Transdisciplinary innovation in irrigated smallholder agriculture in Africa

SIInternational audienceBoosting the productivity of smallholder farming systems continues to be a major need in Africa. Challenges relating to how to improve irrigation are multi‐factor and multisectoral, and they involve a broad range of actors who must interact to reach decisions collectively. We provide a systematic reflection on findings from the research project EAU4Food, which adopted a transdisciplinary approach to irrigation for food security research in five case studies in Ethiopia, Mali, Mozambique, South Africa and Tunisia. The EAU4Food experiences emphasize that actual innovation at irrigated smallholder farm level remains limited without sufficient improvement of the enabling environment and taking note of the wider political economy environment. Most project partners felt at the end of the project that the transdisciplinary approach has indeed enriched the research process by providing different and multiple insights from actors outside the academic field. Local capacity to facilitate transdisciplinary research and engagement with practitioners was developed and could support the continuation and scaling up of the approach. Future projects may benefit from a longer time frame to allow for deeper exchange of lessons learned among different stakeholders and a dedicated effort to analyse possible improvements of the enabling environment from the beginning of the research process. © 2020 The Authors. Irrigation and Drainage published by John Wiley & Sons Ltd on behalf of International Commission for Irrigation and Drainag

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population