One Secretary in Health Ministry Raises Questions Over Service Delivery

The government has implemented a provision to keep only one secretary in the Ministry of Health and Food Safety as part of its decision to reduce the number of ministries and make the administrative structure more efficient. At first glance, the decision appears to be an attempt to cut costs, speed up decision-making and simplify administration. However, concerns have been raised over whether a single secretary can effectively handle broad responsibilities such as health services and food safety in a country with difficult geography, limited health infrastructure, weak food monitoring and growing public health challenges. The ministry is responsible for protecting citizens’ constitutional right to basic health services as well as their right to safe, quality and nutritious food. Earlier, there were two secretaries, one handling technical health-related responsibilities and the other managing administration, staffing, budget implementation, legal coordination and institutional operations. Now, all those responsibilities have been concentrated in one person.

Although unified leadership can theoretically make decisions faster, the Health Ministry is not an ordinary ministry. It must coordinate health services among federal, provincial and local governments, send doctors to remote districts, make health insurance effective, manage the growing burden of non-communicable diseases, strengthen epidemic preparedness, monitor medicine quality and handle supply management. Along with this, the ministry must also oversee food safety, nutrition security, market monitoring, food laboratories and quality control. Regular inspection is needed to prevent the sale of expired, adulterated and substandard food products. Laboratory capacity, trained food inspectors, microbiologists, nutritionists and quality testing experts are also necessary to make the system effective. Real reform, therefore, should not mean only centralizing authority under one secretary. Clear departmental division, empowered divisions, decentralized decision-making, improved staffing, stronger laboratories, digital monitoring and updated laws are needed. Citizens will judge the government not by how many secretaries a ministry has, but by whether hospitals have medicines, doctors are available and food products are safe. Without institutional capacity expansion, placing such a large responsibility on one secretary could create more risk than reform.