The Ministry of Health and Population (MoHP), with technical support from WHO, successfully conducted a comprehensive Joint External Review of its immunization programs and vaccine-preventable disease surveillance systems from 24–30 April 2026.
This milestone exercise, the first of its kind since 2010, follows recommendations from the WHO South‑East Asia Regional Immunization Technical Advisory Group (SEAR‑ITAG) and represents a significant step in strengthening Nepal’s public health systems.
The primary objective of the review was to assess Nepal’s routine immunization performance and evaluate the vaccine-preventable disease (VPD) surveillance systems. Key areas of focus included: measuring progress toward eliminating measles and rubella, overseeing the transition of VPD surveillance functions under the Polio Transition Plan, and strengthening priority VPD-specific initiatives. The review also aimed to provide evidence-based recommendations to enhance VPD surveillance, immunization coverage, outbreak response and priority disease-specific initiatives.
A team of 60 reviewers, including 14 international experts from WHO headquarters and regional offices, WHO India, UNICEF, IFRC, Sri Lanka’s Ministry of Health, members of the Regional Verification Committee for Measles Rubella Elimination, and Nepal’s National VPD expert committee, worked alongside provincial health officials and partners. The team assessed 14 districts in 7 provinces (one high‑performing and one low‑performing district in each province), engaging with health providers, caretakers, and municipal leaders. Provincial debriefings culminated in a national meeting on 30 April 2026 with participation of officials from MoHP, provincial ministries, program divisions, and partners.
The review highlighted strong commitment of the Government of Nepal toward immunization, underpinned by the Immunization Act (2016), and supported by robust service delivery platforms, partner collaboration, and community engagement.
Nepal has sustained its polio‑free status, achieved rubella elimination, re‑validated maternal and neonatal tetanus elimination, introduced new vaccines, and significantly reduced the number of zero‑dose children—all backed by high surveillance sensitivity and strong WHO‑UNICEF coverage estimates.
Despite these achievements, the review identified several key challenges:
- Transition risks due to reduced funding support
- Strategic risks from a changing funding landscape
- Continued reliance on partner-supported systems
- Complexity from epidemiological shifts
- Challenges with private sector integration
- Limited accountability and a dedicated VPD surveillance/immunization workforce
To safeguard Nepal’s health gains and accelerate progress, the review outlined five strategic recommendations:
- Formalize local roles and ensure accountable focal points at the municipal level
- Secure dedicated financing to protect critical surveillance functions
- Advance polio transition implementation with active oversight
- Modernize service delivery and logistics with stronger data use
- Reinforce demand generation and safeguard polio-free status and rubella elimination gains through laboratory integration and tailored strategies
This Joint External Review provides Nepal with a vital blueprint to accelerate Nepal’s national immunization and health goals, ensuring every child remains protected against vaccine‑preventable diseases and sustaining progress in the face of evolving challenges.