Challenges and considerations of applying nature-based solutions in low- and middle-income countries in Southeast and East Asia

Low- and middle-income countries in Southeast and East Asia face a range of challenges related to the rapid pace of urbanisation in the region, the scale of pollution, climate change, loss of ecosystem services and associated difficulties for ecological restoration. Possible pathways towards a more sustainable future lie in the applications of nature-based solutions (NBS). However, there is relatively little literature on the application of NBS in the region, particularly Southeast Asia. In this paper we address this gap by assessing the socio-ecological challenges to the application of NBS in the region – one of the most globally biodiverse. We first provide an overview and background on NBS and its underpinnings in biodiversity and ecosystem services. We then present a typology describing five unique challenges for the application of NBS in the region: (1) Characteristics of urbanisation; (2) Biophysical environmental and climatic context; (3) Environmental risks and challenges for restoration; (4) Human nature relationships and conflicts; and (5) Policy and governance context. Exploiting the opportunities through South-South and North-South collaboration to address the challenges of NBS in Southeast and East Asia needs to be a priority for government, planners and academics.Peer reviewe

A multi-stakeholder strategy to identify conservation priorities in Peninsular Malaysia

Malaysia, with its rapidly growing economy, exemplifies the tensions between conservation and development faced by many tropical nations. Here we present the results of a multi-stakeholder engagement exercise conducted to (1) define conservation priorities in Peninsular Malaysia and (2) explore differences in perceptions among and within stakeholder groups (i.e. government, academia, NGOs and the private sector). Our data collection involved two workshops and two online surveys where participants identified seven general conservation themes and ranked the top five priority issues within each theme. The themes were: (1) policy and management, (2) legislation and enforcement, (3) finance and resource allocation, (4) knowledge, research and development, (5) socio-economic issues, (6) public awareness and participation and (7) rights of nature. In spite of their very different backgrounds and agendas, the four stakeholder groups showed general agreement in their priority preferences except for two issues. Respondents from government and private sector differed the most from each other in their priority choices while academia and NGO showed the highest degree of similarity. This ranked list of 35 conservation priorities is expected to influence the work of policy-makers and others in Peninsular Malaysia and can be used as a model to identify conservation priorities elsewhere

Road risks and environmental impact assessments in Malaysian road infrastructure projects

Roads can promote economic growth and social integration but they can also initiate environmental, economic and socio-political harms. In many cases, these harms can be considerably minimised and the road benefits maximised through proactive planning by road engineers and effective Environmental Impact Assessments (EIAs)

COVID-19 Highlights the Need for More Effective Wildlife Trade Legislation

Over the past three decades, most new human pathogens with substantial impacts on human health or economies have originated in wildlife [1,2]. Coronavirus disease 2019 (COVID-19) is among the latest of these zoonotic diseases and is now a pandemic that has resulted in more than a million fatalities globally as of 1 October 2020 (https://www.who.int/emergencies/diseases/novel-coronavirus-2019). Direct contact between people and animal species due to the wildlife trade and increased human–livestock–wildlife interactions through rapid fragmentation of wildlife habitat are two major factors that contribute to the spread of zoonotic diseases [3,4]. Although localized quarantines and lockdowns around the world appear to be having some minor positive effects on the environment, these short-term successes should not be glorified in view of the profound negative environmental, social, and economic impacts of the COVID-19 pandemic (https://www.iea.org/reports/global-energy-review-2020). We call for urgent action to regulate the trade of wildlife, expand protection for native ecosystems, and reduce consumer demand for wildlife parts and products to lower the risk and severity of future zoonotic diseasesPeer reviewe

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo