Results from On-The-Ground Efforts to Promote Sustainable Cattle Ranching in the Brazilian Amazon

Agriculture in Brazil is booming. Brazil has the world’s second largest cattle herd and is the second largest producer of soybeans, with the production of beef, soybeans, and bioethanol forecast to increase further. Questions remain, however, about how Brazil can reconcile increases in agricultural production with protection of its remaining natural vegetation. While high hopes have been placed on the potential for intensification of low-productivity cattle ranching to spare land for other agricultural uses, cattle productivity in the Amazon biome (29% of the Brazilian cattle herd) remains stubbornly low, and it is not clear how to realize theoretical productivity gains in practice. We provide results from six initiatives in the Brazilian Amazon, which are successfully improving cattle productivity in beef and dairy production on more than 500,000 hectares of pastureland, while supporting compliance with the Brazilian Forest Code. Spread across diverse geographies, and using a wide range of technologies, participating farms have improved productivity by 30–490%. High-productivity cattle ranching requires some initial investment (R$1300–6900/ha or US$410–2180/ha), with average pay-back times of 2.5–8.5 years. We conclude by reflecting on the challenges that must be overcome to scale up these young initiatives, avoid rebound increases in deforestation, and mainstream sustainable cattle ranching in the Amazon

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries