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Public health experts demand tighter global restrictions on fireworks
Fireworks pose an underestimated danger to public health and require stronger regulations and sustained public education campaigns to help prevent devastating, yet entirely avoidable injuries, warn US experts in The BMJ today.
Column: When politics is covered like sports, everything is fair game
When sports and politics collide: The Blue Wave in the midterms Tuesday was the political equivalent of the Chicago Bears 73-0 shellacking of Washington in the 1940 NFL championship game.
Tampa Bay Buccaneers news: Bucs getting ready for Bears
The Tampa Bay Buccaneers are battling against the Chicago Bears in Week 9’s edition of Sunday Night Football.
Palm Beach County 'Best of Season' arts and culture preview
From Broadway hits to classical concerts, here are the top arts and entertainment events coming to Palm Beach.
Why Barry Diller thinks Skydance shouldn't try to beat Netflix
The mogul has advice for the Ellisons and everyone else: "You are simply never going to beat Netflix, ever, unless they do something weird."
The Bear’s Den: Jeffery Simmons is making an impact
Jeffery Simmons is already making a huge impact on the Bears, stepping into a leadership by example role
Pens Points: Bear Down
One last contest at PPG Paints Arena for the Pittsburgh Penguins before hopping on a plane and heading back out west for their annual California swing that begins on Saturday. Tonight the Boston Bruins come to town as leaders of the Atlantic division and owners of the fourth best record in the NHL at the […]
Pilot explains landing at one of the world's most challenging airports
Landing at the tiny Caribbean airstrip is bumpy and intense, but I love the thrill. Here's what passengers don't see during the extreme approach.
What Mack Hollins, Greg Van Roten returning to practice means for the Patriots
The two veterans were back on the practice fields on Wednesday.
AMC Entertainment Q3 Earnings Call Highlights
AMC Entertainment (NYSE:AMC) reported record third-quarter revenue and adjusted EBITDA as a stronger box office, higher attendance and demand for premium screens helped the theater operator return to a quarterly profit. Revenue rose 31.6% from a year earlier to $1.711 billion, while net earnings we
Accel Entertainment (ACEL) Rallies On Q3 Beat As Expansion Progress Fuels Undervalued View
Accel Entertainment (ACEL) just reported third quarter results that topped analyst expectations, with revenue of US$363.56 million and earnings of US$0.25 per share, along with fresh progress in Chicago and Wyoming expansion plans. The stronger third quarter has been followed by a sharp shift in sentiment, with Accel Entertainment’s share price jumping 13.15% in a single day and 21.01% over the past week. This has contributed to an 18.03% year to date share price return and a 32.35% one year...
Bowen Health cuts the ribbon on new facility opening in Wabash
Bowen Health, Indiana’s largest community mental health center and nonprofit healthcare organization, cut the ribbon at its new Wabash location.
New Orleans Pelicans Survive Second Straight Overtime To Beat Utah Jazz In Rematch
The New Orleans Pelicans survive their second straight overtime to beat the Utah Jazz 120-113, improving to 4-4 this season.
New FSU Health hospital under construction in Panama City Beach
A new FSU Health hospital under construction in Panama City Beach is set to open in 2028. The first phase will have up to 180 beds.
Man, 19, arrested for string of business break-ins in Brighton
Between Sept. 19 and Oct. 31, the man allegedly broke into several businesses along Market, Faneuil, and North Beacon Streets by smashing storefront windows and stealing registers and money.
Which Way Are the Political Tides Going for Orange County’s Coast?
From the statehouse to Huntington Beach City Hall, Republicans are in a series of tight races to maintain their seats in an area that’s become a bastion of California conservatives.
Barrett Business Services Q3 Earnings Call Highlights
Barrett Business Services (NASDAQ:BBSI) reported higher third-quarter gross billings but lower earnings per share as new client additions were offset by workforce reductions among existing customers and smaller favorable workers’ compensation adjustments. The company lowered its full-year outlook f
Bears Send Breakout Starter to IR After Jeffery Simmons’ Debut
The Chicago Bears welcomed the NFL's best defensive tackle in Jeffery Simmons, then lost a regular starter the next game. The post Bears Send Breakout Starter to IR After Jeffery Simmons’ Debut appeared first on HEAVY.
Vikings slip in changing face of NFC North
Bears appear to be the division's strongest team, while the Lions are climbing and the Packers await the return of Micah Parsons.
Discriminatory beauty standards have health costs for women of color
Racialized beauty ideals can harm the health of women of color through exposure to potentially harmful chemicals in hair and personal care products.
Democrats get their health agenda ready ahead of takeover
Presented by AstraZeneca{beacon} Healthcare Healthcare The Big Story Democrats get their health agenda ready ahead of takeover Reinstating the Affordable Care Act’s enhanced premium ta…
Tom Brady's NFL Power Rankings: Are The Bears Really The Best Team In The League?
Was the Bears' win over the Seahawks convincing enough to put them at No. 1 over the Bills, 49ers and Broncos in Tom Brady's power rankings?
AMC Entertainment (NYSE:AMC) reports upbeat Q3 2026
Theater company AMC Entertainment NYSE:AMC reported Q3 2026 results beating Wall Street’s revenue expectations, with revenue up 31.6% year on year to $1.71 billion. Its non-GAAP profit of $0.13 per share was in line with analysts’ consensus estimates.For more on AMC Entertainment, read our free ful…
AMC Entertainment (NYSE:AMC) reports upbeat Q3 2026
Theater company AMC Entertainment (NYSE:AMC) reported Q3 2026 results beating Wall Street’s revenue expectations, with revenue up 31.6% year on year to $1.71 billion. Its non-GAAP profit of $0.13 per share was in line with analysts’ consensus estimates.
Reviewing the Bears’ PFN grades from Week 8 vs. Seahawks
After the Bears’ win over the Patriots, we look at how PFN scored each of Chicago’s starters in Week 7.
Watch Jenna Dewan perform ‘All for You’ with Janet Jackson 24 years before she’ll dance to it on “DWTS”
“She’s the mama bear to all of us,” Dewan said of touring with Jackson in a 2018 interview. “Once a Janet dancer, always a Janet dancer.”
Bears place Kentavius Street on injured reserve, sign Stephen Carlson
The Bears made a pair of roster moves Wednesday and are losing one of their defensive tackles.
AMC Entertainment Holdings earnings beat by $0.11, revenue topped estimates
AMC Entertainment Holdings earnings beat by $0.11, revenue topped estimates
Among Strawberries and Food Scraps, Students Find Science - Rutgers Climate and Energy Institute (RCEI)
At two Rutgers research centers, the familiar inspires questions about growing food and making better use of what remains It was October, but inside a greenhouse at Rutgers’ research farm in Cream Ridge, N.J., strawberry plants were still flowering and bearing fruit. Edward Durner invited the visiting Honors College students from Rutgers University-New Brunswick to try the berries, then offered ... Read More
Startup targets new pain point: nighttime | Investors Lab
It's our job to report on investment-worthy innovations coming to market. That doesn't mean we always believe they're in the best interests of the planet. Case in point: a new space-tech project that aims to solve the "problem" of nighttime. With their planned constellation of orbiting satellites equipped with giant mirrors that would beam sunlight to the night side of Earth on demand, the company behind the invention is attracting investors. SN's Lisa Grossman enlightens us.
‘Oh, Mary!’ Seattle stop brings Broadway hit to Paramount Theatre
The Tony-winning, Broadway comedy smash, now running at The Paramount Theatre, has won hearts and sold tickets.
Haaland won election. Now, how will she govern?
By Kevin Hendricks — New Mexico made history Tuesday night with Deb Haaland winning her campaign to be the first Native American woman to win a governor’s seat. Haaland, a Laguna Pueblo member and former U.S. Interior secretary, beat Republican Gregg Hull by 14 points to become New Mexico’s next governor. She takes office Jan. […]
I’m an Entertainment Editor, and These Are the New Christmas Movies on My Watchlist This Year
If you're looking for the best new Christmas movies in 2026, we've gathered holiday films for you to watch on Netflix, Prime Video, Hallmark, and other streamers.
BROWARD HEALTH CELEBRATES TOPPING-OUT CEREMONY FOR MEDICAL OFFICE BUILDING AT BROWARD HEALTH NORTH - Florida Hospital News and Healthcare Report
Shane Strum, President and CEO of Broward Health, signs the beam with fellow executives November 4, 2026- Broward Health celebrated a major construction milestone with the topping out of its […]
NBC’s Steve Kornacki explains why he walked off set during live election coverage
NBC News personality Steve Kornacki explained why he abruptly walked off set during the network’s live midterm election coverage.
Democrat Vasquez wins third term after $21.8 million race
By Kevin Hendricks — After months of TV ads, mailers and text messages across southern New Mexico, voters in the 2nd Congressional District gave U.S. Rep. Gabe Vasquez a third term, and it wasn’t close. Vasquez, a Las Cruces Democrat, beat Republican Greg Cunningham 59% to 41% on Tuesday, according to unofficial results from the […]
Unveiling the science behind a beautiful singing voice
Expert listeners can often form an immediate impression of a singer's performance. But what exactly in the voice drives that judgment? In classical vocal competitions, performers are rated on an overall ...
Flutter Entertainment plc Q3 2026 Earnings Call Summary
Moby summary of Flutter Entertainment plc's Q3 2026 earnings call
Packers vs. Patriots prediction, odds, pick for NFL Week 9
The Green Bay Packers visit the New England Patriots on Sunday, November 8, with both teams looking to build on Week 8 victories. Green Bay is 5-3 after beating Carolina 27-19 on Thursday night, while New England improved to 5-3 with a 24-19 comeback victory over Miami. Kickoff at Gillette Stadium is scheduled for 4:25 p.m. ET on FOX. The matchup […] The post Packers vs. Patriots prediction, odds, pick for NFL Week 9 appeared first on ClutchPoints.
Who is your favorite USC alum?
Simply put, Ohio State cannot afford another loss on the season. So beating Oregon is the bare minimum measure of success this weekend. But Jami and Matt discuss what a good week looks like beyond getting back in the Win Column.
Celtics Prove Grit Beats Hot Shooting In Recent Road Wins
Boston's recent wins show a new identity built on defense and hustle, not just three-pointers. A look at the data behind the Celtics' resilience.
Gaston County health official works to expand mental health resources for teens
Trey Sarter, mental health coordinator for Gaston County Public Health, is working to reach the county’s younger population, a group he said has become a top priority for local public health leaders.
Eagles Trade Pitch Swaps Draft Pick for New Starting QB
Philadelphia Eagles trade pitch lands new starting QB from AFC contender. The post Eagles Trade Pitch Swaps Draft Pick for New Starting QB appeared first on HEAVY.
Earnings call transcript: Madison Square Garden Entertainment beats Q1 2026 forecasts
Earnings call transcript: Madison Square Garden Entertainment beats Q1 2026 forecasts
Boys, 13 and 15, killed in California beach shooting, officials say
LOS ANGELES — The victims of a fatal shooting at a California state beach early Monday were two teenage boys, according to officials. One of them was days away from
Hannah Pingree wins governor’s race
Democrat and former Maine House speaker Hannah Pingree has won the gubernatorial election, beating out her Republican adversary Bobby Charles and Independent Rick Bennett.
Fitness studio Swoot with nightclub-inspired classes to open second location Uptown
The upbeat, boutique fitness studio Swoot plans to open a second location this weekend in Uptown New Orleans, near Loyola and Tulane universities.
Pritzker won big. Now comes the hard part.
With a third term secured and a possible White House bid looming, Pritzker faces tough fights over Illinois' budget, the Bears and data centers.
Palm Beach County students help scientists track where trash drifts in local waterways
Shining A Light on Palm Beach and the Treasure Coast
The Big Ten College Football Playoff Picture: Week 10
The Big Ten is beating itself up and isn't being rewarded as another conference may or may not does. Either way, the CFP rankings are here!
Bean Life Science Museum hosted its annual free Halloween Family Night for students and families
The Bean Life Science Museum hosted its annual Halloween Family Night on Oct. 26, offering families a free evening of hands-on activities, crafts, and opportunities to explore the natural world.
AI in Life Sciences Market to Worth USD 69.34 Billion by 2031, at a CAGR of 26.3%
Delray Beach, FL , Nov. 04, 2026 (GLOBE NEWSWIRE) -- MarketsandMarkets™ projects the global AI in life sciences market to grow from USD 21.58 billion in 2026 to USD 69.34 billion by 2031, at a CAGR of 26.3% during the forecast period. Market growth is fueled by accelerating adoption of AI in drug discovery, clinical research, diagnostics, and precision medicine, along with increasing investments in AI-powered life sciences solutions and the growing availability of real-world and genomic data. Ge
Essentia Health supports new playground at Clinton-Graceville-Beardsley elementary school
Clinton-Graceville-Beardsley (CGB) Schools was excited to show off the new playground at its elementary school during a Sept. 21 open house, and is grateful for a $20,000 contribution from Essentia Health that went toward the purchase of new equipment, supporting a safe and active space for the district’s youngest students.
The Miami Heat Are Losing What Made Them Dangerous
The Miami Heat have built their identity around toughness, defensive intensity, and holding opponents accountable. Those qualities have defined the franchise for years, but through the first seven games of the 2026-27 NBA season, the team has struggled to uphold those standards with the Heat's disastrous start. Miami's 138-117 loss to the Los Angeles Lakers …
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 […]
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...
Video: McKennie joins Juventus group training before AZ Alkmaar clash
Juventus midfielder Weston McKennie trained with his teammates at Continassa this morning, on the eve of a Europa League game against AZ Alkmaar.Juventus are preparing for Thursday’s away Europa Lea...
MSG Entertainment beats estimates on record concert quarter
MSG Entertainment beats estimates on record concert quarter
Madison Square Garden Entertainment earnings beat by $1.31, revenue topped estimates
Madison Square Garden Entertainment earnings beat by $1.31, revenue topped estimates
CVS Health beats estimates, raises guidance amid split plans
Investing.com -- CVS Health Corporation (NYSE: CVS) reported third-quarter adjusted EPS of $2.09, beating analyst estimates of $1.65, as the healthcare giant announced plans to separate into two independent companies.
Seahawks Hit Unwanted Milestone After Lopsided Loss to Bears
The Seattle Seahawks have suffered yet another setback in the 2026 NFL season. The team has suffered an embarrassing defeat to the Chicago Bears with a score of 17-34. The reigning Super Bowl champions now have a current record of four wins and four losses. The franchise had a dominant season in 2025, which led […] The post Seahawks Hit Unwanted Milestone After Lopsided Loss to Bears appeared first on Gridiron Heroics.
Sports on TV/radio listings: Nov. 4
Where to watch and/or listen to today's sporting events that will be televised or broadcast on the radio.
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?
Portsmouth 3-1 Swansea
Pompey supporters have their say after Portsmouth's 3-1 win over Swansea City in the Championship.
Bears-Seahawks Monday Night Football: Overreaction Or Not?
The Monday Night Football game between the Seattle Seahawks and Chicago Bears produced some shocking results. Ben Johnson and Caleb Williams moved the ball at will on that vaunted Seahawks defense and scored 34 points. It was the most points Seattle had surrendered all season. I have three takeaways from the game, and I’ll decide […] The post Bears-Seahawks Monday Night Football: Overreaction Or Not? appeared first on Stadium Rant.
Progressive Democrat Abdul El-Sayed wins Michigan race for Senate
El-Sayed bested Republican Mike Rogers to become the first Muslim senator in US history.
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.
“Good Old Days” – Chris Evert Gets Nostalgic as Billie Jean King Celebrates 51 Years Since Her Historic Rise to WTA No. 1
Chris Evert looked back on her tennis career as Billie Jean King marked the 51st anniversary of the WTA introducing its first official rankings and Evert becoming the first-ever World No. 1 in women’s tennis.
Texas Politics Enter a New Era After Hinojosa's Win
Texas State Rep. Gina Hinojosa won the race for governor, the first Democrat to win the office since 1990. She beat incumbent Greg Abbott, who was seeking a fourth term.
National Navy SEAL Museum honors courage and commitment
Just north of Palm Beach County, along Florida’s scenic Treasure Coast, the National Navy SEAL Museum brings to life the remarkable stories of courage, sacrifice and service that have shaped
Yankees news: Skubal linked to Yanks
Yankees among several teams in on top FA; Murphy walks back taunt; Chisholm likely to walk
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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