The Cow in the Room Livestock and Climate Engagement at the 2022 United Nations Climate Change Conference (COP27)

The UN Framework Convention on Climate Change Conference (UNFCCC COP27) was held November 6-18, 2022, in Sharm el Sheikh, Egypt, and ILRI was there actively telling the livestock sustainability story. Too often, climate discussions focus on the negative aspects of intensive livestock production. The livestock sector is often cited as the most intensive emitter of greenhouse gases within agricultural production systems, contributing to about 18% of anthropogenic greenhouse gas emissions, mainly from methane and nitrous oxide. However, science shows that sustainable livestock can bring adaptation, mitigation and economic growth benefits to both people and the planet. In addition, sustainable livestock production, especially in developing countries, can contribute to building climate resilience while boosting low-emission development and supporting food security and livelihoods. With food, for the first time, taking centre stage at COP27, the CGIAR Research Initiative on Livestock Climate and Systems Resilience, ILRI and the GLAD Project, along with partners, sought to ensure sustainable livestock is recognised as essential to climate change mitigation. As part of this process, we designed an integrated engagement, communications and media outreach plan. This included the innovative campaign dubbed ‘cow in the room’ #LetsTalkLivestock to drive our participation and narrative to COP27 and beyond

Building the capacity of sub-national stakeholders in climate smart agriculture and climate information services

This manual was created to support capacity building among sub-national stakeholders and contribute to the development and implementation of best-bet climate-smart agriculture and climate information services packages geared toward gender and social inclusion

Randomized controlled phase IIa clinical trial of safety, pharmacokinetics and pharmacodynamics of tenofovir and tenofovir plus levonorgestrel releasing intravaginal rings used by women in Kenya

IntroductionGlobally, many young women face the overlapping burden of HIV infection and unintended pregnancy. Protection against both may benefit from safe and effective multipurpose prevention technologies.MethodsHealthy women ages 18–34 years, not pregnant, seronegative for HIV and hepatitis B surface antigen, not using hormonal contraception, and at low risk for HIV were randomized 2:2:1 to continuous use of a tenofovir/levonorgestrel (TFV/LNG), TFV, or placebo intravaginal ring (IVR). In addition to assessing genital and systemic safety, we determined TFV concentrations in plasma and cervicovaginal fluid (CVF) and LNG levels in serum using tandem liquid chromatography-mass spectrometry. We further evaluated TFV pharmacodynamics (PD) through ex vivo CVF activity against both human immunodeficiency virus (HIV)-1 and herpes simplex virus (HSV)-2, and LNG PD using cervical mucus quality markers and serum progesterone for ovulation inhibition.ResultsAmong 312 women screened, 27 were randomized to use one of the following IVRs: TFV/LNG (n = 11); TFV-only (n = 11); or placebo (n = 5). Most screening failures were due to vaginal infections. The median days of IVR use was 68 [interquartile range (IQR), 36–90]. Adverse events (AEs) were distributed similarly among the three arms. There were two non-product related AEs graded >2. No visible genital lesions were observed. Steady state geometric mean amount (ssGMA) of vaginal TFV was comparable in the TFV/LNG and TFV IVR groups, 43,988 ng/swab (95% CI, 31,232, 61,954) and 30337 ng/swab (95% CI, 18,152, 50,702), respectively. Plasma TFV steady state geometric mean concentration (ssGMC) was <10 ng/ml for both TFV IVRs. In vitro, CVF anti-HIV-1 activity showed increased HIV inhibition over baseline following TFV-eluting IVR use, from a median of 7.1% to 84.4% in TFV/LNG, 15.0% to 89.5% in TFV-only, and −27.1% to −20.1% in placebo participants. Similarly, anti-HSV-2 activity in CVF increased >50 fold after use of TFV-containing IVRs. LNG serum ssGMC was 241 pg/ml (95% CI 185, 314) with rapid rise after TFV/LNG IVR insertion and decline 24-hours post-removal (586 pg/ml [95% CI 473, 726] and 87 pg/ml [95% CI 64, 119], respectively).ConclusionTFV/LNG and TFV-only IVRs were safe and well tolerated among Kenyan women. Pharmacokinetics and markers of protection against HIV-1, HSV-2, and unintended pregnancy suggest the potential for clinical efficacy of the multipurpose TFV/LNG IVR.Clinical Trial RegistrationNCT03762382 [https://clinicaltrials.gov/ct2/show/NCT03762382

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Youth engagement in agriculture and food systems transformation in Kenya

Food systems incorporate many actors at different intersecting levels and spaces. Young people1 constitute one of the most significant groups of these actors and contribute significantly to food systems in a variety of ways, from agricultural production and processing to food-related retail services, through formal and informal employment, paid and unpaid labor, and self employment. In addition to engaging through work and livelihoods, young people are involved in research, conservation, and knowledge acquisition and transmission. They also participate in consumer pressure groups and social movements raising awareness on the need for food system transformation and demanding climate change action. Through all these contributions, young people support achievement of the Sustainable Development Goal targets such as those on food security, economic growth, poverty reduction, and environ mental sustainability (HLPE 2021; FAO and AUC 2022)PRIFPRI4; 3 Building Inclusive and Efficient Markets, Trade Systems, and Food IndustryDevelopment Strategies and Governance (DSG); Transformation Strategie

Climate Smart Agriculture Investment Plan for Kenya

Kenya’s Climate Smart Agriculture Investment Plan (CSAIP) provides a strategic and comprehensive case for investing in agricultural development, given climate change and variability. Through a highly stakeholder-engaged development process, the plan identifies, assesses, and prioritizes a list of best-bet CSA investments in Kenya. The CSAIP results in a nationally supported and scientifically screened investment portfolio targeted towards tapping into financial opportunities from the private sector actors, public institutions, international donors, and other key stakeholders who aim to transform the agriculture sector. This CSAIP uses an established framework and process and builds on Kenya’s programs, policies, and strategic plans, such as Kenya’s NDC, and the work of numerous local, national, regional, and international institutions

A global capacity building vision for societal applications of earth observing systems and data: Key questions and recommendations

A three-day workshop held on 23-25 June 2015 at Tacoma was convened to debate issues and formulate a vision and path forward to strengthen the voice of the global societal applications and capacity building community. There were 27 in-person attendees at the workshop, including experts from the applied sciences community already engaged in EO-based capacity building across various themes for the stakeholder community and from the satellite EO data community. International participants provided perspectives on capacity building relevant to their region. For South Asia, the key issue noted in building durable applications was recognizing indigenous knowledge and explicitly using it in the design of decision-making systems that uptake Earth observations. In Southeast Asia, participants noted that solutions built for disaster risk reduction using EO will have to be compatible with country-specific skills and human resource settings that represent wide variability in the region