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HIV is a retrovirus that targets the immune system and, if untreated, can cause AIDS. It is spread by bodily fluids such as blood, semen, vaginal fluids, rectal fluids and breast milk from an individual with a detectable viral load. The virus attacks the immune system by destroying the CD4+ T cells (which protect the body from infection). In 2023, almost 39m people were living with HIV. Nearly 39m individuals worldwide were HIV positive in 2023. Once infected, there is no complete cure for the virus; hence, eradicating it is impossible. Antiretroviral therapy, or ART, is a more recent treatment option. When taken as directed, it can help people live happy, healthy lives by lowering the blood virus load and preventing transmission. It is an epidemic in the world, and WHO (World Health Organization), the Global Fund and UNAIDS are aligned with the Sustainable Development Goal target of ending the HIV epidemic by 2030.

The first case of AIDS in Nepal was reported in 1988. However, the ART service started in 2004 at Sukraraj Tropical and Infectious Disease Hospital, Kathmandu. ART service is free of charge for people living with HIV in various centers in Nepal. Almost 80 ART sites are present in Nepal to provide free services and control infections. According to UNAIDS 2023 Nepal data, the new HIV infection decreased from 2100 (all age groups) in 2010 to less than 500 in 2022.

Notably, AIDS-related deaths declined from 1,700 in 2010 to less than 500 in 2022. People living with HIV who knew their status were 92 percent, and those who were on treatment were 78 percent. Today, people without HIV can take pre-exposure prophylaxis (PrEP) to prevent HIV. It’s a strategy where you can take a daily dose of HIV medication and reduce your risk of getting HIV by 99 percent. Apretude is a new PrEP option that does not need to be taken daily. It is injected every two months to the uninfected partners, significantly reducing the infection.

While we witnessed Covid-19 vaccines being developed within months, creating a vaccine against HIV is challenging due to the unique nature of the virus. The HIV virus mutates rapidly, making it difficult to develop a vaccine that can effectively target all its variations. Almost 250 HIV vaccine trials have been done, but none proved promising. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institute of Health, had launched three mRNA vaccine phase 1 trials. The trial was completed in July 2023. Recently, researchers at the Duke Human Vaccine Institute have successfully induced broadly neutralizing antibodies (which can recognize and block different versions of the virus) against HIV through vaccination for the first time. 

The neutralizing antibodies were produced within weeks, which usually takes years following a natural HIV infection. The phase 1 trial had to be halted due to a non-life-threatening allergy in one of the participants due to additives. Dr Barton F Haynes, director of the Duke Human Vaccine Institute, said, “We are not there yet, but the way is much clearer.” Dr Julie McElrath, the director of the vaccine and infectious disease division at the Fred Hutchinson Cancer Center in Seattle, said, “An effective vaccine is the only way to provide long-term immunity against HIV, and that’s what we need.” As of now, there is no vaccine for HIV, and even after 20 years of failure in HIV vaccine development, there is still hope for one.

In March 2024, news about successfully eliminating HIV using CRISPR-Cas gene editing technology (Nobel Prize in Chemistry, 2020) was circulated. 

CRISPR-Cas is an adaptive immune system found in most bacteria and prevents them from infection by viruses and other foreign genetic elements. Functioning like molecular scissors with the supervision of guide RNA (gRNA), CRISPR-Cas9 can cut DNA at assigned spots, which leads to either the deletion of unwanted genes or the addition of new genetic material into an organism’s cell, paving the way for advanced therapy. The research was only able to eliminate HIV from the infected cells in the laboratory and was not done on humans. However, if this technology can be successfully applied to humans, it could potentially provide a cure for HIV. In 2018, Dr He Jiankui announced the birth of two genetically engineered babies (Lulu and Nana) using the CRISPR Cas9 technology to make them HIV-resistant. 

He Jiankui, a professor at the Southern University of Science and Technology, claims to have disabled the gene for HIV entry into healthy cells. Despite the groundbreaking achievement, serious ethical concerns about using CRISPR remain.

We often hear that there’s no cure for HIV, but at the same time, we also hear about cases where people have been cured of HIV or are in long-term remission. These cases usually involve stem cell transplantation, which was initially done to treat cancer. Stem cell transplantation involves replacing the patient’s immune system with a new one that is resistant to HIV. The primary goal of the transplant is not to cure HIV because the procedure is risky and not suitable for everyone. However, it has shown promising results in some cases. Stem cell transplants replace cancerous cells with healthy stem cells responsible for creating blood, bone and muscle cells.

In this process, HIV can go into a latent stage and remain undetectable. A recent study published in the journal ‘Emerging Microbes and Infections’ found that HIV-virus-like particles (HLP) are 100 times more effective for people living with chronic HIV under cART. If this method is successful in clinical trials, it could potentially help millions of people to be free from HIV. HLP are inactivated HIV particles that can boost immune responses without infecting the person.

Despite extensive research, a cure for HIV remains elusive. Laboratories are continuing their research, exploring various methods in hopes of finding a cure. Currently, the primary treatment for HIV is combined antiretroviral therapy (cART), which involves taking a combination of drugs orally daily. While this regimen does not offer a cure, it has proven effective in reducing viral load and maintaining a healthy immune system. According to the most recent data from the World Health Organization (WHO), 76 percent of people living with HIV were accessing antiretroviral therapy in 2022, a significant increase from 27 percent in 2010. Additionally, in 2021, the FDA approved injectable drugs called Cabenuva and Vocabria for HIV treatment. Administered once a month via intramuscular injection, these drugs offer a more convenient alternative to daily oral medication. 

Considering that prevention is better than cure, taking preventive measures at a personal level can also play a crucial role in stopping the transmission of HIV. This can include using internal or external condoms, avoiding needle sharing, avoiding breastfeeding if you are HIV positive, and utilizing post-exposure precautions if you have been exposed to HIV.

The author is working in a virology lab focusing on HIV drug resistance

Amid speculations about New Delhi’s response to Nepal’s new coalition government under KP Sharma Oli, a warm reception extended to Nepal’s Foreign Minister, Arzu Deuba Rana, by the Indian government in Delhi is being perceived as a positive gesture. This visit closely followed Indian Foreign Secretary Vikram Misri’s visit to Nepal, signaling India’s priority in maintaining strong ties with its neighbor. High-level exchanges like these are often seen as manifestations of friendly relations and a growing understanding between the parties involved. Foreign Minister Rana’s India visit underscores the commitment of both nations to strengthening their bilateral relationship.

India’s response to Foreign Minister Rana’s visit has been interpreted differently by various observers. While some have provided subjective analyses, others have attempted to uncover the strategic implications. Regardless, diplomatic interactions like this are open to multiple interpretations. However, those who are trying to narrate a bad story aiming to destabilize bilateral relations, should be overlooked. Conspirators are everywhere, they should be condemned.   

This article aims to highlight Nepal-India relations, particularly in the context of recent high-level exchanges between the neighbors. It will focus on Kathmandu-New Delhi relations through the lens of KP Sharma Oli’s foreign policy and its approach to neighborly relations.

The importance given to Nepal’s Foreign Minister in India is a reflection of the importance given to the new government of Nepal formed under KP Sharma Oli. This gesture also honors the sentiments of the Nepali people. But the gestures should lead to some concrete action, for which we should wait for a few weeks (at least). Prime Minister Modi and his team are aware that Arzu Deuba Rana is the wife of former Prime Minister and a waiting Prime Minister Sher Bahadur Deuba. They also know that Arzu herself is a leader of the Nepali Congress. In that sense,  Delhi’s response to her might have comprised such mixed posture. But, this time as a foreign minister of Nepal, she was perceived as a representative of the government of Nepal and, by extension, Prime Minister Oli. So, there’s a need to be cautious about possible efforts to create misunderstanding within the coalition by misinterpreting the visit.  

During her meetings with Prime Minister Modi, Foreign Minister S Jaishankar, and other Indian officials, Minister Rana raised several key issues. These discussions covered bilateral relations, development cooperation and economic collaboration. It is important to note that this visit was not heavily loaded with agendas but rather aimed at setting a positive tone in bilateral relations at a time when Nepal’s new ruling coalition has just taken charge. 

Minister Rana’s visit has set the tone for further discussions and future high-level visits. This diplomatic engagement also paved the way for an upcoming meeting between Nepal’s Prime Minister KP Sharma Oli and Indian Prime Minister Narendra Modi. Such interactions are expected to address and resolve longstanding issues, fostering trust and understanding between the two nations. It should be remembered here that Oli and Modi have been maintaining close contact and sharing thoughts on issues of mutual interest.  

During the visit, Minister Rana formally extended an invitation from Prime Minister Oli to Prime Minister Modi to visit Nepal, to which Modi responded positively, indicating that he will visit Nepal in appropriate time. This development is significant, marking the potential for reciprocal visits between the two leaders.

In building relations, the chemistry of the leaders and approach to the issues are also important. This is where the foreign policy approach of Prime Minister Oli comes in.   

Prime Minister Oli’s foreign policy has been shaped by Nepal’s geographic location between its powerful neighbors, India and China. He has consistently prioritized maintaining a balanced and fair relationship with both countries on the basis of the principle of “sovereign equality.”  His well-known assertion that “countries may vary in size, but all countries are equal in terms of sovereignty” encapsulates a core tenet of Nepal’s foreign policy and continues to guide the nation’s diplomatic engagements. This approach, in  a way, aligns with India’s “Neighborhood First” policy and China’s “Peripheral Diplomacy,” both of which emphasize the importance of fostering good relations with neighboring countries.

Prime Minister Oli has emphasized that Nepal’s strategic location should be viewed as an opportunity for development rather than a challenge. He has also expressed appreciation for India’s leadership in global initiatives, such as campaigning of Global South, demonstrating the alignment of interests between the two nations. Throughout his previous tenures, Prime Minister Oli has remained committed to prioritizing Nepal’s national interest, navigating the complex geopolitical landscape with a focus on fairness and balance. In his fourth term as Prime Minister, Oli has, once again, openly requested both India and China to support Nepal’s development endeavors.  

In conclusion, Prime Minister Oli’s foreign policy approach, centered on the principles of “amity with all” and “enmity with none,” aims to promote peaceful and cooperative relations with all nations. From the land of Gautam Buddha, Prime Minister Oli has called on the global community to embrace peace and non-violence as solutions to global crises. Nepal, with its rich heritage of peace, stands ready to contribute to global efforts in promoting harmony and understanding.

The recent visit of Nepal’s foreign minister to India should be analyzed by considering these factors.  

Views are personal

Presumption of innocence, sometimes known as ‘innocent until proven guilty’, is a cornerstone of criminal justice systems around the globe. According to this theory, the prosecution has the burden of proof and an accused individual is presumed innocent until and until their innocence is established through a fair and impartial trial. It is both a defense against erroneous convictions and a necessary part of the right to a just trial. Presumption of innocence has its roots in Roman law, namely in the adage “Ei incumbit probatio qui dicit, non qui negat,” which states that “the burden of proof is on the one who declares, not on the one who denies.”

This idea became well-known in the late 18th century, thanks to the writings of legal scholars like Sir William Blackstone, who is credited with saying, “It is better that ten guilty persons escape than that one innocent suffer.” Over time, this idea persisted and shaped the evolution of contemporary legal frameworks. But it didn’t become well-known in European legal systems until the Enlightenment. Prominent thinkers like Voltaire and Cesare Beccaria fought for the rights of the accused, highlighting the need for fair trials and the presumption of innocence. A further testament to the presumption of innocence was the French Revolution's 1789 Declaration of the Rights of Man and of the Citizen, which stated that “Every man is presumed innocent until he has been declared guilty.”

Legal structure

A number of important international law texts contain references to the presumption of innocence. According to Article 11 of the 1948 Universal Declaration of Human Rights, “Everyone charged with a penal offense has the right to be presumed innocent until proven guilty according to law in a public trial at which they have had all the guarantees necessary for their defense.” The International Covenant on Civil and Political Rights (1966) stipulates in Article 14(2) that “Everyone charged with a criminal offense shall have the right to be presumed innocent until proven guilty according to law.” 

Constitutional recognition 

The presumption of innocence is specifically recognized by a number of national constitutions and legal frameworks. For example: The United States Constitution’s Fifth and Fourteenth Amendments guarantee that no one will be deprived of their life, liberty, or property without first undergoing a fair legal process. According to Article 48 of the European Union’s Charter of Fundamental Rights, “Everyone who has been charged shall be presumed innocent until proven guilty according to law.”

Article 20(5) of the Constitution guarantees the fundamental constitutional right to be presumed innocent unless and until proven guilty. In the same vein, the presumption of innocence in criminal cases is maintained by Section 12 of the National Penal Code, 2018. Therefore, in order to protect the integrity of the legal system, our hard-won liberties, and the dignity of the accused, criminal proceedings and the presentation of suspects urgently need to be changed. It is necessary to discontinue the widely used procedure whereby the Nepal Police parade detainees or individuals accused of minor offenses and issue statements, including information on the people they have detained, including pictures. The institution also needs to be cautious about the effects the practice might have on its investigations into the crime and the suspects, who might be found not guilty by the court. Thus, it is preferable to refrain from taking such rash decisions that can backfire and to inform the public and media until after the investigation is finished and the court issues a definitive ruling.

Principal’s significance

The protection provided by the assumption of innocence shields people from unfair allegations and incorrect convictions. It guarantees that the prosecution bears the burden of proof, having to prove the accused person’s guilt beyond a reasonable doubt. This strict level of proof is necessary to prevent mistakes and preserve the public’s faith in the legal system. The idea of a fair trial is based on this notion. It ensures that the accused has the right to a defense, which includes the capacity to refute the prosecution’s case, have access to legal counsel, and submit evidence. The presumption of innocence protects the fairness and impartiality of the legal system by guaranteeing that the accused receives such treatment. 

In actuality, the presumption of innocent has several difficulties despite its significance:

Influence of the media, extensive media coverage in high-profile cases may cause the public to adopt conclusions about the accused’s guilt or innocence before the trial even ends. This phenomenon, sometimes referred to as ‘trial by media’, has the potential to compromise the trial’s impartiality and threaten the presumption of innocence.

Prior to trial retention, the presumption of innocence may be violated in some jurisdictions where people are detained in pre-trial custody for protracted periods of time. The fact that being detained alone may lead to feelings of guilt emphasizes the necessity for legal systems to strike a balance between the rights of the accused and public safety.

Practical and legal obstacles, reverse onus provisions—which transfer the burden of proof to the accused under certain conditions—may undermine the presumption of innocence in some judicial systems. It is important to closely examine these exclusions to make sure that they don’t compromise fundamental rights.

Presumption of innocence is a fundamental tenet of legal systems all throughout the world. It guarantees that no one is unfairly punished, and that the integrity of the legal system is upheld. Although there are still obstacles in the way of completely implementing this idea, its continuous inclusion in legislative frameworks emphasizes how crucial it is to preserving the rule of law and safeguarding human rights. Presumption of innocence is a fundamental safeguard in the criminal justice system that helps to ensure that people are not unfairly convicted and that justice is served. It sustains the public's faith in the legal system and supports the fundamental human right to a fair trial. But in order to prevent this principle from being undermined by the media, pre-trial procedures, and legislative changes, constant watchfulness is required.

MCC has successfully partnered with 46 countries worldwide, investing more than $15bn in grants that have helped lift over 260m people out of poverty.  This means that we have a rich and varied experience partnering with countries on ambitious and complex compacts, working through diverse challenges, finding innovative solutions and achieving success.  

Thanks to the dedication of MCA-Nepal, led by its diverse board representing civil society, the private sector and multi-sectoral government agencies including the Ministry of Finance, Ministry of Forest and Environment, Ministry of Physical Infrastructure and Transportation, Ministry of Energy, and NEA, we are on track to write a new success story here in Nepal. 

Over the past year, there has been real momentum in the implementation of the MCC Nepal Compact. The signing of the contracts for three substations, the provision of technical support to the Electricity Regulatory Authority, the initiation of the MCA Partnership Program to support project-affected communities, the imminent signing of the 18 km transmission line contract, and the notable progress on obtaining environmental permits and land acquisition provide tangible evidence of the hard work and tremendous achievements of the MCA team. 

At the end of the day, the success of the MCC Compact is ultimately for the benefit of the Nepali people. I want to take this opportunity to thank the media for your accurate reporting that has played a crucial role in keeping the public informed and engaged.  Your work is vital, and we welcome your continued, constructive engagement as we move forward on this Compact. It is part of our core commitment to keeping the public informed and maintaining transparency in our work. As such, the entire MCC Nepal Compact agreement, procurement documents, completed reports and other pertinent information are always available to you and the public on the MCA Nepal website.

It is important to understand that the MCC Nepal Compact is not an isolated initiative; it is an extension of the United States' longstanding legacy of support for Nepal’s growth and development.  The projects we are undertaking will help Nepal meet its domestic power goals while unlocking the potential for cross-border power trade. This transmission line backbone we are building will enable more efficient electricity movement across the grid, contributing to increased access to electricity for all Nepalis and the economic opportunity for cross-border and regional trade of clean energy.

In addition to energy, the MCC Nepal Compact also focuses on improving road maintenance practices and introducing a sustainable climate-smart road improvement process known as Full Depth Reclamation technology to Nepal. These projects will provide higher quality longer lasting roads that make travel less expensive and safer for drivers and pedestrians alike along a segment of the East-West Highway.

We understand that our goals are ambitious and that infrastructure projects come with their own set of challenges. However, I am extremely encouraged by the commitment of all stakeholders, particularly the Government of Nepal and the dedication and quality of the MCA team. And I am confident that, together, we can overcome all challenges, optimize our resources, deliver on all Compact priorities and continue to make meaningful progress for the people of Nepal.

We are proud to be part of this important chapter in Nepal’s growth and transformation and to support the government in achieving the goals of the MCC Nepal Compact and making progress toward Nepal’s long-term development vision. 

The author is resident country director for MCC in Nepal