Suchergebnisse

Vietnam has transitioned from one of the poorest countries globally into a middle-income nation in three decades since the 1986 Economic Renovation (Doi Moi).However, this economic reform miracle has been widely supported by extensive urbanization and industrialization, leading to severe deterioration in environmental quality. While the effect of economic growth on environmental degradation has been extensively investigated, previous studies on Vietnam have largely ignored the role of urbanization and industrialization, the two key pillars in supporting economic growth in Vietnam. As such, this study focuses on the effect of urbanization and industrialization on environmental quality from 1985 to 2021 using the ARDL estimation. Our overall finding confirms that urbanization in Vietnam leads to further environmental degradation in the short run. However, this negative effect disappears in the long run. However, industrialization deteriorates environmental quality in both the short- and long-run. Our empirical results confirm the validity of the environmental Kuznets curve (EKC) hypothesis in the presence of urbanization and industrialization in the Vietnamese context in the long run, implying that Vietnam's environmental quality may be improved in the long run when a certain income level is met. These findings imply that the Vietnamese government should reconsider the priority of its industrialization strategy to ensure that sustainable economic growth is not at the expense of environmental quality in the long run.

AbstractIntroductionThe HIV epidemic in Tijuana, Mexico is concentrated in key populations, including people who inject drugs (PWID). However, HIV interventions among PWID are minimal, and federal funding was provided for compulsory abstinence programmes associated with HIV and overdose. Alternatively, opioid agonist therapy reduces overdose, reincarceration, HIV, while improving antiretroviral therapy (ART) outcomes. We assessed potential impact and synergies of scaled‐up integrated ART and opioid agonist therapy, compared to scale‐up of each separately, and potential harms of compulsory abstinence programmes on HIV and fatal overdose among PWID in Tijuana.MethodsWe developed a dynamic model of HIV transmission and overdose among PWID in Tijuana. We simulated scale‐up of opioid agonist therapy from zero to 40% coverage among PWID. We evaluated synergistic benefits of an integrated harm reduction and ART scale‐up strategy (40% opioid agonist therapy coverage and 10‐fold ART recruitment), compared to scale‐up of each intervention alone or no scale‐up of low coverage ART and no harm reduction). We additionally simulated compulsory abstinence programmes (associated with 14% higher risk of receptive syringe sharing and 76% higher odds of overdose) among PWID.ResultsWithout intervention, HIV incidence among PWID could increase from 0.72 per 100 person‐years (PY) in 2020 to 0.92 per 100 PY in 2030. Over ten years, opioid agonist therapy scale‐up could avert 31% (95% uncertainty interval (UI): 18%, 46%) and 22% (95% UI: 10%, 28%) new HIV infections and fatal overdoses, respectively, with the majority of HIV impact from the direct effect on HIV transmission due to low ART coverage. Integrating opioid agonist therapy and ART scale‐up provided synergistic benefits, with opioid agonist therapy effects on ART recruitment/retention averting 9% more new infections compared to ART scale‐up alone. The intervention strategy could avert 48% (95% UI: 26%, 68%) of new HIV infections and one‐fifth of fatal overdoses over ten years. Conversely, compulsory abstinence programmes could increase HIV and overdoses.ConclusionsIntegrating ART with opioid agonist therapy could provide synergistic benefits and prevent HIV and overdoses among PWID in Tijuana, whereas compulsory abstinence programmes could cause harm. Policymakers should consider the benefits of integrating harm reduction and HIV services for PWID.