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Sean ‘Diddy’ Combs’ prison release date moved up following transfer
The disgraced music mogul is now projected to be released in early 2028 following a transfer to a low-security facility in Pennsylvania.
Jamie Foxx welcomes third child, his first with Alyce Huckstepp
Jamie Foxx and his girlfriend Alyce Huckstepp welcomed their first child together. The "Ray" Oscar winner is also a father to two adult daughters, ages 32 and 18.
Regal Rexnord considers selling its autonomous mobile solutions business amid portfolio review
Milwaukee-based manufacturer Regal Rexnord announced that it will perform a comprehensive portfolio review in which it will explore the possibility of
Nov. 5 Vallejo/Vacaville Arts-Entertainment Source: Faces and Places
On Oct. 17 at the CC and Regina Yin Ranch in Vacaville, the Asian Pacific American Public Affairs (APAPA) celebrated its 25th anniversary with a gala attended by 500 guests.
Caitlin Clark announces historic brand partnership deal
Caitlin Clark has made history multiple times on and off the court during her WNBA career, and she did so again on Wednesday with the announcement of her latest brand deal. Clark is teaming up with DICK’S Sporting Goods on a new, multi-year partnership. which also includes Foot Locker. The Indiana Fever star is the…
Tinto Brass, director known for erotic film ‘Caligula,’ dies at 93
Tinto Brass, the avant-garde Italian director who helmed erotic 1970s films including 'Caligula' and 'Salon Kitty,' has died at 93.
Anthology by local editors imparts wisdom, advice to young women
“Uncertain Girls in Uncertain Times” includes essays from 40 contributors around the country, as well as poems that mirror their life experiences.
Dan Hurley gives brutal reaction to being given game ball
Say what you will about Connecticut Huskies basketball coach Dan Hurley, but he is never going to win anyone over with a charm offensive. Hurley has been incredibly successful at UConn, but he’s also drawn criticism for his antics and outbursts, especially his treatment of referees. But when it comes to his press conference escapades, Hurley can sometimes…
CVS Jumps on Report It Plans to Break Up Health Conglomerate
CVS Health Corp. is discussing plans to spin off its retail pharmacy business, according to the Financial Times, a shocking retreat for the country’s largest drugstore chain.
MacBook Neo 2 is coming, and Apple reportedly expects a massive hit
Apple has a MacBook Neo 2 rumored for early 2027, and a new report from Digitimes indicates the company is expecting it to be a massive hit.
LA film students are eager to pick up Hollywood's pieces
Mergers, layoffs, AI and runaway production have shaken Hollywood. Film students at USC, UCLA and LMU explain why they're pursuing the industry anyway.
Bulls make some history despite blowout loss to Knicks
Times are tough for the Chicago Bulls . On Wednesday, they suffered a 135-105 blowout defeat to the defending champion New York Knicks. The Bulls also saw Jalen Smith go down with a left-hand injury , leaving them vulnerable at center. However, though they lost again, Chicago still made some history. For the first time in franchise history, all 15 […] The post Bulls make some history despite blowout loss to Knicks appeared first on ClutchPoints.
Hugging Face Launches ProtoStar to Tackle Science's Data Problem
There’s a lot of scientific data out there – and universities, government agencies, and research labs have spent decades collecting it. This includes everything from climate change to human biology. Much of it is publicly available. However, that doesn’t necessarily mean other researchers can easily use it. Sometimes, just getting the data into a usable […]
Seattle sandwich chain to close 2 stores, end operations
The Seattle-based sandwich chain Homegrown will close its remaining two stores and catering business amid rising labor costs and food prices.
Physicists sank a telescope 1.5 miles under the sea to put Einstein's relativity to the test
A half-built neutrino telescope on the floor of the Mediterranean Sea searched for cracks in one of physics' most basic invariances. It came up empty, but its limits rival those of detectors many times its size.
Sports figures-turned-politicians mixed results in midterm elections
Former athletes NFL linebacker Colin Allred, MLB slugger Mark Teixeira, and Paralympian Josh Turek are a few of the sports figures who participated in the midterm elections and won.
Marc Maron is figuring out what to do with all his free time
After ending ‘WTF With Marc Maron,’ the comedian is embracing privacy, pursuing new projects and figuring out life beyond the microphone.
Johnson won't seek reelection as House speaker after Republican wipeout
It's a swift rise and fall for Mike Johnson, often seen as an accidental speaker, who nevertheless drew close to President Donald Trump and led the House GOP during a tumultuous era, with one of the slimmest majorities in modern times.
From Yonkers to Florida: How Casino Entertainment Changes Across Destinations
In Yonkers, a casino outing can begin with a simple arrangement: meet for dinner, spend an evening together and head home. Put the same idea into a Florida vacation, and the planning changes. Now there may be a hotel reservation, a concert and a beach day to fit around it. The word “casino” covers both […]
Apple disables Siri AI waitlist in iOS 27, with one exception
A newly updated Apple support document says Siri AI no longer uses a waitlist to enable it, except in “high demand” times.
New Lehman Center director Dante Albertie wants to make Bronx an entertainment destination
Less than two months into his first season as Executive Director of Lehman Center for the Performing Arts, Dante Albertie spoke with the Bronx Times about
As she debuts on Broadway, Kailey Boyle praises Madison theater scene
Boyle, a Middleton High School grad, makes her debut in “Wanted” on Broadway this fall. The show opens officially Nov. 8 in New York.
Report: CVS explores splitting pharmacy, insurance businesses
The Financial Times reported Tuesday that Woonsocket-based CVS is considering a plan to break up by separating its pharmacy chain from its insurance business.
Cannabis Legalization Prevails in Massachusetts; Repeal Question Soundly Defeated
Ten years after legalizing adult-use cannabis, the Bay State voters rejected a prohibitionist proposal, Question 8, which aimed to wipe out the industry.
WA Rep. Adam Smith vows Pentagon oversight; supports Hegseth impeachment
Rep. Adam Smith is poised to chair the Armed Services Committee, placing him at the center of probes into the Trump administration's handling of the Iran war.
What Becerra's historic win says about Latino political power in California
Many voters were already shrugging about the significance of Xavier Becerra’s likely victory — especially Latinos. Only 45% of Latino voters felt “proud” about the prospect of a Latino governor, according to a recent poll.
She's got political savvy, good timing, or both. And she's about to become Mayor Raman
From unexpected contestant to winning candidate, Raman's next challenge is daunting: Fix City Hall.
‘I Play Rocky’ star Anthony Ippolito recalls ‘incredible’ conversation with Sylvester Stallone: ‘A privilege’
Ahead of playing Sylvester Stallone in ‘I Play Rocky,’ Anthony Ippolito had the chance to connect with Stallone to talk about his ‘dark’ times.
Philadelphia’s Open Streets: West Walnut Returns December 6 for Holiday Shopping, Entertainment and Family Fun
The holiday season is one of the most magical times of year in Philadelphia, and this December, shoppers and families will have one more opportunity to experience one of Center…
Mustafa Foundation unveils programs for International Week of Science and Peace
TEHRAN – The Mustafa Science and Technology Foundation has organized a series of programs and educational and media productions to mark the International Week of Science and Peace (November 9–15) and World Science Day for Peace and Development (November 10).
A NASA space telescope plunged back to Earth after a mission that lasted 11 times longer than planned
The Swift Observatory's demise came less than three months after a long-shot rescue mission failed.
Carmelo and La La Anthony reach divorce settlement 9 years after split
La La Anthony first filed for divorce from Carmelo Anthony back in 2021, citing irreconcilable differences. The two have a son, 19-year-old Kiyan Anthony, who is a sophomore at Syracuse University.
The business of winning: Owners from the 8 NWSL playoff teams share their keys to success
Down to Business with Asli Pelit takes you through the exciting, fast-paced (and sometimes confusing) corporate side of women's soccer.
SpaceX Starship Will Need To Re-Fuel 22 Times In Space To Make It To The Moon
The total number of times that any rocket has ever done this is zero.
Nicole Taylor, one of band Taylor Red's identical triplets, dies at 35
Nicole Taylor, one of country band Taylor Red's identical triplets, has died. The singer succumbed to breast cancer at 35.
Woods Hole research ship heads to Lake Superior to hunt neutrinos
The R/V Neil Armstrong is making its first Great Lakes voyage, carrying Cape Cod science into fresh water for an experiment probing the universe.
Prep talk: Three-sport standout Kai Beary plays role for 27-0 JSerra flag football team
Kai Beary, standout in shotput and soccer, is also a girls' flag football star for unbeaten JSerra High.
Bicycles and frozen yogurt: See the business licenses issued in Hamilton County last week
Business licenses issued Oct. 26-30, as provided by the Hamilton County Clerk’s Office.
'The De Los Podcast': Let's talk about Latino mental health
Why are Latinos less likely to seek mental health than other ethnic groups? What might be behind the worsening mental health in our youth? And where do you even start to get therapy? L.A. therapist Guadalupe Cesar-Nuñez answered these questions and more on the latest episode of the De Los Podcast.
Baumgartner lead widens in Eastern WA race for U.S. House
Baumgartner led 50.9% to 48.7% in the 5th Congressional District, a narrow lead but one that has widened since Tuesday night as more votes have been counted.
CVS Health to split into two publicly traded companies by 2028, FT reports
Investing.com-- CVS Health Corp (NYSE:CVS) is planning to split its retail pharmacy business from its insurance operations, potentially unwinding one of the U.S. healthcare industry's largest vertical integration deals, the Financial Times reported on Tuesday, citing people familiar with the matter.
Democrat Bob Brooks wins election to U.S. House in Pennsylvania's 7th Congressional District
2026 ELECTION COVERAGE: Watch Live | Poll Closing Times | All Live Results | Live Updates | Live Fact Check Democrat Bob Brooks won election Tuesday to the U.S. House of Representatives representing Pennsylvania's 7th Congressional District, defeating Republican incumbent Ryan Mackenzie. Brooks, who worked as a firefighter and union leader, concentrated on his blue-collar background, saying he understood the affordability issues facing voters in the Lehigh Valley battleground district. Mackenzie's ties to President Donald
Bryan Adams is thinking about war with America (in 1814)
"It's about respect," said Adams, whose new album reflects Canada's conflicts with President Trump. "Have have some respect for the past, and not just decide one day, 'Oh, this is better for America or whatever.'"
Elon Musk spent $445 million to help Republicans. Their losses put his businesses in the crosshairs
Elon Musk spent at least $445 million to try to help Republicans keep control of Congress
Opponents concede loss in WA ban on trans girls in girls school sports
Opponents conceded passage of a Washington initiative that will ban transgender girls from competing in girls K-12 sports.
Daniel Harding, expanded leadership team, take charge at the L.A. Phil
Gustavo Dudamel has taken his final bow as the Los Angeles Philharmonic's music director, but the orchestra has no plans to slow its world-class roll. Here's what's next under Daniel Harding and the orchestra's expanded leadership.
CVS Health to Split Into 2 Public Companies, Separating Retail and Specialty Pharmacy
Expected in the first half of 2028, the planned separation would create a stand-alone retail pharmacy company with nearly 30,000 pharmacists.
Russell Brand verdict: British actor convicted of rape, sexual assault
Russell Brand was convicted of rape and sexual assault charges in a London courtroom on Thursday, years after a damning investigation by British media.
Girls' flag football: Tuesday's City Section playoffs scores
Check out Tuesday's girls' flag football scores.
Why the Grand Canyon May Be Missing 1.2 Billion Years of History
“Sometimes what is missing can tell us more about the story of Earth than what we can see.”
Billy Evans discusses full frontal nudity in 'You Can See Everything'
Billy Evans, the partner of former Theranos CEO Elizabeth Holmes and 'You Can See Everything' antagonist, addresses hot topics from Nathan Fielder and Lance Oppenheim’s new documentary in a candid AMA.
Staples Grocery aims to be a 'community hub' in Lucketts
A decade after Jonathan and Hilda Staples opened Vanish Brewery in Lucketts, they have expanded the operation to include a new destination a mile down the road on Route 15:
'Richard Avedon: Hollywood' is now on view at Gagosian in L.A.
A new exhibit at Gagosian, 'Richard Avedon: Hollywood,' features more than 120 images, spanning from 1947 to the year Avedon died in 2004.
Jaguars vs. Ravens, odds, injuries, key matchup in Thursday Night showdown
Previewing the Jacksonville Jaguars Thursday Night game at Baltmire.
CVS to split off pharmacy business, ending the healthcare conglomerate era
CVS Health intends to keep together its insurance and pharmacy benefits divisions and create a separate company for its pharmacies, in a breakup set for 2028.
East Ridge council winners to focus on stormwater, business and border region development
"I vote for who I like," said East Ridge resident Pamela Snelling. Snelling voted Nov. 3 at East Ridge United Methodist Church on Prater Road.
Outback franchisee files for bankruptcy, citing California labor costs
San Diego-based Cerca Trova Restaurant Group, which once operated nearly 100 Outback Steakhouse restaurants, filed for Chapter 11 bankruptcy on Monday.
Smokin' Willy, Deli South planning big move in 2027
Two locally owned businesses, Smokin’ Willy in Purcellville and Deli South in Leesburg, are planning a big move in 2027, according to owners Chris and Shannon Scharrer.
Harold Greene dead: Los Angeles news anchor was 82
Beloved Los Angeles news anchor Harold Greene has died, his daughter announced via Facebook. He was 82. Greene worked the majority of his career at ABC 7 before leaving in 2000. His final TV stints were at KCBS, KCAL before he retired in 2008.
If Israeli politics were rational, Arab parties would now be holding all the cards
The existing rules of the political game that preclude full Arab participation are illogical, immoral and counterproductive. The system requires a total reset.
Becerra prepares to take helm as governor with few political debts. But there's questions about his agenda
California is about to enter the 'Becerra era,' though the governor-elect who coined that phrase has dropped few hints about what will define it.
CVS Health explores splitting retail pharmacy, insurance businesses, FT reports
Nov 3 (Reuters) - CVS Health is considering a breakup of its healthcare empire that could separate its retail pharmacy chain from its insurance business, the Financial Times reported on Tuesday, citing people familiar with the matter. A separation wo...
Trump’s Election Day bombshell on Israel points to historic shift in US politics
President Donald Trump is arguably the most pro-Israel president of modern times. So his Election Dayannouncement that the United States would end nearly $4 billion in annual aid to Israel was stunning.
'Passing Strange' premieres in L.A. at Pasadena Playhouse
'Passing Strange,' a 20-year-old rock musical about a striving musician in downtown L.A. has gone to Broadway and been filmed by Spike Lee — but it has never been produced in SoCal. A highly anticipated revival at Pasadena Playhouse is changing that.
Michigan's 'money out of politics' measure passes, faces legal challenge
Unofficial results from the New York Times show Proposal 2 received support from 81% of Michigan voters.
Arizona voters poised to approve restrictions on transgender athletes
A ballot measure that would restrict transgender athletes from participating in girls’ sports appeared headed to approval Tuesday night.
Effort to ban trans girls in K-12 school sports leads Tuesday night
Washington is among the first states in the nation to put the question of transgender girls' participation in school sports directly before voters.
Good Times
For more information about upcoming events in Citrus County this weekend and beyond, go to the events calendar at www.chronicleonline.com, events, event calendar. Also, read the daily Local section of
Business Education Is at a Positive Tipping Point
By Laura Colombo The guest essay in The New York Times—with the title “I Teach at a Business School. It’s Time to Shut Them Down.”—by Academy of Management Scholar Chris Marquis of the University of C...
Incumbent DA reelected by 3 to 1 margin in Hancock County
Incumbent District 7 top prosecutor Bob Granger of East Blue Hill swept up nearly three times as many Hancock County votes as his challenger, Steven Juskewitch, a Dedham attorney, on
Abortion rights amendment passes in Virginia
2026 ELECTION COVERAGE: Watch Live | Poll Closing Times | All Live Results | Live Updates | Live Fact Check Voters have approved a ballot measure that creates a “fundamental right to reproductive freedom” in the Virginia Constitution. The amendment passed Tuesday ensures abortions can occur during the first two trimesters of pregnancy. It allows government regulations during the third trimester while still ensuring that abortions can be carried out to protect the life and
Pennsylvania Flips Senate, Secures Cannabis Legalization Trifecta
The state’s Democrats gained control of the upper chamber for the first time in more than three decades, paving the way to legalize adult-use cannabis.
Who celebrities are voting for in the L.A. mayoral election
Jane Fonda, Samuel L. Jackson, George Lopez, Stevie Wonder, Bob Odenkirk, Mindy Kaling, Adam Scott and Jaboukie Young-White reveal whether they're voting for Karen Bass or Nithya Raman.
Four evening games in winter
The next seven matchdays in the Bundesliga have been scheduled. Eintracht play four times at 18:30, while the second half of the season begins on a Sunday.The Bundesliga has confirmed the schedule for...
Newsom wants to empty death row. Most politicians wouldn’t bother
Newsom's decision, as he ponders a run for the White House, is a self-inflicted test of political endurance from a savvy politician who didn't need to go there.
Everything you need for election night: From the Politics Desk
Plus, poll closing times.
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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