For decades, malaria was considered a disease confined to Nepal’s low-lying Terai and inner Madhesh regions. Now, it has begun making its way into the country's remote Himalayan districts — a development that has alarmed health officials and local communities alike.
In Humla — a district so remote it still remains disconnected from Nepal's road network — two cases of malaria have been confirmed in Tajakot Rural Municipality. The revelation, made public by the Karnali Province Health Services Directorate in Surkhet on the occasion of World Malaria Day, has raised fresh concerns about the spread of the disease into high-altitude regions once considered safe.
"This has been a real shock," said Shyamlal Acharya, contact person for the Health Services Directorate. "Malaria was something we fought in the Terai. Now, seeing it in the Himalayas has challenged our entire campaign to bring cases down to zero in Karnali."
According to Acharya, one of the two infected individuals in Humla had no history of travel to malaria-prone areas, suggesting the disease may now be spreading locally.
Karnali Province has recorded 38 cases of malaria so far in the current fiscal year (FY 2024/25). Seven wards across the province are now categorized as medium-risk for malaria, including areas in Birendranagar Municipality and Gurbhakot Municipality of Surkhet, Khatyad and Soru rural municipalities of Mugu, and several wards of Adanchuli and Tajakot in Humla. Tajakot’s wards 2, 3, and 4 have been identified as high-risk zones.
While 298 wards in Karnali are considered free of malaria risk, 410 are classified as low risk.
The highest number of malaria infections has been reported in Surkhet district, with 25 cases — most of them imported. Panchapuri Municipality recorded seven cases, followed by six in Birendranagar, five in Chaukune Rural Municipality, and a few cases in other localities including Barahatal, Simta, and Lekbesi.
In Kalikot district, three cases were reported in Khandachkram, while Dailekh district recorded 28 cases, with one each reported in Chamundabindrasaini, Dullu Municipality, and Thantikandh Rural Municipality.
Acharya noted that most new cases are among people who traveled from malaria-affected areas outside Nepal, particularly across the open border with India. While local transmission is under control, imported malaria remains a stubborn challenge.
To combat the growing threat, the Health Services Directorate is stepping up its efforts. "We are strengthening malaria surveillance and information systems for more effective decision-making," said Acharya. "Vector control programs are also being intensified in areas at risk."
Still, the emergence of malaria in the rugged hills of Humla — a place that once seemed beyond its reach — signals a worrying new phase in Nepal’s fight against the disease. -- RSS
