Progress on the health-related Sustainable Development Goals and targets in the Eastern Mediterranean Region, 2023: 2nd progress report

The 2030 Agenda for Sustainable Development includes a vision of healthy lives and well-being for all at all ages. This major report provides an update on progress towards the health-related Sustainable Development Goals (SDGs) in the WHO Eastern Mediterranean Region. It presents regional trends between 2010 and 2022 for 50 health-related SDG indicators using available data from WHO and estimates from other United Nations agencies. The report reveals some successes at the country level amid a marked slowdown regionally with setbacks across indicators on health health risks and determinants and access to services. We are at the halfway point for the 2030 Agenda for Sustainable Development: to reverse current trends and ensure the health and well-being of our population we must take bold steps now.

Approaching the SDG targets with sustained political commitment: drivers of the notable decline in maternal and neonatal mortality in Morocco.

BACKGROUND: Between 2000 and 2017/2018, Morocco reduced its maternal mortality ratio by 68% and its neonatal mortality rate by 52%-a higher improvement than other North African countries. We conducted the Exemplars in Maternal and Neonatal Health study to systematically and comprehensively research factors associated with this rapid reduction in mortality over the past two decades. METHODS: The study was conducted from September 2020 to December 2021 using mixed methods, including: literature, database and document reviews, quantitative analyses of national data sets and qualitative key-informant interviews at national and district levels. Analyses were based on a conceptual framework of drivers of health and survival of mothers and neonates. RESULTS: A favourable political and economic environment, and a high political commitment encouraged prioritisation of maternal and neonatal health (MNH) by aligning evidence-based policy and technical approaches. Five main factors accounted for Morocco's success: (1) continuous increases in antenatal care and institutional delivery and reductions socioeconomically-based inequalities in MNH service usage; (2) health-system strengthening by expanding the network of health facilities, with increased uptake of facility birthing, scale-up of the production of midwives, reductions in financial barriers and, later in the process, attention to improving the quality of care; (3) improved underlying health status of women and changes in reproductive patterns; (4) a supportive policy and infrastructure environment; and 5) increased education and autonomy of women. CONCLUSION: Our study provides evidence that supportive changes in Morocco's policy environment for maternal health, backed by greater political will and increased resources, significantly contributed to the dramatic progress in reducing maternal and neonatal mortality. While these efforts were successful in improving MNH in Morocco, several implementation challenges still require special attention and renewed political attention is needed.

Unleashing sustainability in uncertain times: Can we leverage economic complexity, uncertainty, and remittances to combat environmental degradation?

Rapid economic growth and human activities have seriously damaged the environment and hindered the achievement of Sustainable Development Goals (SDGs). Hence, this study aims to explore the impact of economic complexity, uncertainty, and remittance on environmental degradation in 134 countries from 2000 to 2022. In addition, it examines whether uncertainty moderates the relationship between remittance and environmental degradation. Two proxies (ecological footprint and CO2) were used to measure environmental degradation. The analysis was conducted using a cross-sectional dependency test, second-generation unit root test, and panel quantile regression. The results revealed that economic complexity significantly and positively impacted environmental degradation, while uncertainty and remittance significantly and negatively impacted environmental degradation. Furthermore, uncertainty weakened the negative relationship between remittance and environmental degradation. Accordingly, this paper discusses various recommendations and policy implications regarding economic complexity, uncertainty, remittance, and environmental degradation.

Deciphering genetic diversity in conserved cattle bulls to achieve sustainable development goals.

The primary objective of Sustainable Development Goal target 2.5 established by the United Nations is to ensure the preservation of genetic diversity in domesticated animals. The ICAR-National Bureau of Animal Genetic Resources in India has been actively engaged in the conservation of cattle and buffalo bull semen for long-term storage. This present study aimed to assess the genetic diversity present in the conserved cattle bull semen, which would aid in determining the most suitable strategy for future conservation management. A total of 192 bull semen belonging to 19 cattle breeds were selected to evaluate genetic diversity using 17 pairs of FAO recommended microsatellite primers. Total 267 alleles were detected across all the samples which indicates substantial amount of allelic variation is being maintained in conserved bulls. Further, all cattle bulls semen conserved showed higher observed heterozygosity than expected heterozygosity which indicates excess genetic diversity in all the populations. The FST, F IT and FIS value across the loci and population is 0.146 ± 0.009, 0.054 ± 0.038, and - 0.105 ± 0.035, respectively, which suggests lack of inbreeding in conserved cattle bull semen. This study has established genetic diversity in conserved cattle semen samples to achieve sustainable development goals. In addition, it provides compelling evidence that the current approach for conserving cattle bull semen is heading in the correct direction.

Crop yields fail to rise in smallholder farming systems in sub-Saharan Africa.

Drawing on a harmonized longitudinal dataset covering more than 55,000 smallholder farms in six African countries, we analyze changes in crop productivity from 2008 to 2019. Because smallholder farmers represent a significant fraction of the world's poorest people, agricultural productivity in this context matters for poverty reduction and for the broader achievement of the UN Sustainable Development Goals. Our analysis measures productivity trends for nationally representative samples of smallholder crop farmers, using detailed data on agricultural inputs and outputs which we integrate with detailed data on local weather and environmental conditions. In spite of government commitments and international efforts to strengthen African agriculture, we find no evidence that smallholder crop productivity improved over this 12-y period. Our preferred statistical specification of total factor productivity (TFP) suggests an overall decline in productivity of -3.5% per year. Various other models we test also find declining productivity in the overall sample, and none of them finds productivity growth. However, the different countries in our sample experienced varying trends, with some instances of growth in some regions. The results suggest that major challenges remain for agricultural development in sub-Saharan Africa. They complement previous analyses that relied primarily on aggregate national statistics to measure agricultural productivity, rather than detailed microdata.

Coordination between scientific and technological innovation and the high-quality development of Baijiu industry: The coupling and decoupling perspective.

The Baijiu industry is a significant contributor to both the food industry and the light industry. Its high tax characteristics effectively promote the sustainable development of the regional economy. First, the evaluation index system of scientific and technological innovation (STI) and high-quality development of Baijiu industry (HQDBI) were constructed. The entropy-improved CRITIC method was used to measure the weights. Second, the coordination relationship and evolution trend of STI and HQDBI were explored using the coupling coordination model and the Tapio decoupling model. Then, the transfer law and key influencing factors were further investigated using the Markov chain and grey correlation, respectively. The main contribution is the dynamic evolution of the coupling and decoupling relationships from the perspective of multiple Baijiu provinces, and deeply depicts the coordination relationship and evolutionary trends of STI and HQDBI. The results show that: the spatial distribution of the coupling coordination degree shows high values in the east-west and low values in the north-south characteristics. In 2021, a pattern of coordinated development in Baijiu provinces has emerged along the Yangtze River basin. The decoupling state is mainly strong decoupling, but it remains poor in Shanxi. The coordination process is unstable and difficult to achieve leapfrog development. Coordination, sustainability and innovation environment have a greater impact on the coordination of subsystems.

Can new urbanization pilot policies promote green technology innovation in cities: Empirical evidence from China.

The development of urbanization has brought new challenges to the ecological environment, and the promotion of green technology innovation and development is widely recognized as an essential method to achieve cities' economic benefits and environmental protection. This paper examines whether the new urbanization pilot policies (NUP) increase green technology innovation (GTI) from both theoretical and empirical perspectives. This paper examines the impact of new urbanization on GTI by analyzing data from 285 cities in China between 2010 and 2021, using the multi-period DID model with the implementation of NUP as an exogenous policy shock. The study results indicate that NUP significantly affects GTI, and the conclusion still holds after the parallel trend test, placebo test, and other robustness tests. Heterogeneity analysis shows that the NUP significantly enhances GTI in low environmental pollution, non-resource-based, Medium-sized, and Central Region cities. The test of moderating effect shows that NUP has a "linkage effect" with the government's environmental attention, financial investment in innovation, and regional talent pooling. The findings of this paper provide empirical evidence and decision-making reference for promoting NUP and sustainable development of cities.

Navigating challenges and opportunities: AI's contribution to Pakistan's sustainable development goals agenda - a narrative review.

Sustainable Developmental Goals (SDGs) were introduced by the United Nations to ensure the sustainable progress of mankind through various domains. Pakistan, a low-middle-income country, faces many challenges in achieving SDGs. Artificial Intelligence is a rapidly evolving technology presenting significant importance in achieving SDGs. Therefore, this narrative review aimed to evaluate the artificial intelligence technologies that have been utilized globally and nationally which can be implemented in Pakistan focusing on Goal 3 (Good Health and Well-being) of SDGs. AI has been utilized primarily in high-income countries aiming to improve healthcare, thereby progressing towards achieving different targets of Goal 3 of SDGs. Pakistan lacks such initiatives with modest to no improvement across different SDGs. Therefore, Pakistan can adapt initiatives undertaken by resourceful countries to achieve its own SDGs.

Early childhood caries, climate change and the sustainable development goal 13: a scoping review.

BACKGROUND: Sustainable development goal 13 centres on calls for urgent action to combat climate change and its impacts. The aim of this scoping review was to map the published literature for existing evidence on the association between the Sustainable Development Goal (SDG) 13 and early childhood caries (ECC). METHODS: The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In August 2023, a search was conducted in PubMed, Web of Science, and Scopus using search terms related to SDG13 and ECC. Only English language publications were extracted. There was no restriction on the type of publications included in the study. A summary of studies that met the inclusion criteria was conducted highlighting the countries where the studies were conducted, the study designs employed, the journals (dental/non-dental) in which the studies were published, and the findings. In addition, the SDG13 indicators to which the study findings were linked was reported. RESULTS: The initial search yielded 113 potential publications. After removing 57 duplicated papers, 56 publications underwent title and abstract screening, and two studies went through full paper review. Four additional papers were identified from websites and searching the references of the included studies. Two of the six retrieved articles were from India, and one was China, Japan, the United States, and the United Kingdom respectively. One paper was based on an intervention simulation study, two reported findings from archeologic populations and three papers that were commentaries/opinions. In addition, four studies were linked to SDG 13.1 and they suggested an increased risk for caries with climate change. Two studies were linked to SDG 13.2 and they suggested that the practice of pediatric dentistry contributes negatively to environmental degradation. One study provided evidence on caries prevention management strategies in children that can reduce environmental degradation. CONCLUSION: The evidence on the links between SDG13 and ECC suggests that climate change may increase the risk for caries, and the management of ECC may increase environmental degradation. However, there are caries prevention strategies that can reduce the negative impact of ECC management on the environment. Context specific and inter-disciplinary research is needed to generate evidence for mitigating the negative bidirectional relationships between SDG13 and ECC.

Can energy saving and emission reduction policies promote green transformation of industrial enterprises--The Case of China.

In the context of the continued advancement of the green economy transition, the proactive pursuit of carbon emissions reduction and the early attainment of carbon neutrality goals have emerged as essential components in promoting high-quality economic development. Not only does it contribute to the creation of a community of human destiny, but it is also vital to the realization of sustainable development for human civilization. A dynamic evolutionary game model, which encompasses the interactions among government, enterprises, and the public, was constructed to examine the inherent impact mechanisms of the behavior of three players on the development of a green economy under the context of energy saving and emission reduction subsidies. The results showed that the incentive and punishment mechanisms served as effective tools for harmonizing the interests of system members. Within the mechanisms, the public demonstrated a higher sensitivity to rewards, while enterprises exhibited greater responsiveness to fines. Consequently, the government could influence the behavior of enterprises by incentivizing the public to serve as a third-party inquiry and oversight body. Simultaneously, the government could encourage enterprises to expedite green technology innovation by employing a combination of incentive and punishment mechanisms.

The role of ICT investment, digital financial inclusion, and environmental tax in promoting sustainable energy development in the MENA region: Evidences with Dynamic Common Correlated Effects (DCE) and instrumental variable-adjusted DCE.

His research investigates the interplay among investment in Information and Communication Technology [ICT], digital financial inclusion, environmental tax policies, and their impact on the progression of sustainable energy development within the Middle East and North Africa [MENA] region. Recognizing the distinctive hurdles impeding sustainable energy advancement, effective policy formulation and implementation in MENA necessitate a comprehensive understanding of these variables. Employing a Dynamic Common Correlated Effects [DCE] model alongside an instrumental variable-adjusted DCE approach, this study explores the relationship between ICT investment, digital financial inclusion, environmental tax, and sustainable energy development. The DCE model facilitates the analysis of dynamic effects and potential correlations, while the instrumental variable-adjusted DCE model addresses issues pertaining to endogeneity. The results indicate that both ICT investment and the promotion of digital financial inclusion significantly and positively impact sustainable energy development in the MENA region. Additionally, the study underscores the importance of environmental tax implementation in fostering sustainable energy advancement, highlighting the critical role of environmental policy interventions. Based on these findings, governmental prioritization of ICT investment and initiatives for digital financial service integration is recommended to bolster sustainable energy growth in MENA. Furthermore, the adoption of efficient environmental tax measures is essential to incentivize sustainable energy practices and mitigate environmental degradation. These policy recommendations aim to create a conducive environment for sustainable energy progression in the MENA region, contributing to both economic prosperity and environmental conservation.

Corporate governance for sustainable development in Vietnam: Criteria for SOEs based on MCDM approach.

This research explores the nexus between corporate governance and sustainable development, focusing on State-Owned Enterprises (SOEs) in Vietnam. Recognizing the pivotal role of SOEs in the national economy, this study employs a Multi-Criteria Decision-Making approach (MCDM) to assess and enhance the corporate governance frameworks of these entities. First, the Data Envelopment Analysis (DEA) model is employed to identify the most qualified prospective SOEs firms based on several quantitative criteria. Then, the spherical fuzzy analytic hierarchy process (SF-AHP) model is used to identify priority weights for a given set of qualitative criteria, the Evaluation based on distance from average solution (EDAS) model is implemented to rank enterprises in the SOEs sector. To validate the proposed models, a case study conducted within the Vietnamese electric power industry is utilized. The MCDM methodology integrates diverse factors such as business management, corporate social responsibility, and corporate governance shareholder to construct a comprehensive evaluation framework. By applying this approach, the study aims to identify the key drivers and barriers influencing corporate governance practices within Vietnamese SOEs. The study's findings illustrate the efficacy of the suggested approach in evaluating corporate governance performance, providing valuable insights for policymakers, corporate leaders, and stakeholders involved in shaping the governance landscape of SOEs in Vietnam. By aligning corporate governance with sustainable development principles, the research aims to contribute to the ongoing discourse on responsible business practices, offering practical recommendations to enhance the performance and resilience of SOEs in the pursuit of long-term socio-economic and environmental sustainability.

Can low-carbon cities pilot policy promote enterprise sustainable development? Quasi-experimental evidence from China.

With the predicament of sustainable improvement in traditional cities, the low-carbon city pilot policy (LCCPP), as a novel development mode, provides thinking for resolving the tensions of green development, resource conservation and environmental protection among firms. Using Chinese A-share listed companies panel data during 2007-2019, this study adopts the difference-in-differences model to explore the impact of LCCPP on firm green innovation. Based on theoretical analysis, LCCPP-driven environmental rules have the impact of encouraging business green innovation. The relationship between LCCPP and green innovation is strengthened by external media attention and organizational redundancy resources. The mechanism study shows that the incentive effect of LCCPP on firm green innovation is mainly due to the improvement of enterprises' green total factor productivity and financial stability. In addition, the heterogeneity analysis shows that the LCCPP has significantly positive effects in promoting green innovation in high-carbon industries and state-owned enterprises. This research contributes to the understanding of city-level low-carbon policies as a driving force for corporate green innovation, offering practical implications for policymakers and businesses striving for sustainability.

Past, present, and future of sustainable intensive care: narrative review and a large hospital system experience.

Healthcare systems are large contributors to global emissions, and intensive care units (ICUs) are a complex and resource-intensive component of these systems. Recent global movements in sustainability initiatives, led mostly by Europe and Oceania, have tried to mitigate ICUs' notable environmental impact with varying success. However, there exists a significant gap in the U.S. knowledge and published literature related to sustainability in the ICU. After a narrative review of the literature and related industry standards, we share our experience with a Green ICU initiative at a large hospital system in Texas. Our process has led to a 3-step pathway to inform similar initiatives for sustainable (green) critical care. This pathway involves (1) establishing a baseline by quantifying the status quo carbon footprint of the affected ICU as well as the cumulative footprint of all the ICUs in the healthcare system; (2) forming alliances and partnerships to target each major source of these pollutants and implement specific intervention programs that reduce the ICU-related greenhouse gas emissions and solid waste; and (3) finally to implement a systemwide Green ICU which requires the creation of multiple parallel pathways that marshal the resources at the grass-roots level to engage the ICU staff and institutionalize a mindset that recognizes and respects the impact of ICU functions on our environment. It is expected that such a systems-based multi-stakeholder approach would pave the way for improved sustainability in critical care.

Can carbon reduction policies promote sustainable construction development? Evidence from China's green building market.

Carbon emissions have become a global challenge, and China, as the world's largest developing country, has a serious emissions problem. Developing green buildings is an important way of reducing carbon emissions. China's low-carbon city pilot policy may be an effective way of promoting green building development and reducing these emissions. This study uses the low carbon city pilot policy as a quasi-natural experiment and employs the staggered difference-in-differences method to investigate its impact on green building development. The results show that the low-carbon city pilot policy promotes green building development, and this policy promotes it by enhancing regional green innovation capacity, improving green total factor productivity at the firm and regional levels, and reducing the financing constraints of firms in the construction and real estate sectors. In addition, the promotion effect of the policy on green building development is stronger in western and non-resource-based regions and large-scale cities in China. This study contributes to the literature related to environmental policy, green building, and carbon emissions and supports the promotion of green building development and the reduction of carbon emissions.

The Future of Plant-Based Diets: Aligning Healthy Marketplace Choices with Equitable, Resilient, and Sustainable Food Systems.

The future of plant-based diets is a complex public health issue inextricably linked to planetary health. Shifting the world's population to consume nutrient-rich, plant-based diets is among the most impactful strategies to transition to sustainable food systems to feed 10 billion people by 2050. This review summarizes how international expert bodies define sustainable diets and food systems and describes types of sustainable dietary patterns. It also explores how the type and proportion of plant- versus animal-source foods and alternative proteins relate to sustainable diets to reduce diet-related morbidity and mortality. Thereafter, we synthesize evidence for current challenges and actions needed to achieve plant-based sustainable dietary patterns using a conceptual framework with principles to promote human health, ecological health, social equity, and economic prosperity. We recommend strategies for governments, businesses, and civil society to encourage marketplace choices that lead to plant-rich sustainable diets within healthy, equitable, and resilient agroecological food systems.

A Platform for Sustainable Scale: The Challenge Initiative's Innovative Approach to Scaling Proven Interventions.

INTRODUCTION: The global health community continues to face barriers in scaling up evidence-based interventions for widespread adoption. Although many effective interventions have been developed over the years, expanding their reach to benefit broader populations has happened slowly or not at all. OVERVIEW: The Challenge Initiative (TCI) is a nontraditional development platform that supports local urban governments to rapidly scale up proven family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) interventions for the urban poor. TCI prioritizes sustainability and local ownership and uses a health systems approach when planning for and managing scale. TCI strengthens urban health systems with seed funding, coaching, and technical assistance (TA), and TCI University houses "how-to" guidance and tools for implementing the interventions. In turn, local governments commit political will and financial and human resources while using TCI coaching to integrate interventions into routine practice and systems to achieve widespread and sustained impact at scale. RESULTS: As of June 2021, TCI has supported 104 local governments across 11 countries in scaling up effective FP and AYSRH interventions, while also mobilizing about US$28 million from those local governments to facilitate their implementation. TCI has increased capacity and bolstered urban health systems, with 39 local governments "graduating" from TCI support and 2.02 million additional FP clients across 4 regional TA hubs. CONCLUSION: TCI aims to change how local governments coordinate, finance, and implement proven interventions to improve access to quality FP information and services. With built-in incentives for local governments, partners, and donors to participate, TCI is generating significant learning on how local governments can realize sustainable scale and demonstrating how organizations like TCI that facilitate governments to scale up effective interventions can accelerate the scale-up of these interventions across multiple geographies.

Examining the unsustainable relationship between SDG performance, ecological footprint and international spillovers.

For almost a decade, countries have been working to achieve the Sustainable Development Goals (SDGs). Yet progress on the SDGs across countries, as well as across the 17 goals, has proven frustratingly slow. Even countries that have performed relatively well on the SDGs may have done so by causing negative externalities, such as environmental degradation, in other parts of the world. To determine if this is the case empirically, we developed and tested hypotheses concerning how a country's SDG performance is associated with such externalities. We then ran a regression to examine correlations between indices measuring SDG progress, ecological footprints and international spillovers. We found that SDG progress is positively correlated with increased ecological footprints and spillovers. The results indicate that SDG progress remains closely associated with conventional measures of economic growth, and that negative environmental and social impacts of internationally-sourced consumption represent behavioural and structural barriers to meaningful progress on sustainability.