Climate is an important factor for agricultural production. However, in recent years consistent warming and rise in global temperature has resulted in visible impacts on the agriculture across the world. Nepal is not an exceptional case, where rising temperature has already affected the country's agricultural production thereby affecting the food security and agrarian communities. It is expected that the level of vulnerability will be higher in high altitude as compared to the lower altitude. In addition, majority of the population are subsistence farmer in rural parts of Nepal and has low land holding capacity. Nepal is one of the least developed countries in the world with low per capita income, and thus the country's ability to adapt to the extreme climatic events has direct implications in its strategies on agriculture sector development. However, Nepal still lack strong scientific data about the cases of climate change and due to varied geographical setting, sufficient meteorological data cannot be easily obtained from remote parts of the country. This review tries to explore the current status of vulnerability to the climate change in Nepal. In Nepal, more than 80% of the people heavily rely on agriculture for their subsistence and thus, climate change will bring expectedly negative response to the agricultural sector in the country.

BackgroundAvahan, the India AIDS Initiative, implemented a large HIV prevention programme across six high HIV prevalence states amongst high risk groups consisting of female sex workers, high risk men who have sex with men, transgenders and injecting drug users in India. Utilization of the clinical services, health seeking behaviour and trends in syndromic diagnosis of sexually transmitted infections amongst these populations were measured using the individual tracking data.MethodsThe Avahan clinical monitoring system included individual tracking data pertaining to clinical services amongst high risk groups. All clinic visits were recorded in the routine clinical monitoring system using unique identification numbers at the NGO-level. Visits by individual clinic attendees were tracked from January 2005 to December 2009. An analysis examining the limited variables over time, stratified by risk group, was performed.ResultsA total of 431,434 individuals including 331,533 female sex workers, 10,280 injecting drug users, 82,293 men who have sex with men, and 7,328 transgenders visited the clinics with a total of 2,700,192 visits. Individuals made an average of 6.2 visits to the clinics during the study period. The number of visits per person increased annually from 1.2 in 2005 to 8.3 in 2009. The proportion of attendees visiting clinics more than four times a year increased from 4% in 2005 to 26% in 2009 (p<0.001). The proportion of STI syndromes diagnosed amongst female sex workers decreased from 39% in 2005 to 11% in 2009 (p<0.001) while the proportion of STI syndromes diagnosed amongst high risk men who have sex with men decreased from 12% to 3 % (p<0.001). The proportion of attendees seeking regular STI check-ups increased from 12% to 48% (p<0.001). The proportion of high risk groups accessing clinics within two days of onset of STI-related symptoms and acceptability of speculum and proctoscope examination increased significantly during the programme implementation period.ConclusionsThe programme demonstrated that acceptable and accessible services with marginalised and often difficult–to-reach populations can be brought to a very large scale using standardized approaches. Utilization of these services can dramatically improve health seeking behaviour and reduce STI prevalence.

No abstract

Nepal's community forestry program was specifically adopted to address local livelihoods and abate environmental degradation with due consideration of local-specific conservation and development requirements. Although the program has improved forest condition and livelihoods in many cases, it has several limitations and shortcomings particularly in the context of inclusive forest governance. This paper examines the roles and responsibilities of poor, disadvantaged women, Dalits and socially excluded groups in the community forestry process and the way how they are excluded at the time of benefit-sharing and in decision-making. The study is based on three years (2008-2011) long action and learning research in 58 community forest users groups from three eco-zone of Nepal. The study revealed that more attention needs to be paid in making forest user groups more equitable, inclusive and pro-poor in practice. The poor, Dalits, and socially excluded groups are often deprived from their basic rights on accessing of common pool resources, and are often excluded in decision-making system. The notable challenges related to the community forestry in the studied districts include elite domination, inability to provide significant contribution to livelihoods, persistence of social disparity, and low information flow to the poor and marginalized groups.

No abstract

IntroductionPapua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea.MethodsSurveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list.ResultsThe prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed.ConclusionsThe level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naïve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended first-line antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.

The data showed improved rates of screening of clinic attendees and declining trends in sero-reactivity over time. The introduction of point-of-care syphilis tests may have contributed to the improved coverage of syphilis screening. The ICST may be considered for initial syphilis screening at other resource-constrained primary care sites in India such as ante-natal clinics and other KP interventions.

No abstract