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Packers Draft: Week 11 College Football Discussion
Four games will help shape playoff narratives this weekend
Boston Celtics' Top Draft Pick Throws Down Epic Dunk
Chris Cenac Jr. continued to make his presence felt with the Maine Celtics of the G-League.
Raiders’ Future With Maxx Crosby Gets Major Insider Update
The Las Vegas Raiders continued forward with superstar pass rusher Maxx Crosby on the roster through the 2026 NFL trade deadline. Despite more swirling rumors, Crosby remains with the only franchise he has ever played for since being drafted in 2019. Crosby was traded during the offseason. The Raiders agreed to a trade with the […] The post Raiders’ Future With Maxx Crosby Gets Major Insider Update appeared first on Gridiron Heroics.
2027 WNBA Draft Lottery: Which team needs the No. 1 overall pick the most in the JuJu Watkins sweepstakes?
The Comets and Tempo have the best odds to get the top pick on Sunday night, but four other teams are in the mix
'Sunrise on the Reaping' stars Mckenna Grace and Ben Wang draft their ultimate 'Hunger Games' squad
May the odds be ever in Mckenna Grace and Ben Wang's favor.
Dolphins news: Injuries mounting, draft implications vs. Colts, and more
A collection of Miami Dolphins news from around the web, including the mounting injuries for the Dolphins, the draft implications of their game against the Colts, and more.
Browns add defensive star from the SEC in new 2027 NFL Mock Draft
In a new mock draft the Browns get a new tag team partner for Carson Schwesinger.
Why was Jordan Davis listening to Sinatra on his way out of Philly?
The Eagles traded Jordan Davis to the Jaguars for two draft picks on Monday.
Atlanta Hawks and State Farm execs earn national recognition for live entertainment
State Farm Arena leaders Amanda Mann and Trey Feazell earned national recognition for excellence in venue operations.
Today in White Sox History: November 12
Happy birthday to a South Side draft disappointment and indy ball legend!
Malik Willis injury could deliver major blow to Packers’ 2027 draft capital
The Miami Dolphins’ decision to place Malik Willis on injured reserve could have an unexpected effect on his former team, the Green Bay Packers. Since Willis left Green Bay in free agency, his playing time is a factor in determining the compensatory draft pick the Packers may receive. According to Nick Korte, Willis sitting out [...]
Renner's 2027 NFL three-round mock draft: How the trade deadline affected the first three rounds
The 2027 NFL Draft QB class is less loaded than originally thought, so Miami grabs a can't-miss WR.
As you age, more screenings and doctor visits help you stay healthy
As people get older, their health care often changes, with more screenings and more doctor visits aimed at helping them stay healthy long-term.
Win Now, Draft Later: Examining the Jaguars’ 2027 Draft Board
The Jaguars traded their way into a Super Bowl push. Here is what is left in the 2027 draft cupboard.
Kirk Cousins trade grades as Raiders-Vikings swap QB for draft pick
One cannot help but wonder which play from Monday night’s loss to the Buffalo Bills it was that pushed the Minnesota Vikings to this moment. After a woeful performance from backup Carson Wentz, stepping into the lineup in place of an injured Kyler Murray, the Vikings have swung a deal for veteran — and former […]
Steelers Defense Finds Its Rhythm With Bold 2027 Safety Plan
The Steelers defense is elite again thanks to Patrick Graham's smart adjustments. A new mock draft shows the team targeting safety KJ Bolden for the future.
Bob Boone has passed away at age 78
Bob Boone, longtime major league catcher and manager, has passed away, per reports. He was 78. Boone spent 19 years in the major leagues. Drafted out of Stanford by the Philadelphia Phillies in 1969, Boone got a cup of coffee in 1972 before becoming the Phillies’ regular catcher in 1973. He finished third in the […]
Luka Doncic Ruthlessly Mocks Hawks Fans During Lakers Win
Lakers star Luka Doncic made waves by reminding the Atlanta Hawks of their 2018 draft-night mistake during his team's win on Monday. The post Luka Doncic Ruthlessly Mocks Hawks Fans During Lakers Win appeared first on HEAVY.
Davon Godcheaux responds to Jaguars’ trade with 9 emojis
Defensive lineman Davon Godchaux shared his feelings through emojis after the New Orleans Saints announced on Monday that he is being traded to the Jacksonville Jaguars . In exchange for the 10-year NFL veteran, Jacksonville is sending a 2028 sixth-round draft pick to New Orleans, according to Jordan Schultz. Schultz also reported that the […] The post Davon Godcheaux responds to Jaguars’ trade with 9 emojis appeared first on ClutchPoints.
Broncos add OT and LB in 2027 NFL mock draft
The Broncos use their first two picks in this 2027 NFL mock draft to add an offensive tackle and a linebacker.
NFL Draft 2027: Updated order after Jaguars-Eagles trade
How the first round of the 2027 NFL Draft looks after the Jordan Davis deal
Luka Doncic Taunts Hawks Fans With Painful Draft History
Luka Doncic scored 32 points against Atlanta and reminded fans they could have drafted him. He now leads the NBA in scoring while wearing a Lakers jersey.
King’s lost draft of ‘I have a dream’ emerges from a desk drawer
On Aug. 28, 1963, the Rev. Martin Luther King Jr. stood on the steps of the Lincoln Memorial and delivered a speech whose refrain — “I have a dream” — has soared into the canon of American oratory. But the...
Eagles Updated Draft Capital Following The Jordan Davis Trade
Here is a breakdown of the Philadelphia Eagles' updated draft capital over the next three drafts following the Jordan Davis trade.
Are prediction markets revenue ripe for picking in NH?
To many people, prediction markets and sports gaming are a distinction without a difference.Which begs the question: Should New Hampshire be regulating prediction markets, especially as they apply to sports, the same way it regulates — and draws revenue from — sports betting via DraftKings?
Statue of Trump rubbing his foot mocks 'draft-dodging' bone spurs
The anonymous satirical art group Secret Handshake erected a giant statue on the National Mall mocking Trump's 'draft-dodging' bone spurs a week after the midterm elections.
Sporting KC Weekly Schedule: Nov. 9-14, 2026
After concluding the season with a 1-0 road win at San Diego FC on Saturday, Sporting Kansas City begins a 10-week offseason highlighted by several roster-building events announced by Major League Soccer earlier today including the MLS SuperDraft on Dec. 21, free agency opening on Dec. 22 and end-of-year waivers
NFL Mock Draft 2027: Eagles land Jeremiah Smith
A prize at the end of the tunnel of a terrible season?
NFL Draft stock report: buy- Kade Pieper, RG, Iowa Hawkeyes
Kade Pieper has a great mentor in center Logan Jones of the Chicago Bears, and that will serve him well towards reaching the league.
Dodgers notes: Shoki Oda, Aaron Bates, MLB lockout
Japanese right-hander Shoki Oda is one of the most interesting names of the offseason, as the 18-year-old right-hander is meeting with MLB teams, including the Dodgers. The lure of a larger bonus in the U.S. than what they might get in the NPB draft has led to some Japanese teenagers to jump stateside. Yuri Karasawa […]
The career of your average MLB reliever
Sometimes I like to look at a player’s journey and their unlikely road to getting to the present day. And while every player has a tough journey to the big leagues, sometimes that journey involves getting drafted in the high rounds, going through the system methodically, and then making your MLB debut with the team […]
NFL Trade Deadline: Which picks can the Packers trade?
The Green Bay Packers are expected to have 11 draft picks in 2027, but only 7 of them are tradable right now.
Updated 2027 NFL draft order after Eagles’ seventh consecutive loss
The Eagles remain fifth in Tankathon’s 2027 NFL draft order after falling to 2-7. Here’s how Sunday’s results affected their position
NFC North Mock Draft: Making picks ahead of Week 9
The Vikings and the rest of the NFC North re-tool in a new mock draft ahead of Week 9.
Which Yankees deserve protection from the Rule 5 Draft?
Carlos Lagrange leads the pack of candidates to be added to the 40-man roster ahead of the Nov. 17 deadline.
Who are the Steelers taking in expert mock drafts?
The Steelers don’t play this week, making it a great opportunity to look ahead to the 2027 NFL Draft.
NFL Draft prospects to watch: Week 10 college football preview
Looking ahead to potential future members of the Eagles.
Packers Draft: College Football Discussion, Week 10
This week is loaded with high-end college football action
Steelers Land Next Franchise Quarterback in Latest Mock Draft
With Aaron Rodgers saying this season is his last year, the Pittsburgh Steelers will have to find his heir apparent. […]
North Korea tells EU to 'mind its own business' on human rights
by: Sertac ComakNorth Korea's UN mission has lashed out at the European Union over a draft UN resolution. Pyongyang has said the West does not have a monopoly on human rights. North Korea responded to the European Union's draft United Nations resolution on human rights in the country by telling the bloc to "mind its own business," state media reported Thursday.Pyongyang has long been accused by the UN and human rights advocates of committing human rights violations.North Korea's UN mission said
Ex-Steelers Star WR Pinpoints Clear Fix to Receiving Woes
The Pittsburgh Steelers track record with drafting and developing receivers was unmatched for a decade or so. One of the […]
Where did David Stone in USA TODAY Sports latest NFL mock draft?
Where OU defensive lineman David Stone is expected to land in the latest USA Today 2027 NFL Mock Draft.
UCF Baseball Kicks Off Against In-State Foes
Fresh off a historic postseason run, the Knights launch their fall slate against Florida Southern and Stetson to test a revamped roster following heavy MLB Draft losses.
Arrow Up for Steelers 2026 Draft Class?
Welcome to Steelers Morning Rush, our new daily short-form podcast with Alan Saunders, giving a longer perspective on a single […]
Justin Boone's fantasy football rookie dynasty draft pick trade value charts for 2027 and 2028 (November update)
AFC North Mock Draft: Making picks ahead of Week 9
We have a new set of picks surrounding the AFC North ahead of Week 9.
DraftKings Plunges 27% on Weak 2027 Forecast and Prediction-Market Spending; Flutter Sinks 8%, Penn Entertainment Drops 4%
DraftKings is betting big on prediction markets, and Wall Street just balked at the bill. While rivals Flutter and Penn feel the fallout, one number in the company's outlook explains why investors flinched.
Broncos' order of 2027 NFL draft picks before trade deadline
Take a look at how many picks the Denver Broncos hold in the 2027 NFL draft.
United Methodist pastors report slight health improvements in survey
Duke Clergy Health Collaborative researchers cite GLP-1s and reduced congregational conflict as reasons for lower burnout and obesity rates.
Cowboys Face Alarming NFL Draft News for 2027 & 2028
Dallas Cowboys face alarming news on 2027 and 2028 draft picks. The post Cowboys Face Alarming NFL Draft News for 2027 & 2028 appeared first on HEAVY.
Eastern Nebraska, including rural areas, favored online sports betting while the rest of the state said ‘no’
People in north-central Nebraska adamantly struck down two ballot measures that would have legalized online sports wagering.
Deep Dive on the Pelicans’ Future Draft Picks
Watching a team blow up and trade away or cut all the fans' favorite players is as hurtful as a bad breakup. The New Orleans Pelicans had to move on from Anthony Davis's time in the Crescent City after he told them that it was not them; it was him. With a small haul of …
USA TODAY Sports mock draft sends Florida's Jadan Baugh to Browns
USA TODAY Sports' latest NFL mock draft projects Florida running back Jadan Baugh to the Cleveland Browns in the first round.
Saints Rookie Report: Week 9 preview vs. the Browns
Let's take a look at how this year's Saints draft picks are doing
3 Keys to Victory for Ravens-Jaguars Week 9
Can undrafted rookie Joe Fagnano figure out a way to win his first career start and keep the Ravens’ season alive?
The Panthers Should Add This Versatile Lineman in the Draft
Let’s take a closer look at one of the prospects the Panthers could select in the 2027 NFL Draft.
Panthers' 2026 1st-round pick receives harsh midseason grade
Monroe Freeling's midseason grade from CBS Sports doesn't sit atop the 2026 draft class.
Bengals implored to trade first-round pick for Jonathan Taylor
Bengals urged to give up a first-round draft pick for Colts running back Jonathan Taylor ahead of the NFL trade deadline.
Eagles Trade Pitch Swaps Draft Pick for New Starting QB
Philadelphia Eagles trade pitch lands new starting QB from AFC contender. The post Eagles Trade Pitch Swaps Draft Pick for New Starting QB appeared first on HEAVY.
This viral Jarome Iginla video exposed his health issues
A pre-draft clip sparked widespread worry before the Hall of Famer broke his silence.
Steelers land franchise QB in new mock draft update
In this new five-round mock draft, the Steelers rebuild their offense, starting with a potential franchise quarterback to replace Aaron Rodgers.
NFl draft order: Arizona Cardinals fall out of top 10
The Cardinals won on Sunday. Now they aren't in the playoff picture and don't have a top-10 pick in the draft.
Here are the results from the sports wagering ballot measures
Two ballot measures are seeking a constitutional amendment to legalize online sports betting in the state and to create the regulatory framework to tax the wagers.
AFGHS co-signatory countries ask health care users to help fill the financing gap
Hundreds of thousands of Ugandans living with HIV on antiretrovirals could be targeted for user fees or community health insurance schemes requiring modest premium payments, according to the April 2026 version of the country’s America First Global Health Strategy implementation narrative.1 As part of the “sustainable financing for the private not for profit sector” strategy, 491 facilities will be targeted for a phased introduction of user fees and scale up of community health insurance programs.2 In the Ugandan context, PNFP facilities include faith-based hospitals and other health facilities, US missionary organizations and centers of excellence—services that are often co-located at government facilities but run with additional financial and technical resources. 402,000 people—or about 28 percent of the total Ugandan adult PLHIV population on treatment—get ART from the private not for profit sector. The selected facilities provide the majority of ART and prevention of mother to child transmission (PMTCT) services. The plan doesn’t give the total number of clients served by the 491 facilities, so it is not possible to give a precise number. But the majority of 402,000 is a figure in the hundreds of thousands—hence the estimate I’m using.3 The April draft of the Ugandan implementation plan narrative is the only one I’ve been able to review. But the government of Uganda is not alone in turning to health care users to help fill the financing gaps caused by the abrupt withdrawal of US funds. In July 2025, the Government of Liberia introduced user fees for previously free services including “registration, accommodation, patient feeding, hospitalization, and a wide range of surgical and diagnostic procedures.”4 Earlier that year, Liberia rolled out a revolving drug fund designed to stabilize drug supplies by “allowing patients to pay a small fee for standardized, quality medications,” according to a Ministry of Health press release.5 (Both of these approaches had been proposed in the National Health Policy 2022-2031; media coverage explicitly connects the launch with the US foreign aid cuts.) The health financing strategies proposed by Uganda and established in Liberia are qualitatively different from user fees officially adopted by specific health facilities to cover funding shortfalls caused by the new US approach.6 The latter is a stopgap, adhoc change. The former is a national governmental adoption of policies that pass costs on to health care users, despite evidence that such approaches can exacerbate inequities and leave deficits unfilled. Two countries does not make a pattern, but they do point to urgent questions: Have other countries, including Liberia, included user fees or community health insurance schemes in their implementation plans? If so, do any of these narratives have what Uganda’s lacks: a fall-back plan in place in case these strategies for sustainable health systems fail to deliver—as they have before? I wonder if you think about it Subscribe Predictable pitfalls Both community-based health insurance and user fees are as old as the hills. And after decades of people climbing up these hills, duking it out, climbing back down—neither strategy has shown the results the Ugandan implementation plan is counting on. This is, in fact, a hill some folks are willing to die on. (You knew I’d get there, right?) In November 2025, an African-led team of health system experts published a paper directed at low- and middle income country governments trying to figure out how to create self-sustaining health systems. The money wasn’t coming back. It had been more than nine months since the season of freezing, waivering and wood-chippering; two months since AFGHS tumbled into the world touting co-financing requirements and reductions in future US government health aid. Governments were looking for strategies for sustainable, self-financed health systems, the authors wrote. For countries considering user fees and community health insurance to fill the financing gaps, they had a simple message: Don’t. On user fees, the paper states: “Reliance on user fees is ultimately a regressive and inequitable approach. It places a disproportionate burden on the poor and undermines health system goals of equity and financial protection. […] There is overwhelming evidence that user fees mobilise very limited resources for the public health sector, making it an inefficient mechanism for revenue mobilisation.” On community health insurance: “Attempting to shift the burden of funding previously donor-funded services, such as HIV care and management, and TB treatment, onto contributory schemes would exacerbate their fragility and fail to protect the population.”7 The WHO says that community-based health insurance “cannot be expected to provide a major source of funding or coverage,” and noted that most schemes offer only moderate benefit to individuals paying into them, and exclude the poorest segment of the population.8 And yet, the US-Ugandan implementation plan says that community health insurance is “the central pillar of this [PNFP] sustainability strategy” and that this approach that will generate “pre-paid pooled funding at facility and community level [that] improves financial risk protection for households, reduces catastrophic out-of-pocket expenditure, and generates structured, transparent revenue streams that can progressively absorb recurrent costs including health worker salaries.” Unfortunately, Uganda’s own history suggests the pillar might not be able to bear this weight. Ugandans Have Been to this Rodeo Before—and Some Want Their Money Back Uganda introduced its first community health insurance scheme in 1996 with support from international donors.9 Thirty years later, somewhere between 0.2 and 0.3 percent of the population is covered by CHI; just over 1 percent has any kind of health insurance.10 User fees were universally introduced in 1993 as a condition of a World Bank loan.11 They were abandoned in 2001, and in 2004—the year I moved to Uganda to watch the free HIV program get underway—a definitive study found that the fees did not improve health systems and outcomes.12 In 2004, most clinics and hospitals had ‘free’ and ‘fee for service’ options for getting care.13 The fee for service, or “cash and carry” programs had often been established in the years prior to PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. People who could afford to paid for the drugs, often at facilities in the private-not-for-profit (PNFP) sector. When free drugs arrived, some people who’d been paying kept on doing so, perhaps because of shorter wait times, greater confidentiality, convenience or other factors. But in the year that I spent visiting the same clinics around the country week after week—including a “center of excellence” that maintained separate days for cash and carry clients and those accessing free ARVs—lots of people who had been paying tried to switch to the free option. They’d paid because they had no other choice. They’d sold pieces of family land, begged family members for loans, bought pills by the week, and sometimes by the day. Or they were just cash-strapped, like most of us, and wanted the funds for other things. 14 Twenty-two years later, this hasn’t changed. Ugandans pay out of pocket for 30-40 percent of their health care costs, leading one paper to declare that “falling ill is more than a health crisis. It is a financial emergency.”15 One recent study found that up to 48.5 percent of households dealing with tuberculosis sold something, took out a loan or dug into savings to defray the costs of TB care—which is supposed to be universally free.16 The Ugandan implementation plan does anticipate challenges. It proposes a phased approach, with 187 facilities introducing user contribution systems in Year 1, 152 in Year 2, and 153 in Year 3. Willingness to pay and feasibility studies will precede roll out; fees will be tiered by region, and a waiver system is proposed to ensure that no one has to pay who is unable to. Moreover, the plan provides for quarterly reviews of epidemiological data to “ensure that user contributions do not compromise epidemic control gains, ART continuity for the client cohort, TB case management, or PMTCT services.” Alt text: A screenshot of a table included in the implementation plan narrative that is the subject of this stack. It’s got a fetching pink bar at the top. It uses the abbreviation “CHI” which is Community Health Insurance, and FBO which is Faith Based Organizations, and it details the number of facilities that will implement user fees with waivers and community health insurance schemes over the five years of the agreement. As I said in the footnote, this is a super interesting document with a lot of other rich material. Tell me what you see—and what you would have focused on. And if you’ve seen something like this, or anything else that strikes you, in another implementation plan, tell me that too. You can use the Substack message platform or try me on Signal at @endaplague_again.25 (because @mercoonfan was, weirdly, taken). But the plan doesn’t fully explain what will happen if this approach doesn’t work out. Yes, progress will be monitored, and corrective action triggered. However, there is no specified funding replacement if premium and fee revenue prove inadequate. Instead, the authors write, “Currently, COEs serve a total client cohort of over 180,000 across 28 facilities. In the initial years, the U.S. Government (USG) will provide financial support for clients; over time, user fees generated by COEs will become the primary source of funding for sustaining their services.” Failure does not really seem to be an option. Health insurance schemes are more acceptable to the Ugandan population than user fees. Members of Parliament and civil society traveled to Ethiopia to see how that country’s scheme worked. In a follow up report, a veteran civil society group recommended allowing the “health insurance ecosystem to grow organically and [to] keep reviewing the law and regulations as this growth takes root.”17 One study found that more than three-quarters of Ugandans were willing to join a health insurance program.18 However, coverage of community-based health insurance is minimal, as is coverage of any kind of insurance—including private plans.19 A national health insurance scheme bill has been stalled for several years and presently sits with President Yoweri Museveni.20 Community-based health insurance scheme that do exist are expanding in number, but losing enrollees. Between 2022 and 2026, the number of community-based health financing schemes across the country increased by 42 percent, while the number of people enrolled decreased by nearly 11 percent.21 None of this means that community-based health insurance should not happen in Uganda—or that people do not want insurance. It doesn’t even mean that user fees and waivers won’t ever work. But there is highly relevant evidence from Uganda and the surrounding region that it is quite optimistic to describe community health insurance and user fees as central supports for sustainable financing in any sector of the health system. And now for the best-case scenario In the best-case scenario22, the Ugandan approach does exactly what it sets out to do, and so does the Liberian fee structure and revolving pharmacy fund—though I’ve not confirmed that these are in the MoU. In one best-case scenario, Uganda is an outlier, and user fees and community health insurance are not recurrent pillars of self-sustaining financing in other countries’ implementation plans. In another best-case scenario, all countries that include these strategies enjoy success beyond anyone’s evidence-informed wildest dreams: reliable funding generated by health care users fees, great health care outcomes for everyone, no exacerbation of inequities, no crippling household debt. No sold land, repurposed school tuition or high-interest loans. In the best-case scenario, not one of the hundreds of thousands of Ugandans living with HIV receiving antiretrovirals from 491 PNFP facilities misses a refill or leaves care because of user fees or community health insurance premiums. This is the best-case scenario for these people for their own health, and for their families. It is also the best-case scenario if Uganda wants to stay on the path to eliminating HIV as a public health threat. According to the country’s most recent data, 96.5 percent of people living with HIV on antiretrovirals are virologically suppressed. Epidemic control depends ensuring that 95% of people living with HIV know their status, 95 percent of those individuals are on ART, and 95% of those individuals are virologically suppressed. Uganda is still struggling with the first “95"—a frankly abysmal 85.3 percent. If HIV epidemic control and the attendant prevention of new infections, avoidable suffering and premature death matter, the country cannot afford to lose any clients who are currently in care.23 As I write this a couple hours before the polls close for the US elections in the city I live in, I say with soul-deep sincerity: I am rooting for the best-case scenario. I think it’s safe to say that we all are.24 I think it’s also safe to say that if the US and co-signatory governments have inked plans that lead to successful expansion of community health insurance and strategic use of user fees, we all would like to know, now, so that we don’t miss the opportunity to celebrate when success happens. The implementation plan narratives have to enter the public domain. They are the fullest expression of a strategy co-created by two governments. There are assumptions and details that people living in the US and co-signatory countries need to understand that are not available in the MoUs or, to date, in the Congressional Notifications. Some of these details can help other countries that are, as I write this, still working on implementation plans. Others, like a solid count of how many other countries have plans for expanding user fees or health insurance, are important for regional and global health architecture reform initiatives. No matter how this election night turns out, there will be a slew of new Congressional member orientations, briefings and talking points papers in the next few months. Release of implementation narratives should be a bullet point in every context that AFGHS is discussed. These documents can be redacted so that procurement sensitive information isn’t disclosed. There is much more historical precedent for sharing such documents than there is for relying on user fees to fill health financing gaps. Let’s look at the information together so we can hope for the best and prepare for, you know, the other thing. Alt text: A substack first: a bicep selfie! It’s my arm - peachy-white skin, black shirt (flannel, notch neck, too hot for this appallingly balmy November weather, if you’re wondering) and a sticker that says I VOTED 2026. Beige letters on red for I voted. Beige on blue for 2026. You bet I did.25 In your wildest dreams. Subscribe 1 This is a really, really rich 95 page document. There are fascinating ideas and detailed plans in it. It is all worth reading AND I have, in this post, highlighted an instance of content that could pose challenges and certainly posits success of strategies that haven’t worked before. I would love to hear what readers’ see that’s interesting and should be lifted up as something to check for in other implementation plans. I will also shortly be adding a static page to the substack site where implementation plan documents will live. I will put the url into this footnote and it will also be there on emilybass.substack.com by the end of the week. Uganda Implementation Narrative Section 4 April 22 2026 Draft 1.51MB ∙ PDF file Download Download 2 User fees are costs charged for visits, labs, medicines or other health services, usually at the time they are provided. Community health insurance, or community-based health insurance, is what the World Health Organization calls “micro insurance,” which is health insurance targeted at low-income people. 3 As usual (by which I mean always), please prove me wrong. 4 https://smartnewsliberia.com/liberias-ministry-of-health-announces-2025-hospital-service-fees-for-public-facilities/?utm 5 https://moh.gov.lr/news/2025/grand-cape-mount-leaders-residents-embrace-new-community-pharmacy-program/?utm 6 https://www.christianitytoday.com/2026/09/hiv-usaid-pepfar-africa-foreign-aid-cuts-mission-hospitals/?utm 7 https://gh.bmj.com/content/10/11/e021270 8 https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-CBHI 9 https://pmc.ncbi.nlm.nih.gov/articles/PMC2827475/ 10 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 11 https://pmc.ncbi.nlm.nih.gov/articles/PMC527704/ 12 Same citation as the footnote 2 - the article is called “Learning from failed health care reform in Uganda.” To which I say: If only. If. Only. 13 There is a whole taxonomy of user fees to be aware of, if not commit to memory. Out of pocket costs are everything that someone pays for themselves. In this Stack, user fees are planned and policy-supported out of pocket costs. There are also out of pocket costs that people pay to buy drugs or receive tests or health care assessments that would be free if the drugs were on the shelves, or the machines or kits were available, or the staff were on site. A user fee is usually designed to be modest, pegged to willingness to pay, and may be waiveable at the point of care for anyone who is unable to do so. The costs for things that would otherwise be free are whatever the market will bear and people either have to pay them or go without. Out of pocket costs for services and stuff that aren’t available in public facilities are different again from bribes or unofficial fees that some health workers may impose, even though most are indefatigable, tireless and tired, and devoted to their clients. 14 For the record—which really is these footnotes—I would give a whole stack of fridge magnets for a systematic analysis of the economic and social impact of the Mass Unemployment Event in AFGHS countries among the very people who used to be able to afford and cover user fees, both for themselves and vast family networks. Locally employed USAID technical staff, house cleaners, caregivers, drivers and technicians were financial anchors for cousins, friends, friends’ children, friends’ childrens’ cousins, teachers, pastors, neighbors and so many other kinds of kin. Aid recipients lost direct funding; many other people who had not been aid recipients, but parts of the elaborate care webs that function as safety nets for so many people, lost crucial support too. And that’s even before we get to the people who worked at the hotels and restaurants and bars where people employed by the US and its implementing partners used to spend disposable income. Those businesses have lost revenue; those folks have lost jobs. It will be some time coming—and someone will have to fund this work—but I do hope it happens. And I hope, as usual, to be proven wrong. 15 https://eprcug.org/blog/how-out-of-pocket-healthcare-costs-keep-driving-ugandans-into-poverty/ 16 Another straight-to-the-point journal article title. Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers. https://pubmed.ncbi.nlm.nih.gov/32938411 17 https://www.cehurd.org/download/technical-policy-brief-on-community-health-insurance-scheme/?wpdmdl=13661&refresh=6ae9122f5d4ed1793659439 18 https://pmc.ncbi.nlm.nih.gov/articles/PMC10125197/ 19 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 20 https://ugandapost.news/uganda-to-make-health-insurance-mandatory-by-2026/ 21 https://shu.org.ug/download/235 22 With a nod, tip of the stack hat, and wag of the Mercoon tail to a deeply valued reader who told me that I have a tendency to speculate about the worst-case scenarios a little too much of the time. 23 https://news.mak.ac.ug/2026/10/uphia-2025-shows-ugandas-hiv-status-awareness-gap-despite-strong-treatment-outcomes/ As you’ll see in the next footnote, I’ve already written a subSubstack on another topic, so I will be brief with regard to the study referenced in this article. The Uganda Population-Based HIV Impact Assessment, or UPHIA, will never happen in this way again. For more than a decade, PHIAs have been supported by the US government as a way to generate accurate estimates of country progress on key HIV indicators. They are a holdover from the PEPFAR program that was laser focused on ensuring US taxpayer dollars subsidized progress in pandemic control. There may be other population-level surveys and the data may even be publicly released, as the entire set of FY2026 MER data have not. But PHIAs will never happen again. If you’re wondering whether the estimates of HIV progress at country level might get less reliable….you’re not alone. 24 Ooh baby, I hate “we” in almost all forms. But sometimes I go there, when I am looking for company, which I am. Because this Stack moves into the somewhat-uncharted territory of assessing what the implementation plan narratives may suggest about co-signatory countries’ roles and responsibilities to the people living within their borders. The MoUs, specimen and data sharing agreements were templates. Countries’ answers fit into pre-specified questions that did not include, “how are you going to fill financing gaps and stabilize your health system as this plan unfolds?” In contrast, the implementation narratives are open form—the product of co-creation between the two governments. Co-creation can mean lots of things, but nothing leads me to believe that implementation plans are ghost-written by the US government, or that contents were imposed by the US counterparts. Instead, I think the parts of the plans that read like country government initiatives are endorsed, if not initiated by, those governments. For instance, the Ugandan implementation plan narrative describes plans for revenue-generation through fees charged for equipment calibration, repair and maintenance provided through Uganda’s National Equipment Calibration Laboratory, and laboratory accreditation through the Uganda National Accreditation Service (UGANAS), targeting private sector, PNFP, research and academic clients. That’s super specific and also quite ambitious. It doesn’t read like an American idea. There’s also a provision for solar panels, and other stuff that feels country owned and driven. This is where it gets interesting. If co-creation is the case, then both the US and co-signatory governments are accountable for the contents and the outcomes. Most discourse about AFGHS to date has focused on the decisions that America has made, or demanded that other countries make. The AFGHS architects have monopolized the hot seat. As they should, in so many ways. America absolutely created the conditions under which countries needed to come up with health financing strategies to fill unanticipated, catastrophic funding gaps. And with not-too-long a lens, we can look back and see that America is also on the hook for its role in the Bretton Woods institutions that made user fees and health system fiscal austerity conditions of loans during the era of structural adjustment. But in the here and now, it is not at all clear to me that the US is requiring Uganda or any other country to implement specific approaches to sustainable financing. Instead, it is as the authors of that paper up in footnote 6 suggest: African governments have agency. As implementation plans roll out—whether or not the narratives are shared—it will be important to understand what this agency looks like and what it means for people, including the poorest of the poor. And it will be important to figure out how to talk about it safely, respectfully and critically in places other than the literal and metaphorical footnotes. 25 This week’s song is “Once upon a time” by the Moody Blues. (I know, this is gonna be a weird, largely banger-free end of 2026 playlist. HMU with requests.) AND please do watch the video and appreciate the truly amazing opening sequence—a drum kit wasteland, a coupla plastic bags, a bit of sand. Sort of like the hill where fiscal austerity policies that put costs on health care users might go to perish. But then there’s a lady with amazing hair. It’s worth it.
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