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Star Health's Arogya Seva Kendra clinics cross 1.8+ lakh beneficiary visits within a year of their inception, bringing free primary healthcare to communities across 9 states
Star Health and Allied Insurance Company Limited (NSE: STARHEALTH) (BSE: 543412), India's leading standalone health insurer, has been safeguarding the health and well-being of millions of Indians for over 20 years through a strong focus on customer-centricity, transparency, and innovation. Reflecting its commitment to creating lasting social impact, Star Health's CSR initiatives focus on improving health outcomes through accessible healthcare, preventive interventions, and community wellness pro
Ravens QB Tyler Huntley reportedly suffered season-ending turf toe injury after replacing Lamar Jackson vs. Bills
A year after UPS plane crash, South End business owners struggle to stay afloat
Near the site of the fatal UPS plane crash in Louisville, some of the area is still closed to vehicular traffic. Business owners there have struggled to pick up the pieces.
Adam Schefter Reveals Strong Bengals Trade Pivot
The Cincinnati Bengals are reportedly one of the six teams that have made an aggressive offer to the Indianapolis Colts for running back Jonathan Taylor. However, Adam Schefter mentioned that if the Colts do trade Taylor, there will be five teams that are looking to pivot, and the Bengals would be one of those teams. […] The post Adam Schefter Reveals Strong Bengals Trade Pivot appeared first on HEAVY.
Democrat Josh Shapiro wins reelection for governor in Pennsylvania
Democrat Josh Shapiro wins reelection for governor in Pennsylvania.
Mets Morning News: More salary cap nonsense
Your Wednesday morning dose of Mets and Major League Baseball news, notes, and links.
Business Beat : Thurston Woods offers financial incentives to fill multiple positions
STURGIS, MI (WTVB) - Thurston Woods Village, a faith-based retirement community in Sturgis, has launched a maj...
Brenda Lucas: Community news for Wednesday, Nov. 4
Click for community news in the Huntington, West Virginia, and Tri-State area.
How Anthony Ippolito Talked His Way Into Playing Sylvester Stallone in 'I Play Rocky'
Anthony Ippolito saw the opportunity of a lifetime when he learned that Oscar-winning director Peter Farrelly was developing a film about Sylvester Stallone’s determination to write and star in the original “Rocky.” There was just one problem: Nobody had asked him to audition for “I Play Rocky.”
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.
Massive win and really important night
Portsmouth head coach John Mousinho speaks to BBC Radio Solent after the 3-1 win against Swansea City.
Lobo football to health care leadership, Brad Cook finds purpose in building better systems
For Brad Cook, leadership began long before he entered the healthcare industry. As a student at The University of New Mexico, Cook received a full ride scholarship to serve as the head equipment manager for the Lobo football team. This experience gave...
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.
Keeper Owono 'would never intentionally hurt anyone'
Andorra goalkeeper Jesus Owono "would never intentionally hurt anyone" and is "deeply affected" by the death of Tenerife forward Jesus de Miguel, his team-mate said on Wednesday.
Bryce Young, C.J. Stroud continue fourth seasons without new contracts
Judi Dench recalls which actor sent her flowers to woo her for a role
The Oscar winner writes about the gesture in her new memoir, “Is It Too Late to Make a Run for It?”
Atlético v Santa Cruz: Galo's young guns in action today!
Atlético vs Santa Cruz – November 4 (Wednesday) – 3 PMTournament: Copa do Brasil Venue: Arena MRVBroadcast: SporTvMatch Guide: Atlético vs Santa Cruz
Halloween-themed event aims to get youngsters 'excited about science'
GOSHEN — Children in Halloween costumes spent Saturday driving robots, meeting animals and watching chemistry demonstrations at E3 Robotics Center’s sixth annual Science Spooktacular.
Alabama Dealt Surprising News Days Before SEC Showdown vs. LSU
Alabama was just dealt some major news days before the team's showdown against LSU. The post Alabama Dealt Surprising News Days Before SEC Showdown vs. LSU appeared first on HEAVY.
West Ham confirm Parker as boss
West Ham confirm the appointment of former midfielder Scott Parker as their head coach on a two-and-a-half-year deal.
Postgame Reaction: There’s No Excusing These Avalanche Performances
This is bad. The Colorado Avalanche’s 9-6-1 record isn’t the issue. It’s a fine place to be after 16 games […]
CVS Health (CVS) Beats Q3 Earnings and Revenue Estimates
CVS Health (CVS) delivered earnings and revenue surprises of +29.01% and +3.20%, respectively, for the quarter ended September 2026. Do the numbers hold clues to what lies ahead for the stock?
Schmaltz scores game-winner in Mammoth 3-2 win
TORONTO (ABC4 Sports) – Nick Schmaltz scored the winner on a power play with 6:48 left in regulation and the Utah Mammoth beat the Toronto Maple Leafs 3-2 on Tuesday night. Dylan Guenther and Andrew Peeke also scored for Utah. Sebastian Cossa made 27 saves. Clayton Keller added three assists and Mikail Sergachev had a […]
Today’s Papers
La Gazzetta dello SportReal InterThe Nerazzurri restart in style: Feyenoord crushedBisseck opens the account, then Pio and Zielinski score. Chivu keeps climbing the table: ‘Our best version.’Roma ...
‘Arrested Development’ alum David Cross coming to Iowa City
Comedian David Cross, known for his work on “Mr. Show” and “Arrested Development,” talked with The Gazette about fatherhood, his career and more ahead of his appearance Nov. 10 at
Tenerife to hold memorial service for De Miguel on Saturday
Spain's CD Tenerife will hold a memorial service to bid farewell to their late forward Jesús de Miguel on Saturday, the second division club said in a statement. All fans are invited to attend a mass, which will be held at the Heliodoro Rodríguez López stadium.
'Full-time job to keep up with it': Drug pricing program changes worry WV clinic
Beginning in 2027, Trump administration changes to the federal 340B drug pricing program will increase the purchasing and administrative costs for eligible clinics, including in West Virginia, which will have to pay up front for the drugs and seek rebates from drug manufacturers.
Wednesday Bantering: We’re Definitely Getting a Lockout
So I gather there was an election yesterday? Mark Texiera lost his run for Texas’ 21st district. We don’t talk politics on this site really, there’s enough to shout about just in terms of baseball, but I think we can all agree that the good people of Texas deserve better than a vile Yankee. Former […]
Blue wave fizzles in Florida races: Inside Florida Politics podcast
Florida's GOP firmly keeps power including the state's first black governor Byron Donalds, and multiple Congressional and State legislative races.
Should the Broncos trade Marvin Mims before NFL's deadline?
Marvin Mims is scheduled to become a free agent in 2027. Should the Broncos consider trading him now?
Robertson's natural hat trick has Capitals seeing Stars
While Washington did their best to rally after a Jason Robertson natural hat trick in the second period, the Capitals' comeback attempt fell short in a 6-4 loss to Dallas.
Sporting News' NFL midseason All-Pro team: 26 best players by position (so far) in 2026
Here's our All-Midseason team for the 2026 NFL season.
Democrat Zach Dembo wins election to U.S. House in Kentucky's 6th Congressional District
Democrat Zach Dembo won election Tuesday to the U.S. House of Representatives representing Kentucky's 6th Congressional District, defeating Republican Ralph Alvarado.
Sports media world reacts to polarizing first College Football Playoff ranking
It’s Election Day, but it’s also College Football Playoff ranking reveal day, and strong reactions to the ranking would have you believe those are the results determining the future of democracy. On Tuesday night, Rece Davis hosted ESPN’s College Football Playoff rankings show alongside Booger McFarland, Greg McElroy, and Joey Galloway. As the show wore…
Savannah Black Business Gala marks 10th anniversary
The Greater Savannah Black Chamber of Commerce celebrates a decade of supporting local entrepreneurs this December.
‘This might just be the biggest defeat for big money in politics’: Billionaires poured hundreds of millions into Tuesday’s races and still lost
Elon Musk’s pick lost in Texas and billionaires Vivek Ramaswamy and Rick Jackson lost their own races, though California’s wealth tax is trailing.
Las Vegas restaurants absorb higher import prices, adjusting business
Restaurant owners who rely on ingredients from overseas are adjusting how they do business as costs rise.
Caddo Parish voters reject $60 million bond for proposed sports complex
Approved: Caddo Parish voters have approved a $60M bond measure to help fund a proposed $70M sports complex in Shreveport. Full election results here. Rejected: Caddo Parish voters have rejected a $60M bond measure proposed to fund a $70M regional sports complex in Shreveport. Full election results here.
Tennessee embarrassed Alabama. CFP committee embarrassed itself
The CFP committee ranked Alabama eight spots ahead of Tennessee, the team that crushed the Tide. The explanation only makes it worse.
Chinese scientists discover thickening ground ice in parts of warming Tibet
Research counters expectations but the region remains extremely vulnerable to climate change, study warns.
Dodgers notes: Tarik Skubal, Shohei Ohtani
Free agency has officially begun, and the Dodgers are now on the clock to try to fortify their roster before the impending lockout. Left-hander Tarik Skubal is atop the list of the most highly coveted free agents this offseason, and the Dodgers are not the only bidder for his services. Jeff Passan at ESPN reports […]
Shapiro becomes first Democrat to win Lancaster County vote since 1990
Gov. Josh Shapiro not only won reelection Tuesday, he became the first Democratic gubernatorial candidate to win Lancaster County since Robert P. Casey won here in 1990.
The Midterm Election Was About Health Care
In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors, and nurses into positions of power.
Benefits Can Help Older Adults Stretch Their Budgets and Protect Their Health
Every year, older adults leave $58 billion in benefits unused, money that could help cover groceries and prescriptions.
Madison Square Garden Entertainment (MSGE) Q1 Earnings and Revenues Surpass Estimates
MSG Entertainment (MSGE) delivered earnings and revenue surprises of +1,050.00% and +5.03%, respectively, for the quarter ended September 2026. Do the numbers hold clues to what lies ahead for the stock?
Meghan Markle ‘Doomed To Be a Hate-Watch’ on MasterChef Australia
Meghan Markle’s MasterChef Australia gig might grab attention for the wrong reasons. According to a source, the Duchess of Sussex’s appearance in next year’s Junior MasterChef could steal the spotligh...
Election 2026: Nebraska voters reject ballot measures to legalize online sports betting
Nebraska voters have rejected a pair of ballot initiatives that sought to legalize and regulate online sports betting.
This 4-billion-year-old Martian meteorite fell to Earth – and scientists used a genius trick to work out exactly where it came from | BBC Sky at Night Magazine
Scientists have discovered that Mars meteorite Teghaza 001 is in fact one of the oldest Martian meteorites ever discovered.
This weekend's Granada-Tenerife match postponed ❌
The match between Granada Club de Fútbol and Club Deportivo Tenerife, scheduled for this Saturday, November 7, at the Estadio Nuevo Los Cármenes, has been officially postponed following confirmation...
Who needs picks when your offense is lacking?
The Denver Broncos should be buyers at the trade deadline
Jets Make NHL History With Stunning Comeback Win Against Habs
The Winnipeg Jets appeared destined for what would have been a 10th straight loss, finding themselves trailing by a 4-0 score against the Montreal Canadiens at Bell Centre on Tuesday night.But then, suddenly, everything clicked and resulted in a stunning and historic turnaround, not only ending their miserable losing skid but also setting a new […] The post Jets Make NHL History With Stunning Comeback Win Against Habs appeared first on HEAVY.
Portsmouth 3-1 Swansea
Pompey supporters have their say after Portsmouth's 3-1 win over Swansea City in the Championship.
Disney has fought AI firms over copyright. Now it’s testing AI lyric videos
Walt Disney Co. is experimenting with using artificial intelligence to test out different concepts for music videos showcasing the lyrics to its songs, starting with “Go the Distance” from its
Terry Pluto on Cleveland sports TV 'chaos': Where did the games go?
Ideastream sports commentator Terry Pluto explains how shifting broadcast deals and streaming services are creating chaos for Cleveland sports fans trying to watch the Cavs and Guardians.
2027 South Side Sox Top Prospect No. 97: Daniel Wright
The former quarterback is finding his footing in the bullpen
Letter: No one should lack support in a mental health crisis. Here’s how NAMI Utah can help.
Letter: No one should lack support in a mental health crisis. Here’s how NAMI Utah can help.
Regional business leaders share their perspectives on giving back
This month we asked: In what ways does your organization give back to the community?
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.
Police investigating 6 business burglaries on same street in Rogers Park
Milwaukee Brewers 2026 report card: Jackson Chourio
The Milwaukee Brewers are World Series Champions for the first time in franchise history. After finishing the regular season with a 103-59 record, they steamrolled through the postseason, going 11-2 overall and knocking off some of the best teams in baseball on their way to hoisting the commissioner’s trophy. As is the case with every [...]
🗞️ Jesús de Miguel remembered, Champions League Wednesday's front pages
Football is in shock. The death of Jesús de Miguel has stunned the entire sporting world on a Tuesday to forget.On days like this, there is little point in talking about the Champions League or the s...
Caitlin Clark Makes Her Opinion Around Valkyries Winning WNBA Championship Against Dream Extremely Clear
The WNBA’s growth has been impossible to ignore over the past few seasons, with rising attendance, record viewership, and new franchises adding to the league’s momentum. The 2026 season took that progress another step forward, as the Golden State Valkyries delivered a historic championship run just two years after entering the league.
Lack of clinical edge was a big problem
Millwall boss Alex Neil speaks to BBC Radio London after the 3-0 defeat at Birmingham City.
Real Madrid confident of signing Man Utd's Gabriel
Real Madrid head the list of clubs trying to sign 16-year-old Manchester United forward JJ Gabriel.
Yes, 'Ramayana’s' Ranbir Kapoor Went All In On His Rama Training (An Olympian Is Even Involved)
College Football Playoff rankings: Miami leads first rankings of 2026; Notre Dame, Ohio State outside top 10
These 9 candidates for governor just made history
Voters on Tuesday elected the nation's first Black woman governor and the nation's first Native American woman governor.
A ‘bloodbath.’ Georgia Democrats sweep statewide offices in historic political upheaval
A Democratic wave ended decades of GOP dominance in Georgia and threatened the GOP's grip on the state Legislature.
Winners and losers from the 2026 midterm elections
Millions of Americans voted in a midterm election with incredible consequences on billionaires, taxes, AI regulation, and data centers.
‘Enraging’: WA residents despair as insurance premiums climb again
SEATTLE — Kate Neville is dreading the new year. As a freelance grant writer, Neville has to buy her own health insurance, and for years her premiums have been climbing.
Skye chef pledges health before wealth at 'pay what you can' cafe
Araich has been set up in a former woollen mill in Portree and offers healthy food options.
Democrat Troy Jackson wins election to U.S. Senate from Maine
Jackson wins election to U.S. Senate from Maine.
Death is big business in I.Coast, where funerals cost fortunes
Valerie Bli Lou is a shopkeeper from a modest family, but she is determined to give her late father the sumptuous funeral that Ivorian tradition demands -- whether she can afford it or not.- Tears and...
The Midterm Election Was About Health Care
In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors and nurses into positions of power.
Mack Hollins to return to Patriots practice on Wednesday
Hollins’ 21-day window to return from injured reserve is about to open.
Region semifinal pairings finalized for Watertown, Aberdeen area teams
Semifinal pairings have been finalized in area Class A and B region volleyball tournaments.
Jumbo Package: Alabama ranked 5th, national meltdown ensues
Your latest Crimson Tide news and notes.
AI Teammates Launches Ongoing AI Implementation Program for Mid-Market Business Owners
Program builds a working AI system in the first 6 weeks, then continues as an ongoing operating partnership for owners of $1M to $20M businessesSilicon Valley, California--(Newsfile Corp. - November 4, 2026) - AI Teammates, founded by Alice Y. Chen, has launched the AI Architecture Method, a structured implementation program that builds and operates AI systems on behalf of business owners rather than training them to build their own.Image Credit: AI TeammatesTo view an enhanced version of this..
Black voter turnout appears high on Election Day, according to voter coalition
LaTosha Brown, co-founder of the voting rights group Black Voters Matter, said turnout in some states seemed to rival that of 2008, when Democrat Barack Obama was running for president for the first time. Stand with free and independent journalism. Join Press Pass from PBS News She and others said turnout appeared particularly high in Michigan and Mississippi. Brown, speaking during a media briefing organized by the National Coalition on Black Civic Participation, said her
“Sad To Hear What Jorge Posada Had To Say” – Alexandria Ocasio-Cortez Takes Shots at Aaron Boone and Yankees Management
U. S. Representative Alexandria Ocasio-Cortez has questioned the New York Yankees’ decision to retain manager Aaron Boone, calling for changes within the organization after another disappointing season.
Talarico flips Texas Senate seat, in historic win for Democrats
Democrat James Talarico, a former schoolteacher and Presbyterian seminarian who campaigned on a "politics of love," on Tuesday won the US Senate race in Texas, flipping yet another seat for his party ...
Yankees 2026 Roster Report Cards: Angel Chivilli
Angel Chivilli flashed some potential, but struggled with injuries all season.
Uneven And Fragile Progress Against Neglected Tropical Diseases
While substantial progress has been made in driving down the global burden of neglected tropical diseases (NTDs), trends are “uneven and fragile”, and
AFGHS co-signatory countries ask health care users to help fill the financing gap
Hundreds of thousands of Ugandans living with HIV on antiretrovirals could be targeted for user fees or community health insurance schemes requiring modest premium payments, according to the April 2026 version of the country’s America First Global Health Strategy implementation narrative.1 As part of the “sustainable financing for the private not for profit sector” strategy, 491 facilities will be targeted for a phased introduction of user fees and scale up of community health insurance programs.2 In the Ugandan context, PNFP facilities include faith-based hospitals and other health facilities, US missionary organizations and centers of excellence—services that are often co-located at government facilities but run with additional financial and technical resources. 402,000 people—or about 28 percent of the total Ugandan adult PLHIV population on treatment—get ART from the private not for profit sector. The selected facilities provide the majority of ART and prevention of mother to child transmission (PMTCT) services. The plan doesn’t give the total number of clients served by the 491 facilities, so it is not possible to give a precise number. But the majority of 402,000 is a figure in the hundreds of thousands—hence the estimate I’m using.3 The April draft of the Ugandan implementation plan narrative is the only one I’ve been able to review. But the government of Uganda is not alone in turning to health care users to help fill the financing gaps caused by the abrupt withdrawal of US funds. In July 2025, the Government of Liberia introduced user fees for previously free services including “registration, accommodation, patient feeding, hospitalization, and a wide range of surgical and diagnostic procedures.”4 Earlier that year, Liberia rolled out a revolving drug fund designed to stabilize drug supplies by “allowing patients to pay a small fee for standardized, quality medications,” according to a Ministry of Health press release.5 (Both of these approaches had been proposed in the National Health Policy 2022-2031; media coverage explicitly connects the launch with the US foreign aid cuts.) The health financing strategies proposed by Uganda and established in Liberia are qualitatively different from user fees officially adopted by specific health facilities to cover funding shortfalls caused by the new US approach.6 The latter is a stopgap, adhoc change. The former is a national governmental adoption of policies that pass costs on to health care users, despite evidence that such approaches can exacerbate inequities and leave deficits unfilled. Two countries does not make a pattern, but they do point to urgent questions: Have other countries, including Liberia, included user fees or community health insurance schemes in their implementation plans? If so, do any of these narratives have what Uganda’s lacks: a fall-back plan in place in case these strategies for sustainable health systems fail to deliver—as they have before? I wonder if you think about it Subscribe Predictable pitfalls Both community-based health insurance and user fees are as old as the hills. And after decades of people climbing up these hills, duking it out, climbing back down—neither strategy has shown the results the Ugandan implementation plan is counting on. This is, in fact, a hill some folks are willing to die on. (You knew I’d get there, right?) In November 2025, an African-led team of health system experts published a paper directed at low- and middle income country governments trying to figure out how to create self-sustaining health systems. The money wasn’t coming back. It had been more than nine months since the season of freezing, waivering and wood-chippering; two months since AFGHS tumbled into the world touting co-financing requirements and reductions in future US government health aid. Governments were looking for strategies for sustainable, self-financed health systems, the authors wrote. For countries considering user fees and community health insurance to fill the financing gaps, they had a simple message: Don’t. On user fees, the paper states: “Reliance on user fees is ultimately a regressive and inequitable approach. It places a disproportionate burden on the poor and undermines health system goals of equity and financial protection. […] There is overwhelming evidence that user fees mobilise very limited resources for the public health sector, making it an inefficient mechanism for revenue mobilisation.” On community health insurance: “Attempting to shift the burden of funding previously donor-funded services, such as HIV care and management, and TB treatment, onto contributory schemes would exacerbate their fragility and fail to protect the population.”7 The WHO says that community-based health insurance “cannot be expected to provide a major source of funding or coverage,” and noted that most schemes offer only moderate benefit to individuals paying into them, and exclude the poorest segment of the population.8 And yet, the US-Ugandan implementation plan says that community health insurance is “the central pillar of this [PNFP] sustainability strategy” and that this approach that will generate “pre-paid pooled funding at facility and community level [that] improves financial risk protection for households, reduces catastrophic out-of-pocket expenditure, and generates structured, transparent revenue streams that can progressively absorb recurrent costs including health worker salaries.” Unfortunately, Uganda’s own history suggests the pillar might not be able to bear this weight. Ugandans Have Been to this Rodeo Before—and Some Want Their Money Back Uganda introduced its first community health insurance scheme in 1996 with support from international donors.9 Thirty years later, somewhere between 0.2 and 0.3 percent of the population is covered by CHI; just over 1 percent has any kind of health insurance.10 User fees were universally introduced in 1993 as a condition of a World Bank loan.11 They were abandoned in 2001, and in 2004—the year I moved to Uganda to watch the free HIV program get underway—a definitive study found that the fees did not improve health systems and outcomes.12 In 2004, most clinics and hospitals had ‘free’ and ‘fee for service’ options for getting care.13 The fee for service, or “cash and carry” programs had often been established in the years prior to PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. People who could afford to paid for the drugs, often at facilities in the private-not-for-profit (PNFP) sector. When free drugs arrived, some people who’d been paying kept on doing so, perhaps because of shorter wait times, greater confidentiality, convenience or other factors. But in the year that I spent visiting the same clinics around the country week after week—including a “center of excellence” that maintained separate days for cash and carry clients and those accessing free ARVs—lots of people who had been paying tried to switch to the free option. They’d paid because they had no other choice. They’d sold pieces of family land, begged family members for loans, bought pills by the week, and sometimes by the day. Or they were just cash-strapped, like most of us, and wanted the funds for other things. 14 Twenty-two years later, this hasn’t changed. Ugandans pay out of pocket for 30-40 percent of their health care costs, leading one paper to declare that “falling ill is more than a health crisis. It is a financial emergency.”15 One recent study found that up to 48.5 percent of households dealing with tuberculosis sold something, took out a loan or dug into savings to defray the costs of TB care—which is supposed to be universally free.16 The Ugandan implementation plan does anticipate challenges. It proposes a phased approach, with 187 facilities introducing user contribution systems in Year 1, 152 in Year 2, and 153 in Year 3. Willingness to pay and feasibility studies will precede roll out; fees will be tiered by region, and a waiver system is proposed to ensure that no one has to pay who is unable to. Moreover, the plan provides for quarterly reviews of epidemiological data to “ensure that user contributions do not compromise epidemic control gains, ART continuity for the client cohort, TB case management, or PMTCT services.” Alt text: A screenshot of a table included in the implementation plan narrative that is the subject of this stack. It’s got a fetching pink bar at the top. It uses the abbreviation “CHI” which is Community Health Insurance, and FBO which is Faith Based Organizations, and it details the number of facilities that will implement user fees with waivers and community health insurance schemes over the five years of the agreement. As I said in the footnote, this is a super interesting document with a lot of other rich material. Tell me what you see—and what you would have focused on. And if you’ve seen something like this, or anything else that strikes you, in another implementation plan, tell me that too. You can use the Substack message platform or try me on Signal at @endaplague_again.25 (because @mercoonfan was, weirdly, taken). But the plan doesn’t fully explain what will happen if this approach doesn’t work out. Yes, progress will be monitored, and corrective action triggered. However, there is no specified funding replacement if premium and fee revenue prove inadequate. Instead, the authors write, “Currently, COEs serve a total client cohort of over 180,000 across 28 facilities. In the initial years, the U.S. Government (USG) will provide financial support for clients; over time, user fees generated by COEs will become the primary source of funding for sustaining their services.” Failure does not really seem to be an option. Health insurance schemes are more acceptable to the Ugandan population than user fees. Members of Parliament and civil society traveled to Ethiopia to see how that country’s scheme worked. In a follow up report, a veteran civil society group recommended allowing the “health insurance ecosystem to grow organically and [to] keep reviewing the law and regulations as this growth takes root.”17 One study found that more than three-quarters of Ugandans were willing to join a health insurance program.18 However, coverage of community-based health insurance is minimal, as is coverage of any kind of insurance—including private plans.19 A national health insurance scheme bill has been stalled for several years and presently sits with President Yoweri Museveni.20 Community-based health insurance scheme that do exist are expanding in number, but losing enrollees. Between 2022 and 2026, the number of community-based health financing schemes across the country increased by 42 percent, while the number of people enrolled decreased by nearly 11 percent.21 None of this means that community-based health insurance should not happen in Uganda—or that people do not want insurance. It doesn’t even mean that user fees and waivers won’t ever work. But there is highly relevant evidence from Uganda and the surrounding region that it is quite optimistic to describe community health insurance and user fees as central supports for sustainable financing in any sector of the health system. And now for the best-case scenario In the best-case scenario22, the Ugandan approach does exactly what it sets out to do, and so does the Liberian fee structure and revolving pharmacy fund—though I’ve not confirmed that these are in the MoU. In one best-case scenario, Uganda is an outlier, and user fees and community health insurance are not recurrent pillars of self-sustaining financing in other countries’ implementation plans. In another best-case scenario, all countries that include these strategies enjoy success beyond anyone’s evidence-informed wildest dreams: reliable funding generated by health care users fees, great health care outcomes for everyone, no exacerbation of inequities, no crippling household debt. No sold land, repurposed school tuition or high-interest loans. In the best-case scenario, not one of the hundreds of thousands of Ugandans living with HIV receiving antiretrovirals from 491 PNFP facilities misses a refill or leaves care because of user fees or community health insurance premiums. This is the best-case scenario for these people for their own health, and for their families. It is also the best-case scenario if Uganda wants to stay on the path to eliminating HIV as a public health threat. According to the country’s most recent data, 96.5 percent of people living with HIV on antiretrovirals are virologically suppressed. Epidemic control depends ensuring that 95% of people living with HIV know their status, 95 percent of those individuals are on ART, and 95% of those individuals are virologically suppressed. Uganda is still struggling with the first “95"—a frankly abysmal 85.3 percent. If HIV epidemic control and the attendant prevention of new infections, avoidable suffering and premature death matter, the country cannot afford to lose any clients who are currently in care.23 As I write this a couple hours before the polls close for the US elections in the city I live in, I say with soul-deep sincerity: I am rooting for the best-case scenario. I think it’s safe to say that we all are.24 I think it’s also safe to say that if the US and co-signatory governments have inked plans that lead to successful expansion of community health insurance and strategic use of user fees, we all would like to know, now, so that we don’t miss the opportunity to celebrate when success happens. The implementation plan narratives have to enter the public domain. They are the fullest expression of a strategy co-created by two governments. There are assumptions and details that people living in the US and co-signatory countries need to understand that are not available in the MoUs or, to date, in the Congressional Notifications. Some of these details can help other countries that are, as I write this, still working on implementation plans. Others, like a solid count of how many other countries have plans for expanding user fees or health insurance, are important for regional and global health architecture reform initiatives. No matter how this election night turns out, there will be a slew of new Congressional member orientations, briefings and talking points papers in the next few months. Release of implementation narratives should be a bullet point in every context that AFGHS is discussed. These documents can be redacted so that procurement sensitive information isn’t disclosed. There is much more historical precedent for sharing such documents than there is for relying on user fees to fill health financing gaps. Let’s look at the information together so we can hope for the best and prepare for, you know, the other thing. Alt text: A substack first: a bicep selfie! It’s my arm - peachy-white skin, black shirt (flannel, notch neck, too hot for this appallingly balmy November weather, if you’re wondering) and a sticker that says I VOTED 2026. Beige letters on red for I voted. Beige on blue for 2026. You bet I did.25 In your wildest dreams. Subscribe 1 This is a really, really rich 95 page document. There are fascinating ideas and detailed plans in it. It is all worth reading AND I have, in this post, highlighted an instance of content that could pose challenges and certainly posits success of strategies that haven’t worked before. I would love to hear what readers’ see that’s interesting and should be lifted up as something to check for in other implementation plans. I will also shortly be adding a static page to the substack site where implementation plan documents will live. I will put the url into this footnote and it will also be there on emilybass.substack.com by the end of the week. Uganda Implementation Narrative Section 4 April 22 2026 Draft 1.51MB ∙ PDF file Download Download 2 User fees are costs charged for visits, labs, medicines or other health services, usually at the time they are provided. Community health insurance, or community-based health insurance, is what the World Health Organization calls “micro insurance,” which is health insurance targeted at low-income people. 3 As usual (by which I mean always), please prove me wrong. 4 https://smartnewsliberia.com/liberias-ministry-of-health-announces-2025-hospital-service-fees-for-public-facilities/?utm 5 https://moh.gov.lr/news/2025/grand-cape-mount-leaders-residents-embrace-new-community-pharmacy-program/?utm 6 https://www.christianitytoday.com/2026/09/hiv-usaid-pepfar-africa-foreign-aid-cuts-mission-hospitals/?utm 7 https://gh.bmj.com/content/10/11/e021270 8 https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-CBHI 9 https://pmc.ncbi.nlm.nih.gov/articles/PMC2827475/ 10 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 11 https://pmc.ncbi.nlm.nih.gov/articles/PMC527704/ 12 Same citation as the footnote 2 - the article is called “Learning from failed health care reform in Uganda.” To which I say: If only. If. Only. 13 There is a whole taxonomy of user fees to be aware of, if not commit to memory. Out of pocket costs are everything that someone pays for themselves. In this Stack, user fees are planned and policy-supported out of pocket costs. There are also out of pocket costs that people pay to buy drugs or receive tests or health care assessments that would be free if the drugs were on the shelves, or the machines or kits were available, or the staff were on site. A user fee is usually designed to be modest, pegged to willingness to pay, and may be waiveable at the point of care for anyone who is unable to do so. The costs for things that would otherwise be free are whatever the market will bear and people either have to pay them or go without. Out of pocket costs for services and stuff that aren’t available in public facilities are different again from bribes or unofficial fees that some health workers may impose, even though most are indefatigable, tireless and tired, and devoted to their clients. 14 For the record—which really is these footnotes—I would give a whole stack of fridge magnets for a systematic analysis of the economic and social impact of the Mass Unemployment Event in AFGHS countries among the very people who used to be able to afford and cover user fees, both for themselves and vast family networks. Locally employed USAID technical staff, house cleaners, caregivers, drivers and technicians were financial anchors for cousins, friends, friends’ children, friends’ childrens’ cousins, teachers, pastors, neighbors and so many other kinds of kin. Aid recipients lost direct funding; many other people who had not been aid recipients, but parts of the elaborate care webs that function as safety nets for so many people, lost crucial support too. And that’s even before we get to the people who worked at the hotels and restaurants and bars where people employed by the US and its implementing partners used to spend disposable income. Those businesses have lost revenue; those folks have lost jobs. It will be some time coming—and someone will have to fund this work—but I do hope it happens. And I hope, as usual, to be proven wrong. 15 https://eprcug.org/blog/how-out-of-pocket-healthcare-costs-keep-driving-ugandans-into-poverty/ 16 Another straight-to-the-point journal article title. Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers. https://pubmed.ncbi.nlm.nih.gov/32938411 17 https://www.cehurd.org/download/technical-policy-brief-on-community-health-insurance-scheme/?wpdmdl=13661&refresh=6ae9122f5d4ed1793659439 18 https://pmc.ncbi.nlm.nih.gov/articles/PMC10125197/ 19 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 20 https://ugandapost.news/uganda-to-make-health-insurance-mandatory-by-2026/ 21 https://shu.org.ug/download/235 22 With a nod, tip of the stack hat, and wag of the Mercoon tail to a deeply valued reader who told me that I have a tendency to speculate about the worst-case scenarios a little too much of the time. 23 https://news.mak.ac.ug/2026/10/uphia-2025-shows-ugandas-hiv-status-awareness-gap-despite-strong-treatment-outcomes/ As you’ll see in the next footnote, I’ve already written a subSubstack on another topic, so I will be brief with regard to the study referenced in this article. The Uganda Population-Based HIV Impact Assessment, or UPHIA, will never happen in this way again. For more than a decade, PHIAs have been supported by the US government as a way to generate accurate estimates of country progress on key HIV indicators. They are a holdover from the PEPFAR program that was laser focused on ensuring US taxpayer dollars subsidized progress in pandemic control. There may be other population-level surveys and the data may even be publicly released, as the entire set of FY2026 MER data have not. But PHIAs will never happen again. If you’re wondering whether the estimates of HIV progress at country level might get less reliable….you’re not alone. 24 Ooh baby, I hate “we” in almost all forms. But sometimes I go there, when I am looking for company, which I am. Because this Stack moves into the somewhat-uncharted territory of assessing what the implementation plan narratives may suggest about co-signatory countries’ roles and responsibilities to the people living within their borders. The MoUs, specimen and data sharing agreements were templates. Countries’ answers fit into pre-specified questions that did not include, “how are you going to fill financing gaps and stabilize your health system as this plan unfolds?” In contrast, the implementation narratives are open form—the product of co-creation between the two governments. Co-creation can mean lots of things, but nothing leads me to believe that implementation plans are ghost-written by the US government, or that contents were imposed by the US counterparts. Instead, I think the parts of the plans that read like country government initiatives are endorsed, if not initiated by, those governments. For instance, the Ugandan implementation plan narrative describes plans for revenue-generation through fees charged for equipment calibration, repair and maintenance provided through Uganda’s National Equipment Calibration Laboratory, and laboratory accreditation through the Uganda National Accreditation Service (UGANAS), targeting private sector, PNFP, research and academic clients. That’s super specific and also quite ambitious. It doesn’t read like an American idea. There’s also a provision for solar panels, and other stuff that feels country owned and driven. This is where it gets interesting. If co-creation is the case, then both the US and co-signatory governments are accountable for the contents and the outcomes. Most discourse about AFGHS to date has focused on the decisions that America has made, or demanded that other countries make. The AFGHS architects have monopolized the hot seat. As they should, in so many ways. America absolutely created the conditions under which countries needed to come up with health financing strategies to fill unanticipated, catastrophic funding gaps. And with not-too-long a lens, we can look back and see that America is also on the hook for its role in the Bretton Woods institutions that made user fees and health system fiscal austerity conditions of loans during the era of structural adjustment. But in the here and now, it is not at all clear to me that the US is requiring Uganda or any other country to implement specific approaches to sustainable financing. Instead, it is as the authors of that paper up in footnote 6 suggest: African governments have agency. As implementation plans roll out—whether or not the narratives are shared—it will be important to understand what this agency looks like and what it means for people, including the poorest of the poor. And it will be important to figure out how to talk about it safely, respectfully and critically in places other than the literal and metaphorical footnotes. 25 This week’s song is “Once upon a time” by the Moody Blues. (I know, this is gonna be a weird, largely banger-free end of 2026 playlist. HMU with requests.) AND please do watch the video and appreciate the truly amazing opening sequence—a drum kit wasteland, a coupla plastic bags, a bit of sand. Sort of like the hill where fiscal austerity policies that put costs on health care users might go to perish. But then there’s a lady with amazing hair. It’s worth it.
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