Developing a science-based policy network over the Upper Indus Basin

The Upper Indus Basin's (UIB) unique geographical positioning and its ecosystem contributions to the downstream basin in the form of water and energy are of critical importance. UIB is also among the most vulnerable water towers in the world vis-a-vis climate as well as a host of environmental and socio-economic changes. The paucity of ground observations and their associated unknowns make it imperative to study and highlight the grey areas for attention and action by policy planners and basin government and management at different levels in order to improve the management and the governance structures for better water resource management. As this river basin is shared between countries, enhanced co-creation of knowledge can provide greater understanding of the challenges to stakeholders so that they can make better decisions regarding the development of the region. With this in view, the UIB network, comprising four national chapters (Afghanistan, China, India and Pakistan) linked strategically at regional level, was conceived to provide better understanding of the critical issues associated with the UIB. The network strives for a resilient and empowered UIB region through science-based regional cooperation, which promotes coordination and collaboration among organizations working in the UIB to ensure improved understanding of present and future water availability, demand and hazards and to develop gender sensitive solutions for all stakeholders. The special issue is one of such efforts from the network in knowledge generation, exchange, and dissemination to contribute towards an enhanced understanding of climate change impacts in the Indus. The paper presents a time-wise evolution of the network to highlight the importance of cross boundary knowledge and the relevance of such networks. Such a science-based network can provide important information for science-backed policies for the basin countries. It also details the achievements of the network, lessons learnt from such knowledge networks, and the potential for future contributions to basin countries taking into consideration the transboundary nature of the UIB

Immunomodulatory drugs have divergent effects on humoral and cellular immune responses to SARS-CoV-2 vaccination in people living with rheumatoid arthritis

Abstract Understanding the efficacy of SARS-CoV-2 vaccination in people on immunosuppressive drugs, including those with rheumatoid arthritis (RA), is critical for their protection. Vaccine induced protection requires antibodies, CD4+ T cells, and CD8+ T cells, but it is unclear if these are equally affected by immunomodulatory drugs. Here, we determined how humoral and cellular SARS-CoV-2 vaccination responses differed between people with RA and controls, and which drug classes impacted these responses. Blood was collected from participants with RA on immunomodulatory drugs and controls after their second, third, and fourth SARS-CoV-2 vaccinations. Receptor binding domain (RBD)-specific antibodies were quantified by ELISA. Spike-specific memory T cells were quantitated using flow cytometry. Linear mixed models assessed the impact of age, sex, and immunomodulatory drug classes on SARS-CoV-2 vaccination responses. Compared to non-RA controls (n = 35), participants with RA on immunomodulatory drugs (n = 62) had lower anti-RBD IgG and spike-specific CD4+ T cell levels, but no deficits in spike-specific CD8+ T cells, following SARS-CoV-2 vaccination. Use of costimulation inhibitors was associated with lower humoral responses. JAK inhibitors were associated with fewer spike-specific CD4+ T cells. Participants with RA on immunomodulatory drugs mounted weaker responses to SARS-CoV-2 vaccination, with different drug classes impacting the cellular and humoral compartments