Nepal is strategically combining investments from the Pandemic Influenza Preparedness (PIP) Framework and the Pandemic Fund, hosted by the World Bank, to bolster national health security. Pandemic Influenza Preparedness Framework Partnership Contribution (PIP PC) funding supports key technical capacities and preparedness functions, helping build the evidence, expertise and systems needed to strengthen pandemic influenza preparedness, while Pandemic Fund financing is supporting broader implementation and scale-up efforts. Together, the investments are helping Nepal strengthen preparedness capacities in line with the International Health Regulations (2005).
Strengthening respiratory virus surveillance
PIP PC investments have helped strengthen Nepal's influenza surveillance system, providing technical foundations that are now being expanded to cover broader respiratory virus surveillance through Pandemic Fund-supported activities. Through the Structured Operational Research Training Initiative, Pandemic Fund financing is supporting work to assess the completeness and timeliness of severe acute respiratory infection (SARI) case identification across 15 surveillance sites. The findings, together with COVID-19 lessons learned, will help identify operational gaps, strengthen early warning and maintain situational awareness.
Nepal is also generating evidence to support public health policy. An influenza burden-of-disease study at Province Hospital Surkhet and Bhaktapur Hospital is estimating the morbidity and mortality associated with severe acute respiratory infection. At the same time, enhanced surveillance for avian influenza in humans has started at two pilot sites. During 2024–2025, PIP supported the feasibility phase and the development and finalization of the protocol and methodologies. In 2026, the activity is being implemented through the Pandemic Fund, with technical support provided through PIP. This work brings the veterinary and public health sectors together to support One Health coordination and improve the detection of potential human cases.
Connecting surveillance and laboratories
A technical focal point for high-threat respiratory pathogens, supported through the PIP PC, helps link surveillance and laboratory functions, including the regular submission of surveillance data to global platforms such as RespiMART and genomic sequencing data to GISAID. In parallel, a lead biomedical engineer, also supported through the PIP PC, supports certification of biosafety cabinets and preventive maintenance of laboratory equipment, both essential for the safe handling of respiratory pathogens and the quality of laboratory services.
Advancing health care preparedness
Complementary support from the PIP PC and Pandemic Fund extends beyond surveillance and laboratory systems into broader health-care preparedness. Nepal is revising its National Health Infrastructure Guidelines, with attention to ventilation, isolation capacity and readiness for increased demand during infectious disease surges. These technical specifications are being incorporated to support safer management of acute respiratory infections in health facilities. In parallel, the National Oxygen Roadmap is being developed as another component of clinical preparedness. Both activities are being supported through the PF, while drawing on technical expertise from the PIP.
Sustaining preparedness
The longer-term aim is to embed these surveillance, laboratory and clinical preparedness functions within Nepal’s national health system. One example is the planned National Action Plan for Genomic Surveillance, which will provide a framework for institutionalizing genomic surveillance capacity over time.
The experience in Nepal illustrates how targeted PIP PC investments can play a catalytic role in pandemic preparedness, helping establish priorities, technical capacity and evidence that can be leveraged to attract and inform larger-scale investments. Building on this foundation, Pandemic Fund investments are helping expand these capacities and integrate them into routine public health programmes. Together, these complementary investments are strengthening sustainable national systems for influenza and other respiratory threats.