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Jayson Tatum diagnoses Celtics' main early season struggle
After breaking their five-game winning streak to the Rockets, Jayson Tatum had a major insight on what the Celtics led by Coach Joe Mazzulla are struggling with.
Fit Tips: The science of recalling your forgotten glutes
To fix gluteal amnesia (or “dead butt syndrome”), you need to stretch tight hip flexors and retrain your brain to fire your glute muscles using targeted activation exercises. Movement is how you remind your glutes what they’re capable of doing.
Xeris adds longtime biotech exec to its board
The move to bring Menassie Taddese on comes amid reports that the Chicago-based rare disease and endocrinology drug company is being considered for acquisition.
Is One Stalled Business Reason Enough To Sell Zoom Stock?
For questions about this article or underlying research, email help@trefis.com.The growth outlook for the Online business is the one number that should worry a Zoom Communications (ZM) holder, though the concern remains a moderate one. Online brought in about 38% of Zoom's revenue in fiscal Q2 2027.
Trump has defied political consequences for years. The midterms changed that
The elections were a categorical repudiation of a Republican president who has spent the first half of his second term governing without regard to consequences.
How Anthony Ippolito Talked His Way Into Playing Sylvester Stallone in 'I Play Rocky'
Anthony Ippolito saw the opportunity of a lifetime when he learned that Oscar-winning director Peter Farrelly was developing a film about Sylvester Stallone’s determination to write and star in the original “Rocky.” There was just one problem: Nobody had asked him to audition for “I Play Rocky.”
Apple HomePod Mini 2 Review: Still Small, But With Much Larger SoundApple’s HomePod Mini 2 Is Just as Tiny, but My Tests Found Powerful Upgrades
What’s inside the 2026 HomePod, especially its audio, helps it stand apart from the old HomePod Mini, but Siri AI remains an open question.
Marc Maron is figuring out what to do with all his free time
After ending ‘WTF With Marc Maron,’ the comedian is embracing privacy, pursuing new projects and figuring out life beyond the microphone.
Bears-Seahawks Monday Night Football: Overreaction Or Not?
The Monday Night Football game between the Seattle Seahawks and Chicago Bears produced some shocking results. Ben Johnson and Caleb Williams moved the ball at will on that vaunted Seahawks defense and scored 34 points. It was the most points Seattle had surrendered all season. I have three takeaways from the game, and I’ll decide […] The post Bears-Seahawks Monday Night Football: Overreaction Or Not? appeared first on Stadium Rant.
Market Chatter: CVS Health Reportedly Planning to Split Businesses in 2028
CVS Health (CVS) plans to split its business into two companies in early 2028, separating retail pha
Historic election reshapes Georgia's political future: Here's what happened
Georgia voters made history Tuesday, electing Keisha Lance Bottoms as the state's first female governor, returning Sen. Jon Ossoff to Washington and flipping several statewide offices to Democrats.
How a scientist went from hero to traitor in a US water crisis
When the water in Flint, Michigan, became contaminated with dangerous levels of lead, Dr Siddhartha Roy, then a third year PhD student, was part of the team of scientists who publicly contradicted state and federal claims that it was safe. He became a local hero until a new piece of research challenged the idea that children in Flint had been left permanently brain damaged by the crisis. His adherence to the evidence, no matter who it offended, has earned him the 2026 Maddox prize, which recognises individuals who stand up for science and evidence, despite challenges or hostility. He tells Ian Sample how he reflects on his experience in Flint, and why he lost friends as a result of his work there
Title-chasing McIlroy says there's no risk playing in Abu Dhabi amid tensions in Middle East
Rory McIlroy has played down safety concerns about competing at the Abu Dhabi Championship this week amid tensions in the Middle East that have impacted the sports calendar in the region.
Official | Portuguese manager Paulo Fonseca leaves Lyon
Olympique Lyonnais have confirmed the departure of manager Paulo Fonseca. Sporting CP, the club that he is expected to join, have yet to officialise the Portuguese manager’s arrival at the club. In ...
Letters: Science isn’t scary, it’s educational | Book-ban hypocrisy
Science is wonder; evolution isn’t scary Regarding the claim that the state education plan is de-emphasizing evolution (“Florida education chief defends science plan as critics say it ‘danced around’ evolution,” Oct. 28): Science is won…
Berks Nature to Launch New Mental Health Effort
During the 18th annual State of the Environment Breakfast, Berks Nature will introduce the first tool in what the nonprofit envisions as a multidisciplinary community partnership to help local youth find peace, healing, and connection in nature: a map of Reading’s 50+ parks, playgrounds, and green spaces.
49ers Get Strong Message After Brandon Aiyuk Hires Drew Rosenhaus
After being away from the news cycle for a few months, San Francisco 49ers wideout Brandon Aiyuk is back after he hired Drew Rosenhaus to represent him. As a result, Aiyuk looks ready to return to playing football, but will that be with the Niners?Aiyuk will need to apply for reinstatement, given that he’s on […] The post 49ers Get Strong Message After Brandon Aiyuk Hires Drew Rosenhaus appeared first on HEAVY.
What Needs To Be True To Buy Oscar Health Stock Now?
For questions about this article or underlying research, email help@trefis.com.
Reports: CVS Health plans breakup that would separate Hartford-based Aetna from drugstore chain
The CVS Health Aetna breakup would separate its drugstore chain from Hartford-based Aetna and Caremark, creating two public companies by early 2028.
“Bro Really Said the New Standard is Mediocrity”: Fans Troll Dabo Swinney as he Proudly Makes “Six Wins” Claim for Clemson
Clemson head coach Dabo Swinney has sparked a debate after highlighting the program’s record of consistency. Speaking ahead of the Tigers’ upcoming matchup against Syracuse, Swinney pointed out that Clemson is chasing its sixth win of the 2026 season.
Expecting a new grandchild? Here’s why you may need to see your doctor first
When a baby is on the way, doctors often recommend that the mother get certain vaccinations to protect her newborn – and it turns out that other family members who may visit the infant, especially grandparents, are urged to be up to date on certain shots, too.
Why a Four-Hour Elon Musk Doc Sold Out the Ojai Film Festival
“It is a movie of its time in a topic that is really happening.”
\'You\'re going to have fun\': Metal band Nail Bite to perform its last show of 2026 at Phantom Power
Lonna Nelson, one of two vocalists in metal band Nail Bite, says that concertgoers will often walk up to the band after it performs, saying that the band reminds them
Chernobyl’s Dogs May Be Evolving, but Scientists Don’t Know Why
A new study found evidence of natural selection in the dogs of Chernobyl, but it’s still unclear what drove these genetic differences and what evolutionary advantages they may provide.
International Politicians React to Democrats Winning US Midterms
Nov 4 (Reuters) - Governments and politicians around the world reacted to the Democrats winning the US midterm elections, a result that could have major implications for global trade, security and energy prices. Here is a selection of the reaction: SPAIN PRIME MINISTER PEDRO SANCHEZ ON X
This 4-billion-year-old Martian meteorite fell to Earth – and scientists used a genius trick to work out exactly where it came from | BBC Sky at Night Magazine
Scientists have discovered that Mars meteorite Teghaza 001 is in fact one of the oldest Martian meteorites ever discovered.
Benefits Can Help Older Adults Stretch Their Budgets and Protect Their Health
Every year, older adults leave $58 billion in benefits unused, money that could help cover groceries and prescriptions.
Pope at Audience: Politics that tends wounds and fights injustice gives hope
During the Wednesday General Audience, Pope Leo XIV focuses on how Christians can engage in economic and political life in order to build peace, as he ...
CVS Health Stock Leads Defensive U.S. Dividend Value Picks
Washington has just handed investors a plot twist. A Democratic sweep of Congress, fresh worries over debt ceiling fights and pressure on Treasury yields are shaking sentiment, yet pockets of dividend-paying value stocks may quietly benefit from the reset in expectations. This article walks through three U.S. dividend payers from our value-focused screener that appear closely tied to these political crosswinds and explains why each could deserve a second look now. The three stocks below are...
Google’s Next Big Bet Is a Business It’s Never Won
On October 28, Google told Wall Street something that publishers, small businesses and anyone who’s ever depended on search traffic have been telling
Raphinha to sign new Barcelona contract until 2030 on Thursday
Barcelona captain Raphinha is expected to formalise his contract renewal on Thursday, November 5, signing a new agreement that will keep him at the club until 2030. According to SPORT, the agreement ...
Jets Make NHL History With Stunning Comeback Win Against Habs
The Winnipeg Jets appeared destined for what would have been a 10th straight loss, finding themselves trailing by a 4-0 score against the Montreal Canadiens at Bell Centre on Tuesday night.But then, suddenly, everything clicked and resulted in a stunning and historic turnaround, not only ending their miserable losing skid but also setting a new […] The post Jets Make NHL History With Stunning Comeback Win Against Habs appeared first on HEAVY.
Meghan Markle ‘Doomed To Be a Hate-Watch’ on MasterChef Australia
Meghan Markle’s MasterChef Australia gig might grab attention for the wrong reasons. According to a source, the Duchess of Sussex’s appearance in next year’s Junior MasterChef could steal the spotligh...
What’s next after Trump’s massive miscalculation triggers historic defeat
There’s only way to view the Democrats’ staggering midterm election triumph: It is one of the most colossal repudiations of a sitting president in modern history.
New Children’s Entertainment Releases: What Families Can Watch Together in November 2026
Plan family movie nights with November 2026 kids' releases, featuring animated films, holiday stories and familiar characters.
AI Teammates Launches Ongoing AI Implementation Program for Mid-Market Business Owners
Program builds a working AI system in the first 6 weeks, then continues as an ongoing operating partnership for owners of $1M to $20M businessesSilicon Valley, California--(Newsfile Corp. - November 4, 2026) - AI Teammates, founded by Alice Y. Chen, has launched the AI Architecture Method, a structured implementation program that builds and operates AI systems on behalf of business owners rather than training them to build their own.Image Credit: AI TeammatesTo view an enhanced version of this..
A Political Reckoning Shatters Trump’s Grip on Washington
Republican midterm losses leave the president weakened during his final two years in the White House.
“Sad To Hear What Jorge Posada Had To Say” – Alexandria Ocasio-Cortez Takes Shots at Aaron Boone and Yankees Management
U. S. Representative Alexandria Ocasio-Cortez has questioned the New York Yankees’ decision to retain manager Aaron Boone, calling for changes within the organization after another disappointing season.
Angry Voters Usher in Beginning of the End to the Trump Era
The electoral backlash extended even into deep red states and indicated that President Trump has lost his hold over the coalition that lifted him to the White House twice.
Death is big business in I.Coast, where funerals cost fortunes
Valerie Bli Lou is a shopkeeper from a modest family, but she is determined to give her late father the sumptuous funeral that Ivorian tradition demands -- whether she can afford it or not.- Tears and...
Arizona voters poised to approve restrictions on transgender athletes
A ballot measure that would restrict transgender athletes from participating in girls’ sports appeared headed to approval Tuesday night.
“I Don’t Know If I’m Willing to Do It Just to Fight” – UFC Fans May Have Seen the Last of Beneil Dariush Inside the Octagon
Fans may have already seen the last of Beneil Dariush inside the Octagon. The veteran lightweight has endured a difficult stretch lately, losing four of his last five UFC fights, with all four defeats coming by knockout. Most recently, Dariush was stopped by Quillan Salkilld at UFC Perth in May 2026. Before that, he suffered …
WATCH: Sen. Chuck Schumer speaks after Democrats win control of Senate
The longtime Democratic leader told reporters in Washington that “Americans voted for change” and that there had been a “generational remake of the Senate map.”
Democrat J.D. Ford wins election to U.S. House in Indiana's 5th Congressional District
In an upset that many analysts did not see coming, Democratic nominee J.D. Ford defeated three-term Rep. Victoria Spartz in Indiana’s 5th Congressional District in Tuesday's election.
Letters: Credit card change could hurt small businesses
I recently read an op-ed in this newspaper arguing that the Durbin-Marshall credit card mandates would ease pressure on Louisiana businesses and keep our economy growing. As an entrepreneur, I
Nebraska men’s golf fall season recap
Sports writer Connor Krumme describes the many highs and lows that have occurred throughout the Huskers’ latest golf season.
WATCH: Republican Ken Paxton speaks after losing Texas Senate race
"I will commit that I will be praying for him, that he will do good for Texas and this nation," Paxton said about Talarico.
Lightning’s Nikita Kucherov has been on fire since trade request
Nikita Kucherov wants out of the Tampa Bay Lightning , but he still can’t stop going all out for his team. Reports surfaced last Friday that the 33-year-old Kucherov had already asked the Lightning to move him. In the two games since, the two-time Hart Memorial Trophy winner has done nothing on the ice but rack up points. Against the Nashville […] The post Lightning’s Nikita Kucherov has been on fire since trade request appeared first on ClutchPoints.
Democrat Denise Powell wins election to U.S. House in Nebraska's 2nd Congressional District
Powell flipped a district that Democrats have been targeting for several election cycles.
Issue 3 trails; voters approve other constitutional amendments
A proposed constitutional amendment that would allow cities and counties to form economic development districts to attract retail businesses and other operations was at slightly below 50% as of 11...
Issue 3 trails; voters approve other constitutional amendments
A proposed constitutional amendment that would allow cities and counties to form economic development districts to attract retail businesses and other operations was at slightly below 50% as of 11...
Circadian depression: Body clock disruptions take mental health toll
About one in four depression cases follow disruptions to the sleep-wake cycle in what scientists say is a circadian subtype of the condition. After assessing data for more than 10,000 patients, resear...
National Navy SEAL Museum honors courage and commitment
Just north of Palm Beach County, along Florida’s scenic Treasure Coast, the National Navy SEAL Museum brings to life the remarkable stories of courage, sacrifice and service that have shaped
The dangerous myth of the well-meaning health guru
In healthcare, a warm heart is no substitute for a trained mind. Banned Australian naturopath Barbara O’Neill built a global empire on the defense that she "just wants to help," but good intentions mean nothing when uncredentialed health advice causes real-world harm.
Event to celebrate anniversary of ‘Gone With the Wind’
Ninety years after Margaret Mitchell introduced readers to a world that would become one of the most recognizable stories in American literary and cinematic history, the story is coming home.
US stock futures mixed as Democrats score key midterm election wins
Wall Street faces fresh uncertainty over what Democratic control of Congress could mean for taxes, government spending and regulation.
US stock futures tumble as Democrats score key midterm election wins
Wall Street faces fresh uncertainty over what Democratic control of Congress could mean for taxes, government spending and regulation.
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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BREAKING: CVS to Split Into Two Companies
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OPINION
Like all forms of art, film has a special power to bring societal and political change to a society. Filmmaking is a craft that has always been rich in politics and societal influence, so it is impossible to fully understand the craft without understanding its inherently political nature.
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