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Updated nationally determined contributions collectively raise ambition levels but need strengthening further to keep Paris goals within reach.

ABSTRACT: By January 2022, 156 countries had submitted new or updated nationally determined contributions (NDCs) under the Paris Agreement. This study analyses the greenhouse gas (GHG) emissions and macroeconomic impacts of the new NDCs. The total impact of the updated unconditional and conditional NDCs of these countries on global emission levels by 2030 is an additional reduction of about 3.8 and 3.9 GtCO₂eq, respectively, compared to the previously submitted NDCs as of October 2020. However, this total reduction must be about three times greater to be consistent with keeping global temperature increase to well below 2 °C, and even seven times greater for 1.5 °C. Nine G20 economies have pledged stronger emission reduction targets for 2030 in their updated NDCs, leading to additional aggregated GHG emission reductions of about 3.3 GtCO₂eq, compared to those in the previous NDCs. The socio-economic impacts of the updated NDCs are limited in major economies and largely depend on the emission reduction effort included in the NDCs. However, two G20 economies have submitted new targets that will lead to an increase in emissions of about 0.3 GtCO₂eq, compared to their previous NDCs. The updated NDCs of non-G20 economies contain further net reductions. We conclude that countries should strongly increase the ambition levels of their updated NDC submissions to keep the climate goals of the Paris Agreement within reach.

Supplementary information

The online version contains supplementary material available at 10.1007/s11027-022-10008-7.

SUBMITTER: den Elzen MGJ

PROVIDER: S-EPMC9209833 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe Centers for Disease Control and Prevention's Million Hearts initiative includes an ambitious ≥80% blood pressure control goal in US adults with hypertension by 2022. We used the validated Blood Pressure Control Model to quantify changes in clinic-based hypertension management processes needed to attain ≥80% blood pressure control.Methods and resultsThe Blood Pressure Control Model simulates patient blood pressures weekly using 3 key modifiable hypertension management processes: office visit frequency, clinician treatment intensification given uncontrolled blood pressure, and continued antihypertensive medication use (medication adherence rate). We compared blood pressure control rates (using the Seventh Joint National Committee on hypertension targets) achieved over 4 years between usual care and the best-observed values for management processes identified from the literature (1-week return visit interval, 20%-44% intensification rate, and 76% adherence rate). We determined the management process values needed to achieve ≥80% blood pressure control in US adults. In adults with uncontrolled blood pressure, usual care achieved 45.6% control (95% uncertainty interval, 39.6%-52.5%) and literature-based best-observed values achieved 79.7% control (95% uncertainty interval, 79.3%-80.1%) over 4 years. Increasing treatment intensification rates to 62% of office visits with an uncontrolled blood pressure resulted in ≥80% blood pressure control, even when the return visit interval and adherence remained at usual care values. Improving to best-observed values for all 3 management processes would achieve 78.1% blood pressure control in the overall US population with hypertension, approaching the ≥80% Million Hearts 2022 goal.ConclusionsAchieving the Million Hearts blood pressure control goal by 2022 will require simultaneously increasing visit frequency, overcoming therapeutic inertia, and improving patient medication adherence. As the relative importance of each of these 3 processes will depend on local characteristics, simulation models like the Blood Pressure Control Model can help local healthcare systems tailor strategies to reach local and national benchmarks.

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Updated nationally determined contributions collectively raise ambition levels but need strengthening further to keep Paris goals within reach.

Supplementary information

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