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Romanian lawmakers back a minority government to end monthslong stalemate
BUCHAREST, Romania (AP) — Romanian lawmakers sought Tuesday to end a monthslong political impasse by voting for a minority government led by an independent diplomat, who now faces the challenge of securing support in a fragmented Parliament while tackling a large budget deficit. Prime Minister Luca Niculescu won 280 votes for his proposed Cabinet in
What Killed Europe’s Ancient Wild Cattle? Scientists Find a Disturbing Answer
The fate of Scandinavia’s aurochs warns conservationists worldwide that curbing hunting alone may not save species facing depleted genetic diversity and fragmented habitats. The cattle on today’s farms descend from aurochs, wild animals that once roamed much of Europe, Asia, and northern Africa. They disappeared from Scandinavia thousands of years before the species became extinct
September Monthly Review: Health MCP Guy?
For all the time I spend talking about APIs and data exchange, this newsletter has had embarrassingly little interoperability of its own. It’s old-school SaaS, baby - UI or bust. Not all of that is my fault! Substack, for all its popularity, is (as mentioned before) really frustrating as my system of record. The primary user it optimizes towards is the reader, whose attention feeds the app, the Notes feed, and the recommendation network that Substack is actually selling. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe They’re falling into the same trap that Medium once sprinted into, albeit at a much more glacial speed. Younger generations may not remember (or never knew) it, but Medium once lured publications like The Ringer and Signal v. Noise onto its platform, only to lose them as it rebuilt itself around a paywall and an algorithmic feed. Substack’s original pitch circa 2020 was the antidote (you own your list), but every new feed feature chips away at it. I get it: writers are generic supply in the eyes of the Substack product team. Generic supply follows demand, so the consistent pressure on the PMs is to generate demand, which leads to every product cycle going toward discovery (Notes, recommendations, the app, live video). The end result lackluster author tools (laggy and broken analytics are truly crippling) all despite the premium price point. The archive is where it crosses from authorial gripes to actual reader impact, though. Across Substack and LinkedIn, I’ve published 1,218 posts and nearly 900,000 words since 2018. Substack’s native search can see only the 464 posts that live on Substack, and even there it’s woefully inadequate at surfacing relevant content (even for the guy who wrote it)! Readers have the same problem, writ large. Ask the Archive Fixing search (for both my readers and my own use) turned out to be extremely non-trivial, unfortunately: There’s no public API for readers to access content RSS exists for new content notification, but it only carries the 20 most recent posts and cuts paid ones off at the preview The only Substack MCP is an admin tool for analytics The export exists for authors, but it’s painfully awkward and slow. So I built something to work around that: the Health API Guy MCP. It’s a private MCP server holding the full text of everything I’ve written across Substack and LinkedIn. Add it to Claude or ChatGPT as a connector and you can ask things like: It pairs keyword search (for acronyms and case names, of which we have many) with semantic search. Every post is also labeled by topic, form, and court case, so you can pull a lawsuit’s (or multiple cases’) entire docket across Substack and LinkedIn in one query: Hail, Healthapiguyhydra This is also a bit of me eating my own cooking. I’ve spent the year arguing that headless healthcare is arriving and that developers want primitives over abstractions. Last week in Hail, Benihydra, I watched Salesforce plug its platform into Claude and bet that the records underneath outlive whatever interface sits on top: Salesforce must believe that the Hydra’s immortal head is the records, permissions, and business logic (in that they will survive whatever happens to the interface). It felt a bit hypocritical to keep my own archive behind a Substack search bar. The archive is the body. Substack is one head, and now whatever tool you might use is another. Will the EHRs follow my lead? Probably not imminently, but one can hope! Why Founding Members Only The MCP is available to Founding Member subscribers. A few reasons: It costs money and time to run. Hosting, the database, Clerk usage and AI compute for search and labeling are significant operational costs (that increase with usage). Substack gives me no way to automate access. There’s no API to check whether someone is a paid subscriber, so every user is manual operations for now. It’s a beta. We’ll need to improve things and parts will break. I’d rather they break for a small group of dedicated readers who will tell me about it. The Founding tier deserved a real benefit. Until now it was mostly a generous tip. Now it comes with something. If you’re already a Founding Member, reply to this email with the address you’d like provisioned. If you’re not and want in, upgrade here. Larger teams (such as companies) can get access too: group subscriptions at the Founding tier come with the group discount. The admin for the subscription can reply with the list of addresses to provision. Get 20% off a group subscription Pricing Founding membership is now a flat $200 a year, replacing the old suggested $150 that readers could adjust. Existing Founding Members will have access grandfathered in at their previous rate. Month in Review Articles Published Make Networks Dumb Again (Sep 11): AI is making old analog networks cheaper to use and flooding them with machine traffic in the process. A plea for agent-native rails with the intelligence at the endpoints, and for Washington to drag them to ubiquity. Interoperability, Unbuttoned (Sep 29): Interoperability is a series of workflows in a trenchcoat, and this post finally takes the trenchcoat off. A color-coded map shows which provider workflows went digital, which are fragmented, and which still run on fax. Video Content Antitrust’s System of Record Problem (Sep 3): The FTC’s investigation into Epic prompted a ninety-minute webinar, now posted with chapters and a smoothed transcript. We get into why market definition, missing B2B share data, and the SSNIP test leave antitrust poorly suited to systems of record, plus why information blocking may be doing more than any pending lawsuit. The Information Exchange: Cerner Milking Edition (Sep 18): This was so fucking fun. Ryan Tucker, Ryan Brickner, Brad Thorson, and I try an Around the Horn format, complete with points, penalties, and a mute button. We debate whether Oracle Health is dead, who would actually buy Cerner (IBM enters the chat), p(Doom), and why the front desk still hands you a clipboard. Regulatory Ask Not What Your Network Can Do (Sep 23): CDC’s RFI on public health data intermediaries lists use cases already served, unevenly, by eCR, lab reporting, IZ Gateway, and syndromic surveillance. The real opportunity sits in one question about AI: a network that can handle the next emergency without another interface project. Court cases Particle v. Epic: The Naughty Schoolteacher (Sep 4): After a summer-long vigil, the answer on Epic’s early summary judgment bid is two paragraphs and a remedial assignment. Particle advances to the next grade, and market definition gets another year of discovery. The Epic Discovery Files (Sep 8): Texas’s motions to compel arrive with a 251-page appendix of requests, objections, and meet-and-confer letters with Cravath. Inside: Epic using generative AI for document review, denied interoperability requests in scope, and Noerr-Pennington raised against lobbying discovery. Epic v. Health Gorilla: “Working as Designed” (Sep 9): Epic wants nothing to do with the data breach MDL, and explaining why puts fresh discovery on the public docket. The spiciest allegation: Health Gorilla told GuardDog to scrub its law firm business from its website instead of cutting off access. Veeva v. Epic: Legal Bypass Surgery (Sep 15): Veeva asks the Wisconsin Supreme Court to skip the Court of Appeals, while law professors and three policy groups line up as amici. Meanwhile, Epic’s lawyers apologize for another round of citation errors, including a quote that never existed. Texas v. Epic: Behind the Black Bars (Sep 17): The court portal served up Epic’s unredacted filings, revealing a $5 million document review budget and the AI workflow behind it. Also inside: the 200-plus company names Texas wants searched, and one very expensive Zoom invitation. OpenEvidence v. Doximity: Consequences Will Follow (Sep 25): OpenEvidence tells the court it will not comply with a discovery order, and its own lawyers at Quinn Emanuel say they won’t defend the choice. Add years of Slack reported unrecoverable, and Rule 37 sanctions come into view. Health Tech Keeps Choosing Violence (Sep 28): Doximity moves to end OpenEvidence’s case, Epic asks Texas to show its work, and a sleepy Audacious Inquiry patent fight sprouts antitrust and information blocking counterclaims. The main event is a long-sealed Cognizant v. Infosys ruling that hints where system of record antitrust claims can survive. EHRs One Verb for Oracle Health (Sep 14): Oracle’s earnings call quantifies every data center to the decimal point, while Oracle Health gets a single verb: “accelerate.” Panning the few healthcare mentions turns up an agentic care management system, a research-to-care ledger play, and the question of whether healthcare gets Larry’s patience. Epic’s Forretress Under Siege (Sep 30): Judy Faulkner tells a panel Epic paused hundreds of projects to harden its software and calls it a “shame,” while a spokesperson insists the roadmap hasn’t changed. Project Glasswing, a Pokémon-branded QAN sprint, and a trove of Jodel grievances reconcile the two Epics and preview the Jevons paradox coming for all software. Industry Analysis Scanning for a Network (Sep 1): Scan.com raises $220M to build the imaging network labs never got, speedrunning Zocdoc’s consumer-to-B2B pivot. Its wedge to network density may be the most American one available: personal injury litigation. The Front Desk Wants the Damn Whole Building (Sep 16): Hello Patient buys Converse Health, pushing its AI front desk into referrals, chart work, and prior auth. The copilot categories keep blurring, and your distribution partner is still your final boss. Cross-industry Comparisons A Different Patchwork Quilt (Sep 10): Healthcare loves to envy open banking, but the US version has no mandate, a toll booth at Chase, and data quality problems of its own. The grass isn’t greener; it’s another American patchwork quilt, and perhaps a worse one. Hail, Benihydra (Sep 21): Salesforce brings its platform into Claude, Slack, and its own agent, inviting the interfaces that might replace it. Cut off one head and more grow back, so long as the records underneath stay put. Living on A Trade Secret Prayer (Sep 22): Six credit unions are suing Fiserv, the Epic of core banking, by claiming their own member records as trade secrets. Banking has no Cures Act, so its lawyers reach for legal alchemy that healthcare has already tried. Other News None this month External Media Nabla Accelerate NYC: I kicked off fall conference season at Nabla’s Accelerate event in New York, where Delphine Groll opened by asking the room to picture the company it wants to become and the one it doesn’t. I liked her framework of bureaucracy, fear, and ego as the blockers. I also love vendor conferences/events in general - different vibe than industry biggies. Healthcare 101 with Nikhil Krishnan: I briefly guest lectured Out-Of-Pocket’s Healthcare 101 class. Appreciated Nikhil’s takeaways cover whether AI doctors can query HIEs, why healthcare’s data-liberation rules beat most industries’, and the hi-res graphic is in the comments. HCN: Epic Probed by the FTC: I joined the HCN guys to talk through the FTC’s investigation into Epic. Cedric’s new hairdo was an unexpected plot twist. The episode also covers MFN drug pricing, healthcare M&A and Eli Lilly’s acquisition streak. Fall Conferences: At eHealth Exchange’s Annual Meeting in Austin on Oct 27, I’ll moderate a panel on the tensions between AI, HIEs, and timely patient access with Jean Ross (Primary Record), Therasa Bell (Kno2), Byron Crowe (Doctronic), and Michael Marchant (Freenome). Here’s the rest of my schedule if you want to meet up: CommonWell (Redwood Shores, CA): Oct 13-14 Will be participating in a fun Jeopardy event Open@Epic (Madison, WI): Oct 20-23 Will be enjoying Verona, Willy Street, and other local adventures eHealth Exchange and Sequoia Project (Austin, TX): Oct 27-29 Yeehaw HLTH (Vegas): Nov 15-18 Groundhog Day, Venetian Edition RSNA (Chicago): Nov 30-Dec 2 See me at “Governing AI in Breast Imaging: What Health Systems Are Actually Doing” Digital Health Counsel 2026 AI Summit (Seattle): December 2-3 Will likely be speaking to a bunch of lawyers about information blocking Posts I Liked ChatGPT’s Epic integration: game changer or nothing burger?: Joshua Liu, MD offers five thoughts on OpenAI’s Epic launch, starting from the point that it rides the same open APIs available to anyone. He argues read-only access leaves ordering to Art and the ambient startups, and asks why HCA is piloting it alongside Commure. He’s sorta a must-follow at this point - consistently excellent, thought-provoking takes. Epic, Lilly, and the Discovery pass: Seth Chaney reads Epic’s first major Discovery deal (with Eli Lilly), as well as its revised developer terms on commercial displays, as the pipe finally opening between EHRs and pharma. Life sciences and health continue to collide. Scott Rossignol on EHR payer platforms and ePA fees: Scott argues the top ambulatory EHR vendors are turning the prior auth mandate into a per-member-per-year toll on payers, for an API whose operating cost has nothing to do with covered lives. His fix is two lines of regulatory text: put the CRD/DTR/PAS certification criteria in the Base EHR definition, and bring payer-facing ePA connectivity under § 170.404’s cost-based fee rules. It’s a good solution. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Navigating the American Dream: How Integrated Financial Tools, Credit and Rewards Can Help Small Businesses Succeed
(Feature Impact) Owning a small business has been a cornerstone of the “American Dream” for generations. It represents the chance to transform a passion into a livelihood and legacy. However, turning dreams into reality is rarely a smooth or easy process and requires more than ambition alone. Today’s business owners need support and access to tools that enable them to overcome challenges and keep growing.#placement_678081_0_i{width:100%;margin:0 auto;}var rnd = window.rnd || Math.floor(Math.random()*10e6);var pid678081 = window.pid678081 || rnd;var plc678081 = window.plc678081 || 0;var abkw = window.abkw || '';var absrc = 'https://ads.empowerlocal.co/adserve/;ID=181918;size=0x0;setID=678081;type=js;sw='+screen.width+';sh='+screen.height+';spr='+window.devicePixelRatio+';kw='+abkw+';pid='+pid678081+';place='+(plc678081++)+';rnd='+rnd+';click=CLICK_MACRO_PLACEHOLDER';var _absrc = absrc.split("type=js"); absrc = _absrc[0] + 'type=js;referrer=' + encodeURIComponent(document.location.href) + _absrc[1];document.write('');Recent research conducted by the Capital One Insights Center shows 75% of more than 1,000 surveyed small business owners with more than one employee and annual revenues of up to $20 million are confident about the future, and 69% believe their business is actively primed for growth.While this optimism is promising, 47% of business owners still said their operations either stayed the same or became less efficient over the past year, citing issues like back-office friction and fragmented financial systems that make it difficult to get a clear picture of the health of their businesses.If you’re a small business owner eager to grow but not sure how to get there, start with this advice from real small business owners and experts at Capital One.Identify Sources of FrictionBefore you can pour effort into growth, you must understand what barriers are holding you back. Take time to look under the hood of your business to identify where time and energy is being lost.For example, you may be among the 78% of small business owners who feel stressed and uncertain about expense management – think hours spent hunting for receipts, manually entering numbers into software and reconciling accounts. Operational challenges aren’t just a hassle; they also pull attention away from important priorities like serving your customers and planning for growth. “We were focused on making as many candles as possible, especially during the busy season,” said Katie Roering, co-owner of Fontana Candle Co. “A lot of the back-office tasks like procurement, raw material purchasing, forecasting – all the really important things – were done at 3 a.m., 8 p.m. or on Saturday and Sunday, and there really just was not enough time in the day to get everything done that we needed to. We just knew as we continued to grow, we needed to streamline our processes, build out our team and keep moving forward.”Use Integrated Tools to Manage FinancesInstead of balancing 10 different tracking and analysis tools, you can turn to one-stop solutions to improve efficiency. Time gets lost when you’re forced to manually gather and interpret relevant data before you’re able to act. You need a platform that handles the busywork for you.Integrated, or “all-in-one,” financial tools – like accounting and bookkeeping platforms with automation capabilities or business credit cards featuring built-in analytical tools – allow you to easily stay on top of cash flow and day-to-day operations. For small businesses where every hour and dollar makes a difference, consolidating and automating systems can have an immediate impact. In fact, 51% of survey respondents said integrated tools have already fueled their growth.Leverage Credit Access and Rewards WiselyGrowth requires capital, so access to credit is a game-changer for many business owners, with 77% describing it as a key factor in achieving business resilience. Having funds accessible when you need them makes your business more capable of weathering storms such as equipment failures and seasonal slowdowns. It also puts the power in your hands to act when an exciting opportunity presents itself, like an inventory flash sale or the chance to advertise in a new market.Access to credit comes with another advantage: rewards. By using credit cards for your daily business expenses, you can earn cash back, points or travel rewards. Whether you redeem these to cover everyday expenses, book business trips or reinvest in the business, they can act as a bonus source of income. Learn to maximize rewards like the 84% of small business cardholders surveyed so you aren’t leaving money on the table.To learn more about how small business owners can identify obstacles, employ integrated financial tools and use credit as a tool for growth, read the full report at capitalone.com/about/insights-center.Photos courtesy of Shutterstock
Uncovering the Valleys Hidden Below Greenland’s Ice
A new map of the terrain beneath the Greenland Ice Sheet links hundreds of valleys that previous maps missed or left fragmented.
Labour is nostalgic for two-party politics. That cosy, simple time is over
Our fragmented political model will endure for the foreseeable future – and Reform will benefit from it until Burnham learns that cooperation is key, says Guardian columnist John Harris
Fragmented market prevents EU banks from financing bloc's ambitions, EBA chair says
Europe's fragmented banking market is preventing lenders from achieving the scale needed to finance the continent's digital, economic-security and defence ambitions, the chair of the European Banking Authority told Reuters.
Europe has the science. Now it needs a clinical trials system to match.
Europe has the scientific expertise to lead the next generation of cancer research, but slow and fragmented clinical trial processes, particularly in the case of multinational trials, are not allowing it to reach its full potential. The EU Biotech Act can address the existing bottlenecks to turn this excellence into faster research, stronger competitiveness and earlier opportunities for patients.
Why collaboration is key to outbreak and pandemic response
Fragmented data flows and weak interoperability can hinder outbreak monitoring systems, so greater collaboration is vital to improving pandemic response.
Lyric Health Launches AI-Powered Healthcare Operating System to Turn Fragmented Data into Coordinated Care
Lyric Health today announced the launch of its Healthcare Operating System, a platform built to help self-funded employers, third-party administrators (TPAs) and healthcare innovators turn fragmented healthcare data into coordinated member action.
TiVo launches Agent TiVo for AI entertainment discovery
Viewers could spend less time searching and more time watching as TiVo adds conversational AI search across fragmented TV and streaming catalogues.
Healthcare AI’s next test is integration
While advanced AI excels at processing clinical data, healthcare's true test lies in overcoming deeply fragmented administrative workflows.
Viewpoint: Unlocking Europe’s wildfire data
Europe is already investing in the science, technology and infrastructure needed to understand, prevent and fight wildfires. Copernicus provides satellite-based Earth observation and environmental information, while the European Forest Fire Information System provides information on fire danger and forest fires across Europe. Weather and climate systems add forecasts of heat, drought, wind and humidity; historical fire databases show where fires have occurred; and researchers generate increasingly detailed knowledge about fuels, fire behaviour, forecasting, modelling and risk management. Meanwhile, new European research projects are adding digital twins and other tools to this growing ecosystem.However, these data do not necessarily sit together, nor are they necessarily described, structured or governed in ways that allow them to be used together. Much of the information is public, but some is commercially held. Some is sensitive. Some is subject to legal, security or operational restrictions. Even when data can be legally accessed, different systems may use different formats, terminology and rules.Europe therefore faces an unusual paradox: we have vast amounts of relevant information to respond to the wildfire challenge, but not the means to bring it together. For example, a wildfire researcher or emergency service might need to ask whether a particular combination of vegetation, drought, wind and topography has historically been associated with rapid fire spread. The relevant information may exist in several institutions, using different systems and subject to different conditions of access.The challenge is to conduct an authorised analysis that interacts with these sources, combines the results and respects the rules imposed by each data custodian.An important part of the answer can be found in the Fair principles, the idea that data should be findable, accessible, interoperable and reusable. Developed more than a decade ago, these principles have become a central reference point for modern data stewardship, making it easier for people and machines to find data, understand what it means and determine whether it can be reused.Readability by machines is essential, since AI systems will be key to meeting the data challenge. Bring analysis to the dataThe proposition is not to give an AI system unrestricted access to sensitive databases. Quite the opposite. The goal is to make it possible for approved algorithms to go to the data, rather than requiring sensitive data or large datasets to be copied to wherever the analysis happens.Imagine an analysis asking a series of questions of different data stations. At one station it might examine weather and climate data; at another, historical fire records; at another, experimental measurements of fire behaviour. The algorithm does not need to download everything. It can operate within the environment permitted by each data custodian and return only the results that the rules allow to leave.This is sometimes described as data visiting, and related approaches already exist in areas such as federated analysis and federated learning.Sensitive data should therefore not be treated as a free-for-all for machines. This requires appropriate governance at multiple levels. Access needs to be authenticated and authorised. The purpose of an analysis should be defined. The code or model being run should be controlled. Data custodians should be able to specify what can be queried and what results can leave their environment. Activities should be auditable and human oversight should remain where the consequences require it.In other words, the objective is not to trust AI with the data. It is to design systems in which AI never has more access than it needs.As open as possible, as closed as necessaryFair data should also not be confused with open data. Some wildfire data should be openly available. Other information may legitimately need to remain restricted because it concerns critical infrastructure, security, commercial interests, privacy or operational capabilities. The principle should be: as open as possible, as closed as necessary.The important point is that restricted data should not automatically become unusable data. If machines can discover what information exists, understand its meaning, establish where it came from and determine the conditions under which it can be used, authorised analyses can potentially be carried out without the underlying data ever leaving the environment in which it is protected.Restricted data can still be Fair and machine-actionable.This is also an important question of data sovereignty. European institutions should not have to surrender control of their data to a handful of technology platforms in order to benefit from AI. Nor does Europe need to start again by building one giant repository for every piece of wildfire information. The better approach is to connect what already exists.This is the principle behind emerging approaches such as Tryangle, developed through the Leiden Initiative for Fair and Equitable Science. Rather than creating another centralised data warehouse, the approach seeks to provide an interoperable layer through which approved algorithms can visit distributed data sources while respecting the rules of their custodians.In this way, a data station can remain where it is. Its custodians can retain control. Existing databases and applications do not have to be abandoned. What changes is their ability to communicate with other systems through common, machine-readable descriptions, access rules and interoperability mechanisms.But approaches like this need data that meets the Fair principles. Only then can an interoperable ecosystem safely begin to turn fragmented information into collective intelligence.Data infrastructure is wildfire infrastructureThe implications of this approach are entirely practical. Firefighters could gain better intelligence about local and evolving risks. Land managers could test prevention strategies using more comprehensive information about fuels, weather and past fires. Researchers could compare evidence across ecosystems without repeatedly moving huge datasets between institutions. Smaller regions and resource-constrained teams could access analytical capabilities without having to build large data infrastructures themselves.Europe is already investing heavily in satellites, databases, research programmes, forecasting systems and scientific expertise. The question is whether we will connect those investments well enough to turn them into actionable intelligence.That requires policymakers and funders to treat data infrastructure as seriously as physical infrastructure. Data generated or supported through European public funding should be Fair, verifiable and machine actionable by design, wherever legally and ethically possible.Related articlesData Corner: Europe’s burning need for wildfire mitigation researchClimate monitoring must remain a global enterprise, experts sayIn practice, that means funding not only the production of data, but also the infrastructure that makes data usable across systems: metadata, provenance, interoperability, access mechanisms and governance. Where data must remain restricted, we should ensure that it can still be securely discovered, verified and used for authorised analysis.Initiatives such as the European Open Science Cloud offer an existing framework through which these principles can be put into practice. What is needed now is to accelerate implementation and make them a standard part of how Europe funds and builds research and innovation systems.We do not need another generation of disconnected databases. The data is already there. The opportunity is to make it work together, securely, responsibly and quickly enough to help prevent the next fire, rather than simply document the last one.Jean-Claude Burgelman is professor emeritus at the Free University of Brussels (VUB) and editor-in-chief at Frontiers Policy Lab. For more than 20 years he held leading roles in research and innovation policy at the European Commission.
Local politics limits China’s rare earth leverage
China’s rare earth dominance rests on a fragmented system of ministries, provinces and firms, each pursuing their own interests.
Parties across continents launch dialogue in Seoul as politics fractures, challenges converge
Political parties divided by geography and ideology came together in Seoul on Monday around a shared premise: Even as politics grows more fragmented and polariz
Project aims to join up Europe’s ‘fragmented’ science advice
Coordinator of EU-funded initiative wants a “truly connected” science-for-policy ecosystem
Lindsay Clancy case exposes dangers of fragmented U.S. health system, experts say
In the months before killing her children, Lindsay Clancy repeatedly sought help for her deteriorating mental health.
Defeated by physics
The Pentagon's $3.2 billion bet on space-based boost-phase missile defense ignores basic orbital dynamics, offering no real protection while fueling a costly, destabilizing arms race in space.
Colorado lawmaker, House leaders named in workplace-retaliation lawsuit
A former legislative aide has filed a lawsuit alleging she was mistreated, illegally directed to perform campaign work and harmed by a House leadership structure she says was fragmented, politicized and ineffective at protecting employees. The lawsuit, filed by Jennifer Chick, names Littleton Democratic Rep. Sheila Lieder, House Speaker Julie McCluskie of Dillon and House […]
WHO RUNS MARYLAND POLITICS NOW?
ByThe Maryland Wire The Machine Didn’t Die — It Broke Apart Mike Miller is gone. Steny Hoyer is retiring. The two men who helped define Maryland political power for generations are disappearing from the map. Nobody has inherited all of what they controlled. Instead, Maryland power has fractured among Wes Moore, legislative leaders, county organizations, federal figures and a new generation fighting to connect the pieces. By The Maryland Wire For decades, there were two names in Maryland politics that required almost no explanation. Mike Miller. Steny Hoyer. You didn’t necessarily have to agree with them. You didn’t even have to like them. But everyone understood something: Not social-media power. Not cable-news power. Not the temporary power that comes from one big election. They possessed political infrastructure. Relationships. Institutional memory. Donors. Staff. Allies. County leaders. Lobbyists. Legislators. Operatives. And the ability to connect people who needed something with people capable of delivering it. Today one is gone. The other is preparing to leave Congress after more than four decades. And Maryland faces a question it hasn’t had to answer in generations: The answer may be: Nobody. At least not the way Miller once did. Maryland’s old machine wasn’t inherited by one person. It fragmented. And now several ambitious political networks are competing to assemble the pieces. Miller presided over the Maryland Senate for 33 years, becoming one of the longest-serving legislative leaders in American history. He stepped down as Senate president in 2019 and died in January 2021. (Behavioral and Social Sciences) But Miller’s real power wasn’t the title printed on his door. It was the accumulation of relationships behind it. Miller came from Maryland’s old Democratic organization and developed into an extraordinarily adaptable political operator, retaining authority even as the Senate around him became younger and more liberal. (The Washington Post) He understood something fundamental: politics is information. Who wants what? Who owes whom? Which senator needs help? Which county executive wants something in the budget? Which committee chairman can move a bill? Which lobbyist represents which client? Which candidate should receive support today because that candidate could be a senator ten years from now? Miller knew the answers because he’d spent decades collecting them. Miller’s influence wasn’t confined to elected officials. Former Miller aides became prominent Annapolis lobbyists. Maryland Matters noted figures such as Joseph Bryce and Timothy Perry among the high-profile lobbyists who had once served as top Miller aides. (Maryland Matters) That was one of Miller’s greatest political achievements. He didn’t merely accumulate power around himself. He produced alumni. Staffers became lobbyists. Legislators became committee chairs. Allies became power brokers. And decades of relationships reinforced one another. By the end, Mike Miller wasn’t simply a person. He was an ecosystem. Hoyer’s network was different. Miller’s power was rooted in Annapolis. Hoyer connected Maryland to Washington. He served in the Maryland Senate before winning election to Congress in 1981 and ultimately became one of the longest-serving members of the U.S. House and a longtime No. 2 in House Democratic leadership. In January 2026, Hoyer announced that he would retire rather than seek another term. (The Washington Post) His influence stretched through: Prince George’s County, Southern Maryland, Congress, federal agencies, donors, campaign organizations, and generations of Democratic candidates. And Hoyer had something machine builders value enormously: a succession network. That became obvious almost immediately. When Hoyer announced his retirement, Maryland’s 5th Congressional District exploded with candidates. Twenty-four Democrats entered the race. But when the votes were counted, the winner was Adrian Boafo, Hoyer’s former campaign manager. Boafo wasn’t running without establishment help. He was endorsed by Hoyer. He was endorsed by Governor Wes Moore. And he ultimately won the Democratic nomination. (AP News) In his victory speech, Boafo described the result as voters deciding it was time to “pass the torch to a new generation of leaders.” (AP News) That phrase captures the transition perfectly. Hoyer’s seat isn’t simply being vacated. Parts of his network are being transferred. But they aren’t being transferred to another Steny Hoyer. They’re being absorbed into a newer political constellation. And standing prominently inside that constellation is Wes Moore. If someone forces you to name the single person sitting nearest the center of Maryland Democratic politics today, the answer is Governor Wes Moore. The 2026 Democratic gubernatorial primary underscored the scale of his position. Moore won renomination overwhelmingly, receiving roughly 88% of the Democratic primary vote. (WBAL-TV) But raw votes tell only part of the story. Look at the party infrastructure. The Maryland Democratic Party says Steuart Pittman ran for state party chairman in 2025 “at the suggestion of Governor Wes Moore.” Pittman took office that July. (The Maryland Democratic Party) That’s important. Governors traditionally influence their state parties. But party leadership plus fundraising, endorsements, executive appointments and national relationships creates the beginning of something bigger: a political network that could survive the governor’s term. Moore also played a role in the Hoyer succession by backing Boafo. That’s how political organizations reproduce themselves. You support tomorrow’s politician today. And that’s the distinction that matters. Moore has enormous statewide visibility. Miller had decades of accumulated legislative control. Moore can endorse candidates. Miller could influence the environment in which legislators lived every day. Committee assignments. Leadership positions. Legislative priorities. Relationships that had been accumulating since before many current lawmakers entered politics. Moore may have a larger national profile than Miller ever possessed. But he doesn’t possess Miller’s half-century of Annapolis memory. Nobody does. Which is why the modern Maryland political structure looks less like a pyramid and more like several power centers connected by overlapping relationships. One of those centers belongs to Senate President Bill Ferguson. Ferguson controls an institution no governor can simply command. The Senate. Maryland’s official 2026 legislative records identify Ferguson as Senate President. (Maryland General Assembly) That means influence over: committee structure, Senate leadership, legislative priorities, confirmations, and negotiations with the House and governor. But Ferguson is not Mike Miller 2.0. Miller’s extraordinary longevity allowed him to become almost inseparable from the institution. Ferguson possesses the office. Miller possessed the office plus decades of political mythology and accumulated relationships. Those aren’t the same thing. The House now has its own new center of gravity. Official 2026 legislative records identify Joseline Peña-Melnyk as Speaker of the House of Delegates, alongside Ferguson as Senate President. (Maryland General Assembly) That makes the current Maryland governing triangle: Executive power. Senate power. House power. None fully controls the others. And that fact alone demonstrates how different modern Maryland is from the Miller era. The governor proposes. The legislature disposes. Committee leaders negotiate. County interests intervene. And political coalitions shift issue by issue. That’s not one machine. That’s a networked power structure. Then there’s U.S. Senator Angela Alsobrooks. Her significance isn’t that she is the new Hoyer. She isn’t. Hoyer spent decades constructing his network. Alsobrooks brings something different: Prince George’s County roots, a statewide electoral organization, a United States Senate platform, and relationships with national Democratic leaders. That makes her a critical bridge between Maryland and Washington at precisely the moment Hoyer leaves. Hoyer’s retirement therefore doesn’t necessarily weaken Prince George’s influence. It changes who carries it. Prince George’s itself is undergoing a dramatic generational transition. Official 2026 results show Aisha Braveboy winning the Democratic County Executive primary with 87,944 votes and 73.31% of the vote. (Maryland State Board of Elections) That’s political infrastructure. Prince George’s is one of Maryland’s central Democratic vote engines. A county executive with that level of primary support gains: appointments, budget influence, organizational relationships, donor access, and a platform for cultivating the next generation of political leadership. Braveboy therefore isn’t merely another person on the Maryland power map. She controls a place from which a political organization can be built. Boafo is particularly interesting because he sits almost perfectly at the intersection between the old and new worlds. He worked for Hoyer. Hoyer endorsed him. Moore endorsed him. Then Boafo beat an enormous Democratic field for Hoyer’s seat. (AP News) That doesn’t make him powerful on Hoyer’s scale. He’s just beginning. But it illustrates how power actually transfers: not through a ceremonial handoff, but through endorsements, donors, staff, relationships, and voter confidence. Boafo may become Hoyer’s congressional successor. He will not automatically inherit Hoyer’s 40-plus years of political capital. That part has to be rebuilt. This is the part that often gets overlooked. When a machine breaks apart, power doesn’t only move upward. Some people’s relationships become less valuable. Former Miller aides still know Annapolis. Former Miller allies still possess institutional memory. Veteran lobbyists don’t forget how legislation works. But something fundamental disappeared when Miller did: the common center. The person capable of connecting all of them instantly was gone. That changes the value of a political network. Imagine knowing everybody in Annapolis. Useful. Now imagine the person who introduced many of those people, appointed committee chairs, influenced Senate priorities and understood decades of relationships is simultaneously Senate President. Much more useful. Remove that person and the individual relationships remain. But the system becomes decentralized. First: Bill Ferguson. The Senate’s institutional relationships now run through his leadership rather than Miller’s. Second: the House leadership. With the Miller-Busch generation gone, today’s House leaders are building their own committee chairs, alliances and relationships. Third: Wes Moore. Moore became governor after Miller was gone. That distinction matters. Earlier governors had to operate with Miller sitting across State Circle. Moore entered office during a generational reset. Instead of negotiating with the old machine, he has the opportunity to help build the next network. Fourth: Angela Alsobrooks and the emerging Prince George’s generation. Hoyer is leaving. Miller is gone. The county’s political leadership now belongs to another generation. Fifth: politicians who were outside the old Miller organization. When someone dominates an institution for 33 years, inevitably some politicians develop within that organization and others outside it. Miller’s departure created room for people who may never have risen as quickly under the old structure. That’s the biggest point. If Mike Miller’s power had simply transferred to Bill Ferguson, Maryland would still have a machine. If Hoyer’s influence simply transferred to Boafo, Maryland would still have a machine. If every county leader simply took orders from Moore, Maryland would have a machine. None of those things happened. Instead: Moore controls the statewide executive platform. Ferguson controls the Senate. Peña-Melnyk controls the House. Alsobrooks has statewide and federal reach. Braveboy has Prince George’s executive power. Pittman leads the state Democratic Party after Moore encouraged him to seek the role. (The Maryland Democratic Party) Boafo represents the beginning of the post-Hoyer congressional generation. And Baltimore, Montgomery County, organized labor, donors and other county organizations maintain their own centers of influence. That’s not one machine. If you want to understand where Maryland power is moving, don’t simply watch office titles. Watch endorsements. Who does Moore support? Who does Alsobrooks support? Who gets Ferguson’s allies? Who gets House leadership? Who gets Hoyer’s blessing? Who gets labor? Who gets major donors? And most importantly: That is where the new Maryland network becomes visible. The Boafo race was a textbook example. Hoyer’s successor didn’t emerge randomly from 24 candidates. He had ties to the outgoing incumbent and support from the governor. The old network and the emerging one overlapped. And voters chose him. (AP News) Moore may ultimately become the most important person in determining whether Maryland develops another durable statewide political organization. But the test isn’t whether Moore himself remains popular. The test is what happens to the people he supports. Which delegates become senators? Which senators become committee chairs? Which county officials become executives? Which staffers become candidates? Which appointees become statewide leaders? Who gets his donor network? Who gets his political advisers? Who eventually gets his endorsement when Maryland faces a post-Moore gubernatorial succession fight? That’s how we’ll know whether Moore was merely a successful governor— or the founder of another generation of Maryland power. There’s another category worth watching: politicians who came from Miller’s Maryland but remain active in the new one. Dereck Davis is one. Anthony Brown is another. Veteran legislators and former officials throughout the state still possess old relationships that newer politicians don’t. These people can function as bridges. That’s important because political systems rarely reset completely. The new machine usually grows partly from pieces of the old one. Donors don’t disappear. Lobbyists don’t disappear. Operatives don’t disappear. Institutional memory doesn’t disappear. They find new centers of gravity. If you want one name: His overwhelming 2026 Democratic renomination, executive authority, national profile and influence within the Maryland Democratic Party make that difficult to dispute. (WBAL-TV) But saying Moore “runs Maryland” the way Miller once ran the Senate would oversimplify the reality. Maryland power today looks more like this: WES MOORE Statewide organization.Appointments.Fundraising.Executive government.National Democratic relationships. BILL FERGUSON The Senate.Committees.Confirmations.Legislative leverage. JOSELINE PEÑA-MELNYK The House.Committee leadership.Budget and legislative leverage. ANGELA ALSOBROOKS Statewide electoral organization.Federal platform.Prince George’s relationships.National Democratic connections. AISHA BRAVEBOY Prince George’s executive organization.County government.A major Democratic vote base. THE POST-HOYER GENERATION Boafo and the emerging political class that will have to rebuild Hoyer’s Washington-Maryland network rather than simply inherit it. It did something more interesting. Mike Miller’s influence was too personal, too old and too deeply rooted in his own relationships to be inherited whole. Hoyer’s network is too extensive and too intertwined with decades of congressional politics to fit neatly inside one successor. So the pieces are moving. Toward Moore. Toward Ferguson. Toward Peña-Melnyk. Toward Alsobrooks. Toward Braveboy. Toward younger candidates and new county organizations. And toward veteran political survivors who understand both eras. That’s the next chapter of Maryland politics. The person who eventually connects: Annapolis, Prince George’s, Montgomery County, Baltimore, labor, business, donors, the Maryland Democratic Party, and the congressional delegation will possess something Maryland hasn’t truly seen since Miller’s heyday. Not merely another elected official. And maybe that’s why searching for “the next Mike Miller” is the wrong exercise. There may never be another one. The more important question is: Miller spent half a century becoming that person. Hoyer spent decades becoming another version of it. Maryland’s current political leaders are still competing for the privilege. And until somebody actually connects all those pieces, the most accurate answer to the question “Who runs Maryland?” may be the most fascinating one of all: No one does. Not anymore. But there are plenty of people trying. Sources University of Maryland and Maryland Matters — Miller’s 33-year Senate presidency and political legacy. (Behavioral and Social Sciences) Washington Post historical reporting — Miller’s rise from Maryland machine politics and ability to retain power as the Senate evolved. (The Washington Post) Maryland Matters — former top Miller aides who moved into Annapolis lobbying and the changing Senate power structure. (Maryland Matters) Washington Post and Reuters — Hoyer’s January 2026 retirement announcement after more than four decades in Congress and his long Democratic leadership career. (The Washington Post) Associated Press — Adrian Boafo’s 2026 victory in the Democratic primary to succeed Hoyer, including Hoyer and Moore’s support and Boafo’s “pass the torch” remarks. (AP News) Maryland Democratic Party — Steuart Pittman’s official biography stating that he sought the state chairmanship at Moore’s suggestion. (The Maryland Democratic Party) Maryland General Assembly — official 2026 records identifying Bill Ferguson as Senate President and Joseline Peña-Melnyk as Speaker. (Maryland General Assembly) Maryland State Board of Elections — official 2026 Prince George’s County results showing Aisha Braveboy’s dominant County Executive primary victory. (Maryland State Board of Elections) 2026 election reporting — Moore’s overwhelming Democratic gubernatorial primary victory. (WBAL-TV)
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Strengthening Indonesia’s health emergency response through after action review of disaster response in Aceh, North Sumatra and West Sumatra
Severe floods and landslides that struck Aceh, North Sumatra and West Sumatra in late 2025 exposed both the strengths and gaps in Indonesia’s health emergency response, prompting a nation-wide effort to strengthen preparedness for future crises. In the early phase, the scale and speed of the crisis challenged coordination, data systems and surge capacity. To assess the response, the World Health Organization (WHO) Indonesia supported the Ministry of Health’s Center for Health Crisis in conducting a multi-stakeholder after-action review (AAR). The review brought together government agencies, health sub-clusters, NGOs, and partners. “The AAR is a critical process for strengthening our collective response capacity,” said Agus Jamaludin, Head of the Center for Health Crisis at the Ministry of Health. “It provides valuable lessons not only for the Health Crisis Center but also for all stakeholders involved and serves as an important reference for improving future responses across regions.” After Action Review (AAR) brought together key stakeholders to reflect on the emergency response, identify lessons learned, and strengthen preparedness for future health crises. (WHO/Resty Armis)Through structured discussions across four pillars – leadership and governance, information-based decision-making, service delivery and resource management – the AAR identified several strengths. These included the rapid mobilization of national surge capacity, such as health reserve workforce (tenaga cadangan kesehatan) and emergency medical teams (EMT) and the continued provision of essential health services in affected areas. At the same time, the review highlighted challenges. Among them were uneven functionality of Health Emergency Operation Center (HEOC), fragmented early data reporting and reactive logistics deployment. The findings informed five strategic priorities for strengthening the system, including HEOC standardization, integration of the One Crisis Data system, establishing disaster-resilient hospitals and reforming surge capacity mechanisms. The AAR demonstrates that Indonesia’s health emergency response has strong foundations but requires system-level strengthening to shift from reactive to proactive preparedness. By mainstreaming the strengths and recommendations identified, Indonesia can build a faster, more coordinated and more resilient health system – better equipped to protect communities during future crises. Written by Lintang Sibarani, NPO Emergency and Humanitarian Actions, WHO Indonesia
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On 15 June 2026, over 80 representatives from simulation societies, ministries of health, hospitals, universities, international organizations, professional associations and industry partners met at the WHO Academy in Lyon for a joint event of WHO and the Society for Simulation in Europe (SESAM). Together they tackled a pressing question: how can simulation move from isolated initiatives to systematic integration within health systems? The consensus was clear: simulation is no longer a niche educational tool. Beyond training, it strengthens health systems by improving quality of care, patient safety, workforce preparedness, team performance and organizational resilience.Participants agreed the evidence for simulation’s value no longer needs to be demonstrated, but that implementation remains fragmented and too often dependent on individual local champions. Bridging that gap, they said, means both generating further evidence and raising awareness among decision-makers.Discussions pointed to a shared path forward. To achieve scale and lasting impact, simulation must be embedded in national policies, workforce development plans, education systems and financing mechanisms. No institution can do this alone; stronger collaboration between governments, health institutions, academia, professional societies, international organizations and industry partners will be essential.“At the WHO Academy, we see simulation not simply as a training methodology but as a strategic tool for capacity-building, workforce readiness and stronger health systems,” said Dr Bart Janssens, Unit Head, Health Learning and Capacity Building. “This event is not only about discussion; it is about moving from ideas to action.”As health systems worldwide face workforce shortages, growing complexity of care and rapidly evolving competency needs, participants concluded that the question is no longer “Why simulation?” but rather how to scale it, how to sustain it, and how to ensure it becomes an integral part of stronger health systems.Looking aheadThe event marked the beginning of a collaborative effort rather than the end of a conversation. Over the coming weeks, WHO and SESAM will consolidate the discussions, recommendations and priorities that emerged, with a joint WHO–SESAM report to be published soon.
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WHO urges targeted action to strengthen emergency workforce capacities for shared health risks across the Asia-Pacific region
At a time when the world is more interconnected than ever, the World Health Organization (WHO) is disseminating a comprehensive regional analysis of shared health risks across Asia and the Pacific, urging Member States to invest in enhancing workforce capacities regionwide to mitigate these risks and ensure health systems are better prepared to anticipate, tackle and withstand a range of crises and shocks. Over 100 delegates from 49 countries and areas in the Asia-Pacific region reviewed results from the regional risk analysis during the WHO-led Asia Pacific Health Security Action Framework (APHSAF) Stakeholders Meeting in Malaysia. Synthesizing insights from 21 strategic risk assessments and more than 800 multisectoral experts, the regional analysis highlighted an urgent imperative: countries must proactively invest in emergency workforce preparedness to navigate a landscape where climate hazards, disease outbreaks and geophysical events increasingly overlap. These complex converging crises create devastating, compounding impacts on health systems and communities – reiterating the need for investing in a fit-for-purpose regional health workforce and multisectoral action.Key findings: an evolving risk landscape More than half of the participating countries ranked flooding, cyclones, dengue and pandemic-potential respiratory pathogens as being of high or very high risk, while antimicrobial resistance, landslides and gastroenteritis remain widespread concerns as well. “Given that 51% – over half – of these assessed hazards are deeply interconnected, isolated health interventions are no longer sufficient,” said Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific. “Extreme weather events like cyclones and floods directly trigger subsequent disease outbreaks, while environmental degradation – driven by sea-level rise, coastal erosion and saltwater intrusion – fuels health risks across the Pacific. Mitigating these cascading risks requires unified, cross-sectoral action linking environmental, agricultural and public health policies to build true regional resilience.” Priority recommendations for action To address critical vulnerabilities, WHO calls on Member States in the Asia-Pacific region to urgently prioritize the following strategic actions: Bridge workforce capacity gaps. Embed and standardize emergency preparedness within academia to promote regional workforce interoperability. Foster multisectoral coordination. Address ad-hoc taskforce responses and fragmented surge support through formalized contingency plans and standard operating procedures that are frequently updated and tested. Secure sustainable financing for emergencies. Overcome systemic barriers to access dedicated funding for both immediate anticipatory actions and long-term emergency preparedness initiatives. Enable emergency-ready primary health care. Embed emergency management into public health workforce readiness planning. Ensure that emergency planning is inclusive. Establish clear pathways for inclusive emergency planning that actively involves communities most at risk and other vulnerable groups. Optimize communication. Update risk communication and community engagement strategies, aligning them with seasonal risk calendars. Elevating workforce readiness to meet regional health risks While the gaps identified are significant, the Asia-Pacific region possesses solid foundational pillars, including dedicated clinicians, laboratory staff, rapid response teams, emergency medical teams and extensive community networks. However, to adequately address the compounding nature of modern crises, the various components of the emergency workforce must collaborate cohesively. True resilience depends entirely on transforming this currently fragmented workforce into a highly trained, interconnected and rapidly deployable asset. To achieve this, WHO is actively advancing regional workforce capacities through the Global Health Emergency Corps initiative. This initiative – supported by the Gates Foundation and the Institute of Philanthropy – seeks to build a seamless network of emergency workforce across borders and sectors, ensuring that when a crisis strikes, a standardized, well-coordinated and trained workforce is immediately ready to respond. “Scaling up emergency workforce readiness is no longer optional,” said Dr Gina Samaan, Regional Emergency Director for WHO in the Western Pacific. “It is the definitive factor that will determine how effectively the Asia-Pacific region safeguards health and protects lives in an increasingly unpredictable future.” ____________________For more information, or to arrange media interviews, contact: Ara Johannes, WHO Western Pacific Health Emergencies Division: johannesa@who.int WHO Western Pacific Communications: wprocom@who.int
WHO urges targeted action to strengthen emergency workforce capacities for shared health risks across the Asia-Pacific region
Kuala Lumpur, Malaysia, 11 June 2026 – At a time when the world is more interconnected than ever, the World Health Organization (WHO) is disseminating a comprehensive regional analysis of shared health risks across Asia and the Pacific, urging Member States to invest in enhancing workforce capacities regionwide to mitigate these risks and ensure health systems are better prepared to anticipate, tackle and withstand a range of crises and shocks. Over 100 delegates from 49 countries and areas in the Asia-Pacific region reviewed results from the regional risk analysis during the WHO-led Asia Pacific Health Security Action Framework (APSHAF) Stakeholders Meeting in Malaysia. Synthesizing insights from 21 strategic risk assessments and more than 800 multisectoral experts, the regional analysis highlighted an urgent imperative: countries must proactively invest in emergency workforce preparedness to navigate a landscape where climate hazards, disease outbreaks and geophysical events increasingly overlap. These complex converging crises create devastating, compounding impacts on health systems and communities - reiterating the need for investing in a fit-for-purpose regional health workforce and multisectoral action. Key findings: an evolving risk landscape More than half of the participating countries ranked flooding, cyclones, dengue and pandemic-potential respiratory pathogens as being of high or very high risk, while antimicrobial resistance, landslides and gastroenteritis remain widespread concerns as well. “Given that 51% - over half - of these assessed hazards are deeply interconnected, isolated health interventions are no longer sufficient,” said Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific. “Extreme weather events like cyclones and floods directly trigger subsequent disease outbreaks, while environmental degradation - driven by sea-level rise, coastal erosion and saltwater intrusion - fuels health risks across the Pacific. Mitigating these cascading risks requires unified, cross-sectoral action linking environmental, agricultural and public health policies to build true regional resilience.” Priority recommendations for action To address critical vulnerabilities, WHO calls on Member States in the Asia-Pacific region to urgently prioritize the following strategic actions: Bridge workforce capacity gaps. Embed and standardize emergency preparedness within academia to promote regional workforce interoperability. Foster multisectoral coordination. Address ad-hoc taskforce responses and fragmented surge support through formalized contingency plans and standard operating procedures that are frequently updated and tested. Secure sustainable financing for emergencies. Overcome systemic barriers to access dedicated funding for both immediate anticipatory actions and long-term emergency preparedness initiatives. Enable emergency-ready primary health care. Embed emergency management into public health workforce readiness planning. Ensure that emergency planning is inclusive. Establish clear pathways for inclusive emergency planning that actively involves communities most at risk and other vulnerable groups. Optimize communication. Update risk communication and community engagement strategies, aligning them with seasonal risk calendars. Elevating workforce readiness to meet regional health risks While the gaps identified are significant, the Asia-Pacific region possesses solid foundational pillars, including dedicated clinicians, laboratory staff, rapid response teams, emergency medical teams and extensive community networks. However, to adequately address the compounding nature of modern crises, the various components of the emergency workforce must collaborate cohesively. True resilience depends entirely on transforming this currently fragmented workforce into a highly trained, interconnected and rapidly deployable asset. To achieve this, WHO is actively advancing regional workforce capacities through the Global Health Emergency Corps initiative. This initiative - supported by the Gates Foundation and Institute of Philanthropy - seeks to build a seamless network of emergency workforce across borders and sectors, ensuring that when a crisis strikes, a standardized, well-coordinated and trained workforce is immediately ready to respond. “Scaling up emergency workforce readiness is no longer optional,” said Dr Gina Samaan, Regional Emergency Director for WHO in the Western Pacific. “It is the definitive factor that will determine how effectively the Asia-Pacific region safeguards health and protects lives in an increasingly unpredictable future.” For more information, or to arrange media interviews, contact: Ara Johannes, WHO Western Pacific Health Emergencies Division: johannesa@who.int WHO Western Pacific Communications: wprocom@who.int
Towards a responsive health system and equitable access to quality RMNCAH services
Indonesia’s vast geography and sociocultural diversity shape the delivery of reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in ways that are both enabling and challenging. Across provinces, significant variation has been observed in how services are planned, resourced, and delivered. These variations in service standards and quality are felt daily in the lives of women, newborns and adolescents. Despite these challenges, progress is visible. National estimates show a drop in maternal mortality ratio, from 331 to 140 per 100 000 live births since 2000, signaling improvements in care quality and access. Fertility has stabilised and contraceptive use has grown, yet unmet reproductive health needs persist, and adolescent pregnancies continue to reflect early marriage and limited access to youth-friendly services.To better understand how Indonesia’s health system has evolved under decentralisation, the Ministry of Health, supported by World Health Organization (WHO), United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), IPAS and the Asian Development Bank (ADB), conducted a joint external review of RMNCAH programmes. This review draws on multiple sources of evidence, including existing literature, policy documents, national health system data, as well as field visits to six selected provinces to represent Indonesia’s geographic and administrative diversity. During the field visits, review teams observed service delivery in health facilities, spoke with health workers and local leaders and met mothers and families to understand how RMNCAH policies are operationalised. One of the challenges identified was the management of low birthweight (LBW) infants, a major contributor to neonatal deaths, under resource constraints. One midwife described a severe case of extremely LBW twins, one stillborn and the other died after three days of care. She recalled how the surviving infant struggled to swallow and may not have received breast milk, while simultaneous emergencies required the team’s attention, affecting the care provided to the infant.A subsequent review of the case by the district health office revealed insufficient antenatal care, fragmented maternal medical history due to population mobility, referral delays, limited provider capacity in neonatal intravenous access and a heavy workload that constrained proper newborn monitoring. These insights informed recommendations to strengthen both system-wide and service-level responses. Since the early 2000s, Indonesia’s decentralisation initiative has given much of the responsibility for funding, staffing and managing health services to regional governments. While the Ministry of Health sets national clinical standards, daily management of public health facilities falls under regional authorities through the Ministry of Internal Affairs. While this arrangement allows services to be tailored to local needs, it also depends heavily on local capacity for planning, budgeting and management. Health facilities and district health offices are better positioned to translate national priorities into local action when they have access to consistent technical support, helping health workers manage resource constraints and infrastructure gaps.The complexity of Indonesia’s health system governance is no easy feat to navigate. Understanding these dynamics is essential to strengthening policy, improving coordination and ensuring more equitable access to services across Indonesia. Under the leadership of Ministry of Health, recommendations from this exercise will be key in guiding the nation’s roadmap to an equitable and quality health system for RMNCAH.Written by Edit Oktavia Manuama, National Professional Officer (Maternal, Newborn, and Child Health), and Jessie Yunus, National Professional Officer (Gender, Rights, Equity, and Disability Inclusion)
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DAV announces new partnership with Solace Health supporting veterans’ care
ERLANGER, Ky. – DAV (Disabled American Veterans) is proud to announce a new partnership with Solace Health as its first new partner in 2026. The partnership is supported by a donation from Solace Health to advance DAV’s mission of empowering veterans to lead high-quality lives. The collaboration brings together two organizations focused on helping veterans receive timely, coordinated, high-quality care, regardless of where they receive it. While many veterans receive care through the VA, which offers an integrated and coordinated whole-health model, others receive some or all of their care through private health systems using Medicare or other insurance benefits. These veterans often need help to understand health insurance rules, manage their treatment, and navigate between multiple health care systems. “Disabled veterans often have complex health challenges, and DAV’s advocacy work strives to minimize barriers to timely, high-quality care, primarily within VA., but increasingly between VA and private providers,” said DAV CEO and National Adjutant Barry Jesinoski. “Our partnership with Solace Health can offer support for veterans who are eligible for VA care and Medicare, particularly those who split their care between the VA and private health systems. Veterans who don’t use VA at all can also benefit from the care coordination services that Solace Health provides, usually with little or no out-of-pocket cost to them.” Solace Health provides professional health care advocacy services, connecting patients with experienced advocates who help schedule appointments, explain benefits, coordinate care among providers, and manage administrative burdens with private health care systems, thereby allowing veterans and their families to focus on health and recovery. “For many veterans, the fight doesn’t end when service does,” said Jeremy Gurewitz, CEO and co-founder of Solace Health. “Veterans living with serious medical conditions often encounter a private health care system outside of the VA that is fragmented and difficult to navigate. Through this partnership with DAV, Solace Health advocates can help cut through red tape, improve care coordination, and simplify scheduling of medical appointments. We’re proud to support DAV in helping veterans to successfully navigate health care systems so that veterans, particularly disabled veterans, receive the care they have earned.” DAV provides a lifetime of support for veterans of all generations, their families, caregivers, and survivors. Each year, DAV’s no-cost programs and services help more than 1 million veterans access the benefits and health care they have earned, connect with meaningful employment, and ensure their voices are heard on Capitol Hill. About DAV DAV is dedicated to ensuring our promise is kept to America’s veterans. DAV does this by helping veterans and their families access the full range of benefits available to them, fighting for the interests of America’s injured heroes on Capitol Hill, providing employment resources to veterans and their families, offering programs and services to empower them, and educating the public about the great sacrifices and needs of veterans transitioning back to civilian life. A nonprofit organization with nearly 1 million members, DAV was founded in 1920 and chartered by the U.S. Congress in 1932. About Solace Health Veterans face complex health challenges, and the path to care is far harder than it should be. They deal with fragmented services and providers, each with unique requirements and paperwork. Solace Health advocates—healthcare experts with 16 years’ experience on average—help veterans navigate this landscape when they need it most. Advocates schedule appointments, explain benefits and keep doctors aligned. They take the lead on calls and documentation, and their no-homework ethos eases burdens on veterans and their families. Solace Health is covered by Medicare and Medicare Advantage, and most veterans pay little or nothing out of pocket. We’re honored to support DAV members.
Annual health checks could end 'fragmented' cerebral palsy care
Molly Lane says yearly GP checks could mean a better quality of life for people with the condition.
RFK Jr.: ‘Fragmented’ addiction treatment system ‘has not worked in this country’
Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. on Monday touted a new $100 million effort to fight opioid addiction highlighting the country’s “fragmented” system for…
Our Darwinian Approach to Health Care Costs
In his latest column, President and CEO Dr. Drew Altman presents his Venn diagram of health care cost problems and shows how, in our fragmented health system, reducing one health cost problem often makes another worse.
Investment and Statecraft: The International Politics of Sovereign Wealth Funds - Georgetown Journal of International Affairs
In 1953, Kuwait established the world’s first sovereign wealth fund to invest the country’s oil revenues and generate returns that would reduce its reliance on a single resource. Since then, over 100 separate funds have been created to preserve national wealth and ensure long-term fiscal sustainability. Today, they manage over $10 trillion in global assets. In this discussion with GJIA, political economist Kathryn Lavelle explains the increasingly novel dynamics that surround fund behavior and what the world can come to expect from their growing presence in international financial markets. GJIA: When it comes to the roles sovereign wealth funds (SWFs) play in global markets and politics, what would you say makes them unique? Kathryn Lavelle: Sovereign wealth funds (SWFs) operate on behalf of governments as investors. That in itself is a strange relationship. Within them, a core contest takes place between the state’s interests (or sovereign) part of the dynamic, and the money interests (or wealth) part of it, and these two aspects are frequently in contradiction, serving fundamentally different goals. SWFs are also quite fascinating because when you talk to the people who manage these funds, they have an interest in convincing you that the decisions are made almost exclusively on a financial basis—they really will go to great lengths to differentiate their government owners and those who make the management decisions. At the same time, these people ultimately answer to someone in power. Therefore, for most SWFs, it remains deeply unclear who is actually making the investment decisions and for what purposes. Of course, it is not always clear how other vehicles, such as hedge funds and private equity make the decisions they do, but I think what a lot of people find particularly disconcerting about SWFs is that they seem to act on behalf of people who have a different identity from their own. People who could be trying to manipulate politics and markets in a way that would have a long-term effect on their own populations. Regular investors come and go at will, and they only share an interest in profit as far as most of us understand. However, SWFs have that extra “sovereign” part right behind them that obscures their true interest. GJIA: These funds can be found in countries all across the globe, in both authoritarian states and democracies. Would you say SWFs differ in their goals and structures between regime-type? KL: It is not necessarily regime type that makes the goals and structures of SWFs different. It has to do with their economies. Let’s look at a country like China. There’s going to be a debate about exactly how to characterize the regime, but it is a country with many different kinds of sovereign wealth funds, and a particularly opaque state connection to each. At one time, some of the state-owned Chinese oil companies created specialized investment vehicles listed outside Chinese markets that excluded parts of the firms that were more associated with human rights violations. At the same time, the China Investment Corporation (CIC)—China’s largest SWF—draws a lot of concern, not necessarily because of its investment activities, but because of the dynamics of global politics. So, I wouldn’t really tie differences to regime types themselves in a wholesale way, but rather to how such funds are perceived and how they are structured. Saudi Arabia’s SWF is getting all kinds of attention for its involvement in Hollywood, and this takes me right back to when I was a student in the 1980s, when people were concerned about Japanese investment entities buying assets in Hollywood. They aren’t quite the same in financial terms, but it’s the same kind of concern about foreign investment that drives people to be suspicious, and the whole idea that “foreigners are influencing Hollywood.” This holds true across industries, and it reflects where politics are in places like the United States right now. One metric we can try to look at is transparency, where all the funds will tell you, “we are transparent.” The problem you’ll keep running into with this approach is how you value things. When trying to do comparative studies of equity markets, you’ll find that every country doesn’t use Generally Accepted Accounting Principles like we do in the United States. A fund may appear opaque politically and not want people to show what they’re invested in or what their intent with that investment is, but they could also just not be able to report it because of the way it was purchased, or the kinds of shares they purchased. There are some assets out there that really are difficult to put a monetary value on. GJIA: To what extent do domestic politics shape SWF behavior in both the investing “home” country and the recipient “host” country? KL: This depends on the type of fund present and also on the extent to which voters’ political views are able to influence the fund. For example, in a democratic home state like Norway, the SWF doesn’t invest in nuclear weapons or tobacco because of social concerns, but there is a continuing debate over whether it should invest in oil, even though that’s where most of the money comes from. The degree to which Norway will continue to make those investments, and whether they contradict the government’s overall climate goals, is an open question in Norwegian politics. Because of the way the fund’s governance is structured, it may not be easy to resolve. On the other hand, some people consider pension funds, like the State Teachers Retirement System (STRS) in Ohio, to be quasi-SWF. They have a very strict separation between the people who make up the management division and the fund owners. No teacher or professor would want to invest in things that may harm the future of their students. At the same time, a fund manager might see an opportunity in a diversified multinational corporation that offers a good return, despite it deriving part of its revenue from e-cigarettes. These contests are very apparent. Domestic politics can work in host countries too. A good example is Singapore’s SWF, Temasek, investing in Thailand’s telecommunications sector. If you study political economy, you already know that countries everywhere are uncomfortable with foreign ownership of their telecom sectors because a foreign entity could monitor or manipulate our communications with each other. In the case of Temasek, there was significant pushback from Thai citizens surrounding the deal, which went on to influence national political sentiment toward Singapore as a whole, underscoring the risks some SWFs may face with their investment choices. In this case, fund behavior led to the dissolution of the entire Thai government in 2006 and a subsequent coup d’état. GJIA: To address some of this unease, the Santiago Principles were established in 2009 to ostensibly promote trust and transparency. From your perspective, have these mechanisms actually changed fund behavior? KL: In international relations theory, we always like to have a clear set of norms and best practices—the orientation we want the proverbial ship to be going in. In that regard, the Santiago Principles at least got the discussion going about which direction SWFs should take at a time when people were very skittish about the growing size of these funds. Nobody wanted them to be out there and potentially destabilizing economies, so talks about disclosure, conditions for withdrawal, and the independence of managers were helpful when initiated. The biggest stumbling block was that there wasn’t exactly a good way to measure compliance with the Principles, let alone how to hold funds to them. If you read the Principles, they’re overall quite vague. In general, a fund doesn’t want to reveal how and why they make certain investment decisions because that information is proprietary—a fund makes money off of how and why it makes decisions—so how do you reconcile that with loosely-defined ideas of openness? Some decisions might have a political purpose. The bottom line is that trying to figure out and assign a score to compliance is not easy, and it is therefore the reason why the Santiago Principles never really got off the ground to the point where they could truly direct fund behavior. GJIA: Many emerging markets are looking to build their own SWFs from mineral and oil revenues. Historically, have funds shaped development trajectories in these countries? KL: I think the big story in international emerging markets investment is that the investment is increasingly no longer unidirectional. In the past multinational corporations of primarily Western background were the main form of foreign direct investment in a country. That has changed dramatically, to the point where you have companies from so-called “developing countries” taking over companies in the United States. Therefore, the landscape of international investment has changed, and I think SWFs are certainly a possibility to be the next step in the game. Historically, you didn’t need an entire financial vehicle to reinvest commodity revenues in your country, but as emerging markets get more financially sophisticated, their capacity to operate such funds has increased. SWFs would allow treasuries to move from relying on holding foreign exchange assets like cash or government bonds to having broader financial markets and targeted growth areas, while easing pressure on welfare expenditures. GJIA: With their increasing financial weight, do you see the presence of SWFs being a factor in the political choices leaders will have to make with regard to domestic and foreign policy? KL: It will depend on just how big the funds get. One of the reasons people are already apprehensive is because of their scale, and if certain SWFs in certain countries achieve a large-enough size, the presence will absolutely be cause for concern. The other factor political leaders will have to consider are their objectives. It’s not always clear how to define a SWF, or even where its activity is concentrated, but it is certainly a worry from the perspective of national security of opaque external investment. More than that, I think one of the most interesting questions going forward is whether the United States, the home to the world’s largest financial markets, will develop its own fund, for which the Trump administration announced a plan. There have also been several proposals in Congress. Were it to come into being, it would have tremendous weight. At the same time, one of the hallmarks of U.S. capitalism is a lack of government ownership of shares, so it would not be clear how such a fund would be received in domestic politics, or which direction it would take. Given how politically fragmented the country is, a Democratic administration would likely be concerned about different sectors of the economy, such as healthcare, and want investment there, rather than a Republican administration, which might prefer defense industries. No investment vehicle could thrive under conditions of such instability. Moreover, it remains unclear where the money to fund a theoretical U.S. SWF would come from. It would be a fundamentally different entity depending on whether it is financed with debt, economic surplus, commodities, or the sale of state companies, as in the case of Singapore. If it is debt, or government borrowing of some form, then the fund would have to outperform whatever the cost of that debt is, which is not an easy thing to do. I think our political leaders have enough on their plate. Our system has worked well keeping political and investment functions generally separate. We have seen different forms of business rise and fall, and even the perception of different countries, all of which funds are tied to. Unless a major SWF either starts—like in the case of the United States—or collapses—an issue that concerns the Saudis, I don’t see any political tsunamis on the horizon. . . . Kathryn Lavelle is the Ellen and Dixon Long Professor of World Affairs at Case Western Reserve University in Cleveland, Ohio. Her research explores the exchange between domestic and international and political institutions with a particular emphasis on political economy and multilateralism. Dr. Lavelle’s first book, The Politics of Equity Finance in Emerging Markets, explored the political circumstances that surround large issues of stock in the developing world. After being granted tenure at Case Western, she was awarded an American Political Science Association Congressional Fellowship and named the William A. Steiger fellow, a designation given to the most promising political scientist in her class of fellows. While in Washington during 2006-2007, she worked on the staff of the House Committee on Financial Services on issues related to domestic and international monetary policy. Dr. Lavelle holds a PhD in political science from Northwestern University; an M.A. in government and foreign affairs from the University of Virginia; and a bachelor’s degree in international economics from Georgetown University. She is a permanent member of the New York Council on Foreign Relations. This transcript has been lightly edited for clarity and length. Interview conducted by Sid Mehrotra. Image Credit: Jason Leung, Unsplash Content Licenses, via Unsplash
International Day of Sports for Development and Peace | Division for Inclusive Social Development (DISD)
The Department of Economic and Social Affairs is pleased to announce that the 2026 International Day of Sport for Development and Peace will spotlight the theme “Sport: Building Bridges, Breaking Barriers,” underscoring sport’s unique capacity to foster connection, inclusion, and peace in an increasingly fragmented world. As a universal language that transcends cultural, social, and boundaries, sport serves as a powerful catalyst for social transformation.
WellSpan Health Announces Comprehensive Migration of Technology Portfolio to AWS
Add to FavoritesWellSpan Health, the leading health care system serving Central Pennsylvania and Northern Maryland, today announced plans for a comprehensive cloud migration of its full technology infrastructure. Together with Amazon Web Services (AWS) as its preferred cloud provider, WellSpan will transition its applications, data and environments from traditional data centers to AWS. This migration will establish the foundation for delivering next-generation, AI-enabled health care solutions that reduce administrative burden and improve outcomes for patients across the region and beyond. Supercharging Innovation, Efficiency and Patient Outcomes WellSpan's migration of systems and clinical applications, which serve 1.2 million patients across nine hospitals and 250+ facilities, is expected to be complete by April 2026, one of the fastest full-scale migrations in the health care industry. This transformation enables WellSpan to unify disparate data systems for care teams and patients alike, achieving operational efficiencies and care improvements that fragmented systems are unable to deliver. “Our comprehensive migration to the cloud accelerates our ability to deploy new clinical capabilities that transform patient care while advancing our overall innovation strategy,” said Roxanna Gapstur, Ph.D., R.N., president and CEO, WellSpan Health. “When a physician can access complete patient imaging in seconds instead of hours, we're not just modernizing technology—we're improving patient outcomes. Our new cloud infrastructure also enables us to quickly implement solutions that will free our clinicians from thousands of hours of administrative work annually so they can focus on what they do best: caring for our communities.” The transition allows WellSpan to move away from a data center-based model and enables the rapid deployment and scale of AI technology. WellSpan’s strategic partner, General Catalyst’s Health Assurance Transformation Company (HATCo), facilitated the collaboration with AWS to support the migration. WellSpan’s transformation journey benefits from HATCo’s specialized technology solutions, as well as General Catalyst and AWS’s significant partnership to improve patient outcomes, which was announced in January 2025. “Our decision to go all-in on AWS will enable insights and innovations impossible in traditional siloed environments,” said Kasey Paulus, executive vice president and chief operating officer, WellSpan Health. “This is the largest health care technology transformation in our region's history, and it positions WellSpan to be a premier partner for technology leaders across the country.” “WellSpan is building a foundation with AWS that will improve care and outcomes for patients across their health system by bringing data together into standardized formats that are optimized for AI applications,” said Dan Sheeran, vice president and general manager, Healthcare and Life Science, AWS. “To do this, it is essential to have the most secure and compliant cloud when handling patient data, along with AWS’s built-in AI governance and responsible AI frameworks that follow the industry’s highest standards to protect patient information. We look forward to continuing to work alongside WellSpan as they unlock the cloud and AI’s full potential to deliver exceptional care to their patients.” Key Benefits of the AWS Collaboration Full Portfolio Migration: WellSpan will transition its applications and data from on-premises data centers to AWS, including full IT environments and specialized applications for functions such as nursing, cardiology, pharmacy and the company’s supply chain systems. This represents approximately 7.5 petabytes of clinical and non-clinical data and more than 300 applications—the most comprehensive health system cloud migration in the Mid-Atlantic region. Approved Architectures: AWS will deliver secure, WellSpan-specific architectures tailored to each build, ensuring compliance and reliability across the health system. Unified, AI-Ready Data: Migrating to AWS enables WellSpan to harmonize data across separate systems, transforming unstructured clinical notes and multi-modal datasets into standardized, AI-ready formats. Accelerated Results and Improved Outcomes: Automated data normalization and processing will enable the deployment of applications that reduce turnaround times for items such as analyzing medical imaging or patient records from days to minutes, helping clinicians get patient results faster and improving overall health outcomes. Reduced Administrative Burden: The transition to AWS will enable swift deployment of AI-powered solutions that reclaim thousands of hours for WellSpan’s clinical and corporate teams, allowing them to focus on patient care rather than paperwork. Elastic Infrastructure: Cloud architecture will enable WellSpan to scale computing resources dynamically, supporting seasonal demand fluctuations without infrastructure investments, as well as the rapid deployment of new services across multiple locations simultaneously. Most Secure, Compliant Cloud: AWS offers the highest network availability of any cloud provider, with more than 166 HIPAA-eligible services and certifications for global compliance standards, including HITRUST CSF. Built-in AI governance and responsible AI frameworks ensure that WellSpan’s data is protected under the industry’s most rigorous standards. Tags:News releaseInnovation and partnerships
Japan’s politics will face further pressure in 2026
In 2026, Japan’s fragmented Diet will have less room to govern as economic pressures, demographic decline and regional uncertainties sharpen policy trade-offs
'Fragmented' Microsoft tools undercut efficiency at Amazon and Whole Foods, internal Deloitte review found
Whole Foods' use of Microsoft 365 apps remained disconnected from Amazon, leading to inefficiencies and security concerns, a Deloitte review found.
Youth Sports Was 2025’s Breakout M&A Theme. Here’s What’s Next
What had long been a fragmented, passion-driven corner of the sports economy became an active segment for investors and strategic acquirers.
A new dawn in global health: UHC as the path toward national health stewardship
The UHC High‑Level Forum in Tokyo marked an unmistakable turning point. It signaled a shift from dialogue to pragmatic action, with health and finance ministries jointly designing country‑owned, fiscally grounded UHC strategies to move beyond fragmented, crisis‑driven responses toward resilient, durable health systems that can make Universal Health Coverage (UHC) a reality. UHC means ensuring...