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Participants in religious festivals have practiced animal sacrifice as a core part of Hinduism for hundreds of years-at a small scale by individuals and at large scale at major festivals. Butchers frequently perform sacrificial slaughter openly, in sight and sound of other animals with little or no guidance from or adherence to hygienic standards, which are poor or non-existent. One Health principles could guide development of interventions to protect human and animal health and welfare from these practices, but this concept is poorly understood in Nepal. Animal welfare organizations and international outcry have prompted some action through the Supreme Court, but the result fell short of a ban and little has been done in the face of religious considerations. Public health agencies and policymakers must act to implement effective regulations and enforce laws to prevent the human, animal, and environmental health risks surrounding these inhumane and unhygienic practices in order to ensure the protection of animal welfare and public health.

The small densely populated country of Nepal rises from just above sea level to more than 8800 m and encompasses many agro-ecological zones. Rich in both nature and culture, livestock are integral to household and national economies. Most Nepalese consider the cow sacred, and slaughter is forbidden. Other nonhuman animals are less esteemed, slaughter is not proscribed, and many are sacrificed during religious festivals. Limited financial and material resources, inadequate feed supplies, poor access to veterinary services, absence of appropriate legislation, and ignoring the needs of livestock as sentient beings can compromise welfare and lead to inhumane treatment. This article reviews the welfare status of various groups (food-producing stock, work animals, street dogs, experimental animals, and elephants in captivity). Several animal welfare charities are represented. Suggestions for improved welfare are discussed, but the prognosis is not encouraging especially in view of the widespread struggle and people's own struggle for survival.