With recent advancement in medical technologies, the approach to treat diseases has widely broadened in today’s era. In 21st century, stem cells have become an attractive method for the treatment of injuries in order to restore the normal function of the body. Globally, numerous researches are underway to find possible sites and methods of using stem cell in medicine. Stem cells are gradually becoming a better option for therapeutic use due to their remarkable properties. They have the ability of self-renewal and differentiation into any kind of tissues or cells . This remarkable feature provides the hope for curing many diseases that were thought to be incurable in past. Currently, variety of diseases can be treated through the stem cell therapy including tissue damage due to Injury, Neurological diseases (Stroke, Spinal Cord Injury, Amytrophic Lateral Sclerosis, Multiple Sclerosis) , Cardiovascular diseases (Myocardial Infraction, Congestive heart failure) , autoimmune diseases (Rheumatoid Arthritis, Systemic Lupus Erythematosus, Type I Diabetes) , Musculo-skeletal diseases (Osteoarthritis, Tennis elbow, Frozen shoulder, Muscular Dystrophy) , Cancer , Congenital diseases  and skin diseases .
Nepal is a developing country located in South Asia. In the research field of advanced modern medicine and technology there is still inadequate progress here and thus, major improvements are required. Diminutive progress has been made in the sector of stem cell therapy for treatment of diseases. In other hands, the developed countries are using stem cells as therapeutic purpose. Recently, researchers in Japan have taken a pioneer role in their effort to create ready-made stem cell bank . Developed countries which are investing a significant percentage of their annual budget in such researches. Investment in such an expensive field is a great challenge for a developing country like Nepal.
In 2017, National Institute of Health (NIH), USA has funded 252 million USD and 1,646 million USD for only Embryonic Stem Cells (ESCs) research and stem cell research respectively . Iran has invested 2.5 billion USD . Indian government invested 8 million USD for stem cell research in two years period  and different organizations are involved which provide cost effective treatment. According to Global Industry Analysts (GIA)’s report stem cell research market exceeded 3.2 billion USD in 2017 . According to a new market research report stem cell banking market is project to rich 9.30 Billion USD by 2023, while in 2018 market 6.28 Billion USD . According to a report of 2014, 47 countries have practiced hematopoietic stem cell transplantation (HSCT) in 36,469 patients out of which the percentage of allogeneic and autologous transplantations was 43% and 57% respectively . The cost of allogeneic transplantation in India is around 20,000 USD and in USA 250,000 USD, which is added extract economic burden to the Nepalese patients those required stem cell based therapy. In Nepal, the estimated cost of Hematopoietic Stem Cell Transplantation (HSCT) for autologous and allogeneic transplantations are 3,000 USD and 10,000 USD respectively, which is much lesser compared to countries like USA and India .
For the establishment of stem cell therapy, there are still lots to be done in Nepal. The main challenges are lack of trained/qualified personnel, poor economic status, cost and quality  which subdues the use of stem cells as regenerative therapy for treatment of diseases. For stem cell research, it requires a highly sophisticated laboratory set up and especially trained manpower . Likewise, the establishment of research laboratory requires costly materials including reagents, media, and sophisticated equipments. Nepal also lacks adequate government guidelines for the stem cell use and legal support. In addition, lack of infrastructure, poor transfusion services and lack of international collaboration support strategies also prevails. Also, lack of adequate knowledge about stem cell therapy due to people’s belief in primitive therapy and traditional cultural issues  are equally affecting the establishment of stem cell therapy. Due to various circumstances, Nepalese people are dependent on foreign countries to receive treatment which has added an extra economic burden. In other hand, for the same reasons researchers are facing challenges in understanding the mechanism of action, isolation and identification and preventive methods and immune mediated rejection after transplantation in humans . Experimental conditions like, in-vitro and in-vivo environmental condition, genetic instability, functional activity and differentiation meditators also influence the use of stem cells. The First Global Bone Marrow Transplantation (BMT) conference organized in Kathmandu in 2017 discussed about BMT in low middle income counters of South-East Asia. They pointed out the challenges in autologous stem cell transplantation of which the greatest barriers were high cost due to chemotherapy-based mobilizing regimens and unavailability of cryopreservation .
Beside this, stem cell therapy has opened new era for future medicine for the treatment of various non-communicable diseases such as cancer, Alzheimer’s disease, traumatic injury, heart disease, and diabetes etc., both acute and chronic diseases that may improve health and extend the human life span. So, it is of utmost importance that Nepal should have stem cell therapy facility and also government funded research laboratory for the same. In our view Government of Nepal needs to come up with a proper plan, policy and budget and encourage Nepalese researchers who are trying to pave the path of stem cell research in their own home. This will certainly provide a great relief to the Nepalese population who are currently deprived of such modern medical facility. Despite various constraints in Nepal, Nobel Hospital has successfully treated five individuals with HSCT as reported with low operative cost as compared to other countries like India and America . Due to its cost, stem cell therapy may facilitate to the Nepalese peoples and also increase economic status by medical tourism opportunity in the nation.
Citation: Saud B, Malla R, Shrestha K (2019) Stem Cell Therapy in Nepal: Challenges and Opportunities. J Stem Cell Res Dev Ther 5: 022.
Copyright: © 2019 Bhuvan Saud, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.