Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Our Global Voices Posts

Confronting the Silent Killer in Nepal

Posted on by Bethany Hall
May Measurement Month volunteers screen local resident outside of a temple in Pokhara, Nepal. Photo credit: Kiran Adhikari
May Measurement Month volunteers screen local resident outside of a temple in Pokhara, Nepal. Photo credit: Kiran Adhikari

“We are measuring the blood pressure of many people who’ve never had their blood pressure measured before,” explains Dr. Dinesh Neupane, the country coordinator for May Measurement Month in Nepal. “When we approach people about being screened, we often hear that they don’t need their blood pressure checked because they feel healthy.”

But Dr. Neupane and his cadre of trained volunteers understand the threat of this “silent killer.” High blood pressure, or hypertension, causes an estimated 10 million deaths worldwide each year and is a leading risk factor for cardiovascular diseases.1 Dangerously, the condition is often overlooked because it frequently does not produce symptoms.

Dr. Neupane and his Nepali colleagues are out to challenge the status quo. They have set their sights on screening thousands of people across Nepal for high blood pressure during May Measurement Month to help raise public awareness about hypertension.

CDC collaborates with the World Health Organization, Resolve to Save Lives, and other global partners to reduce heart attacks and strokes worldwide. CDC provides support for various hypertension initiatives, including Nepal’s 2019 May Measurement Month campaign.

Taking measures to save lives

May Measurement Month is a global awareness campaign launched by the International Society of Hypertension in May 2017. The initiative aims to increase access to blood pressure screening in an effort to prevent deaths and disability worldwide. Dr. Neupane and colleagues have been participating since the initiative’s launch.

“Our first year, we screened 6,000 participants. Our second year, about 15,000. This year, we’re hoping to reach 50,000 people. Each year we grow, increase our team of volunteers, expand our geographic coverage, and improve our screening protocols, our training curriculum, and our outreach.”

The Nepal Development Society, the organization overseeing May Measurement Month in Nepal, engages volunteers with health science backgrounds as well as Female Community Health Volunteers to screen and educate participants at health facilities, offices, public places, or even participants’ homes. During the 2018 inauguration of May Measurement Month in Nepal, the team measured the blood pressure of the Minister of State for Health and Population. This year, they plan to screen the blood pressure of the prime minister, members of parliament and policy makers.

Charting a path to better health

Minister of State for Health and Population, Padma Kumari Aryal, receives blood pressure screening at 2018 May Measurement Month inauguration. Photo credit: Kamal Ranabhat
Minister of State for Health and Population, Padma Kumari Aryal, receives blood pressure screening at 2018 May Measurement Month inauguration. Photo credit: Kamal Ranabhat

The World Health Organization estimates that about 30% of all deaths in Nepal are due to cardiovascular diseases and that 1 in 4 Nepali adults have high blood pressure.2 Treatment for high blood pressure is simple, effective, and affordable, but many people are unaware of their condition or have limited access to treatment.

A recent study in Nepal showed that in 2016 just over 1 in 3 Nepalese diagnosed with hypertension were aware of their condition and less than 20% of those people were receiving treatment.3 Left untreated, high blood pressure can lead to heart disease, stroke, and kidney failure. In low- and middle-income countries like Nepal, many of the deaths from noncommunicable diseases like cardiovascular diseases occur prematurely—in people under the age of 70.2

While creating awareness is a critical first step, Dr. Neupane and his colleagues recognize that there is an enduring issue. “Right now, after we screen participants, we can only advise people to go to the health facility for further diagnosis and treatment,” explains Dr. Neupane. “In the future, we’d like to improve the referral system by establishing a formal linkage to the health system for those identified as having high blood pressure during the May Measurement Month campaign.”

Creating momentum for change

In three years, the Nepal Development Society’s efforts have transformed from a small, local program to a national campaign. While the nonprofit has struggled with funding and technological limitations, the support of local and federal governments and the work of their tireless volunteers has allowed them to make great strides.

“As awareness increases, we see the potential for long-term interventions to reduce the burden of hypertension in Nepal. Nepal has been an exemplary country for reducing maternal and child mortality and we want to repeat such success for hypertension,” states Dr. Neupane.

With the current speed of progress, Nepal could soon become a role model for hypertension control for many low- and middle-income countries.

Dr. Neupane is also affiliated with Johns Hopkins Bloomberg School of Public Health where he contributes to Resolve to Save Lives initiatives.


  1. Olsen MH, Angell SY, Asma S, et al. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: The Lancet commission on hypertension. Lancet. 2016; 388(10060):2665-2712
  2. World Health Organization. Noncommunicable diseases country profiles 2018.
  3. Mehata S, Shrestha N, Mehta R, et al. Prevalence, awareness, treatment and control of hypertension in Nepal: data from nationally representative population-based cross-sectional study. J Hypertens. 2018; 36:1680-1688. DOI 10.1097/HJH.0000000000001745.
Posted on by Bethany HallLeave a commentTags , , , ,

Tracking Lassa Fever Across Three Countries

Tracking Lassa Fever Across Three Countries

  When a Beninese migrant worker fell ill in Nigeria in December 2017, he decided to return to his parents’ home in Togo for care. His condition deteriorated during his trip through Benin. On his trip he stopped at Tandou Health Center in Tchaourou, Benin, was attended to by two healthcare workers, and continued his Read More >

Posted on by By Lesley Chace, MPH CDC FETP Lead - Francophone West AfricaTags , , , , , ,

From Mangoes to Meningitis: A Tale of One Laboratory Scientist in Burkina Faso

Rasmata Ouédraogo-Traoré PhD is the Chief of the Medical Analysis Laboratory of the Charles De Gaulle Pediatric Hospital, which houses the National Reference Laboratory for meningitis in Burkina Faso, and a professor of bacteriology-virology, medical sciences and pharmacy at the University of Ouagadougou. A concerned mother in Burkina Faso says to me, “I think that Read More >

Posted on by Professor Rasmata Ouédraogo-Traoré, PhDTags , , ,

Overcoming Refusals to Polio Vaccination in Uttar Pradesh, India

In 2014, WHO South-East Asia Region (SEAR) became the fourth region, among WHO’s six regions, to be certified as having interrupted all wild polio virus (WPV) circulation. India was the last country to eliminate polio in SEAR, proving that polio could be eradicated in the most challenging settings. Multiple international partners collaborated with Government of Read More >

Posted on by Alford (A.J.) Williams, Public Health Advisor, Global Immunization Division

I have seen Ebola. Now you have a vaccine.

Debut of preventive use of Ebola Virus Disease (EVD) vaccine for health care and frontline workers in Uganda before an outbreak For the first time, an unlicensed Ebola vaccine tested in clinical trials during the West African outbreak was offered to health care workers (HCWs) and other front line workers (FLWs) working in facilities bordering Read More >

Posted on by Rosalind Carter-Epidemiologist, Global Immunization Division

Readying the World for Maternal RSV Vaccine

Updated from the original posting on Vaccines Work on February 18, 2019 By getting vaccinated in pregnancy, mothers can safeguard themselves and their infants in the first few vulnerable months of life against certain diseases. This strategy is a powerful approach for reaching two stages of life often underserved by current immunization programs—pregnancy and early Read More >

Posted on by By Dr. Bruce Innis, Global Head, Respiratory Infections & Maternal Immunization, PATH Center for Vaccine Access and Immunization, and AMI Strategic Leadership and Dr. Sadaf Khan, PATH Senior Program Officer and AMI Maternal & Newborn Health Technical AdvisorTags , , ,

Promoting access to and use of clean and safe water to stop hepatitis E


My name is Dr. Matthew Goers, an Epidemic Intelligence Service (or EIS) officer with CDC’s Division of Global Health Protection. Our division works with other countries and international organizations to respond to international disasters, disease outbreaks, and humanitarian crises. In September of 2017, Namibia began reporting sporadic cases of acute jaundice, abdominal pain, and fatigue. Read More >

Posted on by Dr. Matthew GoersTags , , ,

Thirty years of a Unique Partnership to End Polio-GPEI


In 1988, CDC joined three other partners (World Health Organization (WHO), United Nation International Children Fund (UNICF) and Rotary International to launch the ambitious Global Polio Eradication Initiative (GPEI). The world was a dangerous place with respect to polio. A case of polio occurred every 90 seconds, meaning 350,000 children had paralytic polio every year. Read More >

Posted on by Dr. John F. Vertefeuille - Incident Manager for the CDC Polio Response and Branch Chief of the Polio Eradication Branch, Global Immunization Division, Center for Global Health, Centers for Disease Control and PreventionTags , ,

Getting to the Heart of the Matter in Latin America and the Caribbean

A blood pressure screening in Barbados raises awareness of hypertension and cardiovascular disease.

“I don’t get migraines, I don’t get dizzy spells any longer,” explains Ms. Williams, a patient at a polyclinic on the Caribbean island nation of Barbados. “It is working for me where I have no problems now with high blood pressure. Yes, I’m hypertensive, but I’m controlled.” Ms. Williams was enrolled as a patient in Read More >

Posted on by Bethany Hall, Scientific Health Communications FellowTags

Rapid Detection Accelerates India’s Response to Nipah Outbreak

CDC is working internationally to build laboratory capacity so that disease can be identified at their source. Photo: CDC India

  On May 17, 2018, almost two weeks after his brother died of febrile illness, a male patient in his mid-twenties visited a hospital in Kerala, India, with a fever. A day later, he was dead — but not before his doctors noticed his symptoms were consistent with encephalitis.Recognizing the potential danger, they immediately sent Read More >

Posted on by Dr. Kayla Laserson, CDC India Country Director