Risk Assessment and Sustainable Development: Towards a Concept of Sustainable Risk

Dr. Mehta examines two dominant approaches for managing health and environmental risks and suggests that they would better serve if integrated

Climate change and disaster impact reduction

Based on papers presented at the 'UK - South Asia Young Scientists and Practitioners Seminar on Climate Change and Disaster Impact Reduction' held at Kathmandu, Nepal on 5-6 June, 2008

Five feet high and rising : cities and flooding in the 21st century

Urban flooding is an increasingly important issue. Disaster statistics appear to show flood events are becoming more frequent, with medium-scale events increasing fastest. The impact of flooding is driven by a combination of natural and human-induced factors. As recent flood events in Pakistan, Brazil, Sri Lanka and Australia show, floods can occur in widespread locations and can sometimes overwhelm even the best prepared countries and cities. There are known and tested measures for urban flood risk management, typically classified as structural or engineered measures, and non-structural, management techniques. A combination of measures to form an integrated management approach is most likely to be successful in reducing flood risk. In the short term and for developing countries in particular, the factors affecting exposure and vulnerability are increasing at the fastest rate as urbanization puts more people and more assets at risk. In the longer term, however, climate scenarios are likely to be one of the most important drivers of future changes in flood risk. Due to the large uncertainties in projections of climate change, adaptation to the changing risk needs to be flexible to a wide range of future scenarios and to be able to cope with potentially large changes in sea level, rainfall intensity and snowmelt. Climate uncertainty and budgetary, institutional and practical constraints are likely to lead to a combining of structural and non-structural measures for urban flood risk management, and arguably, to a move away from what is sometimes an over-reliance on hard-engineered defenses and toward more adaptable and incremental non-structural solutions.Hazard Risk Management,Wetlands,Natural Disasters,Adaptation to Climate Change,Climate Change Impacts

Status and potential of bacterial genomics for public health practice : a scoping review

Background: Next-generation sequencing (NGS) is increasingly being translated into routine public health practice, affecting the surveillance and control of many pathogens. The purpose of this scoping review is to identify and characterize the recent literature concerning the application of bacterial pathogen genomics for public health practice and to assess the added value, challenges, and needs related to its implementation from an epidemiologist’s perspective. Methods: In this scoping review, a systematic PubMed search with forward and backward snowballing was performed to identify manuscripts in English published between January 2015 and September 2018. Included studies had to describe the application of NGS on bacterial isolates within a public health setting. The studied pathogen, year of publication, country, number of isolates, sampling fraction, setting, public health application, study aim, level of implementation, time orientation of the NGS analyses, and key findings were extracted from each study. Due to a large heterogeneity of settings, applications, pathogens, and study measurements, a descriptive narrative synthesis of the eligible studies was performed. Results: Out of the 275 included articles, 164 were outbreak investigations, 70 focused on strategy-oriented surveillance, and 41 on control-oriented surveillance. Main applications included the use of whole-genome sequencing (WGS) data for (1) source tracing, (2) early outbreak detection, (3) unraveling transmission dynamics, (4) monitoring drug resistance, (5) detecting cross-border transmission events, (6) identifying the emergence of strains with enhanced virulence or zoonotic potential, and (7) assessing the impact of prevention and control programs. The superior resolution over conventional typing methods to infer transmission routes was reported as an added value, as well as the ability to simultaneously characterize the resistome and virulome of the studied pathogen. However, the full potential of pathogen genomics can only be reached through its integration with high-quality contextual data. Conclusions: For several pathogens, it is time for a shift from proof-of-concept studies to routine use of WGS during outbreak investigations and surveillance activities. However, some implementation challenges from the epidemiologist’s perspective remain, such as data integration, quality of contextual data, sampling strategies, and meaningful interpretations. Interdisciplinary, inter-sectoral, and international collaborations are key for an appropriate genomics-informed surveillance