Over a decade ago, the International Vaccine Institute (IVI) shifted its focus to Nepal and began establishing a network of clinical trial sites to make safe and affordable vaccines, tailored to local needs, a reality. A new documentary, produced by IVI, captures the remarkable story of these public health efforts in Nepal, from the challenges to the breakthroughs.

Nestled in the Himalayas, Nepal is renowned for its rich cultural heritage and stunning mountain views. However, healthcare access and recurring outbreaks of infectious diseases remain among its significant challenges. According to estimates by the WHO and UNICEF, contagious diseases kill over 50,000 people in Nepal every year. More than 5,000 of them are children under five who suffer from diarrheal diseases. Improved access to vaccines can help reverse this devastating trend and save thousands of lives.

“There are some diseases which have been inflicting high mortality and morbidity in the population [of Nepal] for a very long time, for which we still do not have perfect vaccines: tuberculosis, gastroenteritis, and respiratory tract infections. And we also have large outbreaks of dengue every year,” says Dr. Bibek Kumar Lal, Director of the Family Welfare Division, Ministry of Health and Population of Nepal, in his interview for the documentary.

It was this urgent need—and the determination to reduce the burden of infectious diseases—that first brought IVI to Nepal. This aligned with the organization’s mission to discover, develop, and deliver safe, effective, and affordable vaccines—empowering vaccine equity, impact, and sustainability globally. Starting with support for cholera and typhoid fever vaccine development, IVI soon recognized the importance of building sustainable clinical research capacity within the country.

According to Dr Saluja, there were very few sites doing this kind of work in Nepal. Searching for collaborators and suitable facilities, Dr. Saluja and his team travelled across the country for several months.

“We visited about 18 medical schools in Nepal. I was amazed to see the immense potential Nepal had. But unfortunately, it was untapped potential,” says Dr. Saluja.

One of the major challenges was a lack of experience in conducting clinical trials, which necessitated adherence to Good Clinical Practice (GCP) standards. Another challenge was the reluctance among political leaders to give a go-ahead for clinical trials in Nepal.

“It was extremely difficult to convince the politicians. Nobody was ready to take the risk,” shares Dr. Mohan R. Sharma, Professor, Director of Research Department, Tribhuvan University Teaching Hospital.

Despite initial hesitation among some policymakers, local medical institutions and leaders partnered with IVI to champion GCP-compliant clinical trials. Together, they collaborated and problem-solved, helping shift policy perspectives and enabling this milestone. Their collaboration laid the groundwork for a new era of clinical research in Nepal. In parallel, IVI launched a series of training programs to equip local medical professionals with the most up-to-date knowledge necessary to conduct high-quality clinical research.

Running clinical trials in practice requires not only advanced scientific expertise but also strong connections and trust within local communities. Many of these communities are scattered across mountainous terrain, making them difficult to reach. Deep-rooted cultural beliefs, a strong tradition of Ayurvedic medicine, vaccine hesitancy, and patriarchal family structures all pose challenges to engaging the population in clinical research.

In conducting clinical trials, IVI and its partner organizations rely not only on scientists, clinicians, and lab technicians. A major part of the success of clinical trials also depends on field coordinators, who are on the frontline, navigating rugged terrain every day to meet study participants and engage in conversations with local leaders and community members. In rural areas, where men often make health decisions for their families, these leaders and community members, along with their conversations, are essential—not just for participation in trials, but for shifting mindsets about healthcare.

In the documentary, we followed some of our field workers in the Dhulikhel neighbourhood and observed how their work helps strengthen health security and build a more inclusive public health system in Nepal.

Watch the documentary to discover the transformational impact IVI’s vaccine clinical trials have made in Nepal, leading to increased engagement in clinical research, new employment opportunities, and lasting health benefits for local populations.

by Elena Krivovyaz

Last updated: 23 June 2025