Medical personnel in 1990 included 1,124 physicians, 19 pharmacists (in urban areas), 24 dentists (in urban areas), 601 nurses, and 2,380 midwives. In 1994, there was 1 hospital bed per 4,281 inhabitants. As of 1999, there were fewer than 0.05 physicians per 1,000 people and 0.2 hospital beds. In the same year, there were nine private hospitals and at least 10,000 private pharmacies in the country. Most of the medical personnel work in the Ka¯thmāndu Valley and health services elsewhere are in short supply. The public sector provides most of the country's health care. Traditional medicine and faith healing are still used frequently, especially in the hill districts. In 1999, only one in 10 rural dwellers lived within one hour of a hospital. In the same year, total health care expenditure was estimated at 5.4% of GDP.
Although protected by mountain barriers, Nepal is in frequent danger from epidemics, notably cholera. Japanese encephalitis is endemic in the Terai plain and inner Terai zone. Overall, 70% of illness is from communicable disease. Common afflictions are black fever ( kala-azar ), amoebic dysentery, eye diseases, typhoid, and venereal diseases. Malnutrition, contaminated water, and inadequate sanitation cause widespread health problems. Improved health programs in rural areas have helped control malaria, leprosy, and tuberculosis. However, tuberculosis remains a significant health problem. In 1999, there were 209 cases of tuberculosis per 100,000 people. In 2000, 81% of the population had access to safe drinking water and 27% had adequate sanitation.
In 1997, immunization rates for children up to one year old were as follows: tuberculosis, 96%; diphtheria, pertussis, and tetanus, 78%; polio, 78%; and measles, 85%. Major causes of illness in children are perinatal conditions, diarrhea, measles, and severe respiratory conditions.
Nepal has a large number of drug addicts. Stringent amendments to the Narcotic Drug Control Act were adopted in 1986 in response to pressure from the United States and the United Kingdom.
As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 32.9 and 10 per 1,000 people. Birth control was used by 29% of married women in 2000. In the same year, the average life expectancy was 59 years. Malnutrition is a common problem. Over half of all children under five were underweight in 1996. In 2000, 54% of children under five were malnourished.
As of 1999 the number of people living with HIV/AIDS was estimated at 34,000, and deaths from AIDS that year were estimated at 2,500. HIV prevalence was 0.3 per 100 adults.