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Fans Furious as The Chicks Cancel L.A. Show Moments Before Doors Were Set to Open
Fans expressed their outrage after country music icons The Chicks canceled their show in Los Angeles just moments before doors were set to open. The band announced on Monday, November 2, that “due to ...
Brandon Aiyuk reporting to 49ers
San Francisco 49ers WR Brandon Aiyuk has submitted paperwork to be reinstated, his agent Drew Rosenhaus said.
3 players the Titans should try trading before the deadline
Identifying three players the Tennessee Titans should try trading before the NFL trade deadline (Nov. 10)
Giants Should Target Senzatela for More Bullpen Depth
Antonio Senzatela offers a versatile solution, bringing starter experience and proven relief stability to stabilize the San Francisco Giants’ taxed pitching staff.
Tennis legend Rafael Nadal joins Real Madrid board
Rafael Nadal won 22 grand slam titles in his tennis career before retiring in 2024
Fantasy Football Start’em, Sit’em Week 9: RB Edition
Here are some of the top starts and sits for the ninth week of the NFL season, including starting Tyler Allgeier and sitting Derrick Henry.
Apple Music's Selfie Sing lets you take videos of yourself doing karaoke
The videos are limited to one minute, thankfully.
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.
Detroit Red Wings Suffer Another Major Injury Blow
Detroit Red Wings goalie John Gibson exits Tuesday's loss to Tampa Bay with an injury. Todd McLellan discusses Daniil Tarasov and what's next.
Browns make seven roster moves after Steelers loss
Practice squad shakeup for the Cleveland Browns heading into Week 9
Experts criticise clubs' rhetoric on ending betting sponsorships
The tone adopted by representatives of Brazilian clubs during Tuesday’s (3) public hearing at the Supreme Federal Court (STF) on the ban on betting companies drew criticism from football marketing a...
Yankees 2026 Roster Report Cards: Angel Chivilli
Angel Chivilli flashed some potential, but struggled with injuries all season.
Rory McIlroy agrees with claim that LIV Golf 'wanted to destroy The European Tour'
Rory McIlroy supports claims that LIV Golf intended to destroy the DP World Tour to serve as its replacement.
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 […]
Deen’s Daily: Iginla Facing Health Issues; Avalanche Road Woes; Jets Complete Improbably Comeback
An unfortunate story broke yesterday about Jarome Iginla and his current health battles. The Colorado Avalanche had one road win […]
Opponent Breakdown: Georgia Tech Yellow Jackets Offense
Brent Key started last season 9-1 before losing three straight games to close out a strong season for a Georgia Tech program that hasn’t had a lot of 9-win seasons as of late. Key faced lofty expectations this season after such a good season, but things have gone about as poorly as possible for Tech. […]
Mets Morning News: More salary cap nonsense
Your Wednesday morning dose of Mets and Major League Baseball news, notes, and links.
Mack Hollins to return to Patriots practice on Wednesday
Hollins’ 21-day window to return from injured reserve is about to open.
Braves News: Salary cap proposal, Rolddy Muñoz review, and more
Atlanta Braves news and notes from Tuesday.
Can Meta’s Business Pay For Its Spending?
For questions about this article or underlying research, email help@trefis.com.Management said on its October 21, 2026 call that Meta Platforms (META) is spending heavily on servers, data centers and network infrastructure.
Nadal set to join Real Madrid board of directors
Tennis great Rafael Nadal is set to join the board of Spanish football giants Real Madrid.
2027 South Side Sox Top Prospect No. 97: Daniel Wright
The former quarterback is finding his footing in the bullpen
NBA makes Draymond Green decision after ejection vs Suns
Another Draymond Green ejection, another familiar wave of fans waiting to see if the league will actually punish him. Draymond Green found another way to lose his cool, getting ejected after taking Khaman Maluach down and getting into an altercation with Dillon Brooks in the aftermath.
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 […]
Buckeyes Roll into Saturday's Game as Massive Favorites Against Oregon
Ohio State opens as massive favorites on Saturday against the Oregon Ducks.
Weekly Stat Review: Post Week 8 edition
The loss versus the Packers officially lost Ejiro Evero his job - it’s hard not to see why.
Sam Leavitt provides positive update on hamstring injury
The Tigers’ quarterback says his hamstring improved significantly during the team's bye week.
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...
Scientists spot elusive particle decay in search for 'Zeptoverse'
Scientists have found evidence for a rare particle decay occurring once in 10 billion particles at the LHCb experiment at CERN.
NFl draft order: Arizona Cardinals fall out of top 10
The Cardinals won on Sunday. Now they aren't in the playoff picture and don't have a top-10 pick in the draft.
Report Milan agree record 50m-a-year Adidas kit deal
La Gazzetta dello Sport reports that Milan have reached a record €50m-a-year agreement with kit manufacturer Adidas, which will design the Rossoneri’s shirt for ten years starting in 2028.Milan wi...
Today in White Sox History: November 4
Happy birthday to a true underachiever, Skeeter Webb!
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?
Scott Parker 'very confident' of promotion after West Ham appointment
Scott Parker has said he is delighted to return to West Ham after being appointed as the club's new manager.Parker replaces Nuno Espirito Santo as manager at the London Stadium, followingthe latter's ...
Bills trade deadline candidate: Colts receiver Josh Downs
The ninth installment in the series examining possible Bills trade targets before the deadline
Fabian Bredlow raises suspicion about Galatasaray whistling
Speaking after VfB Stuttgart’s 2-0 defeat against Galatasaray on Matchday 4 of the 2026/27 UEFA Champions League, Fabian Bredlow expressed a suspicion regarding the whistling coming from the stands....
Jumbo Package: Alabama ranked 5th, national meltdown ensues
Your latest Crimson Tide news and notes.
More Segunda matches postponed: Andorra-Mallorca also called off ❌
This weekend’s match between FC Andorra and RCD Mallorca has been officially postponed. The sporting authorities and both clubs have agreed to call off the fixture amid the shock gripping Spanish fo...
Expert predictions, picks for Florida's Week 10 game vs Oklahoma
Here are the Gators Wire staff's predictions and picks for college football's Week 10 SEC matchup between the Florida Gators and Oklahoma Sooners.
Tennessee Titans news: Bye week gives chance to reflect
The Tennessee Titans are entering the bye week at the right time.
MIT scientists break a 20-year rule and unlock never-before-seen crystal structures
MIT scientists have challenged two decades of conventional thinking by discovering that flexible molecular connections, rather than rigid ones, can unlock entirely new ways to arrange nanoparticles. The breakthrough could lead to a new generation of designer materials with unusual properties and applications in electronics, medicine, and energy.
Alabama's College Football Playoff ranking creates major Tennessee controversy
Alabama has two losses and already fell to Tennessee, yet the Crimson Tide opened fifth in the College Football Playoff rankings while the Volunteers landed 13th.
Rafa Nadal joins Real Madrid's board of directors 🎾
Real Madrid has officially announced the appointment of Rafa Nadal to its board of directors. The club has thus formalized the arrival of one of Spanish sport’s greatest legends to its governing bod...
Patriots Get Offensive Line Reinforcement Ahead Of Packers Game
New England made several roster moves Tuesday, but the return of an offensive tackle could become particularly important as the Patriots prepare for Green Bay.
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.
Jayson Tatum diagnoses Celtics' main early season struggle
After breaking their five-game winning streak to the Rockets, Jayson Tatum had a major insight on what the Celtics led by Coach Joe Mazzulla are struggling with.
Patriots vs. Dolphins snap counts: O-line shakeup continues
Notes and thoughts on the Patriots’ snap counts from their 24-19 win over the Dolphins.
Portsmouth 3-1 Swansea
Pompey supporters have their say after Portsmouth's 3-1 win over Swansea City in the Championship.
Is One Stalled Business Reason Enough To Sell Zoom Stock?
For questions about this article or underlying research, email help@trefis.com.The growth outlook for the Online business is the one number that should worry a Zoom Communications (ZM) holder, though the concern remains a moderate one. Online brought in about 38% of Zoom's revenue in fiscal Q2 2027.
Jack Williams makes his TSSAA football first round playoff predictions
Tennessean high school sports reporter Jack Williams makes his predictions for the top TSSAA football games in the first round of the playoffs.
Chiefs News: Kingsley Suamataia is playing his part
The latest Chiefs news, brought fresh to you every morning!
Who needs picks when your offense is lacking?
The Denver Broncos should be buyers at the trade deadline
Pens Points: Penguins blow another one with late-game collapse
Here are your Pens Points for this Wednesday morning… The Pittsburgh Penguins fell 3-2 to the Vegas Golden Knights on Tuesday night after special-teams struggles cost them another game, as they failed to capitalize on key power-play opportunities, including a lengthy two-man advantage in the third period. [Recap] NHL Commissioner Gary Bettman said he is […]
Iowa football rises in latest USA TODAY Sports 1-138 re-rank
The Hawkeyes rose up the USA TODAY Sports 1-138 re-rank after a big win over Wisconsin.
Man United mock Roma with brutal tweet after comeback victory
Safe to say Manchester United enjoyed their comeback win against Roma on and off the field as the Red Devils mocked the Giallorossi with a brutal tweet at full-time.Roma wasted a two-goal lead at Old ...
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...
2026 science Nobel Prizes: Who are the winners, and is there a gender gap problem?
Password is Euronews Tech Talks’ new monthly series unpacking tech and health tech news from Europe and the world. In this first episode, we discover who the scientists awarded Nobel Prizes are, and w...
Juventus to Get More Cash from Owner, Outline Priority
Juventus have announced yet another capital increase of up to €250M, to be activated in due course. They were in the red by €66M in the last session. The stakeholders will have to pour more money ...
Golden Nuggets: Less than a week until the trade deadline
Your daily San Francisco 49ers news for Wednesday, November 4th, 2026
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.
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.
Heisman Trophy enters a new era with fan access carrying an eye-popping price
Heisman Trophy gives fans unprecedented access, but wait until you see the price.
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.
Massive win and really important night
Portsmouth head coach John Mousinho speaks to BBC Radio Solent after the 3-1 win against Swansea 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.
Paul will 'hang up gloves' if he loses to Doumbe
Jake Paul says he will retire from boxing if he loses to MMA star Cedric Doumbe on 24 December in Dubai.
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 ...
Raphinha to sign new Barcelona contract until 2030 on Thursday
Barcelona captain Raphinha is expected to formalise his contract renewal on Thursday, November 5, signing a new agreement that will keep him at the club until 2030. According to SPORT, the agreement ...
The Daily Hilario: Here to there, and here again
Your daily dose of off-topic shenanigans
Europa League lights in Brussels await!
Preview of RSC Anderlecht clashWith four points already on the board and plenty of momentum behind them, our Red Bulls head into a crucial phase of the UEFA Europa League this Thursday at 18:45 CET. I...
Canada bars Russia & Belarus from junior tournament
Canada will not let ice hockey players from Russia or Belarus take part in the World Junior Championships next month.
Titans’ biggest problem to fix during 2026 bye week
The Tennessee Titans are approaching their 2026 bye week with more questions than answers. Sure, Cam Ward’s development remains central to the franchise’s long-term ambitions. However, Tennessee’s struggles extend well beyond the quarterback position. The offense has shown occasional flashes of explosiveness. The defense, though, has repeatedly […] The post Titans’ biggest problem to fix during 2026 bye week appeared first on ClutchPoints.
AI boosts operational efficiency but not systemic climate action, global study finds
Artificial intelligence (AI) is widely promoted as a tool for sustainable development, but whether its operational gains translate into deeper ecological transformation remains uncertain. A new global assessment examines how AI diffusion relates to seven core United Nations Sustainable Development Goals (SDGs), covering health, education, clean energy, industry and infrastructure, sustainable cities, responsible consumption and production, and climate action. It also explores the channels behind
New Children’s Entertainment Releases: What Families Can Watch Together in November 2026
Plan family movie nights with November 2026 kids' releases, featuring animated films, holiday stories and familiar characters.
🗞️ 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...
Dolphins announce passing of perfect 1972 team member Bob Heinz
The Miami Dolphins are mourning the loss of former defensive lineman Bob Heinz, who helped the franchise win consecutive Super Bowls and complete the NFL’s only undefeated campaign in 1972-73. He passed away in California on Oct. 31 at 79 years of age. This news comes shortly after the Detroit Lions handed the Minnesota Vikings their first loss of […] The post Dolphins announce passing of perfect 1972 team member Bob Heinz appeared first on ClutchPoints.
Russell Wilson takes first step towards NC State coaching job after CBS move
Russell Wilson has interviewed for the vacant NC State head coaching job, just months after retiring from the NFL and joining CBS Sports as an analyst. The former Seattle Seahawks quarterback is now one of two high-profile candidates linked with the role, alongside Philip Rivers, who also played college football for the Wolfpack.
Girls' flag football: Tuesday's City Section playoffs scores
Check out Tuesday's girls' flag football scores.
Gardner-Johnson released by Bills after spitting ban
The Buffalo Bills release safety CJ Gardner-Johnson after he serves a one-game suspension for spitting in the direction of an opponent.
Cold showers: A rewarding way to cut your emissions?
Making this small change to your daily routine could be as impactful as recycling.
Problems at health trust buildings could cost additional £20m
The maternity building on the Royal Victoria Hospital site is already tens of millions of pounds over budget.
Lightning’s Nikita Kucherov has been on fire since trade request
Nikita Kucherov wants out of the Tampa Bay Lightning , but he still can’t stop going all out for his team. Reports surfaced last Friday that the 33-year-old Kucherov had already asked the Lightning to move him. In the two games since, the two-time Hart Memorial Trophy winner has done nothing on the ice but rack up points. Against the Nashville […] The post Lightning’s Nikita Kucherov has been on fire since trade request appeared first on ClutchPoints.
Jake Ferguson gets good prognosis on ankle injury
Dallas Cowboys tight end Jake Ferguson suffered an ankle injury in Week 8, but head coach Brian Schottenheimer said the initial feedback was good.
The dangerous myth of the well-meaning health guru
In healthcare, a warm heart is no substitute for a trained mind. Banned Australian naturopath Barbara O’Neill built a global empire on the defense that she "just wants to help," but good intentions mean nothing when uncredentialed health advice causes real-world harm.
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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