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Richard Ojeda unseats GOP leader, reflecting a shift in North Carolina politics
Trump’s billionaire-blue collar coalition has been smashed by class politics
As tech bosses get richer and ordinary Americans struggle, Democrats put the case against the US’s grotesque unfairness – and voters responded, says Guardian columnist Aditya Chakrabortty
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.
FSU Partners With Special Olympics Florida to Expand Access to Health Screenings
Florida State University students and faculty partnered with Special Olympics Northwest Florida to provide accessible health and wellness screenings for individuals with intellectual and developmental disabilities at The Arc Big Bend in Madison, Fla. on Sept. 23. The Healthy Hearing and Strong Mind event brought together audiologists and students from the School of Communication Science…
Lawsuit filed against 'Money out of Politics' proposal after Michigan voters pass initiative
Almost immediately after Prop 2 passed in Michigan, a lawsuit challenging its legality was filed in federal court.
How Science and the Environment Fared in the 2026 U.S. Midterms
Science was on the ballot across the United States in Tuesday’s midterm elections. On federal, state, and municipal levels, hundreds of people with backgrounds in science, technology, engineering, mathematics, and medicine ran for office. Americans also voted on measures related to conservation projects, pollutant abatement, healthcare access, and environmental reviews.
How Trump and Republicans lost the 2026 midterm elections, according to AP Voter Poll
After more than a decade with Donald Trump at the epicenter of U.S. politics, most voters appear exhausted and exasperated by him, according to The AP Voter Poll, a survey of midterm voters in all 50 states.
If Israeli politics were rational, Arab parties would now be holding all the cards
The existing rules of the political game that preclude full Arab participation are illogical, immoral and counterproductive. The system requires a total reset.
Prop. 40's failure points to the tax California already pays for its wealth: Politics overrun by money
The playbook for defeating the the billionaire tax was simple: Stoke economic fears and confuse Californians.
Anti-Transgender Political Rhetoric Played an Outsized Role in the 2026 U.S. Midterm Elections
Your Support Saves LGBTQ+Youth's Lives Every DayDonate94% of transgender and nonbinary youth said recent anti-LGBTQ+ politics caused stress or anxiety, […]
Israel’s Coalition Politics Are More Complicated Than Identity
The idea that Israel’s Jewish opposition parties can join forces with Arab parties to remove Netanyahu overlooks fundamental disagreements that make such a coalition difficult to form, let alone sustain....
CAIR, CAIR-MI Congratulate Sen-Elect Abdul El-Sayed on Defeating the ‘Politics of Hate’ to Become First Muslim Senator
Muslim civil rights and advocacy groups praise people of Michigan for rejecting hate and Muslim voters for record turnout The Council on American-Islamic Relations (CAIR), the nation’s largest Muslim civil rights and advocacy organization, and its Michigan chapter, CAIR-Michigan, today congratula
‘Money Out of Politics’ ballot measure passes, constitutional convention fails
Proposal 2 on Michigan ballots, the “Michiganders for Money Out of Politics” initiative, has passed.
Palm Beach County students help scientists track where trash drifts in local waterways
Shining A Light on Palm Beach and the Treasure Coast
CMG Jacksonville TV, Jacksonville University Athletics announce new broadcast partnership
Cox Media Group Jacksonville TV and Jacksonville University Athletics announced on Wednesday a new broadcast partnership that names Action Sports Jax TV the exclusive home of JU Athletics broadcasts in Northeast Florida.
I On Politics
CB2 MEETING: Community Board 2 has scheduled a Regular Monthly Meeting and Public Hearing of the Full Board: Thursday, November 5, 2026, 6:30 P.M., at Sunnyside Community Services, 43-31 39th Street, Ground Floor, Sunnyside. CB6 MEETING: Community Board 6 Meeting Notice: Thursday, November 12, 2026 at Queens Borough Hall, Helen Marshall Cultural Center, 120-55
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
APT29-Linked Hackers Hijack Web Analytics Script to Deliver iOS and Android Exploits
APT29-linked attackers use compromised sites and Plerdy analytics to deliver iOS and Android exploits that steal browser and device data.
The Donald Trump Era in American Politics Is Ending
The takeaways from the midterms are clear: no amount of billionaire spending could overcome the fact that Donald Trump’s dominance is coming to a close, the Left has much more room to grow, and we have entered a period of new possibility in US politics.
This Week In Politics: G20 Foreign Ministers’ Meeting
Amid national divides over the upcoming midterm elections, international friction also surfaced at the Group of Twenty’s (G20) foreign ministers’ meeting in Atlanta, Georgia, on Friday, Oct. 30, and Saturday, Oct. 31. Top diplomats from the G20, an international forum comprising the world’s largest economies that convene to address global economic policy and development, gathered...
The Universe Should Be Empty. A Single Trapped Antiparticle Might Finally Reveal Why It Isn’t.
Scientists chilled a single positron to its quantum ground state, chasing physics’ biggest mystery.
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 […]
Iran Holds Technology Olympics
TEHRAN (Tasnim) – Iran has held the third edition of the Technology Olympics, an event aimed at identifying talented young people, strengthening their problem-solving skills, and connecting them with real-world industrial projects and the knowledge-based economy.
Joe Morrissey returns to politics, unseats 16-year Petersburg City Council incumbent
Joe Morrissey (D), a former Virginia senator whose political career has been marked by controversy, defeated Howard W. Myers, the 16-year incumbent, for a seat on the Petersburg City Council.
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects
Michigan voters have voted in favor of Proposal 2, which aims to “get money out of politics.”
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects
Michigan voters have voted in favor of Proposal 2, which aims to “get money out of politics.”
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects
Michigan voters have voted in favor of Proposal 2, which aims to “get money out of politics.”
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects
Michigan voters have voted in favor of Proposal 2, which aims to “get money out of politics.”
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects
Michigan voters have voted in favor of Proposal 2, which aims to “get money out of politics.”
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects
Michigan voters have voted in favor of Proposal 2, which aims to “get money out of politics.”
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.
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 [...]
‘A mandate for change’: Democrats remake Texas politics in election rout
By Brad Brooks Nov 4 (Reuters) - Texas Democrats, shut out of every statewide office for more than three decades, have toppled Republicans from the top of the ballot to the bottom, remaking the political landscape of the nation’s largest conservative s...
'A Mandate for Change': Democrats Remake Texas Politics in Election Rout
By Brad Brooks Nov 4 (Reuters) - Texas Democrats, shut out of every statewide office for more than three decades, have toppled Republicans from the top of the ballot to the bottom, remaking the political landscape of the nation’s largest conservative state in a single earth-shattering night.
Daniel McCarthy: A slippery slope to criminalizing politics
Politics has high enough stakes without the losers being sent to prison – or losing their heads.
Hidden planet emerges from the glare
Stars are so bright that their glare overwhelms faint nearby planets. Scientists combined detailed physics from telescope observations with modern computational techniques to precisely remove this glare. After applying the tool to existing JWST images, they found a previously hidden giant exoplanet. Technique could improve planet-detection sensitivity without requiring changes to telescope hardware.
How space weather shapes young planets
Scientists suspect powerful solar flares helped strip away the atmospheres of planets like Mars. A Michigan State University researcher is now searching for evidence of how those same forces shape planets beyond our solar system. Adina Feinstein, assistant professor of physics and astronomy, believes exoplanets are the key to understanding the early days of our solar system. This week, she received a Schmidt Sciences FirstLight grant to investigate how space weather influences young planets.
I’m a scientific researcher. This ethics board has soul-crushing side effects.
Institutional review boards can safeguard human subjects without burying scientists in paperwork.
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.
A tiny squeeze dramatically changes the magnetism of exotic materials
Scientists have discovered that a simple mechanical squeeze can dramatically alter the magnetic properties and electrical behavior of exotic materials called altermagnets. The surprising breakthrough could open the door to faster, more energy-efficient electronics and new technologies for quantum computing.
Democrats seize Congress in sweeping midterm repudiation of Trump
Democrats seized control of both the Senate and House of Representatives on Tuesday, scoring sweeping victories in Republican strongholds for the first time in generations.
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.
Column: Remembering Election Central As Who’s Who of Fayetteville Politics
Before election results went virtual, candidates and residents gathered at the former Holiday Inn Bordeaux to await voting returns.
'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.
Letters: Science isn’t scary, it’s educational | Book-ban hypocrisy
Science is wonder; evolution isn’t scary Regarding the claim that the state education plan is de-emphasizing evolution (“Florida education chief defends science plan as critics say it ‘danced around’ evolution,” Oct. 28): Science is won…
IVF Patients, Doctors Navigate Fetal Personhood Laws’ Unknowns
People trying to start families and clinics trying to help them have been left confused and worried since the Supreme Court overturned Roe v. Wade, triggering fetal personhood laws in several states.
Democratic candidates Acton, Brown win on historic night in Ohio politics
Voters selected in the first woman to be elected governor in Ohio and returned former U.S. Sen. Sherrod Brown to Washington.
Pope at Audience: Politics that tends wounds and fights injustice gives hope
During the Wednesday General Audience, Pope Leo XIV focuses on how Christians can engage in economic and political life in order to build peace, as he ...
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.
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
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
It’s time to reunite
Election season is over. Most of us exercised our constitutional right to choose representatives for office who best reflected our values and those we believed were best prepared to lead and solve the very real challenges facing our state, nation and county. The 2026 election season was full of both extreme highs and extreme lows. […]
‘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.
Democrats secure historic majorities in the midterms — and are poised to win even more seats
The party is poised to have strong majorities in Congress for the final two years of President Trump’s term. Follow for live updates.
Michigan's 'money out of politics' measure passes, faces legal challenge
Unofficial results from the New York Times show Proposal 2 received support from 81% of Michigan voters.
Texas just went blue, and the tech bros are sad
Texas, with its limited red tape and vast resources, drew in the tech crowds. Now, it's politics turned bluer, and the execs are a little upset.
Lewiston’s mayor faces runoff after a tumultuous year in city politics
Challenger Rick LaChapelle had 45.7% of votes to 35.3% for Mayor Carl Sheline, according to unofficial results.
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.
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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Former Health and Human Services Secretary Xavier Becerra wins California governor’s race
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Watch News 10+ for continuing election coverage
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LANSING, Mich. (WLNS) — Michigan voters approved Proposal 2 Tuesday, a citizen-led measure its backers say will get “money out of politics,” setting up a likely court fight in the coming months. Th…
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OPINION
Like all forms of art, film has a special power to bring societal and political change to a society. Filmmaking is a craft that has always been rich in politics and societal influence, so it is impossible to fully understand the craft without understanding its inherently political nature.
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Wayzata Students Combine Technology, Sports in AI Project
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Everything you need for election night: From the Politics Desk
Plus, poll closing times.
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