as politically unstable. The centrist Nepali Congress party won the first multi-party elections in 1991 and the Communists became the leading opposition party. Then in 1994, mid-term elections were called after the ruling Congress government lost a parliamentary confidence vote, resulting in a hung parliament, and the Communists, who emerged as the single largest party, formed a minority government. Then the minority Communist government soon fell and was followed by several successive weak coalition governments. All of these governments recognized a constitutional monarchy, retaining earlier ties to the crown within the political system.8
In 1996, spurred on by their frustration with the inability to affect change through the political process, one group of the Communist party splintered off to create the Communist Party of Nepal (Maoists) and subsequently declared a “Peoples War,” which decimated Nepal’s infrastructure and economy and paralyzed the country over the next decade. The civil war, which cost the country over fifteen thousand lives with countless others missing, tortured or displaced, lasted for ten years until the signing of a UN-led peace accord between the government of Nepal and the Maoists in 2006.9 The country has yet to fully recover.
The years between 1996 and 2006 saw two parallel governments in operation: the unstable government of Nepal (which mainly operated in a vacuum from within the Kathmandu Valley) and a parallel Maoist government that clandestinely operated throughout most of the rest of the country. Regarding the former, the Nepali Congress won an absolute majority of seats in parliament in 1999 and formed a majority government, with Krishna Prasad Bhattarai as the prime minister. An internal power struggle soon ensued within the Nepali Congress party, however, and led to the ouster of Bhattarai and his replacement by his long-time rival within the party, Girija Prasad Koirala, in March 2000. This government lasted little over a year when Koirala resigned in July 2001 and was replaced by his rival Sher Bahadur Deuba.
In June 2001 a national tragedy threw the already fragile central government (which still held loyalties to the crown) into further nebulousness. King Birendra (who still held much political currency), Queen Aiswarya, and seven other members of the royal family were killed by Crown Prince Dipendra, who was reportedly angered over his parents’ choice of his arranged marriage. The crown prince then allegedly shot himself as well and within days Birendra’s brother Gyanendra assumed the throne as king of Nepal.10
In May 2002 the country was thrown into further political uncertainty. The king dissolved parliament upon the recommendation of Prime Minister Deuba, who had been threatened with censure by his own party for supporting the extension of an official state of emergency. After a short one-week direct rule by King Gyanendra, Lokendra Bahadur Chand became prime minister in October 2002, followed by Surya Bahadur Thapa (2003–2004) and Sher Bahadur Deuba again (2004–2005). Then, on February 1, 2005, citing incompetence by the central government to properly manage the ongoing Maoist insurgency, King Gyanendra suspended the constitution and once again assumed direct authority. The king’s action sparked massive public protests, now referred to as Loktantra Āndolan ‘Democracy Movement’.11 Just over a year later he buckled under pressure, restoring the previous parliament on April 24, 2006. Girija Prasad Koirala was elected as prime minister. One of the first orders of business taken up by the newly reinstated parliament was a promise to hold elections within a year for a new parliament that would take up the task of writing a new constitution and usher in a new political era for Nepal. Three days later, on April 27, the Maoists announced a unilateral truce. And on May 1, Maoist leader Dr. Baburam Bhattarai acknowledged that if the Constituent Assembly (CA) elections were found to be free and fair, they would abide by the results. The Maoists were again ready to re-enter the political process of Nepal.
After two postponements in 2007, the long awaited Constituent Assembly election was finally held on April 8, 2008. The Communist Party of Nepal (Maoists) won 220 out of 575 elected seats and became the largest party in the CA. On May 28, 2008, the newly elected Constituent Assembly approved a temporary constitution abolishing the Hindu monarchy, declaring Nepal a secular state, placing the army under the command of the parliament rather than the king and stripping the king and his family of all royal privileges. The royal family would now live as equal citizens of the land, paying taxes and being subject to its laws. Nepal, the last remaining Hindu kingdom in the world, was now officially declared the Federal Democratic Republic of Nepal.
Over the next four years the elected Constituent Assembly would itself be caught in a constant quagmire of political in-fighting, positioning and bickering, and more prime ministers would come and go. Girija Prasad Koirala continued in the role as prime minister of the new Federal Democratic Republic of Nepal from May to August 2008 before being forced to resign. Then Maoist strong-man Prachanda was elected as prime minister by the Constituent Assembly in August of that same year and was expected to oversee the transition from monarchy to republic but he was forced to resign in May 2009 after his controversial sacking of a Nepali army general. He was followed by Madhav Kumar Nepal of the Communist Party of Nepal (Unified Marxist-Leninist), who resigned in 2011 amidst further serious political deadlock.12 He was followed by Jhala Nath Kanal (February 2011–August 2011), and finally Maoist second-in-command Baburam Bhattarai (August 2011–March 2013). After its failure to draft a new constitution (having been given two years and two more one-year extensions to do so), the Constituent Assembly was finally dissolved on May 28, 2012. New elections were called for, and the date of November 2012 was set, in hopes of electing new members to a new Constituent Assembly that all hoped could get the job done.13 In the interim, Baburam Bhattarai stayed on as head of a “caretaker government,” the elections were again postponed, and on March 14, 2013, Chief Justice Khil Raj Regmi was sworn in as the head of a new “interim election government” tasked with carrying out the election process. This is where the process sits as of the publication of this book.
One of the most devastating effects of all of this political turmoil is a loss of hope for the future of Nepal. The general public is very frustrated with the gamesmanship being played at a time when the politicians should be engaged in nation building. One commentator accuses the Constituent Assembly of “procedural maneuvers instead of being honestly involved in drafting a proper constitution of the country and building the nation for which they were elected” and Nepal’s political process of “’forever recycling leaders’ [the same old politicians] that haunts the house of Nepal from the fifties” (NACSS 2009). Reflecting on the implications to healthcare, another commentator concludes that “the superficial changes in political structure have not brought about any changes in the life of ordinary people” and that “the state of health service development is no way different now than it was during the active [civil war] conflict period” (Ghimire 2011). What happens next will ultimately be the domain of the historians. One thing is universally accepted, however, namely that further political instability will only further detour the prevention and treatment of HIV and AIDS in Nepal.
1.2 General cultural features
Many aspects of Nepal’s current-day cultural features have been shaped by elements of her past history. And many of these same general features play a role in shaping and promoting the HIV and AIDS epidemic in Nepal. In the remainder of this chapter I will discuss many contemporary aspects of Nepal’s culture, focusing cursorily on the resultant impact on the spread of HIV and AIDS in the former Himalayan kingdom. Some of these factors will be taken up again more at length in subsequent chapters.
1.3 Population demographics
David Seddon (1995:4) has commented that many of the demographic characteristics of Nepal play an important role in determining the pattern of development of the HIV and AIDS epidemic in the country. According to the latest figures available, Nepal’s population is now 26.6 million, of which 33 percent are under the age of fourteen, 62 percent are between age fifteen and sixty-four, and only 5 percent are over age sixty-five. The population growth rate is 1.35 percent and the sex ratio for the total population is 0.94 male/1 female (NPHC 2011). The latest estimated birth rate is 21.85 births/1,000 population and the death rate is 6.75 deaths/1,000 population. Infant mortality is listed at 43.13 deaths/1,000 live births and life expectancy is 66.51 years for the total population. The total fertility rate is 2.41 children
