health emergency management120 (compared to a global 115 MoHA. (2014). National Emergency Operations Centre (NEOC): Introduction. Ministry of Home Affairs, Government of Nepal. Retrieved from http://neoc.gov.np/ en/introduction-2.html 116 MoHP. (2021). Health Emergency Operation Center Network of Nepal: The Voyage and the Vista. Ministry of Health and Population, Government of Nepal. Uprety, D.R., Rana, B., Shrestha, K. (2020). Disaster Risk Governance in Nepal: Challenges and Way Ahead. Flood Resilience Portal. Practical Action. 117 118 Ibid. 119 NDRRMA. (2022). Emergency Preparedness and Response Assessment 2022 – 2030: Ready 2 Respond Methodology. National Disaster Risk Reduction and Man- agement Authority, Government of Nepal. 120 Health-emergency management is defined, per the SPAR tool, as capacity that focuses on national planning for health-emergency management and for systems that enable countries to be prepared for—and operationally ready to respond to—any public health events, including emergencies, in accordance with the re- quirements of the IHR. 43 average of 72 percent and regional average of 80 percent) a sustainable health system that is prepared for emergencies, per the 2022 SPAR. It performed relatively well in response it is essential to invest in national health and research systems to the COVID-19 pandemic in its ability to test, trace, isolate, and prioritize health security moving forward. This includes and treat, communicate risks, roll out vaccines, and vaccine improvement in surveillance capacity and epidemic modeling coverage. However, the lesson from COVID-19 has been that capacity and further training of existing personnel. the health sector was not adequately prepared and responded in a reactive manner.121 In addition, continuity of regular In conclusion, Nepal has been making conscious efforts health services was a challenge as resources were diverted to build its civil-protection and emergency-management to respond to the pandemic and as prepositioning and supply services, but gaps remain. In the context of the ongoing of critical health commodities such as medicines, personal federal transition process, there is a strong need for improving protective equipment, and oxygen was weak. EWARS remains intergovernmental coordination and clarity of roles as well as inadequate for monitoring new and emerging diseases. To build providing additional resources and training. Entry Points: Primary Response 1. Strengthen the surveillance system and data sharing to improve public health decision-making for health-sector preparedness and response: • Expand coverage of sentinel sites and ensure they are operational. • Add event-based surveillance and risk-based surveillance for human and animal health to establish an integrated surveillance system. • Conduct advanced analysis for disease surveillance and epidemiological modeling. 2. Operationalize the One Health Approach to strengthen health security: • Enhance monitoring of plant, animal, and human diseases at all 14 cross-border entry points to monitor and mitigate health crises. • Strengthen the One Health secretariat for effective coordination and information sharing across the three key ministries and expand the technical committee to include the NDRRMA. 3. Establish a consolidated inventory of critical infrastructure and allocate budgets for repair and maintenance: • Consolidate ongoing efforts to create an inventory of critical infrastructure and assets including digital infrastructure and backup plans in the event of a crisis. • Ensure provisions are in place for periodic audit and maintenance to safeguard critical infrastructure. 4. Establish clear lines of command and coordination between NEOCs and HEOCs: • Develop explicit command hierarchies and coordination protocols between the NEOCs and HEOCs to address communication gaps. • Define SOPs for communication during crisis to clarify the roles of various agencies. 5. Enhance local-level capacity for SAR: • Provide resources for additional SAR equipment which are prepositioned at the local level. • Optimize use of available infrastructures, including by repurposing holding centers built during the pandemic for other emergency responses. MoHP. (2021). Responding to COVID-19: Health sector preparedness, response and lessons learnt. Ministry of Health and Population, Government of Nepal. 121 44 SOCIAL & LIVELIHOOD SUPPORT COMPONENT SUBCOMPONENT INDICATOR ML 5. Social and 5.1 Coverage and 5.1.1 An adaptive SP policy or strategy is in place with adequate financial livelihood scalability of SP commitments, clearly defined roles and responsibilities, and coordination UNMET support between SP and DRM for crisis response 5.1.2 SP programs and systems are in place, with adaptive design features BASIC to scale up or out in a timely and effective way during and after crises 5.2 Food security 5.2.1 The government has the capacity to safeguard the availability of food and livelihoods through comprehensive policies and plans alongside effective monitoring UNMET and forecasting of food-related outcomes 5.2.2 The government has the capacity to ensure access to food supplies NASCENT by operationalizing policies and coordination mechanisms 5.3 Continued 5.3.1. Educational resources, infrastructure, and learning outcomes are ADVANCED access to education safeguarded during crises 5.4 Crisis-induced 5.4.1 The needs of existing and newly internally displaced populations are UNMET displacement taken into consideration in planning and responses 5.4.2 Refugees and asylum seekers are included in crisis-preparedness N/A plans and responses Overview: Nepal has a large portfolio of SP programs, but most attention in the wake of the COVID-19 pandemic, but are not designed to promote household resilience or to be contingency plans require more resources to be implemented. scalable in response to crises. Response and recovery efforts Resettlement in the aftermath of the 2015 earthquakes has tend to focus on rehabilitation of houses and not on recovery generated significant experience and demonstrated limitations of livelihoods. Preparedness measures for food insecurity tend of current frameworks. Ratings for various subcomponents to focus on food stockpiling and subsidizing inputs to boost range from unmet to basic. production. Continuity of education has received increased COVERAGE AND SCALABILITY OF SOCIAL PROTECTION Nepal has a large portfolio of SP programs that cover about another 1.9 million households and 6.4 million individuals as a third of the population. The programs include public sector of March 2, 2023. pensions, cash transfers, scholarships, health subsidies, and public works and are implemented by a variety of institutions. GoN spends substantially on a wide portfolio of SP programs. One program, Social Security Allowances (SSA), provides Nominal expenditure on SP has grown fivefold over the last 10 cash transfers to about 3.5 million senior citizens, single years, reaching NPR 134.4 billion, or 3.5 percent of GDP and women, persons with disabilities, selected children, and 11 percent of total expenditure, in FY 2019. The expenditure on endangered ethnicities. The scholarships cover another 3 SP is estimated to have exceeded 4 percent of GDP since then. million students. The (contributory) health insurance covered However, over half of this is spent on public sector pensions. 45 While Nepal has a robust constitutional and legal basis for GoN is making efforts to make SP programs scalable in SP, it lacks an overarching policy framework for SP. Social response to shocks. Under the leadership of the NDRRMA, security, employment, education, health, food, and housing GoN is currently drafting shock-responsive SP guidelines are fundamental rights enshrined in the constitution, and that will enable SP programs and systems to be mobilized to there are other fundamental rights for Dalits, women, children, deliver relief and recovery. The guidelines are expected to be and senior citizens. Various legislations formulated in the last approved by the end of FY 2023. The guidelines will define few years provide a legal basis for existing or new programs the types of shock to be covered, beneficiary identification including SSA and the Prime Minister’s Employment Program processes, types and amounts of benefits, institutional roles (PMEP). However, in the absence of an overarching SP policy and responsibilities, and more. Following the approval of the framework, the various laws, policies, and programs do not SRSP guidelines, the program operating guidelines of SSA and always come together effectively to deliver SP. PMEP are expected to be amended to enable flexibility during times of shocks. While the overall coverage is good, the coverage of the poor and vulnerable remains a challenge. Existing programs, with SP delivery and relief and recovery programs continue to the exception of PMEP, are mostly categorical in nature, but be hampered by weak and fragmented delivery systems. SP the categories are not necessarily correlated with poverty programs are constrained by the lack of robust delivery systems, or economic vulnerability. They are not designed to build including the lack of a harmonized system. Each program has resilience for poor and vulnerable households. Only 55 percent its own information system and its own identification and of households in the bottom quintile and 48 percent in the enrollment process; no integrated database of households second-poorest quintile receive any social assistance. The is linked to programs, which leads to inefficiencies in data child grant is pro-poor by virtue of being focused on poorer collection and management, gaps in coverage, and challenges districts, but given the small benefit size, it has little impact on in delivering disaster response. There has been notable poverty. The Social Security Act has provisions for transfers to progress in the last few years, including digitization of the civil the poor that could be operationalized to expand coverage to registry and SSA beneficiary database, roll-out of e-payments the poor. for delivery of SSA in over 735 LGs, and efforts to design and develop an integrated social registry (ISR). Crucially, existing SP programs are not designed to be flexible enough to scale up in response to shocks. Current The ISR will be crucial to operationalize the SRSP guidelines programs are designed to address static vulnerabilities and are and achieve efficiency gains in the delivery of SP. MoHA has rigid in their design and fund-flow arrangements with limited approved the policy framework for the ISR. Building on the coordination with disaster-response agencies. Recurrent national ID and civil registration, the ISR will help to improve disasters such as floods and landslides as well as one-off identification and inclusion of populations of interest as well as events like the COVID-19 pandemic have exposed the absence coordinating key SP programs and actors, all while supporting of safety nets for large segments of the population and the the delivery of coordinated responses to shocks, including inability of existing programs to scale up. To address the those related to climate. Efficiency gains in the delivery can impact of the pandemic, GoN delivered in-kind relief initially, enable more resources to be mobilized toward the poor and followed by cash relief, but neither action mobilized existing vulnerable. delivery systems. 46 FOOD SECURITY AND LIVELIHOODS Food insecurity and malnutrition persist in Nepal, despite to food security and nutrition, notably the Zero Hunger the country’s progress in reducing stunting in children under 5 Challenge National Action Plan (2016–2025), the Agriculture years from 36 percent in 2016 to 24.8 percent in 2022 (NDHS Development Strategy, the Multi-Sector Nutrition Plan Phase 2016 and 2022). Twenty-nine percent of households in urban II (MSNP 2018–2022),124 and the Food and Nutrition Security areas and 38 percent of rural households are food insecure Plan of Action (2013).125 The MSNP III is currently under according to the Household Food Insecurity Access Scale.122 development. In addition, following the outcomes of the 4th In 2019, Nepal ranked 73rd out of 117 qualifying countries with National Food Systems Dialogues in September 2022 and a score of 20.8 on the Global Hunger Index, a multidimensional the UN Food Systems Summit Dialogues 2021,126 the National approach to measuring hunger that looks at the adequacy of Planning Commission has been leading the formulation of the national food supply, child undernutrition, and child mortality. Food Systems Transformation Strategy Plan (2023–2030), Nepal’s Global Hunger Index has improved over the years, which is currently pending approval of the Council of Ministers. going from 36.8 in 2000 to 20.8 in 2019. Increasing incidence However, there is no single overarching food-security and of climatic shocks, particularly drought and erratic rainfall, is nutrition policy that brings coherence to these plans. likely to increase food insecurity. Data from the Household Risk and Vulnerability Survey 2019 suggest that food insecurity is With regard to supply chain management and the rising among shock-affected households. distribution system, although GoN has its own strategic food reserves, it continues to rely on external partners, such Key underlying factors are low productivity and as the WFP and Food and Agriculture Organization, and underinvestment in agriculture and food security and low international humanitarian assistance during emergencies. productivity. Nepal ranks low globally and even regionally in The Food Management and Trade Company (FMTC) manages terms of investments in food security and nutrition.123 While the food stocks at four South Asian Association for Regional Right to Food and Food Sovereignty Act of 2018 requires all Coordination (SAARC) food banks and eight National Food levels of government to coordinate to identify citizens at risk of Security Reserves in nine major cities across the country for famine, arrange for storage of food, provide subsidized or free food security.127 The FMTC currently stocks 8,000 metric tons food to citizens at risk of food insecurity, and develop short- and 25,000 metric tons of food in its SAARC and national food and long-term plans to prevent malnourishment, investments reserves, respectively. The national food reserve is not solely have been limited. for crises but used throughout the year for the company’s regular operations—that is, for sales through its depots during There are multiple policies and strategies in Nepal that cover normal times and through concessional shops during festivals. food security and nutrition, but there is no single overarching During emergencies, the same stock is purchased by MoHA policy or strategy. The Right to Food and Food Sovereignty for distribution. Nepal has rarely been able to access the food Act of 2018 enshrines the fundamental right of the citizens stock in the SAARC Reserves, owing to lack of clear guidelines of Nepal to food, food security, and food sovereignty. The and procedures.128 Nepal continues to rely heavily on external government has promulgated several policies that contribute partners, such as the WFP, and international humanitarian 122 NPC, WFP. (2019). The Food Security Atlas of Nepal. Kathmandu: National Planning Commission, Government of Nepal 123 NPC. (2018). Towards Zero Hunger in Nepal: A Strategic Review of Food Security and Nutrition, p.15. National Planning Commission, Government of Nepal. 124 Multi-Sector Nutrition Plan-II (2018–2022) was formed by GoN under the leadership of National Planning Commission in coordination with six different sectors (Health, Education, WASH, Women, Children, and Senior Citizens, Agriculture, and Livestock, Local Governance), with financial support of a €23.35 million from the EU. 125 MoAD. (2013). Nepal Food and Nutrition Security Plan of Action (FNSP). Ministry of Agricultural Development, Government of Nepal. Retrieved from https://faolex. fao.org/docs/pdf/nep163184.pdf 126 Three national and seven provincial-level dialogues were conducted, with 1,306 participants from various relevant sectors. Food Management & Trading Company Ltd. Food Security. Retrieved from http://fmtc.org.np/food-security 127 128 CPGA consultations, June 2023 47 assistance during crises. Maintaining an emergency food fall under the Ministry of Industry, Commerce, and Supplies, stock is a challenge partially because of the lack of modern which works through the FMTC, while disaster response is storage structures of adequate capacity in all provinces. under MoHA. The NDRRMA is virtually absent from all food- The UN’s Earthquake Contingency Plan for Nepal notes that security policy dialogue. This is particularly critical in the beyond these reserves, procurement from the private sector context of erratic monsoon rainfall this year—which is likely to and from India is part of contingency planning.129 lead to a decline in domestic production—combined with the Indian government’s ban on rice exports. Nepal’s ability to keep international borders open during crises is weak, and therefore control over prices is limited. In this context, preparedness for food insecurity has focused Nepal is a landlocked country between India and China. To its on stockpiling and subsidizing agricultural inputs. Over east, west, and south, Nepal shares an open border with India, 50 percent of the MoALD budget in FY 2023 was allocated and to its north a border with China. Trade flows into Nepal toward subsidies for seeds and fertilizers that are not targeted. are directly affected by neighboring countries’ decisions, as Activities such as building community storage facilities for was seen during the 2015 blockade that disrupted trade and seeds and grains, often discussed as ways to strengthen supplies into Nepal for over four months, leading to acute supply of food at the local level, seem to fall between narrowly shortages and increased prices of supplies and fuel. India is defined mandates of line agencies and not get the requisite Nepal’s largest trading partner, accounting for 65 percent of allocation. This is a preparedness activity that could be Nepal’s total trade, and more than 85 percent of all imports financed using resources from the DM funds. enter through India, irrespective of their country of origin. 130 Nepal has limited alternative land routes to China with difficult, Protection of small farmers from shocks is another aspect mountainous terrain and subject to frequent disruptions due of preparedness that requires more attention. Small farmers to landslides. are very exposed to shocks that reduce crop and livestock yield and the farmers’ food security. However, in the absence There is lack of clarity in roles and responsibilities of relevant of a broad-based SP scheme targeted at the poor and given sectors and ministries with regard to preparedness for food limited coverage of available agriculture-insurance products, insecurity. For instance, as the food security cluster Country the losses they incur because of natural hazards and other lead and the line ministry under the Right to Food and Food shocks are often not compensated adequately to ensure their Sovereignty Act, MoALD is required to lead all efforts to recovery. The assistance provided as part of disaster relief safeguard food security, during crises and otherwise. However, and recovery does not consider the impact of disasters on its mandate is seen to cover only ensuring sufficiency of livelihoods or food security. The coverage of crop and livestock agricultural production, and the ministry often lacks the insurance remains very low despite the subsidies available, resources to go beyond that. Transport and supply mandates owing to challenges noted in Chapter 4.3. CONTINUED ACCESS TO EDUCATION In the wake of the pandemic, the national government sector both during normal times and during times of crisis. developed multiple guidelines and protocols to help ensure The COVID-19 Education Cluster Contingency Plan 2020131 continuity of education. The pandemic provided momentum aims to ensure continuity of learning for all children in all areas toward more investment in crisis preparedness, in ways that including those with disabilities and those from marginalized may help address the challenges that affect the education backgrounds by providing alternative ways for learning during 129 UN Nepal. (2021). Earthquake Contingency Plan Nepal, 2022. United Nations Nepal. Retrieved from https://un.org.np/resource/earthquake-contingen- cy-plan-nepal-2022 130 Cosic, D., Bajracharya, R.D., Dahal, S., Rana, S.S., Shrestha, R., & Pandey, B. (2016). Nepal development update – development amidst disturbances. Washington, DC: World Bank. https://www.doe.gov.np/assets/uploads/files/54ba4942574885a514869a72a6b456cd.pdf 131 48 school closures of the sort that occurred during lockdowns finances and HR) and many community schools suffer from as well as preventing dropout when schools reopen. The underfinancing, even in normal times. While some budgetary COVID-19 Student Learning Facilitation Guidelines 2020 132 provisions were made by the federal government, with some elaborate on alternative means of teaching, which mainly LGs also putting in their own resources, the adequacy of the involve using digital technology for remote learning. budget could be questioned. However, the reach and effectiveness of these alternative Building on the COVID-19 response, the new Nepal School means were uneven, given the large digital divide. UNICEF’s Education Sector Plan (2022–2032) includes disaster Child and Family Tracker (CFT) Baseline Survey, conducted preparedness and education in times of disaster as a cross- during initial months of lockdown, revealed that 95 percent of cutting issue. Section 5.6 of the plan addresses Education in students were out of school during the lockdowns, with only 52 Emergencies and Crises—natural disasters, pandemics and percent studying at home and only 29 percent with access to epidemics, war, conflict, displacement, and migration. The distance learning, of whom only half were using that access. 133 UN Earthquake Contingency Plan 2022136 also addresses Findings from the seventh round of the CFT survey conducted continuity of learning in the event of an earthquake, led by in July 2021 showed that self-study using textbooks remained the IASC Education Cluster. The plan lays out procedures by a dominant approach among students (63 percent), especially which the international humanitarian community will work to among children enrolled in public schools (70.5 percent), and support GoN in the event of an earthquake. In addition, the only 18 percent of the students from community schools were Nepal National Framework for Education 203025 requires that reported to have access to online classes.134 The availability of education policies, sector plans, and budget planning include the required digital infrastructure (strong Wi-Fi connection, at risk assessment, preparedness and response to emergency least 3G broadband access) in community schools and teachers situations for education, and initiatives that respond to the is also questionable, which has significant implications for educational needs of children, youth, and adults affected by delivery of online classes. In addition, the guidelines entrust disaster, conflict, displacement, and epidemics. the schools and respective LGs with several additional duties and responsibilities, including primary responsibility assigned Nepal has adequate plans in place to ensure continuity of to teachers to ensure continuous monitoring and support to education, but effective execution of these plans remains children and parents/guardians while the chidren continue a challenge mainly on two fronts: resources and equitable to learn during the school closures. This includes providing access to digital technology. Success of these plans requires materials to children without access by adopting safety adequate financing and human resources and identifying and standards and maintaining trainings for teachers without much investing in required infrastructure to promote alternative clarity or assurance of additional budgetary or HR support to learning modalities, especially investments to increase extend such services and carry out activities.135 This can be households’ access to the internet, to narrow the digital divide particularly tricky, as not all LGs are equally able (in terms of and disparities in learning outcomes. 132 MoEST. (2020). Student Learning Facilitation Guidelines 2077. Ministry of Education, Science and Technology, Government of Nepal. 133 UNICEF. (2020). Tracking the Socio-Economic Impact of COVID-19 on Children and Families in Nepal Baseline Findings. 134 UNICEF. (2021). UNICEF Child and Family Tracker Survey 2021 - Findings from the seventh round CFT survey conducted during the period of July 11th to 18th, 2021. MoEST. (2020). Student Learning Facilitation Guidelines 2077, Clause 5.1.1, 5.2.4 and 7.5.2. Ministry of Education, Science and Technology, Government of Nepal. 135 136 UN Nepal. (2021). Earthquake Contingency Plan Nepal, 2022. United Nations Nepal. Retrieved from https://un.org.np/resource/earthquake-contingen- cy-plan-nepal-2022 CRISIS-INDUCED DISPLACEMENT Overview: Crisis-induced displacement is an important issue in routinely have to do with the simple fact that rebuilding homes Nepal. Resettlement in the aftermath of the 2015 earthquakes can take a long time. Such situations are not addressed in any has both generated significant experience and demonstrated policy or plan. People in situations of protracted displacement limitations and pitfalls of current frameworks for dealing with are also particularly severely affected by a more general gap in both temporary and permanent displacement. Learning from displacement policy, which is a lack of attention to sustainable these experiences, and putting in place policies, processes, and livelihood recovery. The Disaster Victim Rescue and Relief expertise in advance, will be all the more important as climate Standard’s Sixth Amendment (2017) and Seventh Amendment change intensifies vulnerability to displacement from a range (2020) provide support for the displaced, including one-off of hazards including floods, heatwaves, landslides, and GLOFs. cash transfers in case of loss of residence, productive lands, or means of livelihood, but these one-off payments are not Several government plans anticipate crisis-induced short- needs tested and do not address longer-term livelihood term displacement, and some institutional resources are challenges, especially as they arise in situations of protracted in place for their implementation. The key document is the displacement, or the situation of people who lack citizenship Camp Coordination and Camp Management contingency plan certificates and official land titles. prepared by Department of Urban Development and Building Construction under the Ministry of Urban Development, Given increasing risks of permanent displacement and need which coordinates the Shelter Cluster. Important activities to for resettlement, important lessons from recent experience operationalize the plan, conducted during the past decade, include paying close attention to livelihoods, cultural life, and include the identification and management of open spaces for consultations with displaced people and host communities. emergency shelter and training of first responders, including Under resettlement policies developed in the aftermath of the Nepal Army, Nepal Police and Armed Policy Force, in Camp 2015 earthquakes, large numbers of people whose settlements Coordination and Camp Management principles such as appeared at risk from landslides were resettled in new sensitivity to the needs of women and other vulnerable integrated settlements, but many have faced several problems. groups. These preparedness exercises are complemented by Often, people either returned to their original settlements or humanitarian actors—for instance, through Shelter Cluster 137 continued to spend several months a year there despite the planning in the Earthquake Contingency Plan. There is also risks because they needed access to farmland and other relatively strong capacity to track and monitor displacement natural resources including fodder for livestock. There have through the Displacement Tracking Matrix, a database run by also been cases of tensions between displaced people and host the International Organization for Migration, which is also the communities over strain on natural resources including water. co-lead of the Camp Coordination and Camp Management Even though attention to cultural appropriateness was part cluster. of resettlement and reconstruction policies, many displaced people have also voiced displeasure with the houses they Significant gaps exist in addressing protracted displacement, were provided and with a lack of options for reconstruction displaced populations, and their livelihood needs. Significant designs approved by the NRA. These issues point to the need numbers of people displaced during the 2015 earthquakes and for emphasis on consultations and participation right from less severe disasters since then, such as the 2021 Melamchi the beginning of a protracted displacement or resettlement flash flood, have been unable to return to their homes or situation, which must also extend to host communities, resettle to new locations. Such protracted displacement along with adequate compensations. Lessons can be drawn scenarios can emerge for a number of reasons, including from World Bank’s experience with community-responsive drawn-out administrative processes for resettlement, but they resettlement for development projects. MoUD. (2018). Shelter Cluster Nepal Contingency Plan for the Coordination of Shelter Preparedness and Response in Nepal. Ministry of Urban Development, 137 Government of Nepal 50 Entry Points: Strengthening Social and Livelihood Support 1. Institutionalize SRSP by approving SRSP guidelines so existing SP systems and programs can be used for more efficient and inclusive delivery of relief and recovery. In addition • Ensure that the SRSP guidelines emphasize impact of shocks on livelihoods and the provisions to help households recover their livelihoods after disasters. • Amend program guidelines of key SP programs—SSA and PMEP—to align with the SRSP guidelines and enable them to flexibly respond to shocks. • Ensure sustained investment in the ISR required to implement SRSP and help achieve efficiency gains, which will enable assisting a larger share of the poor and the vulnerable. 2. Invest in communal storage facilities for seeds and grains to promote food security. 3. Revisit the risk-management framework for small farmers: • Review subsidies to target them better and ensure availability of inputs on time and in sufficient quantities. • Promote insurance products through increasing awareness and providing more points of access for farmers. • Coordinate the NDRRMA and food-security-coordination bodies, including by including the NDRRMA on the board of the FMTC and other food-security and nutrition committees. 4. Improve financing of preparedness interventions in the education sector to ensure continued learning during crises: • Ensure adequate financing and human resources for effective implementation of education continuity plans. • Invest in infrastructure to promote alternative learning modalities, especially infrastructure that will increase households’ access to the internet, narrow the digital divide, and reduce disparities in learning outcomes. 5. Enhance government’s planning and processes for resettlement. • Draw lessons from past experience for resettlement policies to emphasize consultative, community-responsive processes to ensure that issues of livelihoods, cultural life, and social cohesion are addressed. 51 52 SUMMARY AND CONCLUSION SUMMARY OF FINDINGS The overarching conclusion of this analysis is that while Nepal can manage smaller, localized crises, it is not prepared for large, multisector crises. Crisis preparedness is not established as a policy priority. Institutions concerned with crisis risks have a sectoral outlook and emphasize crisis response over preparedness. There is no effective institutional arrangement that is motivated and empowered to analyze risks and coordinate preparedness across sectors. An adequate legal and policy framework exists for crisis preparedness, but the NDRRMA, the institution established to lead cross-sectoral preparedness and response, is still in its early days of institutionalization. It is not sufficiently equipped with staff and financial resources to fulfill its substantive mandate. Overlapping roles and responsibilities between different agencies further impede the NDRRMA’s ability to convene and coordinate across stakeholders in natural hazards, pandemics, and food- insecurity situations. Its roles overlap with MoHA when it comes to natural hazards, and it does not really have a presence when it comes to pandemics and food insecurity. However, it does have opportunities to lead efforts at cross-sectoral crisis preparedness and livelihood recovery, which do not have a clear institutional home. LGs play a key role in implementing crisis response and preparedness activities. However, these are also relatively new institutions that are still in the process of being set up as part of the transition to a federal structure of government, and, broadly speaking, they lack the staffing, capacity, and resources to meaningfully engage in preparedness activities. The government operates strong EWSs for some of the key hazards, including flood- and health-risk monitoring, but a multi- hazard EWS has yet to be established. The DHM’s hazard forecasting for floods and extreme weather is in high demand, but it lacks adequate staff and capacity to generate actionable advisory. Impact-based forecasting has yet to be institutionalized. Health-risk monitoring has a functioning reporting system from but has weak points when it comes to monitoring zoonotic risks, and the One Health approach is still nascent. Food-security monitoring was disrupted during federal restructuring, and the monitoring entities at the local level do not yet have people and processes in place to resume it. Nepal struggles to put in place sufficient financing both for essential public services that are also crucial for multi-hazard preparedness—especially a strong public health system—and for contingent liabilities arising from high-impact risks. GoN has limited crisis-risk financing mechanisms to finance crisis response, recovery, and reconstruction, and large-scale response and recovery are mainly financed through DPs and humanitarian appeals. The government is now trying to put into place a risk- layered approach to financial preparedness, outlined in the National Disaster Risk Financing Strategy (2020). The DM funds are in place at the national, provincial, district, and local levels and have sufficient financing for basic preparedness activities and to respond to less severe, localized crises. However, access to resources from the federal DM funds for LGs is cumbersome. The only ex ante DRF instrument at the sovereign level is a Cat-DDO that expired in 2023 and is currently being renegotiated. There is almost no sovereign-level insurance, and coverage by private insurance remains very limited. Data gaps related to risk information pose a significant challenge to expanding coverage of insurance. There is no consolidated inventory of critical infrastructure to enable costed scenario planning and risk modeling for insurance. Contingency planning for critical infrastructure, including establishing an inventory of such infrastructure and financing strategies for their maintenance and repair, is key. 53 Nepal has made significant efforts to align its national public health policies, laws and regulations with IHRs and enhance EPR planning. However, operationalizing them is a challenge, and there are gaps in primary-response capacity across the fields of health, emergency response, critical infrastructure and services, and emergency management. A key challenge is to sustain the achievements made as a result of the response to the COVID-19 pandemic and strengthen the public health system in the medium and long term. Emergency services are equipped with specialized personnel and resources but face challenges in terms of adequacy and readiness to tackle large-scale disasters, accountability for equipment use and maintenance, and resilience of communication systems. At the local level, EOCs are supposed to provide the backbone of primary response, with capacity to coordinate with security services, respond to local emergencies such as forest fires, and feed information up the chain, but only some municipalities have established EOCs so far. Strong SP systems and well-targeted support for recovery of livelihoods affected by shocks is crucial to protect development gains. Nepal has a large portfolio of SP programs that cover about a third of the population, but most programs are not designed to promote household resilience or to be scalable in response to crises. Disaster relief and recovery are often slow and inefficient, particularly as they fail to mobilize existing SP programs and systems. In addition, disaster relief and recovery do not account for impact on livelihoods, and little attention is paid to recovery of livelihoods after disasters. The NDRRMA is leading the drafting of SRSP guidelines that will enable the mobilization of existing programs for delivery of relief and recovery in a more efficient and inclusive manner. In addition, GoN has also initiated the establishment of an ISR to enable swift identification of affected and vulnerable households. Both chronic food insecurity and risks of acute food insecurity in the wake of other crises are high. Preparedness measures by different ministries and agencies tend to focus on food stockpiling and subsidizing inputs to boost production, but neither is systematically based on risk analyses. Investing in community storage facilities could significantly strengthen preparedness. Continuity of education has received increased attention in the wake of the pandemic. The contingency plans require more resources to be implemented. An often-overlooked aspect concerns school buildings, which are not constructed to offer resilience against flooding, extreme heat, and earthquakes and landslides. Crisis-induced displacement is a critical issue in Nepal and bound to become more so with climate change. Resettlement in the aftermath of the 2015 earthquakes has generated significant experience and demonstrated limitations of current frameworks, highlighting the importance of consultations and participation both of displaced people and host communities and of emphasizing livelihoods. Learning from these experiences, and preparing policies and processes for resettlement and displacement in advance, will be even more important as vulnerabilities from a range of hazards including floods, heatwaves, landslides, and GLOFs intensify. KEY ENTRY POINTS Table 3 presents a prioritized list of entry points for strengthening crisis preparedness in Nepal grouped into two categories— Priority I and II—where recommendations that emerge mainly from the cross-sectoral assessment and those that will have a systemic impact in enhancing crisis preparedness are listed in Priority I. The recommendations are aligned to the Green, Resilient and Inclusive Development (GRID) agenda that the GoN has adopted. The table below also shows timeline for the recommendations - short term (S, under 12 months), medium term (M, 2-3 years) and long term (L, 4-5 years). Notably, some of the activities recommended here are already being initiated. See Annex C for a mapping of the current World Bank portfolio against these recommendations. 54 Table 3: Entry points for strengthening crisis preparedness in Nepal. PRIORITY 1 ENTRY POINTS LEGAL AND INSTITUTIONAL FOUNDATIONS TIMELINE 1 Strengthen the NDRRMA’s role and institutional capacity through more dialogue, resources, and autonomy to S-M enable it to • Coordinate preparedness across crises including natural hazards, pandemics, and food insecurity, and • Support LG capacity building for key preparedness activities and engagement with communities. 2 Clarify responsibilities of government agencies working on preparedness and response at different levels of S-M government, including by • Establishing standard operating procedures (SOPs) for communication during crises. • Consolidating the chain of command and communication between the national emergency operating center (NEOC) and EOCs at the district and local levels and between the NEOC and Health EOC. UNDERSTANDING RISKS 3 Strengthen hydromet forecasting by institutionalizing impact-based forecasting, possibly via the hydromet S-M policy and law, expand the network of hydromet monitoring stations, and ensure adequate resources for their maintenance. 4 Support the development of an inclusive multi-hazard EWS. This includes: S-L • Supporting NDRRMA to conduct a periodic MHRA. • Investing to expand the natural hazards monitoring to include landslide and lightning, • Enhancing sectoral capacities for monitoring certain risks e.g., in agriculture and hydro power, and LG capacity for monitoring other risks, • Strengthening of monitoring of food insecurity through operationalizing food-security information centers at the local level. • Strengthening institutional collaboration by establishing intersectoral forums to produce tailored, actionable weather advisories and by developing interoperability across existing EWSs, including those in Health. FINCIAL PREPAREDNESS 5 Invest further in national DRF catastrophe-risk models as a core element of risk management by M-L • Expanding catastrophe-risk modeling to cover other hazards such as floods (this has already been initiated with World Bank support). • Considering sovereign earthquake-risk insurance based on risk modeling and insurance for public assets at high risk. • Developing earthquake- and flood-insurance products for households; they could be subsidized for low- and medium-income households. 6 Promote development of domestic market for agricultural insurance by M-L • Developing hybrid agri-insurance products with a combination of indemnity-based and index-based coverage that account for risks more effectively. • Expediting decentralization of administration of agri-insurance from MoALD to the LG 7 Streamline LG’s access to federal DM funds by simplifying the procedures in the federal DM fund’s operating S guidelines. 55 PRIMARY RESPONSE 8 Strengthen the surveillance system and data sharing for effective public health decision-making, including S-M decisions regarding health-sector preparedness and response by: • Expanding coverage of sentinel sites and ensure they are operational. • Adding event-based surveillance and risk-based surveillance for both human and animal health to establish an integrated surveillance system. • Conducting advanced analysis of disease surveillance and epidemiological modeling. 9 Operationalize the One Health approach in order to strengthen health security by M-L • Enhancing monitoring of plant, animal, and human diseases at all 14 cross-border entry points to monitor and mitigate health crises, and • Strengthening the One Health secretariat’s ability to coordinate, and share information across, the three key ministries, and expanding its technical committee to include the NDRRMA. 10 Establish a consolidated inventory of critical infrastructure and allocate budgets for repair and maintenance: S-M • Consolidating ongoing efforts to create an inventory of critical infrastructure and assets including digital infrastructure and backup plans for them in the event of crisis. • Ensuring provisions for periodic audit and maintenance to safeguard critical infrastructure. SOCIAL AND LIVELIHOOD SUPPORT 11 Institutionalize SRSP by approving SRSP guidelines to enable the use of existing SP systems and programs for S-M more efficient and inclusive delivery of relief and recovery, and • Ensure that the SRSP guidelines emphasize impact of shocks on livelihoods and the provisions to help households recover their livelihoods after disasters. • Amend program guidelines of key SP programs—SSA and PMEP—to align with the SRSP guidelines and enable them to flexibly respond to shocks. • Ensure sustained investment in the ISR required to implement SRSP and help achieve efficiency gains, which will enable assisting a larger share of the poor and the vulnerable. 12 Invest in building local level communal storage facilities for seeds and grains to promote food security. M 56 PRIORITY 2 ENTRY POINTS UNDERSTANDING RISKS 13 Support development of an inclusive multi-hazard EWS, including by S-M • Ensuring budget lines for recurring expenditures for maintenance and staffing are in place. • Strengthening communication of early warnings to the public. 14 Systematically identify vulnerable groups and assess group-specific risks and impacts of key hazards to inform M-L preparedness and response by establishing consistent analytical frameworks and processes. Periodic Climate Change VRA could use such a framework. FINANCIAL PREPAREDNESS 15 Continue to use available contingent financing instruments such as the Cat-DDO, including the World Bank’s S-M Cat-DDO and ADB’s Contingent Disaster Financing, and ensure that such financing can be mobilized to assist the most vulnerable during crises. 16 Promote development of a domestic market for crisis-risk agricultural insurance: M-L • Promote awareness of agri-insurance products among low-income farmers and incentivize insurance agents to expand their coverage. • Strengthen public-private partnerships to improve data collection, product development, and outreach for the insurance sector and to support capacity building. 17 Enhance procurement and public financial management during crises: M • Improve internal controls and oversight of post-disaster expenditures. • Support LGs to detail emergency procurement provisions in their procurement laws and regulations. • Introduce dedicated budget coding for DRM expenditure for easier tracking of such expenses. PRIMARY RESPONSE 18 Enhance LG capacity for SAR by: M-L • Providing resources for additional SAR equipment which are pre-positioned at the local level. • Optimize use of available infrastructures—for example, by repurposing holding centers built during COVID-19 for other emergency responses. SOCIAL AND LIVELIHOOD SUPPORT 19 Revisit the risk-management framework for small farmers: M • Review agricultural subsidies to target them better. • Promote farmers’ access to insurance products. • Ensure that disaster relief and recovery efforts consider impacts of crises on livelihood and food security. 20 Improve financing of education continuity plans to ensure continued learning during crises and invest in M infrastructure to promote alternative learning modalities. 21 Enhance government’s planning and processes for resettlement by drawing lessons from past experience to M-L emphasize consultative, community-responsive processes and ensure that issues of livelihoods, cultural life, and social cohesion are addressed. 57 58 APPENDICE A: LIST OF INDIVIDUALS CONSULTED Ministry of Finance • Mr. Muktiram Acharya, Undersecretary, International Economic Cooperation and Coordination Division • Mr. Surya Prasad Pokharel, Undersecretary, International Economic Cooperation and Coordination Division Ministry of Home Affairs • Mr. Mahadev Pantha, Joint Secretary • Mr. Tulasi Acharya, Undersecretary • Mr. Ganesh Ojha, Undersecretary National Disaster Risk Reduction and Management Authority • Mr. Anil Pokharel, Chief Executive • Mr. Rudra Singh Tamang, Joint Secretary • Mr. Rameshwor Marahatta, Joint Secretary • Mr. Dhruba Khadka, Undersecretary • Mr. Yogesh Parajuli, Finance Officer • Mr. Rajendra Sharma, Undersecretary, Hydromet National Planning Commission • Mr. Prakash Dahal, Joint Secretary Ministry of Health and Population • Dr. Krishna Poudel, Chief of Policy, Planning and Monitoring Division • Dr. Guna Nidhi Sharma, Sr. Health Administrator • Dr. Hemanta Ojha, Chief of Zoonotic Section Department of National ID and Civil Registration • Mr. Nabaraj Jaisi, Undersecretary Ministry Labor, Employment and Social Security • Ms. Shobha Pokhrel, Undersecretary Ministry of Agriculture and Livestock Development • Ms. Shabnam Aryal, Joint Secretary • Mr. Arun Prakash Bhatta, Undersecretary • Mr. Ashish Shrestha, Section Officer • Dr. Ram Nandan Tiwari, Joint Secretary, Animal Health Division • Dr. Nabin Ghimire, Animal Health Division Ministry of Education • Mr. Arjun Dhakal, Director, Centre for Education and Human Resource Development 59 Department of Hydrology and Meteorology • Ms. Archana Shrestha, Deputy Director General • Ms. Shanti Kandel, Senior Divisional Meteorologist • Mr. Sunil Pokhrel, Senior Divisional Hydrologist • Mr. Dinkar Kayastha, Senior Divisional Hydrologist Department of Water Supply and Sewerage Management • Mr. Ram Kumar Shrestha, Deputy Director General Nepal Telecommunication Authority • Mr. Achyuta Nand Mishra, Deputy Director Nepal Electricity Authority • Mr. Suresh Bahadur BhatTerai, Spokesperson and Director of System Operation Food Management and Trading Company Limited • Mr. Mohan Prakash Chand, Chief Executive Officer • Ms. Sarmila Neupane Subedi, Information Officer Development Partners • Mr. Surendra Karki, Technical Coordinator, Food and Agriculture Organization • Mr. Nur Pant, Senior Health Adviser, USAID • Mr. Santosh Gyawali, AID Development Program Specialist, USAID • Dr. Allison Gocotano, Team Leader, Health Emergencies Program, World Health Organization • Dr. Subash Neupane, National Professional Officer, WHO • Ms. Lorena Lando, Chief of Mission, International Organization for Migration • Dr. Karma Gurung, Migration Health Officer, International Organization for Migration • Ms. Dipina Sharma, National Project Officer, International Organization for Migration • Ms. Abhilasha Gurung, Health Specialist, UNICEF • Mr. Krishna Jogi, Programme Manager, Emergency, Livelihoods, Resilience and Climate Change, World Food Programme • Dr. Shridhar Thapa, Programme Policy Officer, Evidence, Policy and Innovations Unit, World Food Program • Mr. Moti Thapa, Emergency Preparedness and Response Program, World Food Program • Mr. Ratindra Khatri, Logistics Cluster Focal Person, World Food Program • Ms. Stine Heiselberg, Head, United Nations Resident Coordinator Office • Mr. Prem Awasthi, Humanitarian Coordination Officer • Ms. Anne Peters, Humanitarian and Resilience Manager, British Embassy • Mr. Siddhartha Sharma, National Planning Commission, United Nations Development Program • Ms. Naomi Kato, Project Formulation Adviser Japan International Cooperation Agency • Mr. Gaurav Panthi, Program Officer, Japan International Cooperation Agency Civil Society Organizations • Mr. Deepak Thapa, Director, Social Science Baha • Mr. Jeevan Baniya, Assistant Director, Social Science Baha Individual Experts • Mr. Gangalal Tuladhar, DRM Expert • Ms. Bishakha Lakshmi Khadka, Head of Corporate Affairs and CSR, Ncell 60 APPENDICE B: CPGA DATA-COLLECTION PROCESS A comprehensive search of both gray and academic literature was undertaken in the initial phase of the assessment. This search extended to the websites of various international organizations, civil society organizations, and NGOs that focus on crisis- preparedness measures in Nepal. The objective was to gain a deeper understanding of the current state of Nepal’s readiness in the face of potential crises. The literature was examined with a focus on the five core pillars of crisis preparedness. Findings from the desk-based review were supplemented by qualitative data gathered through consultations with experts at the World Bank and external experts who hold critical engagements in the five areas of crisis preparedness. Consultations were conducted through semistructured interviews. Within the World Bank, consultations were held with key Global Practices and Cross-Cutting Solution Areas: DRM; Fiduciary; Agriculture and Food; Education; Health, Nutrition, and Population; Social Protection and Jobs; and Climate Change. Externally, discussions were conducted with various departments and ministries of the government: Ministry of Finance, National Planning Commission, Ministry of Home Affairs, National Disaster Risk Reduction and Management Authority, Ministry of Health and Population, Ministry of Agriculture and Livestock Development, Department of Hydrology and Meteorology, and Food Management and Trading Company Limited. Furthermore, dialogues were initiated with several development partners, including the WHO, WFP, FAO, United States Agency for International Development (USAID), International Organization for Migration, United Nations Children’s Fund (UNICEF), the British Embassy, Japan International Cooperation Agency, United Nations Resident Coordinator Office, and United Nations Development Programme. Civil society organizations, such as Social Science Baha, and individual subject-matter experts also provided invaluable insights during the consultation. As part of the analysis, the CPGA assigns maturity levels to the five preparedness components and their subcomponents based on the number and mix of affirmative responses to the pertinent guiding questions. The maturity levels indicate the following: • Unmet: Nothing or very little has been done to address aspects of preparedness, for reasons including capacity constraints. Typically, either there are no plans, systems, or institutions in place, or there is little to no ability to follow through and operationalize. • Nascent: Some (or minimal) efforts have been made to promote ex ante preparedness, though typically with little ability to follow through. A plan, system, or institution may be in place, but it does not address crisis preparedness as a priority. The system suffers from resource and capacity constraints, resulting in limited implementation and operationalization. Ex post relief and response are typically the focus of government intervention. • Basic: Decent efforts have been made to promote preparedness, with a vision laid out in relevant policy or planning documents. Progress in implementation may be uneven or disjointed because of shortfalls in capacity or resourcing. Priority is still often given to ex post response over preparedness. • Good: Clear and dedicated efforts related to preparedness are evident. The (sub)component typically has thought-through and dedicated plans, systems, or institutions in place. Most, but not all, areas are well resourced and have decent capacity. The balance of priorities may still favor response. • Advanced: Comprehensive efforts have been made to promote preparedness, with few gaps remaining. Often this means that a (relatively) advanced plan, system, or institution is in place. While it may still have some shortfalls, it generally covers all aspects needed to ensure holistic uptake of preparedness activities. Preparedness is prioritized and mainstreamed in key government documents and plans. For a full set of methodological guidelines, refer to the CPGA Technical Note. 61 APPENDICE C: MAPPING OF CURRENT WORLD BANK PORTFOLIO AND KEY DP ENGAGEMENT AGAINST THE RECOMMENDATIONS RECOMMENDATIONS WORLD BANK PORTFOLIO OTHER DP ENGAGEMENT 1 Strengthen the NDRRMA’s TA: MDTF resources for capacity building (till role and institutional Aug 2023) capacity 2 Clarify responsibilities WHO: Support to directives being between government drafted for provincial HEOCs agencies, chain of command (includes reference to liaison with and coordination mechanism PEOCs/DEOCs) 3 Strengthen impact-based Policy reform: Hydro met policy being drafted. hydro-met forecasting (Prior Action in GRID DPC II, which is expected to be followed by hydro-met law) TA: TA to strengthen hydro-met forecasting 4 Support development of an Policy reform: WHO: Support to integrate National inclusive multi-Hazard EWS • Concept note for MH-EWS developed. Alert and Response Framework in • Expansion of coverage of EWS to cover the EWS more hazards (PA in second CatDDO) 5 Systematically identify TA: TA for Gender Equality, Disability and Social the vulnerable groups and Inclusion (GEDSI) strategy assess group-specific risks and impacts of key hazards to inform preparedness and response 6 Continue to utilize available Policy reform: Preparation for Second Cat-DDO contingent financing underway instruments such as the World Bank’s Cat-DDO 7 Invest further in national TA: TA for cat-risk modeling for earthquake and DRF catastrophe risk models flood as core element of risk management. 62 RECOMMENDATIONS WORLD BANK PORTFOLIO OTHER DP ENGAGEMENT 8 Promote a domestic market for agriculture insurance. 9 Streamline LL’s access Policy reform: Amendment to the DRRM regulation to federal DM funds for to enable streamlined transfer of funds from expedited fund flow. National DM fund to provincial and local levels (Prior action in second Cat-DDO) (Amendment to the DM fund guidelines is also ongoing) 10 Enhance Procurement and Public Financial Management (PFM) during crises. 11 Strengthen surveillance Policy reform: Expand the list of notifiable prioritized system and sharing of data. diseases, syndromes and conditions for surveillance (Prior action in the second CatDDO) Investment: Health P4R: Piloting Climate sensitive disease surveillance system (to be eventually linked to the National Alert and Response Framework) 12 Operationalize the One Infectious Animal Disease Act (aligned with One Health Approach Health Strategy, prior action in GRID DPC 3) 13 Establish a consolidated TA: inventory of critical • Rapid Visual Screening (RVS) completed in 13 infrastructure districts for 10,000 public facilities under the Earthquake Housing Reconstruction Project. Further resources required to expand RVS and integrate with other databases (e.g. in Health). • TA to NDRRMA and FCGO to develop a valuation framework for assets 14 Ensure adequate provision of search and rescue (SAR) equipment 63 RECOMMENDATIONS WORLD BANK PORTFOLIO OTHER DP ENGAGEMENT 15 Institutionalize shock- Policy reform: Approval of SRSP guidelines (Prior responsive social protection action in GRID DPC 2) (SRSP) • Approve the SRSP TA: guidelines. • TA to draft the SRSP guidelines. • Ensure sustained • TA to draft ISR operating guidelines. investment in the integrated social Investment: Design and development of the ISR registry (ISR) under Strengthening Systems for Social Protection and Civil Registration (SSSPCR) project 16 Invest in communal storage facilities for seeds and grains. 17 Revisit the risk management Policy Reform: Post-disaster recovery of USAID: Tayar Nepal (2019-2024) framework for small farmers livelihoods is part of the SRSP Guidelines Partnership with eight including by (Approval of the guidelines is a prior action in municipalities to support small scale • reviewing agricultural GRID DPC II) disaster resilient infrastructure and subsidies to target it early recovery support to hard-hit better, communities after a disaster. • promoting access to insurance products for farmers, and • ensuring disaster relief and recovery considers impact on livelihoods and food security. 18 Improve financing of ADB: education continuity plans Disaster Resilience of to ensure continued learning Schools Project (2018-2024): during crises Reconstruction and retrofitting of damaged schools and institutional capacity building for disaster resilience 19 Enhance government’s planning and processes for resettlement 64 APPENDICE D: REFERENCES • Asian Development Bank. 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