Climate-smart fisheries: CO2 emissions reduction and food security are complementary

In the global north, climate-smart fisheries (CSF) policies prioritise steps to combat CO2 emissions from SSF, in a response to the fact that globally, CO2 emissions from small-scale fisheries (SSFs) increased by over 5.8 times between 1950 and 2016. However, in the global south, CSF policies on SSF prioritise food and income security over CO2 emission reduction. In this paper, we examine this apparently contrasting interpretation of CSF as a conceptual framework to interpret the case study of Sierra Leone, one of Africa's poorest countries where we found that small-scale coastal fishers are preoccupied with mitigating the impact of climate change on their food and income security rather than with lowering their CO2 emissions. The self-image of SSF in Sierra Leone is that of being victims of climate change rather than perpetrators of it, and they justify this stance by claiming their livelihoods are being threatened by climate change. However, it could be argued that the best way to keep Sierra Leonean SSF CO2 emissions low is to prioritise their food and income security: in other words, that food security and CO2 reductions are complementary not contradictory. This, at any rate, is the argument of the current paper. The fieldwork for this study entailed co-created research in Sierra Leone and it involved 103 stakeholders who met face-to-face and online between January and March 2022 and through village meetings. The results of this fieldwork showed that food and income security and not CO2 emissions are the priorities in the stakeholders’ interpretation of CSF. However, if food and income security are not prioritised, communities are likely to adopt maladaptive strategies which undermine marine protected areas (MPAs) and exacerbate overfishing, thereby increasing CO2 emissions. Moreover, investment in aquaculture as a supplementary or alternative livelihood can directly increase food security and incomes and at the same time indirectly serve as a CO2 mitigation measure. In addition, weather information communication is an important CSF measure which both protects fishers from the impact of climate change and reduces their CO2 emissions. Accordingly, we argue that the contrast between reducing CO2 emissions and protecting food security from climate change may be more apparent than real in Sierra Leone coastal fisheries, since both policies may work in tandem together. This study therefore contributes a new interpretation of CSF in the global south: instead of seeing it as posing a conflict between CO2 emissions reductions and food security, we have shown the two objectives can be complementary. The wider implication of this paper is that CSF strategies for SSFs do not have to be polarised between the global north's focus on the reduction of CO2 emissions from fishing vessels and the global south's focus on the mitigation of the impact of global warming on SSFs. There are circumstances when the two objectives may be in harmony

Non-AIDS defining cancers in the D:A:D Study-time trends and predictors of survival : a cohort study

BACKGROUND:Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these.METHODS:Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression.RESULTS:Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort.CONCLUSIONS:The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century