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GTA VI’s download will need up to 212GB of hard drive space
You can start pre-loading GTA VI on November 10th.
Gender equality pays off for business – so why are companies pulling back?
Gender equality and diversity are good for business – but while increasing numbers of women are reaching top spots in the corporate world, more initiatives are needed to keep momentum going.
PENN Entertainment, Inc. (PENN) Stock Dropped 31%: What’s Behind the Sell-Off?
Greenlight Capital, an investment management firm, recently released its Q3 2026 investor letter. A copy of the letter can be downloaded here. The funds returned -3.3% in the third quarter of 2026, compared with a 2.3% gain for the S&P 500, bringing their year-to-date return to -1.5% against the index’s 12.7% advance. The disappointing performance […]
God Of War Laufey Collector's Edition Doesn't Include The Game, This Time On Purpose
After Ragnarok's special edition accidentally shipped without download codes, Sony seems to have taken inspiration
RFK Jr accused of ‘blatant bigotry’ after claiming Arabs ‘don’t produce science or literature’
Health secretary suggests Middle Eastern Muslims do not win major prizes because their religion holds them back, a claim branded ‘factually inaccurate’ and offensive
Windows 11's new Cloud Rebuild can resurrect PCs that won't boot
Cloud Rebuild downloads Windows and your drivers from Windows Update, even when your PC won't boot.
Cronos: The New Dawn story DLC ‘Cronos: Lazarus’ launches December 3
Cronos: The New Dawn story downloadable content “Cronos: Lazarus” will launch on December 3, developer Bloober Team announced.
Alliance Entertainment Brings Exclusive Danny Elfman Signed Collectibles and Preserved Vinyl to L.A. Comic Con
PLANTATION, Fla., Oct. 30, 2026 (GLOBE NEWSWIRE) -- Alliance Entertainment Holding Corporation (Nasdaq: AENT), a scaled entertainment commerce a...
Some Google Home Speakers downloading massive amounts of data in the background
The new Google Home Speaker has an issue where it downloads hundreds of gigabytes of data in the background for some owners.
Apple Releases watchOS 27.2 With Siri AI Enhancements
Apple today released watchOS 27.2, the first major update to the watchOS 27 operating system. watchOS 27.2 can be downloaded through the Settings app on the watch or the Apple Watch app on a connected iPhone. Software can only be installed when the Apple Watch is on the charger and has over 50 percent battery. According to Apple's release notes, watchOS 27.2 introduces new Siri AI features and extends Siri AI to new languages.
Chamber ALX Names 2026 Best in Business Winners, From Hypergoat Coffee to Continues Arcade
Meet the eight Alexandria businesses and leaders who took home top honors at the Chamber ALX’s 2026 Best in Business Awards.
HealthForce Kentucky to Share Its Immersive Health Science Model at NCHSE 2026
2026 zSpace Program of Distinction honoree will show how one AR/VR ecosystem powers mobile, K-12, and workforce development healthcare training...
AB Science will hold a web conference on Wednesday, October 14, 2026, from 6:00 p.m. to 7:30 p.m.
PRESS RELEASE AB SCIENCE WILL HOLD A WEB CONFERENCE ON WEDNESDAY, OCTOBER 14, FROM 6:00 P.M. TO 7:30 P.M. Paris, October 12, 2026, 6:00 p.m. AB...
TEGNA and Disney Entertainment Television Renew ABC Affiliation Agreements in 13 Markets
TEGNA and Disney have entered into a comprehensive, multi-year deal that renews station affiliation agreements for all of TEGNA’s ABC-affiliated stations....
Some Google Home Speakers caught downloading hundreds of gigs of data
The issue might be tied to failed attempts to install a firmware update.
Amazon plans more than 2,000 holiday hires in Tampa Bay
The online retailer’s nationwide hiring target includes roughly 21,000 employees from Florida, with more than 300,000 nationwide.
Communities worry for their health after Trump weakens pollution limits: 'It's a kick in the gut'
Biden-era changes to the Clean Air Act would have tightened regulations for industrial sites, but the Trump administration has given exemptions to hundreds of facilities. People living near the sites are concerned about air quality and their well-being.
Australian public servants demand AI safeguards as politicians eye staff savings
One Nation’s Barnaby Joyce wants retiring public servants replaced with AI.
Morning Download: Nevada-San Jose State football game to air live on NSN
On weekday mornings, Nevada Sports Net will recap three big headlines of the day in its Morning Download. Read below for today's topics.
Apple Releases macOS Golden Gate 27.2
Apple today released macOS Golden Gate 27.2, the first major update to the macOS 27 operating system that launched in September. Mac users can download macOS Golden Gate 27.2 by opening up the System Settings app and using the Software Update option. macOS Golden Gate 27.2 overhauls the brightness and volume sliders, plus it expands Siri AI to new languages including French, Japanese, Korean, Portuguese, and Spanish. Apple's release notes for the update are below.
Download all 20 Apple HomeView wallpapers here
Apple tonight rolled out the HomeView 27.2 system update, ahead of the device’s official launch on November 13.
Andrew Hastie blasts One Nation’s ‘MAGA-style politics’ after cartoon mocking Jacqui Lambie’s vaginal prolapse
The 'Please Explain' cartoon series from Pauline Hanson's One Nation continues to depict Hastie as a traitor.
WHO urges vigilance after Kenya confirms second Ebola case
The World Health Organization (WHO) continues to support Kenya’s efforts to contain Ebola after a second person tested positive for the Bundibugyo virus, the UN agency’s representative in the country said on Thursday.
WHO urges faster action to end lead exposure which kills 3.5 million annually
Countries must accelerate efforts to prevent lead exposure, which is estimated to cause more than 3.5 million deaths globally each year and affects hundreds of millions of children, the World Health Organization (WHO) said on Thursday.
Whitlam would push Australian PM Albanese to go ‘bigger and bolder,’ biographer says
Albanese read the biography in office, calling its author to discuss Whitlam’s political mistakes as he encountered them.
GOG Aims To Revive Physical PC Games
GOG has long been a proponent of game preservation, with its Game Preservation Program seemingly working tirelessly on getting old PC games up and running on modern hardware and providing downloadable, DRM-free, offline installers for those games, and recently even partnering with Big Box...
November 2026 PS Plus Essential Games Available to Download Now
Tour a Dead Island, board a Monster Train
Casual game store Legacy Games is shutting down, purchases won’t be re-downloadable despite ‘keep forever’ slogan
After February 2027, players will no longer be able to download or install purchased games…
AI Business Use Rises Despite Growing Concern | The Morning Download for Oct. 13
Plus, Meta’s new model.
An Xbox Series X can now run PlayStation 5 games, but there’s a catch
While PS5X can let Xbox Series X users play PlayStation 5 games, it only works in the console's official Developer Mode, and there's no public download yet.
WHO scales up Ebola readiness in 22 countries across three continents
The World Health Organization (WHO) is strengthening Ebola preparedness amid conflict and displacement affecting millions of lives in a region that spans parts of Africa, Asia and Europe.
Exclusive Brethren church denies claims of coordinated political campaign in Australia
Parliamentary inquiry demanded the global leader of the sect and his son attend to answer questions.
Cabka’s emission reduction targets validated by the Science Based Targets initiative
A major milestone in Cabka’s decarbonization journey Amsterdam, Netherlands - 19 October 2026 - Cabka N.V. (together with its subsidiaries “Cabka”, or the...
Raiders cut OL Evan Neal from the practice squad
The Raiders cut offensive lineman Evan Neal from their practice squad on Monday, the team announced.
The Hollywood Minute and The Rhonda Swan Show: Wake Up SoCal Edition Spotlight Christy DiNapoli of West Village Entertainment & Technology and Music Industry Community
Los Angeles, CA, Oct. 12, 2026 (GLOBE NEWSWIRE) -- The worlds of entertainment, technology, and entrepreneurship increasingly overlap, opening d...
WHO calls for urgent health action across the Eastern Mediterranean
The head of the World Health Organization (WHO) has called for promoting, providing and protecting health in the Eastern Mediterranean region, home to some of the world’s top humanitarian crises such as Sudan, Yemen and the Occupied Palestinian Territory.
AI coding agents hijacked using AGENTS.md file in Downloads folder
Researchers found a malicious AGENTS markdown instruction file in a customer's Downloads folder that tricked an AI coding agent into installing a rogue npm package.
Business Beat: Adventure Zone to host Trunk or Treat event Tuesday evening
COLDWATER, MI (WTVB) - Adventure Zone in Coldwater, Michigan, has officially announced its upcoming Trunk or T...
Mario Kart 8 Deluxe Has Been Updated To Version 4.0.1, Here Are The Full Patch Notes
Download it today
Health care shakes up the Iowa election
If Democrats flip Congress, health care could find its way to the top of their 2027 agenda.
New research finds privacy protections preserve most social science findings amid growing census data debate
In the largest study of its kind, researchers from MIT Sloan School of Management and Carnegie Mellon University found that roughly 91% of published...
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New substance use and mental health treatment center opens in Springfield
A new substance use and mental health treatment center has opened in Springfield, expanding access to recovery services for residents across Hampden County.
Flutter Entertainment PLC: Q3 2026 Earnings Release
NEW YORK, Nov. 04, 2026 (GLOBE NEWSWIRE) -- Flutter Entertainment plc (NYSE: FLUT) (“Flutter”), the world’s leading online sports betting and iGaming...
Attackers Hunt for Gaps, Enterprises Demand Proof: Regula’s 2027 Identity Verification Predictions
RESTON, Va., Nov. 02, 2026 (GLOBE NEWSWIRE) -- Regula, a global developer of identity verification solutions, today released its 2027 identity ...
Thermo Fisher Scientific (TMO) Benefits on Broad-Based Recovery Across Life-Science Markets
Broyhill Asset Management, a Charlotte-based firm, issued its third-quarter 2026 investor letter. The letter can be downloaded here. The Broyhill Equity Composite decreased by 0.3% in Q3, underperforming the MSCI All Country World Index, which gained 1.7%. For the first nine months of the year, the Composite returned 1.9%, compared to 13.4% for the Index. The […]
Big Tech faces a political reckoning in Ohio
A victory for Sherrod Brown in Ohio's competitive Senate race could embolden politicians in both parties to take on the tech industry.
Kenya: 20 Ebola contacts released from quarantine
Twenty people associated with Kenya’s first case of Ebola Bundibugyo virus disease have been reunited with their families after being released from quarantine following completion of the mandatory 21-day monitoring period.
GTA 6 game size revealed, as pre-load commences in just over two weeks
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Ebola: UN officials condemn killing of nurse in DR Congo
The UN’s Ebola coordinator and the head of the World Health Organization (WHO) have deplored the killing of a nurse working to halt the spread of the disease in the Democratic Republic of the Congo (DRC).
Scammers Are Taking Advantage of Hype for PS5 Emulators by Tricking Gamers Into Downloading Malware
Security experts have issued a warning over fake PS5 emulators after they found scammers were tricking gamers into downloading malware.
Ukraine: Critical health supplies destroyed in ongoing Russian attacks
Ongoing and deadly Russian attacks across Ukraine are causing serious healthcare disruption, with more than $1.5 million-worth of medicines and supplies destroyed in four separate strikes on warehouses used by the UN there since July.
NEWS: Biomedical Studies, NSF-Funded Science, Student-Led Projects, and More on NASA’s SpaceX CRS-35
ISS National Lab-sponsored research aims to advance regenerative medicine, improve understanding of natural hazards, and inspire the next generation of scientists and explorers
World News in Brief: healthcare crisis in Yemen’s Taiz and Afghanistan, UN mission in Western Sahara ends
The humanitarian crisis in Yemen is worsening, particularly in the southwestern city of Taiz, which is being encircled by paramilitary Iran-backed Houthi forces.
Pocket Planet Canada Takes Immersive Entertainment to New Heights With Everest: The First Ascent
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Lamont praises UConn health purchase of Waterbury Hospital, Fazio says ‘Nothing was done about it’
WATERBURY, Conn. (WTNH) — On the doorstep of Waterbury Hospital, Gov. Ned Lamont and a set of local political allies hailed UConn Health’s purchase of the Brass City’s largest healthcar…
The Week in Business: What’s the Deal with That Iowa Steel Mill?
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US teens can access ‘nudify’ apps despite Apple and Google’s parental controls, report finds
Exclusive: Using test accounts, Tech Transparency Project downloaded 135 apps with features to generate nonconsensual nude imagery
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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Pope hope, that’s entertainment, and getting ahead in the CIA
Happy Friday friends, I want to start by just breathing for all of us a big long collective sigh of relief at the news this week that the pope’s doctors have basically blown the all clear for Leo’s health. Going from knowing nothing to him declaring to the world he needed surgery, to a cancer diagnosis, to bouncing out of the hospital in barely even days, to ringing the bell in less than two weeks is whiplash inducing. But in the best possible way. We are living in a world in which the Roman pontiff, by dint of history, biography and circumstance, is once more at the epicenter of global affairs. Not just conversations about religion, or Christian and post-Christian values, but the bleeding edge of the most pressing issues of human affairs. Think I am exaggerating a touch? Consider the images of the crowds who greeted Leo in Paris just weeks ago, and juxtapose them with the absolute photo negative scenes unfolding there recently. Ask yourself how many world leaders are talking about AI right now and directly citing the pope as they do so. Try to name a country who has had as many top-ranked diplomats in and out of both Russia and Ukraine in the last three years as the Vatican has in the last three months. It has been fascinating to watch Leo XIV emerge as not just a kind of pop culture reference point or totem to be cited (Francis was often name-checked this way) but as a kinetic force in global conversation. Given the state of things, we need global figures of gravitas and values, even better if they have real wisdom behind what they are saying. So news of Leo’s illness was, it seemed to me, a tremor with potentially Richter Scale implications. That not only has the worst not come to pass but instead we’ve had the best of outcomes announced is something to really be grateful for. Humanity, it seems to me, is entering one of its irregular but cyclical phases where the pace of change — technological, social, and geopolitical — outstrips the ability of previously settled norms and received wisdom to cope. Such periods – and I think the first decades of the last century were a similar such time – throw into question the viability of all kinds of institutions. And many of ours have been straining to breaking point for a few years now. The papacy has the power and the potential to be a steadying pole in all of this. That’s my hope, anyway. It’s a lot to freight the office with, though it is arguably its ultimate purpose from its founding, to be a steadying rock on which all that matters can be anchored. It’s also, of course, an intolerable weight of responsibility to place on a single man. But I am encouraged to have hope in – and for – Leo. The apostle whom he succeeds, after all, was famously unequal to some moments, failed some tests of faith, and resiled from taking the road which led ultimately to the circus on Vatican hill. Human frailty and limitations, of health, of character, of temper, can open us to Christ, whose strength is greatest in our weakness, so St. Paul learned. That gives me hope, and I am sure it consoles Leo, too. And so I will continue to pray for him. Because we need apostles of rock right now. Here’s the news. Subscribe The News The Dicastery for the Doctrine of the Faith issued yesterday a new document “Venite ad me: Considerations on the Transmission of the Faith in an Epochal Change.” It’s not a short document, and it is at pains to stress this isn’t a doctrinal note from the dicastery, either. Rather, it brings together reflections on an important issue from the Church around the world. Some of it I actually found really rather powerful. It is, however, 25,000, which is a lot for a busy reader to get through on a weekday. So, you can read our busy reader’s summary right here. — News broke yesterday of an Oct. 22 meeting of U.S. bishops with President Donald Trump. The meeting was organized by an official at the Heritage Foundation, according to several sources close to the meeting. Video of several U.S. bishops praying in the Oval Office over President Trump was posted on social media Thursday afternoon, first by White House Communications Advisor Margo Martin, and then by the official twitter.com account of the Archdiocese of Denver. The meeting has drawn sharp criticism because of its proximity to the upcoming midterm Congressional elections, in which Democrats are widely expected to win control of the House of Representatives, while control of the Senate remains closely contested. Sources close to the bishops’ conference told The Pillar that some USCCB senior officials were surprised by the existence of the meeting when video of it first emerged online. And a source close to conference president Archbishop Paul Coakley of Oklahoma City told The Pillar that the archbishop was “deeply frustrated” by the occasion of the meeting. An official conference spokesperson told The Pillar that the meeting was “not organized with or by the USCCB” and was “not affiliated with the conference.” You can read the whole story here. — The next National Eucharistic Congress will be held in Indianapolis in 2029, a return to the city that hosted the last gathering in 2024. You read it here first. By here, I don’t mean this newsletter, I mean at The Pillar. We broke the story this week. It’s a big deal, in as much as the last congress was a roaring success and the next installment has the potential to be a real focal point for evangelizing efforts in the coming years. Read all about it here. — As Pope Leo prepares for the longest trip of his pontificate, Church leaders in Uruguay say the pontiff will encounter a highly secularized culture, in a country with a very different Catholic history than many of its South American neighbors. The nation has not had a papal visit since 1988, and leaders who spoke with The Pillar say it has a dire need for evangelization, even amid the prospect of a small revival in faith. This is real reporting on the Church in the country, and frankly a story you simply are not going to be able to read anywhere else. Read the whole thing. — The Archdiocese of Detroit announced this week a plan that would see the vast majority of its parish priests reassigned next summer, amid a restructuring process expected to dramatically shrink the number of parishes in the archdiocese. Archbishop Edward Weisenburger said this week that the plan “asks much of our priests,” but is a “sacrifice they are making as brothers of one, unified presbyterate.” The thing is, as JD pointed out in an analysis yesterday, pastors of parishes have a legal right to stability in office, so the only way this kind of wholesale reassignment goes ahead is if all of the archdiocesan clergy agree to resign. That creates its own kind of legal issues, though, and re-raises longstanding questions about the effectiveness of canonical due process protections for priests when dealing with coercive exercises in authority. Read the whole thing here. — More than three months after the Dicastery for the Doctrine of the Faith issued its decree declaring the excommunication of the leadership of the Society of St. Pius X, questions remain about the full effects of the society’s schism. Specifically, the DDF’s July claim that marriages witnessed and confessions heard by SSPX priests are now invalid remains contested — and it emerged this week it appears that the Vatican’s own legal experts don’t agree. You can read my whole analysis of the situation and what it means here. All I would add is that the DDF’s undeveloped, some would say unsubstantiated, claim about the invalidity of some SSPX sacraments came in their July Explanatory Note on the schismatic consecrations by the society that month. It touches directly on both papal acts of governance — indeed it purports to nullify them — and the most intimate pastoral encounters possible in a parish setting. If there is one aspect of the Francis-era style of governance I would like the curia to finally cut out, root and branch, it would be these attempts to try to effect extraordinarily sensitive legislative acts via a note. — At least a dozen French bishops have spoken out following an eruption of violence on the country’s streets Oct. 17. Not surprisingly, they unanimously condemned the violence, but the length and content of their interventions varied significantly. Several sought to distinguish between the actions of rioters and what they suggested were the legitimate concerns of peaceful young protesters. Many also evoked Pope Leo XIV’s Sept. 25-28 visit to France, suggesting it offered a powerful counter-image to the scenes of looting and destruction. A number of bishops also stressed their solidarity with law enforcement officials who struggled to contain the disorder, as well as the owners of the roughly 3,000 damaged or looted businesses. What’s the background to the nationwide unrest that the French media calls “les violences du 17 octobre”? And what exactly are the bishops saying? Read all about it here. — A Polish bishop called for the firm defense of unborn children as well as compassion for their mothers this week, as the lower house of Poland’s parliament passed two bills seeking to liberalize the country’s abortion laws. The bill on decriminalizing assistance in an abortion passed by 217 votes to 213, while the abortion in cases of fetal abnormality bill passed by 233 to 203, thanks to the government’s majority in the lower house. Both bills will now move to the Polish Senate, the upper house of parliament, where the ruling coalition has a larger majority. The fetal abnormality bill is symbolically significant because if it became law, it would effectively overturn a 2020 ruling by Poland’s Constitutional Tribunal that a 1993 law permitting abortion for a severe and irreversible disability or a life-threatening incurable disease was unconstitutional. Read the whole story here. Subscribe **[The St. Paul Center App | Bible Study On-The-Go Read and understand the Bible with St. Paul Center’s new app! With today’s leading Catholic Scripture scholars as your guides, the St. Paul Center app empowers you to read the Bible](https://stpaulcenter.com/app?utm_source=pillar&utm_medium=email&utm_campaign=applaunch)** from the heart of the Church. Download the app for free at either the Apple or the Google app stores. https://stpaulcenter.com/app That’s entertainment I have written before about my deep and sincere reservations about the celebrity exorcist subculture which has taken root in American Catholicism. And, because I am very ill at ease with the entire thing, I try to keep a weather eye on the phenomenon without being drawn into the kind of online back-and-forth which these figures sometimes generate. Earlier this week, JD noted that one such celebrity exorcist type, Fr. Chad Ripperger, has undertaken, on the request of his bishop, a year’s fast from interviews and public speaking. I’m sure that will be salutary for him, if for no other reason than that receiving with docility requests from one’s rightful ecclesiastical superiors always comes with graces. Then a second thing happened this week which caught my eye. Apparently, another fixture in the celebrity exorcist world, Fr. Carlos Martins, has initiated a lawsuit against two lay men — apparently associates of Rippenger, though I am unclear in what way, exactly — for allegedly defaming him and his ministry on a podcast. It seems the suit was initiated nearly a year ago and is now pending. At issue, I read, is that the two men described Martins on a podcast as “not who he says he is” with regard to his exorcism ministry and that he “doesn’t know what he’s talking about.” These statements Martins considers to be false and defamatory and, his suit claims, “directly affected the sale and reception of [his] The Exorcist Files book that was newly released at the time these episodes aired.” I don’t want to get too into the weeds of the details here, but a couple of things struck me about all this.
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