DHANGADHI: High-level government negotiations have officially begun inside the Intensive Care Unit of Seti Provincial Hospital, where 69-year-old medical reform campaigner Dr. Govinda KC lies critically ill on the fourth day of his 24th hunger strike.

The senior orthopedic surgeon launched his latest fast-unto-death at the Krishna Temple Dharmashala (a pligrim rest house) on July 23 after Prime Minister Balen Shah’s administration ignored his deadline to address systemic failures in health governance.

A government delegation—comprising Prime Minister’s Health Advisor J.P. Agrawal, MP Pukar Bam, Education Secretary Chudamani Paudel, and Health Secretary Dr. Bikash Devkota—briefly visited Dr. KC at his bedside before initiating formal talks with his representatives, Dr. Amrit Jaisi and Pawan Thapa, in the hospital director’s office.

The immediate trigger for Dr. KC’s latest protest was the unadvertised appointment of retired Army Major General Dr. Devendra Khatri as Vice-Chairperson of the Medical Education Commission on July 7, which Dr. KC claims bypasses merit-based competition to serve private medical college lobbies.

Beyond revoking Khatri’s appointment, Dr. KC is demanding an end to scholarship cuts, a halt to unmonitored seat increases in sub-standard private institutions, the full enforcement of the 2019 National Medical Education Act’s mandate to make medical education non-profit by 2028, and expanded healthcare infrastructure in Sudurpashchim.

Furthermore, his demands extend to broad state accountability, calling for legal action against those responsible for the September 2025 Gen Z protest violence and high-level investigations into political corruption cases dating back to 1990.

While the government team has expressed general openness toward addressing healthcare reforms, the talks have hit a significant deadlock over Dr. KC’s demand to remove Dr. Sunil Prasad Joshi, Vice-Chancellor of Shahid Dasharath Chand University of Health Sciences, and the university’s Registrar.

Government representatives maintain that no legal mechanism currently exists to dismiss them outright, creating a major hurdle in the negotiations.

As dialogue continues, attending physicians warn that Dr. KC’s physical condition is rapidly worsening due to critically low blood sugar levels and severe electrolyte imbalances, narrowing the window for a negotiated breakthrough as public pressure mounts.