The Kingdom of Eswatini has made major strides in the HIV response with the goal of ending AIDS as a public health threat by 2030. Eswatini, being the first African country to achieve and surpass the 95-95-95 global HIV treatment targets in 2020, has 94% of adults (15 years and older) living with HIV aware of their status, 97% of those who are aware of their status are on antiretroviral therapy (ART), and 96% of those on ART have achieved viral suppression. The number of new HIV infections shows a steady decline over the years from 14,000 in 2010, to 4,800 in 2020 and is projected to further decline to 4,300 in 2023. HIV-related deaths have also been on the decline from a peak of about 10,000 deaths in 2005 to 2,600 in 2021 and 2,370 in 2022 (2021 UNAIDs report). The Mother-to-child transmission of HIV has also dropped from 6.3% in 2017 to 1.2% in 2022.

The strong leadership at both the political and Ministry of Health (MoH) level coupled with World Health Organization Eswatini's (WHO) presence, has resulted in a well-coordinated response that also complements the support from partners evidence-based, patient-centered care at scale. In Eswatini, WHO recommendations are the primary documents that inform the implementation of health programs, including revision of National strategic plans and treatment guidelines to suit the Eswatini epidemic status. Over the years, Eswatini has been an early adopter of the WHO HIV treatment recommendations including, policy briefs, guidelines, and tools. This character trait is what has made the kingdom achieve the 95-95-95 treatment targets ahead of time leading to a decline in HIV new infections and HIV-related deaths.

WHO provided technical leadership and assistance to the Ministry of Health in policy dialogues, development, implementation, and review of the National HIV investment case, strategic plans, and guidelines. These documents created an enabling environment for the MOH and stakeholders including civil society groups to have a shared vision, harmonizing the national response implementation and resource mobilization efforts from Government and Donors.

Among the key milestones that WHO supported in the Eswatini HIV response is the establishment of the antiretroviral therapy (ART) program in 2003 to improve access to treatment and care services. The launch of the 3 by 5 initiative by WHO and UNAIDS was also conducted in the same year. The WHO policy guidance was key in mobilizing resources for the procurement of antiretrovirals (ARVs) and in guiding the clinical delivery of ART services in Eswatini. As a member of the HIV Treatment Technical working group, WHO has been readily available to the MOH and partners to provide technical guidance on treatment optimization initiatives. This led to the National HIV treatment guidelines changing as per WHO recommendations to more tolerable fixed-dose combinations that are given once a day with fewer side effects. As per WHO recommendations, the country phased out the use of stavudine d4T and introduced the fixed-dose combination with tenofovir disoproxil fumarate plus lamivudine (TDF/3TC) and Efavirenz (EFV). In 2016, Eswatini adopted the WHO treat-all policy. The policy was successfully implemented at scale translating the knowledge gained from the operational studies that were implemented in the country prior to WHO recommendations. These included the MaxART Early Access to ART for All (EAAA) study that was implemented by the MOH with support from partners and WHO. As more patients were being initiated, Eswatini scaled up differentiated ART services and provided different models of ART service delivery including fast track, community refills, and multi-month scripting. Currently, stable clients in Eswatini can receive up to 6 months supply of ART refills and clinical appointments.

As per WHO recommendations, task shifting of HIV testing services from nurses to lay counselors, adherence support to peer-peer, and introduction of Nurse-led ART initiation was introduced in Eswatini. This allowed for the rapid decentralization of ART initiation and follow-up care and improved treatment coverage. WHO also provided technical assistance to allow for the decentralization of laboratory services including Point-of-Care CD4 testing, DNA PCR testing, and viral load testing. In 2016, WHO technically led the assessment of the viral load testing capacity and provided recommendations for scale up which were adopted by MoH. One key recommendation from the assessment was to build the capacity of the National Laboratory including human resources, the supply chain system, and decentralization of viral load testing from the national referral laboratory to regional laboratories. The country adopted and implemented these recommendations with support from PEPFAR and Global Fund leading to wider access to viral load monitoring and adherence support. As of today, all four regions of Eswatini have laboratories that can conduct viral load testing. The decentralized testing improved viral load testing coverage and turnaround time for results to support clinical management.

In 2016, as part of local evidence generation to inform National Policy, PEPFAR and WHO supported the MOH to plan and conduct a HIV drug resistance survey as guided by the WHO global protocol. WHO provided technical assistance in the local adaptation of the HIV drug resistance (HIV DR) protocol, and in the analysis of the results. The survey findings were disseminated in 2018 and showed that in Eswatini, the HIV pre-treatment resistance among new ART initiators was 10.3% to non-nucleoside reverse transcriptase inhibitors (NNRTI). WHO recommends that countries with NNRTI resistance over 10% should urgently consider changing their first-line backbone to Dolutegravir. Following the survey results, WHO provided technical assistance to drive the change of the policy towards the introduction of the more potent and more tolerable Dolutegravir-based regimen in Eswatini. This policy is what really moved the country to the viral suppression rates observed today (of greater 95 % ) leading to the reduction in HIV deaths and new infections

As a country, Eswatini through MOH and health partners, will continue to push for policies and adopt evidence-based recommendations provided by WHO that will further complement the achievements that have been made thus far. The country plans to achieve 95-95-95 in all population groups and sustain the gains by building a resilient health system that is patient-centered.

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Eswatini achieves the 95-95-95 HIV treatment target - a decade ... - WHO | Regional Office for Africa

The XRP Ledger is the open-source distributed ledger technology developed by Ripple that is designed for executing fast and affordable transactions. The native cryptocurrency that operates on the XRP Ledger is known as XRP. Since the creation of the XRP Ledger in 2012, there has been significant growth in activity and adoption by individuals and institutions. Understanding the network statistics can provide insight into the overall health and trajectory of the XRP ecosystem.

The total number of accounts on the XRP Ledger is one metric that demonstrates the increasing usage and popularity of the network. In January 2016, there were just over 150,000 accounts created on the ledger. As of September 2023, there are more than 7.5 million accounts, representing a growth rate of over 4,900%. The pace of new account creation accelerated in late 2017 and early 2018 as interest in digital assets expanded exponentially. However, even in recent years, the total number of accounts has continued to steadily climb.

Much of this growth can be attributed to the entrance of institutional players and companies leveraging the speed, scalability, and low transaction fees of the XRP Ledger for cross-border payments and other use cases. The diverse base of accounts, from exchanges to banks, is a positive sign for the ongoing adoption of the network. The increasing account figures point to the real-world utility that the decentralized XRP Ledger is providing.

In addition to the total accounts, the transaction volume on the XRP Ledger also provides insight into the adoption and usage of the network. In January 2017, the ledger was processing around 300,000 transactions per day. As of September 2023, it is consistently handling between 3 to 7 million transactions per day. The highest daily transaction figure reached nearly 15 million in January 2018 amidst the overall crypto market mania.

Even during more steady periods, the consistent multi-million transaction per day figures demonstrate the active baseline utilization of the network. Much of this activity comes from exchanges, market makers, and transaction batching. However, there are also real use cases like money transfers and institutional cross-border payments that rely on the XRP Ledger. As more businesses and individuals experiment with and integrate XRP for payments, the transaction volumes are likely to continue increasing.

One important element related to the ongoing maturation of the XRP Ledger is the decentralization provided by the expanding group of validators. Validators on the XRP Ledger are servers or nodes that independently verify transactions and maintain agreement on the status of the ledger. Increasing the number of validators improves the resilience and decentralization of the network.

In January 2017, there were only around 10 public validators operated by Ripple and a few others. The recommended UNL or unique node list included these validators. As of September 2023, there are over 30 active validators on the public UNL and hundreds more non-validating nodes and validators on private or testing UNLs. This demonstrates significantly improved decentralization of the ledger as more entities run validators and trust different UNLs.

Prominent companies like Coinbase now operate XRP Ledger validators. The wide distribution and lack of reliance on only Ripple-operated validation will be key for the ongoing security and decentralization of the network. Overall, the growth trends for accounts, transaction volumes, and validators all signal the increasing maturity and adoption of the XRP Ledger.

The development of the XRP Ledger over the past decade has been impressive, but it is still in the early stages of enterprise and institutional adoption. While the signs are promising, there are open questions regarding the speed and scope of further adoption.

Some of the factors that could influence future growth include regulations, interoperability with CBDCs, partnerships, and overall crypto market conditions. It is unlikely that adoption and activity will follow a linear path. However, the XRP Ledger stands well-positioned to capture a significant share of the payments market. The built-in speed, scalability, low transaction costs, and institutional-grade features give it utility advantages.

As a native digital asset, XRP has the potential to serve as a bridge currency and liquidity tool between different currencies and networks. The cross-border payment flows between banks and financial institutions are where Ripple hopes to insert XRP as a reliable intermediary asset.

Thanks to the speed and scalability of the XRP Ledger, settled payments in 3-5 seconds are possible. With more bridges and partnerships connecting fiat currencies and other crypto assets to XRP, the demand and volume could increase exponentially. XRP skeptics point to the lack of major bank adoption so far as a question mark. However, the demonstrable efficiencies of using XRP provide a compelling incentive for financial institutions.

Though the future is uncertain, the XRP Ledger appears well-equipped technically to become a leading worldwide payment rail through the leveraging of the XRP digital asset. Connectivity and liquidity will be the keys to unlocking this potential. If achieved, the usage and rate of adoption of XRP could accelerate rapidly as network effects take hold.

In summary, the growth trends for accounts, transactions, validators, and decentralization point to the increasing maturation of the XRP Ledger. There is still a long runway ahead for further adoption and when viewed in the context of other leading cryptocurrency networks, the XRP Ledger remains in the early stages. The unique capabilities and positioning of XRP make it a leading contender to become a global liquidity tool and decentralized payment rail for institutions and enterprises. But uncertainties remain around regulatory clarity, bank adoption, and competition. Overall, the long-term outlook looks bright for the XRP Ledger and XRP cryptocurrency becoming a core component of the global financial infrastructure.

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The Growth and Adoption of the XRP Ledger - BTC Peers

Last Tuesday, the citys utility committee approved Epcors flood mitigation plan. On Sept. 12, the vote goes to city council.

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Edmonton River Valley Conservation Coalition is concerned about this plans impacts not only on the river valley, but also on the protection of our drinking water. We oppose the project and urge council to think carefully about what resilience actually means.

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We have five interrelated concerns. The first is the cutting of 577 trees, including 77 mature trees. Replanting young trees will not replace mature trees; the latter offer exponentially greater carbon sequestration, flood and drought mitigation, and habitat. Some areas will be kept cut as root-free maintenance zones with lawn-covered walls with security fencing on top. It seemed lost on Epcor and councillors that one of the main causes of the climate crisis behind extreme flooding is deforestation. Nor did Epcor consult with the energy transition climate resilience committee (the advisory group that reports to council on climate matters). Edmontonians were angry about the loss of 200 trees in Hawrelak Park, yet council now seems ready to approve a project involving the loss of nearly three times that number.

Our second concern is further impact to the wildlife corridor, in particular on pinch points that are already in desperate need of restoration. This will drive wildlife into residential areas and increase conflict. It also negates our responsibility to help ensure the safe passage of wildlife along a critical corridor from the Rockies to Hudson Bay.

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Our third concern regards the questionable wisdom of trying to hold back the river in a flood plain. As Calgary and High River learned 10 years ago, water will do what it wants. Cities around the world have learned the hard way that concrete berms and barriers are mistakes. In cities in the Netherlands and the U.K., concrete walls are now being removed along rivers. They have found that working with, rather than against, nature is far more effective in preventing floods.

The cities above are instead restoring flood plains to allow for absorption of water in the landscape. In Edmonton, this would mean re-wilding Rossdale and E.L. Smith water treatment plants so that there is minimal infrastructure and healthy soil and vegetation that can absorb water during a flood. This slow-water approach is cost-efficient, protects wildlife corridors, restores vegetation that holds up banks, prevents drought (the twin crisis to flooding), and increases habitat. Why is Epcor not proposing this nature-based solution, and why is the city not demanding it, when the concrete approach has been proven to fail?

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Our fourth concern is Epcors lack of a long-term plan to decentralize water treatment. How resilient is a water system in which over 90 communities rely on just two water treatment plants (located in flood plains)? Epcor says that decentralization involves decreasing water consumption, and admits they have no plan to encourage that. At Tuesdays meeting they said the only consumption reduction they are considering targets people who have trouble paying their bills not affluent landowners who water their lawns, even though lawn watering is apparently one of the main reasons for consumption spikes in summer. This is the problem with considering water a business.

We should be protecting our drinking water through protecting the resilience of the river valley. By further degrading the flood plain and ignoring the need for decentralization, Epcor is arguably making the water system vulnerable in Edmonton and much of the region. Yes, decentralization would cost more in the short term. But consider the cost when the concrete fails (for water always wins) and the city and 90 communities are without drinking water, and all the infrastructure including the $65 million worth for this project alone is lost because we did not respect the flood plain. Epcor says much of their infrastructure goes back to the 1940s; might now be a good time to rethink the system? And while Epcor says the $22-million grant they are receiving is tied to this project, there are also grants available for ecosystem restoration, as well as for truth and reconciliation.

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That brings us to our final main concern. How does one even put a price tag on protecting the river valley and land that has the same archaeological designation as UNESCO World Heritage sites? We do not understand how the city can say it cares about decolonization while continuing to disturb important Indigenous cultural sites, as well as disrespecting the river and the land.

Council is aware of all the concerns above. For the protection of our river valley and our water, we urge them to ask Epcor for a plan that aligns with the nature-based solutions for flood mitigation happening and working in cities around the world. The urgency of the situation means we have to get this right, now.

Kristine Kowalchuk is chair of the Edmonton River Valley Conservation Coalition.

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Opinion: Edmonton must protect its river valley and drinking water - Edmonton Journal

Bitcoin is a digital currency that operates on a decentralized network of computers, without the need for a central authority or intermediary. Bitcoin ETFs are exchange-traded funds that track the price of bitcoin and allow investors to gain exposure to the cryptocurrency without having to buy, store, or manage it themselves.

There are several potential benefits of investing in bitcoin ETFs, such as:

Liquidity: Bitcoin ETFs trade on regulated stock exchanges, which means they have high liquidity and can be easily bought and sold throughout the day.

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Diversification: Bitcoin ETFs can offer investors a way to diversify their portfolio and hedge against inflation, currency devaluation, or geopolitical risks.

Simplicity: Bitcoin ETFs eliminate the hassle of dealing with bitcoin wallets, exchanges, or custodians, which can be complex, costly, or insecure.

Tax efficiency: Bitcoin ETFs may have lower tax implications than directly owning bitcoin, depending on the jurisdiction and the type of fund.

However, there are also some drawbacks of investing in bitcoin ETFs, such as:

Fees: Bitcoin ETFs charge management fees and other expenses that reduce the returns for investors. These fees may vary depending on the fund provider and the structure of the fund.

Tracking error: Bitcoin ETFs may not perfectly replicate the performance of bitcoin, due to factors such as market volatility, liquidity constraints, or regulatory issues. This means that the price of the fund may deviate from the price of bitcoin over time.

Regulatory uncertainty: Bitcoin ETFs are subject to the rules and regulations of the jurisdictions where they are listed and traded, which may change or differ from those governing bitcoin itself. This creates uncertainty and risk for investors, especially in countries where bitcoin is not widely accepted or legal.

Limited availability: Bitcoin ETFs are not widely available in many markets, as they face significant regulatory hurdles and skepticism from authorities. As of August 2023, only a few countries have approved or launched bitcoin ETFs, such as Canada, Brazil, and Germany.

Decentralization means that no single entity or authority has control over the network, the transactions, or the governance of the system. Instead, the power is distributed among the participants, who can verify, validate, and contribute to the network in a transparent and democratic way.

Why is decentralization important for the cryptocurrency industry? There are several reasons:

Decentralization enhances security. By eliminating the need for intermediaries or central servers, decentralization reduces the risk of hacking, censorship, or manipulation. The network is protected by cryptography and consensus mechanisms that ensure its integrity and reliability.

Decentralization promotes innovation. By allowing anyone to participate and contribute to the network, decentralization fosters a culture of creativity and experimentation. The network can evolve and adapt to the changing needs and preferences of the users, without being constrained by bureaucratic or regulatory barriers.

Decentralization empowers users. By giving users more control over their own data, assets, and identity, decentralization enhances their privacy and sovereignty. Users can choose how to interact with the network, what services to use, and whom to trust, without relying on third parties or intermediaries.

The cryptocurrency industry will only become better as it becomes decentralized. Decentralization is not only a technical feature, but also a social and economic vision. It is a vision of a more open, fair, and inclusive world, where everyone can benefit from the opportunities and advantages of digital currencies.

Bitcoin ETFs are a convenient, decentralized and accessible way for investors to gain exposure to the cryptocurrency market, but they also come with some challenges and risks. Investors should weigh the pros and cons of investing in bitcoin ETFs carefully before making a decision.

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Bitcoin ETFs will enhance Crypto Market Decentralization - Tekedia

Blockchain brings revolutionary and harmless solutions to help develop new technologies and adapt existing ones. One key factor in blockchain tech is decentralization, which became its synonym. The broader decentralization finance (DeFi) has the inherent way of a democratic financial system. Ethereum, being the first of such blockchain networks, saw the rise of DeFi protocols and budding decentralization that now, the community thinks, is in jeopardy.

In the past several days, the discussion around Lido Finance being the biggest Ethereum staker saw an increase. This came at a point when some prominent ETH staking protocols reportedly committed or were preparing to commit the self-limit rule of 22%.

Amid this 22% self-limiting ETH staking provision, the issue of Lido Finances current Ethereum staking came into the mainstream discussion. The liquid staking protocol is the biggest on the Ethereum blockchain and accounts for about 32.4% of the overall staked ETH, according to the Dune Analytics data.

The staking mechanism over the decentralized protocols is meant to provide a better alternative to the traditional governance system. The regime was expected to work smoothly keeping the underlying decentralization intact. But it gets disturbed with the more control getting amassed to a single entity.

Ethereum community members considered the issue a threat to the decentralization of the blockchain network and called out over social media.

In an X (formerly Twitter) post on Friday, the chief decentralization officer at Ethereum, Evan Van Ness, stated Lido Finance as the biggest attack on Ethereums decentralization. Historically the protocol is on its way to breach 33% of all the staked Ethereum and yet no one is talking about it.

Prominent Ethereum investor Ryan Berckman posted a long tweet and talked about the threat to Ethereum from the growing centralization of Lido.

Berckman expressed concerns that Lidos uncapped dominance uniquely poses a threat to Ethereums reputation as a decentralized blockchain. He also raised the possibility that this dominance could potentially impact the long-term valuation of ETH. Berckman urged that addressing this issue is crucial to safeguarding these goals from being hindered.

Berckman conveyed that if such a scenario were to occur, it could potentially influence the rate of their growth significantly. Consequently, it might also impact the benefits Ethereum brings to humanity and the numerical value of ETHs long-term valuation.

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Lido Finance ETH Staking Nears 33%; Alarming for Decentralization - The Coin Republic