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Columbia County Public Health confirms 3 cases of measles
Columbia County Public Health announced Wednesday they have confirmed at least three cases of measles in Columbia County.
23rd Women’s Business Conference took place at Pablo Center
More than 400 people gathered at the Pablo Center in Eau Claire on Wednesday for the 23rd annual Women’s Business Conference.
‘Opportunities are endless’: Hornets Sports and Entertainment team up with developers for the old Epicentre
Queen City Quarter, formerly known as the Epicentre has been acquired by a group of development partners including Hornets Sports and Entertainment.
‘Opportunities are endless’: Hornets Sports and Entertainment team up with developers for the old Epicentre
Queen City Quarter, formerly known as the Epicentre has been acquired by a group of development partners including Hornets Sports and Entertainment.
After everything, are we really buying back in on Oregon football?
A win at Ohio State this weekend could conceivably propel the Ducks back into the CFP discussion. Is it worth believing?
Pennsylvania health officials confirm a sixth measles-related death
Pennsylvania health officials are still investigating a seventh death reported by Franklin County’s coroner last month.
Small Business Saturday set for Nov. 28 in downtown Cape Girardeau
The annual Small Business Saturday in downtown Cape Girardeau is set for Saturday, November 28.
U Maine Political Science chair calls Jackson campaign “impressive” even with “blue wave” help
ABI spoke to University of Maine Political Science Chair Mark Brewer on Wednesday to get his take on how the national environment played a role in deciding Maine’s senate race.
Live Nation announces entertainment lineup for National Finals Rodeo in Las Vegas
Live Nation is offering country, rock and comedy performances at venues on the Strip during this year’s Wrangler National Finals Rodeo in Las Vegas, Dec. 4 through Dec. 12.
Shots fired near Yale Health, Yale PD headquarters
New Haven police reported shots fired near the Yale Health Center at 55 Lock Street Wednesday afternoon.
How to correctly recycle your political yard signs in Omaha
Don’t just throw your political yard signs away now that election day has come and gone: make sure you recycle them correctly.
Monument Health expands into Wyoming with new Gillette clinic
Monument Health opened its Gillette Clinic at 469 WYO 50 on Monday, offering primary care, diagnostics, and specialty services to over 21,000 Wyoming patients.
CVS plans to break up $117 billion healthcare conglomerate
The move mirrors the break up of Walgreens.
Benson vows cost relief as businesses brace for new era of Democratic ‘trifecta’ control
Jocelyn Benson’s decisive victory is an opportunity to pursue tax, labor and environmental policies that have long been opposed by business groups. How far she intends to go and which proposals she will embrace remain unclear.
City of Independence to make recommendations on better supporting local businesses
The City of Independence hopes new policy changes will make it easier for small businesses to stay open, operate and grow.
Mad Science: Pickle-themed experiments
Radiant Randy with Mad Science of Greater Kansas City joins Shane and Guest Host Steve Serrano to show off a few pickle experiments.
Monarch butterflies get tiny trackers to help scientists follow their mysterious migration
Solar-powered radio tags attached to nearly 1,750 monarchs this year are helping provide answers to monarchs' migration routes.
Work halts on conversion of shuttered Dearborn hotel after investigation into whether people were living there illegally
Perhaps 100 people had been living in the building over the last year, police were told.
Clemson University mourns death of alumnus, business school namesake Billy Powers
Clemson University is mourning the death of alumnus Wilbur O. “Billy” Powers, a philanthropist and namesake of the university’s business school. He was 90 years old.
CVS plans to break up $117B healthcare conglomerate
A CVS split would follow a decade-long trend of consolidation, with health insurers combining with pharmacy benefits firms and medical providers.
Phoenix business owner hosts shed giveaway for tornado victim
The owner of Shed Gal felt compelled to help out after seeing the devastation.
Prepping for business at The Honey Baked Ham Company
The Honey Baked Ham Company has options to help you prepare for holiday gatherings.
Mental health evaluation ordered for man accused in deadly shooting of North Royalton building commissioner
The man accused of fatally shooting the North Royalton building commissioner inside the service department, was ordered to undergo a mental health evaluation Wednesday.
People say they want small smartphones—the Enough Phone will put that to the test
It won't win the specs race, but it will actually fit in your hand.
Healthy Living with USA Health: Prostate Cancer
In this ‘Healthy Living with USA Health’, Dr. Tarek Lawen joins us with what you need to know about prostate cancer.
UMaine political science chair cites affordability, Trump in election results
WABI TV5 News at Noon
Married Entrepreneurs: Cris & Charmaine Eddings on Building Business
Cris and Charmaine Eddings are married entrepreneurs who came to business from very different directions.
Married Entrepreneurs: Cris & Charmaine Eddings on Building Business
Cris and Charmaine Eddings are married entrepreneurs who came to business from very different directions.
Phoenix business owner hosts shed giveaway for tornado victim
As residents in Heber-Overgaard continue cleanup, a local business owner is donating a storage shed to someone impacted by the tornado.
SIUC to host resource workshop for military veteran small business owners
Southern Illinois University Carbondale will host a resource workshop for military veteran small business owners and those wanting to start a small business.
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.
LeTourneau political science professor analyzes historic Texas election shift
Shift in Latino and suburban voters drives Democratic victories statewide, he said.
LeTourneau political science professor analyzes historic Texas election shift
Shift in Latino and suburban voters drives Democratic victories statewide, he said.
Medline plans January price hikes as it decides inflation isn’t going away soon
Despite the squeeze from inflation, the company announced it will a $1 billion share buyback.
UMaine political science chair cites affordability, Trump in election results
University of Maine political science chair Mark Brewer said Wednesday that he and the rest of the nation witnessed a banner night for Democrats.
Late actor’s posthumous memoir reveals explosive on-set fight with co-star
Eric Dane died in February at age 53.
Science Central: Mixology
Kristen Peck, Marketing Manager, Science Central, talks about Mixology, an event for people 21+ years old, featuring a Whiskey Experience.
Music mogul reportedly reconciles with ex after bitter divorce
Billionaire entertainment mogul David Geffen, 83, is reportedly back together with his 33-year-old ex-husband Donovan Michaels months after their divorce.
CVS plans to break up $117 billion healthcare conglomerate
The move mirrors the break up of Walgreens.
Orlando Health Watson Clinic opens new freestanding ER in North Lakeland
Orlando Health Watson Clinic Lakeland Highlands Hospital opened a new freestanding emergency department in North Lakeland.
Yellow Light Coffee & Donuts plans downtown Detroit for next location
The business is taking over the former Dilla’s Delights space in Harmonie Park for its third space.
Opinion: Anthropic’s stark warning makes the case for taking AI out of Silicon Valley’s hands
Anthropic's IPO filing warns of catastrophic risks. An attorney who has challenged AI companies argues for federal control over the technology.
Global Entertainment Holdings Highlights PyX Wallets Business Combination and Smart Wallet Development Plans
Global Entertainment Holdings, Inc. (USOTC:GBHL) announced the release of a video interview with PyX Wallets Chief Executive Officer Ryan Contardi, outlining the company’s product development strategy following the recently completed business combination between the two businesses.
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.
CVS is breaking up its health-care empire
The era of health-care vertical integration is in the rearview.
Palm Beach County students help scientists track where trash drifts in local waterways
Shining A Light on Palm Beach and the Treasure Coast
UWM profitability rebounds in Q3 amid elevated interest rates
The news comes three months after a massive loss that led to an expensive deal to obtain cash.
Election 2026: Nebraska voters reject ballot measures to legalize online sports betting
Nebraska voters have rejected a pair of ballot initiatives that sought to legalize and regulate online sports betting.
INTERVIEW: WEAU Political Analyst John Frank discusses results of midterm election
Hello Wisconsin’s Bob Gallaher sat down with WEAU Political Analyst John Frank.
USC political science expert breaks down S.C. elections
South Carolina voters reshaped the state’s political landscape Tuesday night.
HOMETOWN HEALTH: Cannabis involved in most substance-related ER visits for teens, study finds
Cannabis-related emergency room visits also are rising among adults ages 19 to 24.
Letter: No one should lack support in a mental health crisis. Here’s how NAMI Utah can help.
Letter: No one should lack support in a mental health crisis. Here’s how NAMI Utah can help.
CVS Health to separate into two publicly traded companies
The two companies could become active acquirers.
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.”
Xeris adds longtime biotech exec to its board
The move to bring Menassie Taddese on comes amid reports that the Chicago-based rare disease and endocrinology drug company is being considered for acquisition.
Why big mergers aren’t in Inova’s playbook
Inova President and CEO Dr. J. Stephen Jones outlined the system's growth plans and capital project strategy.
Decades-old tech gets new life from metro Detroit startup
A metro Detroit startup is looking to take tech developed in 1979 and modernize it for clinical use.
Decades-old tech gets new life from metro Detroit startup
A metro Detroit startup is looking to take tech developed in 1979 and modernize it for clinical use.
🍷 The sip heard ‘round town| Sports Daily Newsletter
And Caitlin Clark loves Philly, y'all.
Washington initiative to ban trans students from girls’ sports ahead in early returns
A statewide ban on transgender students competing in girls’ school sports was leading on election night, according to early tallies.
Political analysts discuss Wisconsin governor's race results
Democrat David Crowley defeated a Republican with close ties to President Donald Trump on Tuesday, rising from a childhood in one of the nation’s poorest neighborhoods to become the first Black person to lead the battleground state.
If You Can Get 5/5 On This History And Science Quiz, You're Smarter Than 98.4% Of People
Test your knowledge of science and history!
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.
Slack vs Discord; a comparison for businesses
Slack vs Discord were built for different audiences, one for work, one for communities. See which platform actually fits business teams best.
A ‘bloodbath.’ Georgia Democrats sweep statewide offices in historic political upheaval
A Democratic wave ended decades of GOP dominance in Georgia and threatened the GOP's grip on the state Legislature.
Caddo Parish voters reject $60 million bond for proposed sports complex
Approved: Caddo Parish voters have approved a $60M bond measure to help fund a proposed $70M sports complex in Shreveport. Full election results here. Rejected: Caddo Parish voters have rejected a $60M bond measure proposed to fund a $70M regional sports complex in Shreveport. Full election results here.
Political analyst digs into Election Night in Wisconsin as results come in
Political analyst digs into Election Night in Wisconsin as results come in
JB Pritzker and Juliana Stratton declared winners
Juliana Stratton becomes only the second Black woman to represent Illinois in the U.S. Senate. Meanwhile, Pritzker returns for a third term.
Exclusive: YouTube is cooking up something new called 'Tamba,' and it looks pretty social
YouTube's latest Android app reveals a mysterious 'Tamba' project with followers, DMs, group chats, and other social features.
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects
Watch News 10+ for continuing election coverage
Montgomery leaders approve resolution to form new health care authority
The Montgomery City Council announced Tuesday night that it voted 6-3 to approve a resolution authorizing the establishment of the Health Care Authority of Montgomery.
Bryan police investigating workplace shooting
Bryan police are investigating a workplace shooting Tuesday evening.
University of Toledo to launch online master’s degree in data science and AI in spring 2027
Bill Kulies, director of UToledo’s School of Interdisciplinary Data Science, said the program is fully online and can be taken full time or part time.
University of Toledo to launch online master’s degree in data science and AI in spring 2027
According to UToledo, graduates will be prepared for jobs that use advanced analytics, machine learning and AI to drive better decisions, inform strategy and advance innovation.
Small fire found behind store sign in central Lincoln, LFR says
A fire at a business on O Street in central Lincoln has drawn an emergency response Tuesday evening.
Las Vegas restaurants absorb higher import prices, adjusting business
Restaurant owners who rely on ingredients from overseas are adjusting how they do business as costs rise.
I look up as I walk, my healthcare costs look down
An Osaka Metropolitan University researcher analyzed 338,706 person-months of data linking objective smartphone step counts from Osaka Prefecture’s official health app with health-insurance claims for 20,950 adults aged 40 and over. Generalized additive models revealed that the non-linear association between daily steps and subsequent 6-month healthcare expenditures transforms with age. Predicted costs were largely insensitive to steps among middle-aged adults but fell steeply with increasing steps among older adults.
Inside Iowa Politics: Why this national election legal scholar is concerned about close elections
Ben Ginsberg, a longtime campaign election legal advisor, is urging candidates to accept the results of voters' decisions in the 2026 elections.
Chamber of Commerce announces their 2026 Best in Business Awards honorees
The Charlottesville Regional Chamber of Commerce has named the recipients of its annual Best in Business Awards.
Mind Your Business: #19 Affordable Care Act & Medicare Updates
In this episode of Mind Your Business, host Gabriel Castillo, Executive VP of Corporate Marketing for IBC Bank, talks about the Affordable Care Act and Medicare program updates.
Mental health evaluation ordered for man accused of assaulting police officer
On Monday afternoon, the man was allegedly involved in a violent encounter with police near Armory and Cleveland streets
Palmetto Sports Daily: USC looks to keep momentum going, Clemson aiming for consistency
PSD discuss USC looking to keep momentum going and Clemson aiming to be more consistent, plus MBB season opener wins and losses.
Two big office building sales show strength of owner-occupiers in Cleveland market
The buildings, in Independence and Beachwood, were purchased by local groups that, like other owner-occupiers, enjoy a financing advantage when it comes to office buildings.
Eyewitness News Extra: Connecticut Business & Industry Association (Part 1)
Brian talks to Chris Dipentima, President and CEO of CBIA.
Main Street El Dorado launches 2026 New Business Mini-Grant Program
Main Street El Dorado announced it is now accepting applications for its 2026 New Business Mini-Grant Program to spur economic growth and support entrepreneurs in the historic downtown district.
3 arrested in connection to robbery at Pulaski County business
According to the Pulaski County Sheriff’s Office, the three suspects allegedly broke the front glass door of the store. They reportedly stole chainsaws, guns and other items
Duly’s private equity backer looks for an exit: report
Ares Management is seeking a buyer for its stake in Illinois’ largest independent physician group after almost a decade.
Slavic Village CDC to lease building on catalytic corner
Three commercial spaces are available to help reinvigorate that part of the Cleveland neighborhood, with particular interest in finding a restaurant.
Manchester pizzeria sees business increase after Dave Portnoy review
The restaurant recently received the rating, and staff say business has increased since.
Woman arrested after shots fired at Winnsboro business
A woman has been arrested following a shots-fired incident at a business in Winnsboro.
Covenant becomes first mid-Michigan health system to offer new cardiac imaging technology
New technology will provide doctors with a detailed image of the heart and a faster testing experience for patients.
Madison’s Restaurant & Bar to close after 26 years in business
In a statement posted to Instagram, restaurant staff confirmed the closure, saying “After 26 incredible years, it’s time to say goodbye.”