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Hannah Pingree wins governor’s race
Democrat and former Maine House speaker Hannah Pingree has won the gubernatorial election, beating out her Republican adversary Bobby Charles and Independent Rick Bennett.
ARCare triples nurse capacity by combining RPM and chronic care management
A redesigned nursing workflow connects home blood pressure readings with patient relationships – expanding remote monitoring across three states.
Daughter vows to keep late father’s Camano landscaping business alive
Stanwood-Camano is remembering Francisco “Sisco” Zavala, a longtime landscaper and business owner who died suddenly on Oct. 1. His family will honor him at a memorial on Saturday, Nov. 7,
Rome's Cinema Capitol to Reopen in January After 2024 Tornado Damage
The Capitol Arts Complex is preparing to reopen its independent cinema after being closed for repairs following tornado damage.
Trump’s midterm drubbing could give trade partners room to resist
Us midterm election results could ease trade tensions with Asia and Europe, impacting investment commitments and trade talks with China and India.
A looming deadline to fund the government will shape Congress’ unusual lame duck session
Before Democrats take control, Congress must fund expiring health care programs, confirm HHS nominees
Kraft Heinz to divest its North American coffee business in $650 million deal
Kraft Heinz will divest its North American coffee business to private equity firm One Rock Capital Partners as CEO Steve Cahillane works to revive the company.
Fitness studio Swoot with nightclub-inspired classes to open second location Uptown
The upbeat, boutique fitness studio Swoot plans to open a second location this weekend in Uptown New Orleans, near Loyola and Tulane universities.
CVS Health to split pharmacy chain from health insurance
CVS Pharmacy will be separate from CVS Health, housing major insurer Aetna and benefits manager Caremark
Five midterm winners and losers: MAHA mowed down, Dem docs scrub in, Medicare for All returns
Democratic doctors were among the winners in the midterm elections, while the MAHA movement and President Trump's health agenda were losers.
CMG Jacksonville TV, Jacksonville University Athletics announce new broadcast partnership
Cox Media Group Jacksonville TV and Jacksonville University Athletics announced on Wednesday a new broadcast partnership that names Action Sports Jax TV the exclusive home of JU Athletics broadcasts in Northeast Florida.
UK government announces public interest investigation into Sky deal to takeover ITV's media arm
U.K. Culture Secretary Lisa Nandy says she will intervene in the planned 1.6 billion-pound or $2.2 billion deal between Sky and ITV’s media and entertainment arm. Nandy said Wednesday that
Old Forge Library to host Social Security workshop
Old Forge Library will host a free Social Security planning workshop Nov. 10, covering retirement benefits, claiming ages, taxes and options for couples.
S.D. Biotech announces annual award winners
South Dakota Biotech recognized outstanding industry partners recently with awards presented at its annual summit.
The daily habits that have the biggest impact on healthy aging
Fatty15 reports that healthy aging relies on consistent daily habits such as a nutritious diet, regular physical activity, sufficient sleep, stress management, and social connections.
APT29-Linked Hackers Hijack Web Analytics Script to Deliver iOS and Android Exploits
APT29-linked attackers use compromised sites and Plerdy analytics to deliver iOS and Android exploits that steal browser and device data.
Election 2026: Nebraska voters reject ballot measures to legalize online sports betting
Nebraska voters have rejected a pair of ballot initiatives that sought to legalize and regulate online sports betting.
Cosmic Baseball announces 2027 Takeover Tour stop at Gwinnett Field
Cosmic Baseball, the immersive blacklight baseball experience, has announced its 2027 touring schedule across 44 Minor League Baseball (MiLB) stadiums.
CVS confirms it will split pharmacy business from insurance
The 2018 merger of insurance behemoth Aetna and a 9,000-store retail pharmacy chain had built a $117 billion empire.
Aroma Joe's now open in Bucksport
Aroma Joe's has opened its new location, its 58th in Maine, at 80 US-1 in Bucksport. The newly built, 1,170-square-foot coffeehouse and drive-thru features coffee and espresso drinks, flavor infusions,
CVS to split into two companies, in major breakup of its $117 billion healthcare empire
CVS Health said Wednesday it is splitting into two companies, marking one of the largest shakeups in the healthcare industry. It’s a major reversal of the mergers that brought together the nation’s largest drugstore retailer along with health insurance giant Aetna and pharmacy benefit manager Caremark.
CVS to split into two companies, in major breakup of its $117 billion healthcare empire
CVS Health said Wednesday it is splitting into two companies, marking one of the largest shakeups in the healthcare industry. It’s a major reversal of the mergers that brought together the nation’s largest drugstore retailer along with health insurance giant Aetna and pharmacy benefit manager Caremark.
CVS Health is splitting into two companies, separating its pharmacies from insurance
CVS Health expects the separation of Aetna and Caremark from about 9,000 pharmacies to be completed in the first half of 2028
Fortnite's Ultra-Rare Pirate Shop Token Hunt Sparks Wave of Profiteering and eBay Listings
Fortnite Players Are Doing Things Epic Would Probably Prefer They Didn't to Try to Get the Ultra Rare Pirate Shop Token.
Commentary: Rural and religious Americans lost faith in science. We can win them back
In July 2014, a man sick with Ebola flew from Liberia into Lagos, Nigeria, one of Africa’s largest and busiest cities. One imported case in a place like that could
Top health takeaways from the midterm elections
Democrats gained control of both chambers of Congress, and doctors and scientists won key seats. Here are the top health takeaways from the midterms.
‘Extreme’ orchestra feat coming to Paramount Theatre
Acclaimed pianist Stewart Goodyear joins Orchestra Iowa at Cedar Rapids’ Paramount Theatre on Nov. 14-15 to perform all five Beethoven piano concertos in chronological order across two days.
HCPSS Teams Up with Student Group to Drive Student Interest in and Understanding of Coding, Computer Science, and Artificial Intelligence
Several years ago, Julie Wray and Carrie Trudden, Howard County Public School System’s (HCPSS) then- and current coordinators of Instructional Technology, began receiving emails from a group called Howard County Hour of Code (HocoHOC). At the time, Wray and Trudden were unfamiliar with the group and skeptical about its offer to partner with the district […]
Happening in Boise: The Blues, Cell Block Tango and Cinema
Here’s a look at what’s happening around Boise from November 6 through November 8.
‘Arrested Development’ alum David Cross coming to Iowa City
Comedian David Cross, known for his work on “Mr. Show” and “Arrested Development,” talked with The Gazette about fatherhood, his career and more ahead of his appearance Nov. 10 at
CVS Health to split in two, separating pharmacy business from insurance
Nov 4 (Reuters) - CVS Health said on Wednesday it will split into two companies, separating retail pharmacy from its insurance and pharmacy-benefit operations in a major unwinding of the
State employees to see small jump in health premiums under new PEIA proposal
During a hearing Thursday, Oct. 29, 2026, the PEIA Finance Board released a plan that raised health insurance premiums 2% next year. This affects West Virginia state government employees.
CVS to split off drugstore business in major breakup of healthcare giant
The move would reverse the company's $78 billion acquisition of Aetna, and dismantle the vertically integrated healthcare conglomerate it created in 2018.
CVS to split off drugstore business in major breakup of healthcare giant
The move would reverse the company's $78 billion acquisition of Aetna, and dismantle the vertically integrated healthcare conglomerate it created in 2018.
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.
Jackson Hole Mountain Resort drops afternoon pass
New pass caters to fans of groomers, free parking, fewer crowds.
'Full-time job to keep up with it': Drug pricing program changes worry WV clinic
Beginning in 2027, Trump administration changes to the federal 340B drug pricing program will increase the purchasing and administrative costs for eligible clinics, including in West Virginia, which will have to pay up front for the drugs and seek rebates from drug manufacturers.
UGA celebrates Science and Ag Hill modernization
The University of Georgia completed the second phase of its Science and Ag Hill modernization initiative and celebrated with a ribbon-cutting and tour of the renovated facility on Oct. 28,
Trinity's 50th production of 'A Christmas Carol' will be something 'people will really talk about'
PROVIDENCE – Taavon Gamble has never directed “A Christmas Carol.”
Quinn to exhibit photography at Blackstone River Theatre
CUMBERLAND – Blackstone River Theatre’s Art Gallery will host an exhibit and sale of concert photography by Kerry Quinn on display through Dec. 20, viewable two hours before and during
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.
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.
Three Trade Partners for the Detroit Tigers This Winter
With the team needing relief pitching and several teams needing outfield help, the Detroit Tigers have several potential trade partners. The Motown team allowed 11 walk-off hits in 2026 and blew 32 saves, both the most by an American League team. Although their offensive core and deep starting rotation will be back for next season, …
\'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
Brenda Lucas: Community news for Wednesday, Nov. 4
Click for community news in the Huntington, West Virginia, and Tri-State area.
Halloween-themed event aims to get youngsters 'excited about science'
GOSHEN — Children in Halloween costumes spent Saturday driving robots, meeting animals and watching chemistry demonstrations at E3 Robotics Center’s sixth annual Science Spooktacular.
I moved to Europe for free health care. I miss my patient portal
“To be honest, in Malta, I pay for medical care all the time. I just pay differently,” writes Mariska Breland.
Disney has fought AI firms over copyright. Now it’s testing AI lyric videos
Walt Disney Co. is experimenting with using artificial intelligence to test out different concepts for music videos showcasing the lyrics to its songs, starting with “Go the Distance” from its
‘Enraging’: WA residents despair as insurance premiums climb again
SEATTLE — Kate Neville is dreading the new year. As a freelance grant writer, Neville has to buy her own health insurance, and for years her premiums have been climbing.
Declining influenza vaccinations continue among health care workers
Despite often caring for patients at higher risk of severe outcomes from respiratory virus infection, health care workers in Oregon continue to lag in rates of vaccination against the potentially
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..
CVS Health To Split Into Two Companies As Pressure Mounts On Vertical Integration
CVS Health will split into two companies, putting the more than 9,000 drugstores under one business and its Aetna health insurance and pharmacy benefit operations into another.
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
Charity donates mental health packs to primary schools
Amy Watson is offering support through a charity she set up after the death of her partner Joe Phipps.
St. Albert the Great Academy: Finding amazement in agrarian science
St. Albert the Great is typically remembered in history by his Latin title, "Albertus Magnus." This Dominican abbot and bishop in the Catholic Church is remembered not just for his
Nebraska football’s special teams search for consistency as kicking woes persist
A major talking point with Nebraska football is a lack of consistency on special teams. These failures have led to Matt Rhule replacing Kyle Cunanan with Matt Hohl for all field goals and points after touchdowns.
PJHS Halloween
Students and staff at Pleasanton Junior High shared their Halloween spirit, dressing up in spooky and fun costumes and characters.
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.
Shapiro becomes first Democrat to win Lancaster County vote since 1990
Gov. Josh Shapiro not only won reelection Tuesday, he became the first Democratic gubernatorial candidate to win Lancaster County since Robert P. Casey won here in 1990.
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.
Declining influenza vaccinations continue among health care workers
Despite often caring for patients at higher risk of severe outcomes from respiratory virus infection, health care workers in Oregon continue to lag in rates of vaccination against the potentially
Incumbent Republican Dave Zimmerman handily wins 99th House District
Republican Rep. Dave Zimmerman was reelected to an eighth term in Pennsylvania’s 99th House District on Tuesday with 68% of the vote. He defeated Democratic challenger Ethan Gabrick, who received
Hal E. Kovert, Architect, Business Leader, Crothersville Native Succumbs
Hal E. Kovert, founder of Kovert Hawkins Architects in Jeffersonville and a longtime contributor to the civic and philanthropic life of Southern Indiana and Kentucky, died Saturday, Oct. 24, 2026, at the age of 73. He was a native of Crothersville. Kovert co-founded Kovert Hawkins Architects with longtime business partner and friend John Hawkins in […]
Republican Steve Mentzer wins another term to the 97th House District
Republican Steve Mentzer will serve another term in Pennsylvania’s 97th House District after winning 55.6% of the vote Tuesday.
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
Nature comes to life in ‘MOMIX: Botanica’ at the Schaefer Center on Nov. 12
MOMIX presents Botanica, a visually stunning dance and illusion show exploring nature’s rhythms, at Appalachian State University’s Schaefer Center on November 12. This multisensory performance combines athleticism, inventive props, and atmospheric music to transform dancers into flowers, insects, and fantastical creatures.
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.
A jack of all tales: Orville Hicks delights museum annual meeting with stories of Appalachia
JEFFERSON — The Orion Schoolhouse became storyteller Orville Hicks’ front porch on Oct. 20 as he regaled the Museum of Ashe County History’s board members with old mountain tales and
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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The Last Disney+ Original?
(Welcome to my weekly streaming ratings report, the single best guide to what’s popular in streaming TV and what isn’t. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. If you were forwarded this email, please subscribe to get these insights each week.) Before we get going, I wanted to remind readers about how I plan to keep your trust while I add advertising to this newsletter. As you’ve no doubt noticed, I’m running ads now, but the danger is that it could impact my analysis and writing. I have a list of sponsors on my About Page, so if you think I’m biased, you can check out who’s sponsored this newsletter! This is something that I’m not sure anyone else in digital media does (if you’re a writer or media outlet and you do this, let me know and I’ll shout you out!) but it’s something I’d love to see embraced by the entire industry. Sunlight, i.e. transparency, is often the best disinfectant. Okay, on to this week’s issue. We (finally) have another major Disney+ TV show to talk about, so that’s my main focus for today. Plus, we had a lot of new shows come out, including the fourth seasons of The Diplomat and Tulsa King! And Love is Blind! The Lowdown! Also, four (four!) straight-to-streaming films came out this week, featuring a lot of big names and celebrities, so I’m going to look at those. All that, mixed news for the WNBA, Reacher ends its run on the charts, Skydance does well in September viewership, NYU’s Sundance dominance, all the flops, bombs and misses, and a whole lot more. Let’s dive right in! (Reminder: The streaming ratings report focuses on the U.S. market and compiles data from Nielsen’s weekly top ten viewership ranks, Luminate’s Top Ten Data, JustWatch and Reelgood interest data, Samba TV household viewership, company datecdotes, Netflix hours viewed data, Google Trends, and IMDb to determine the most popular content. While most data points are current, Nielsen’s data covers the weeks of October 12th to October 18th, 2026. You can find a link to my terminology here.) Subscribe Television - Disney+’s Porridge Problem Listen, per my headline, VisionQuest isn’t the last Disney+ Original. At least, I’m pretty sure it’s not. They have other MCU shows in development. Well, maybe one: But it sure feels like the end of an era. I’d call it their “porridge too hot” era, to quote myself from The Ringer. I told Ben Lindbergh that Disney+ seemingly couldn’t figure out the right amount of content. In the heights of the Streaming Bubble Era (circa 2019 to 2022), they started releasing an insane amount of TV shows. After their growth slowed, they’re down to two or three shows a year, and that might be down to 1 by 2027. Here’s my TV shows by year chart: Even at the time, I thought Disney was making too many shows (that cost too much). Today? They’re definitely making too few shows (though the budgets are more in check, at least according to the reporting). Porridge too hot, porridge too cold; too many shows, now not enough. Which makes evaluating VisionQuest so interesting. This show didn’t have a great lead-in, whether it be a Marvel Cinematic Universe film (the last non-Sony-produced-Spider-Man flick came out The Fantastic Four from July of 2025) or Marvel Cinematic Universe TV show (the two this year were Wonder Man back in January and _Daredevil: Born Again_in May, both of which underwhelmed). And so far, VisionQuest hasn’t quite recaptured the MCU Originals glory, but it has some signs of sparks. First, it made Samba TV, though at a lowly ninth place. At least it made it, a feat some other Marvel shows didn’t accomplish. (Ironheart landed on the Samba TV charts one week at tenth place, but Wonder Man and Daredevil: Born Again both missed.) VisionQuest also made Luminate, though with only 3.0 and 7.6 million hours. But it missed Nielsen in its first week. The best news might be its 7.8 on IMDb, on 12K reviews so far, great numbers, even for a superhero show. Looking at those numbers, this show will really need to pick up in future weeks—and it may since it’s coming out weekly—or Disney will have another disappointment on its hands. Disney+ binge-released their last few shows to try to boost numbers, but that meant shows like Iron Heart and Wonder Man didn’t last long on the charts. _Daredevil: Born Again’s_last season missed entirely (though it came out weekly). Here’s the Disney+ Originals by totals: And for a fun new look, here are those same shows, rearranged by the years they came out: That really shows that, in addition to Disney+ releasing fewer shows, those shows just don’t hit like they once did. If I had to offer one main explanation, it’s that Marvel Studios moved away from characters who starred in the Avengersmovies (The Scarlett Witch, Vision, Hawkeye, Loki, Falcon, Winter Soldier) to characters who didn’t (Moon Knight, She-Hulk, Iron Heart, Wonder Man, Daredevil). It sounds trite, but more popular IP tends to do better than less popular IP. In Marvel’s case, beloved, decades-old characters trump newer ones. And yes, I think this is a problem for Disney. The failure of Marvel TV shows to linger for weeks on the charts, unlike in 2021 and 2022, explains why Disney’s share of the charts has plummeted: That’s a strategic issue. Yes, these shows are really expensive, but without them, Disney+ will struggle, especially if Disney+ keeps raising prices AND licenses out its shows non-exclusively. My recommendation? Return to the core value proposition, which is Disney+ as “genre HBO”. The goal is six shows a year, coming out weekly, spaced out throughout the year. When a show hits, keep it coming back. Make three to four of those shows Marvel or Star Wars, and fill out the rest with IP swings like Percy Jackson, Goosebumps or something like National Treasure. And make YA-skewing shows like Coven Academy to fill out the schedule. Disney, you can get this porridge just right, er, make the right number of shows. Quick Notes on TV Netflix’s sophomore, er, junior, er, senior season slump abated very, very slightly this week. I speak of The Diplomat, which returned for its fourth season on 15-Oct. Credit where credit is due, this show debuted in April of 2023, and has put out new seasons every year since. Has that helped the viewership? Not really. This season opened to 16.4 million hours, which is down significantly from the first season (21.7 million hours) and down somewhat from the second season (18.0 million hours), but it is up from last year’s 14.2 million hours opening. On Samba TV, it opened to third place; that’s also very good. On Luminate, it opened to 25.0 million hours, which is good, but over thirty million hours is a hit on that platform. Netflix wisely renewed it, since it’s steady and, frankly, Netflix needs hits.1 Paramount+ put out Tulsa King’s fourth season on a Friday. After putting out most of their big, usually-Taylor Sheridan-scripted shows out on Sundays last year, they’ve clearly moved to Fridays going forward. Was this a thought-out strategic change, Netflix mimicry, or a data-inspired move? Tough to say. Fridays are crowded with new movies, but so are Sundays with new shows. Anyways, this one is coming out weekly, and we haven’t seen it hit the Nielsen or Luminate charts yet. But it did make Samba TV at fifth place, which is a good opening. Still, if this doesn’t make Luminate or Nielsen next week, I’d call it a disappointment. Netflix had two unscripted shows hit the charts this week, one a docu-series and one a reality competition show. Tyson is a four-episode docu-series about one of boxing’s most popular fighters, and it made both the Samba TV and Luminate charts, but not Nielsen. That’s a solid run for only four episodes (assuming it didn’t cost an arm and a leg to produce). Netflix’s latest season of Love Is Blind also returned for its eleventh season, which opened to 10.0 million hours, down from previous seasons. It also had 11.0 million hours according to Luminate, roughly in line with the Nielsen numbers. Last issue, I analyzed the triple successes of Below, Carrie and Crystal Lake, noting that all three have done well. I mostly used Nielsen, but all three shows also made Samba TV (see above). Crystal Lake in particular did very well on Luminate, getting 35.0 million hours, top for Peacock among first seasons: The top “show” of the week would have been Thursday Night Football again, at 41.7 million hours. This is still above last year’s game, but it continues the season’s overall downward trend, which happens every year. (Though a big week is coming, based on the news stories I’ve seen.) As I said before, I’ll do a deeper dive on all the October games later this month, with comparisons to previous years. One company is quietly on a roll, when you consider the shows it makes and streams. I speak of Skydance—a point Variety made—noting that it produces Neagley and Reacher for Amazon, along with Paramount+’s Lioness, which means it produced three of the top four shows of September according to Nielsen. By the way, Neagley fell off the Nielsen charts after four weeks, which is a pinch short for how well it started, but it’s still a huge success. (Interestingly, it finished just 7.3 million hours ahead of the cancelled Ride or Die.) The point, though, which I’ve made before, is that Prime Video still has a problem with how many co-productions it buys, most notably _The Boys_from Sony and Reacher/Jack Ryan from Skydance. It’s not a critical flaw—everyone licenses shows—but Amazon still struggles to make its own hits. Reacher finally fell off the Nielsen charts, so here’s its final rank for season four: We’re just getting started with this issue, but the rest is for paid subscribers of the Entertainment Strategy Guy, so if you’d like to find out… ...An example of the algorithm NOT picking a film… …whether or not Netflix buys shows simply for the movie poster… ...if East of Eden is above the Obliterated Line... ...what four star-studded straight-to-streaming films didn’t chart... ...and a whole lot more... ...please subscribe! We can only keep doing this great work with your support. If you want an idea of just how much content you’d get in a full issue, check out this older issue.
Mitigating health risks to protect communities
WHO and development partners have been working throughout 2026 to strengthen the capacity of health workers across Indonesia in risk assessment and public-health emergency preparedness. These efforts strengthen prevention, detection and response for emerging infectious diseases, even when no such event has occurred.