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An effective and just Financial Mechanism will be crucial to the success of the Global Plastic Treaty. The content in the latest Chair’s Text from INC-5.1 on finance (primarily in Article 11) could be strengthened to avoid replicating shortcomings in existing financing models, which have often been insufficient and have not always provided the necessary resources for global sustainable development. Experiences with climate finance mechanisms reveal a pattern of misdesign that needs to be addressed. The current Article 11 reflects the deep divisions evident in the two main proposals tabled at INC-5.1 in November 2024. In the light of past precedents and tensions, we argue that several core design principles related to scope, scale and social and health considerations could ensure that the Global Plastics Treaty’s Financial Mechanism supports just, ambitious and transformative global action on plastic pollution. Furthermore, we argue that several elements in the current treaty text may undermine the design and implementation of an effective and just Financial Mechanism for the future Global Plastics Treaty. These risks include overemphasizing waste management; missing connections between finance and other measures in the treaty; risks of not addressing the most effective responses; not adequately addressing plastic leakage, releases and emissions; sustaining financial investments in techno-economic lock-ins lacking sufficient safety and sustainability criteria, standards and monitoring requirements and the prospect of plastic credits, which risks repeating past false solutions. There is an opportunity for the treaty to overcome these challenges with a financial mechanism that addresses overproduction and incentivizes safer, more sustainable, accessible and cost-effective upstream solutions.
IDgenetix is an advanced multi-gene pharmacogenomic (PGx) test that incorporates drug-gene interactions, drug-drug interactions, and lifestyle factors to guide medication management for patients diagnosed with major depressive disorder (MDD), anxiety, or other mental illnesses. In a previously published randomized controlled trial (RCT), IDgenetix significantly improved patient response and remission rates (Bradley et al., 2018). In this analysis, we aimed to compare the clinical outcome results from the RCT with real-world evidence from an open-label study (Cao et al., 2023).
Methods
Subjects with moderate to severe MDD at baseline per their HAM-D17 or PHQ-9 scores were included in the analysis for the RCT (n=261) and real-world data (n=242). In both studies, 8-week response and remission rates were analyzed for patients using IDgenetix-guided medication management (Guided) compared to patients receiving standard of care (Unguided).
Results
Patient response and remission rates strongly aligned between both studies. Response rates for the IDgenetix-guided participants in the RCT were 49% compared to 58% in the real-world data. Remission rates in the Guided group were 31% in both the RCT and real-world study compared to 22% and 19%, respectively, for participants in the Unguided group.
Conclusions
Comparing the clinical outcome results from the RCT with real-world data demonstrated the consistent impact of IDgenetix on patient response and remission rates. This study provides robust evidence-based research that supports the clinical use of IDgenetix to guide medication management in patients with MDD.
In this chapter, the authors focus on connections between human health, environmental quality, climate change and sustainability. Taking planetary health and sustainable development perspectives, the authors track the rapidly changing ecology of childhood in the twenty-first century. They consider opportunities for early childhood educators to integrate health and environmental learning through positive educational responses that engage children in actions for change. The authors note that ‘whole-school approaches’ best support education for sustainability, health and fairness, as well as promoting healthy cognitive, physical and emotional development. They welcome stronger partnerships between health professionals and early childhood educators to create ‘green and healthy’ learning environments. In essence, the authors reiterate that living sustainably is not only good for the planet, but also vital for the health and wellbeing of children, families and communities.
As Australian cities face uncertain water futures, what insights can the history of Aboriginal and settler relationships with water yield? Residents have come to expect reliable, safe, and cheap water, but natural limits and the costs of maintaining and expanding water networks are at odds with forms and cultures of urban water use. Cities in a Sunburnt Country is the first comparative study of the provision, use, and social impact of water and water infrastructure in Australia's five largest cities. Drawing on environmental, urban, and economic history, this co-authored book challenges widely held assumptions, both in Australia and around the world, about water management, consumption, and sustainability. From the 'living water' of Aboriginal cultures to the rise of networked water infrastructure, the book invites us to take a long view of how water has shaped our cities, and how urban water systems and cultures might weather a warming world.
At the beginning of the new millennium, Australia's cities and their peri-urban and rural hinterlands were in the midst of a worsening drought. Having developed in the mid-1990s, the Millennium Drought finally broke in 2010, at least in south-eastern Australia. It was the most severe drought experienced in southern Australia since instrumental records began in the early twentieth century, thanks to a combination of natural variability and anthropogenic climate change. The urgency of water restrictions and supply augmentation that had characterised the drought years gave way to more pressing matters of the electoral cycle. As Australian cities continue to grow, it remains be seen as to whether plans to shape the urban form as a water catchment of its own materialise beyond model suburbs and local initiatives and what their implementation might mean for the water infrastructure and cultures of the past.
After World War II, Australians and new migrants rushed to build their dream home and garden. As housing estates proliferated in the suburbs, local authorities struggled to keep pace with increasing demand for water supply and sewerage connection. In all five cities, suburbs were constructed with no roads, kerbing and channelling, or sewerage. New subdivisions had reticulated water, but manual night cart collection continued in some suburbs and septic tanks were common until sewer lines were built. As the housing stock increased and septic systems were replaced with reticulated sewerage, water supplies were stretched beyond capacity. Authorities turned to the well-worn path of dam construction to increase supply, but when consumption exceeded capacity, especially in hot, dry seasons, unpopular water restrictions were implemented, with hoses and sprinklers banned. The sight of green suburban lawns turning brown undermined the myth of unlimited supply at the turn of a tap, but expectations were reinstated as soon as it rained.
Both Indigenous and non-Indigenous Australians have learnt to cope with climate variability in meeting water needs over a range of time-scales. The five cities are locations that Aboriginal people cared for and maintained relationships with water over tens of thousands of years, knowledge of which is maintained today. In the face of a changing climate and continuing population growth, the five cities face challenges in developing and maintaining sustainable and equitable approaches to water provision and management. Each response to water management problems is shaped by path-dependent effects of earlier decisions and the ‘wicked’ nature of problems that defy simple solutions. The five cities are marked by climatic diversity, and all are at least partly built on floodplains. Each has a distinct relationship with the natural water of its hinterland and the proximity of ocean outlets for sewage disposal.
The diverse water systems and ecologies of the places that would become Australia’s capital cities sustained Aboriginal peoples for thousands of years because of two key factors: Aboriginal knowledge of water and associated wetland and riparian ecologies, and respect for life-sustaining water as a central tenet of Aboriginal cultures. For millennia, and often enduring in the wake of the violent rupture of colonisation, Aboriginal peoples understood the affordances and risks of different forms of water and preserved these understandings in robust oral traditions. This enabled them to follow seasonal abundances of water and avoid its seasonal hazards. For all Australian Indigenous cultures, water is a storied medium that connects the past and present in the ‘long now’: a living and lively substance that sustains their Country.
In the first half of the twentieth century, the replacement of labour-intensive methods of obtaining household water and disposing of wastes by networked infrastructure made possible a change in Australian housing layouts. The informal, mixed-use cottage gave way to the ‘bungalow’ with more specialised interior spaces and internal bathrooms, allowing rising living standards in working-class households. The extension of networked water supplies and sewerage, and increasing lot sizes with more space for gardens and lawns increased per capita water consumption in the five cities. To improve the sanitary condition of the ‘respectable’ working-class, State governments intervened in housing markets by providing access to low-cost suburban housing, but disparities in domestic water facilities persisted, with much of the inner city housing stock lacking internal bathrooms, laundries, toilets, hot water services, and taps. At the end of World War II, the five cities faced serious housing shortages, and with rising prosperity came strong demand for new suburban housing.
White settlers domesticated water by shaping and regulating natural water features into systems of dams, piped networks, and waste disposal facilities. Clean water is a common resource when there is no restriction on its use, and each use of the resource makes less available to others. Overuse of common water resources was an early feature of the five cities, and effective solutions were the product of democratic institutions that empowered citizens to take collective action and express demands for improved infrastructure. In Sydney, Melbourne, and Adelaide, sanitary reform through investment in networked water infrastructure in response to the threat of cholera was underway by the mid-nineteenth century; the development of effective sewerage was delayed by the costs of extension across large metropolitan areas and the fragmentation of political authority between local councils. The smaller cities, Brisbane and Perth, were slower to invest, and water supplies continued to be unreliable and subject to pollution from cesspits. By the start of the twentieth century, variations in water infrastructure systems reflected the path-dependent nature of earlier solutions, which would constrain the options available to future decision makers.
The signs of climate change continue to signal themselves through increased weather extremes. These events have major implications for the continued reliable supply of fresh water and safe removal of waste. As the limits to the environment become increasingly obvious and pressing, these constraints will serve as a significant challenge for future generations. In the past 200 years, Australians have learned a great deal about the fragility of their environment and the need to work within its limits – the wisdom of the country's first peoples still has much to teach us in our future responses to change.
In the wake of the ‘golden age’ of economic growth in the early 1970s, public provision of urban infrastructure came under the close scrutiny of governments seeking to reduce the size of their bureaucracies in the face of expanding budgets, rising prices, and increasing unemployment. Australian governments and water utilities followed the UK and USA by introducing price mechanisms to attain more efficient water use. This coincided with severe droughts that affected urban water supplies and led state governments to impose residential water restrictions, save for Brisbane, where catastrophic floods in 1974 reminded residents of their vulnerability to the elements. Growing concern for the environment, as well as the implications of environmental degradation for human health, meant that the sights, smells, and sounds of the Australian suburbs were on the eve of change. The use of suburban waterways as drains for industrial and domestic waste would no longer be tolerated, as local residents campaigned to protect built and natural environments from pollution and development projects. Such health and ecological concerns collided with the neoliberal reform agenda of the 1990s, when newly restructured water utilities faced a series of crises in their provision of water and disposal of wastes.