Syringe exchange programs meant to slow HIV's alarming spread in West Virginia limited by political resistance

Photo by R. Konkathi, Unsplash

Despite federal recommendations and community efforts to stem HIV infections among opioid or methamphetamine users in central Appalachia, the disease continues to spread. Harm-reduction advocates and medical providers cite resistance to syringe exchange programs as the primary obstacle, reports Taylor Sisk of KFF Health News. "The situation likely hasn’t improved, in part because of politicians who contend that such programs encourage illegal drug use."

In 2021, West Virginia's HIV outbreak was particularly concerning to officials from the Centers for Disease Control and Prevention. Sisk writes, "The CDC’s HIV intervention chief called it 'the most concerning HIV outbreak in the United States and warned that the number of reported diagnoses could be just 'the tip of the iceberg.'" 

Rural areas without substance disorder treatment or disease education present a ripe breeding ground where HIV can spread undetected. Ryan White HIV/AIDS Program Director Christine Teague "is concerned for West Virginia’s rural counties, most of which don’t have a syringe service program," Sisk adds. "Tasha Withrow, a harm reduction advocate in rural Putnam County, said her sense is that HIV numbers aren’t alarmingly high there but said that with little testing and heightened stigma in a rural community, it’s difficult to know."

Robin Pollini, a West Virginia University epidemiologist who conducts community-based research on injection drug use, told Sisk, “You would think that in a state that had the worst HIV outbreak in the country, we would have a statewide testing strategy." Sisk reports, "Teague would like every rural county to have a mobile unit. . . offering harm reduction supplies, medication, behavioral health care, counseling, referrals, and more."

While disease prevention through syringe exchange programs is well documented, the CDC's health warnings and recommendations for improved access to syringe exchanges have been largely ignored. Sisk reports, "In April 2021, the state legislature passed a bill limiting the number of syringes people could exchange and made it mandatory to present a West Virginia ID."

A made in the USA bicycle is in the works; maker hopes tariffs on Chinese imports will spur American production.

Guardian's USA-made children's bike is
still evolving. (Guardian graphic via WSJ)

Children’s bike maker Guardian Bikes moved its production from China to the U.S. intending to build its bikes with as many American-made parts as possible, reports Natasha Khan of The Wall Street Journal. The company's founder, Brian Riley, hopes "steep tariffs" on Chinese imports pledged by President-elect Donald Trump will make American-made bikes and parts more competitive.

Moving bicycle component production to the United States will still be tough partially because China has dominated the sector for decades. Riley knows the challenges and is still moving in that direction. Khan explains, "For now, components from China represent about 90% of the total cost of Guardian’s parts. By the end of next year, Riley hopes that figure will be about 20%. Guardian is starting production of its own bike frames. . . . As a result of Guardian’s new manufacturing, American-made parts could represent about 60% of the cost."

One of the reasons Riley moved his company to the United States was to build a "safer bike that could prevent the kind of head-over-heels braking accident that had injured his grandfather years earlier," Khan reports. "Many bikes sold at retailers such as Walmart or Target aren’t fully assembled when they are shipped to the retailers from overseas, so manufacturers don’t have oversight on the final assembly. Riley told Khan, "By controlling every aspect of production, we can guarantee the quality of every bike that rolls off our assembly line."

Riley admits that opening a U.S. factory was expensive and time-consuming. "At first, workers were slow to build the bikes, putting together 100 a day. It took time and constant tweaking of the assembly line to improve their speed and efficiency," Khan writes. Riley told her, "We had to bite the bullet. We had to be willing to lose money for a while to get to the other side of the strategy.”

The creation of Guardian's USA-made bike is evolving. "Guardian plans to begin making bike frames at the factory this year, using American steel. . . . Guardian is also considering making rims itself," Khan reports. "The bike maker has approached U.S. suppliers that could provide grips and reflectors."

Riley told Khan, "Everyone says making bikes here is impossible." Kahn adds, "His factory shows it isn’t."

Opinion: U.S. Postal Service should deliver mail, not profits. Privatization 'would be a nightmare for rural Americans.'

U.S. Postal Service history dates back to 1775. Its goal
was to deliver mail. (Photo by Joel Moysuh, Unsplash)

Postmaster General Louis DeJoy deployed plans to make the U.S. Postal Service profitable. But turning a profit isn't the point of mail delivery, write Tribune Phonograph editorial members Kris O’Leary and Brian Wilson. Service is the heart of the USPS, and its lack significantly impacts rural areas.

"The U.S Postal Service should focus on delivering the mail, not delivering a profit," they write. "Privatization of the postal service has been a dream for some who see the opportunity for profit, but it would be a nightmare for rural Americans who would see service cuts, additional delays and increasing costs. These would disproportionally impact rural residents simply due to the economics of having fewer potential customers over a wider area."

In many business ventures, privatization "can be a wonderful thing. . . . . It can bring about innovation. . . and the adoption of new efficiencies," O'Leary and Wilson add. "In a recent interview, President-elect Donald Trump broached the idea of revisiting privatization of the postal service as a potential goal. . . . Trump’s comments come at the same time that Postal Service leadership is under increased bipartisan scrutiny for spiraling increases in rates and ever-diminishing service standards."

In a December congressional hearing, members berated DeJoy for failing to meet service benchmarks and repeated upgrade delays. "Georgia Rep. Rich McCormick, a Republican, lambasted DeJoy," the editorial board writes, "leading to DeJoy covering his ears during the hearing." DeJoy defended his optimization strategies and said lawmaker interference could "end" the Postal Service.

However, profit-margin goals have little to do with the Postal Service's actual purpose. O'Leary and Wilson write, "DeJoy and other postal leadership have lost sight, if they ever had it, of the service that is at the core of the Postal Service. If DeJoy’s version of operational leadership and strategy were applied to highways, we would see interstates being turned into gravel roads."

If the U.S. postal service is privatized, its goal will become profits above all. "It will funnel off large city metro areas that can make money and drop rural areas that cover more land miles than people," O'Leary and Wilson add. "This is most of the U.S. population not living on either population-dense coast. The Midwest could lose any mail or package service if this becomes a reality. . ."

A historic first in Alaska may mean drilling in an untouched national refuge; Native Alaskans want a 'seat at the table.'

Map by Sarah Melotte, The Daily Yonder, from Bureau of Land
Management data. Click on map to enlarge.

Alaska’s Arctic National Wildlife Refuge is big, beautiful, and rich in natural resources and biodiversity. It has also been the "focal point of more than six decades of drilling controversy," which will come to a tentative resolution when tracts within the region's 19-million-acre expanse open for oil and gas leases this month, reports Sarah Melotte of The Daily Yonder. Native Alaskan communities want to be among the decision-makers for the coastal land that "is estimated to contain 11.8 billion barrels of recoverable oil."

Drilling in ANWR has never been done before. The region is home to "charismatic species like polar bears, wolves, and the caribou that are sacred to the Gwich’in, a Northwestern Alaska tribe," Melotte writes. "Oil and gas operations elicit mixed responses from Alaskan Natives. . . Some worry that drilling activity will hurt vulnerable wildlife and subsistence living, others say the oil and gas industry funds important infrastructure for their communities."

The coastal region, also known as the North Slope Borough, receives 95% of its total budget from oil and gas development taxation. Reservation members also depend on shareholder income regional corporations generate and pay out to Alaskan Natives. The Artic Slope Regional Corporation serves as an example. The company "has over 13,000 shareholders who receive dividends," Melotte notes. "Since its establishment in 1972, the ASRC has distributed more than $1 billion in dividends."

"Many leaders of the Iñupiat, an indigenous people native to Alaska’s North Slope Borough, say that oil and gas operations can be good for native communities if conducted responsibly," Melotte reports. Nagruk Harcharek, president of the Voice of the Arctic Iñupiat, a nonprofit organization that advocates for Alaska’s Iñupiat people, told Melotte, "Before oil and gas, you couldn't graduate high school and stay in the North Slope. Now there are K-12 schools in every North Slope village."

Harcharek used a past North Slope drilling project to help explain how Native Alaskans want to be included in drilling activity and practices. Melotte writes, "He said they were consulted 'early and often' in the decision-making process. . . . He said they want to be included before decisions are announced publicly."

Despite Alaska's rich natural resources, many Alaskan Natives live in poverty and still hunt for food, and drilling activities could interfere with their reliance on wild game. "Hunting is more than just a hobby in many native villages with high poverty rates," Melotte writes. "Hunting is a method of survival, said Dr. A.L. Lovecraft, professor of Political Science and director of the Center for Arctic Policy Studies at the University of Alaska. '[Drilling] also comes with all of this other baggage... Problems related to health, indoor health, indoor air quality, outdoor air quality.'"

Quick hits: Wallet-draining breakfast prices; the 'Walmart effect;' rural short story winner; bird flu stats; shouses

Photo by E. Aceron, Unsplash

Budget-busting beef with eggs and coffee breakfasts won't be cheaper anytime soon. "While commodities such as beef and eggs have long been volatile, others such as coffee have jumped in price more recently," report Patrick Thomas, David Uberti and Elizaveta Galkina of The Wall Street Journal. "Average prices for food at home rose in November by the largest annual pace in a year. . . . Store-bought ground [coffee] roasts have jumped 11% in price over the past year to an all-time high." In slightly less of a buzzkill, pork prices have remained steady, and "the average price of white bread is down around 3% over the past year."

Walmart's motto is "save money, live better," but oftentimes, that's not what happens to places after Walmart moves in. "New research suggests that the company makes the communities it operates in poorer — even taking into account its famous low prices," reports Rogé Karma for The Atlantic. "Walmart’s many defenders argue that the company is a boon to poor and middle-class families, who save thousands of dollars every year shopping there. . . .Two new research papers challenge that view." Read the research here.

Haworth's character, Michael, decides to venture home.
(Photo by Julian Scholl, Unsplash)

When one season of life ends, another begins -- or does it? Jeremy Haworth's short story "Blood Brother" explores Michael Riordan's path from retirement boredom to the uncertainty of going home. Haworth writes, "The sudden thought of home occurred to him. . . . Years had elapsed since he had crossed the threshold of the old farmstead. But the twinge in his chest told him time was shortening. The thought of death. . . an instinct to finally lay the ghosts of the past to rest. . ." Hadworth's story is the winner of the second annual “Best in Rural Writing Contest” presented by the rural literary journal The Milk House with support from The Daily Yonder.

The spread of bird flu or H5N1 in dairy cows has put many dairy farmers and consumers on edge. To help measure and mitigate the virus in cow herds, the Department of Agriculture rolled out mandated milk testing in December. The USDA is sharing its testing results with up-to-date graphics of confirmed bird flu cases, also called HPAI, found in U.S. herds. Over the past 30 days, testing found 182 new cases in two states. See the details here.

Shouses don't have to be small. This shouse is located in Okeana, a small unincorporated
community in rural Ohio. (Morton Buildings photo)

Rural landscapes have made room for country-living architecture that goes beyond barn-shaped homes and wood cabins. "Barndominiums" and "shouses" are dotting the countryside in surprising numbers. "Look carefully the next time you’re driving on the back roads of America, and you’re bound to spot a shouse — a hulking rectangular structure. . . . It could easily be mistaken for a machine shed," reports Dionne Searcey of The New York Times. "From the outside, shouses look a lot like the better-known barndominiums, or barndos for short. . . . It’s difficult to trace the genesis of shouses. . ."

'Fancy mechanic' Brienna Hall works for a company few have heard of doing work vital to maintaining all the tech in our lives. "The piece of equipment that the entire world has come to rely on — and Hall is specially trained to handle — is called an extreme ultraviolet lithography machine," reports Ben Cohen of The Wall Street Journal. "It’s the machine that produces the most advanced microchips on the planet . . . maybe the most remarkable thing about these invaluable machines is that they’re all made by the same company: ASML. . . . This one Dutch company is responsible for all of the EUV lithography systems that help make the chips in so many of your devices. Like your phone. And your computer. And your tablet. And your TV. Maybe even your car, too."

Goal-setting can be an important part of improving your news organization

Benjy Hamm

By Benjy Hamm
Director, Institute for Rural Journalism

January is a time when many people set new goals for themselves. There’s something about a new year or a milestone birthday that makes people think more about planning, goals and self-improvement.

Even if you’re not one to make personal New Year’s resolutions, you still should think about what goals you would like for your department or newspaper to accomplish in the coming year.

People who operate day to day -- or week to week as the case may be with weekly newspapers – often don’t take enough time to think about the larger, more important goals for themselves and their news organization.

In many years of working with newspapers and online news sites, I watched as the advertising, circulation and business departments set specific goals for each year and measured their performance against those goals. Newsrooms at larger news organizations sometimes did the same thing, but I found that journalists at smaller newspapers often were reluctant to set goals for various reasons.

The No. 1 reason they cited: News is unpredictable and priorities are determined by the news. Other times, journalists said they were uncomfortable with trying to measure goals for news coverage and other content, with fears of clunky story quotas or forced adherence to pre-determined plans.

Those concerns are understandable, but they should not lead to the alternative – no goal-setting or planning.

One of the primary differences between a good news organization and a great news organization is planning. Another key difference is the ability to set important goals and reach them.

When I worked at Landmark’s community newspaper division, we realized that many of the annual strategic plans from our newspapers left out the newsroom. So, we asked each newsroom to establish department goals that would lead to improvements for readers, the newspaper and online site, and the community.

The newsroom’s goals need to be tied to the overall goals of the organization. That seems obvious, but sometimes the newsroom’s goals conflicted with the goals of other departments. For example, one newsroom developed a plan to increase coverage of an adjoining community at the same time the advertising and circulation departments were reducing their efforts in that community because of poor sales.

That exposed a problem with internal communication, among other issues, but at least the fact that the newsroom wrote down its goals led to a fuller discussion about newspaper-wide strategies. And if you think that lack of communication only happens at larger news organizations, then you might be surprised to learn that it occurred at a smaller weekly newspaper.

Goals also need to be specific and, as much as possible, measurable. Everyone needs to understand how you will achieve your goals. A lot of businesses set goals based on the SMART concept – specific, measurable, achievable, realistic and time-specific. Using the SMART approach forces you to focus on the most effective ways to achieve your goals, such as clearly identifying the goal (specific), determining how you will know if you reach the goal (measurable) and establishing deadlines (time-specific).

We found that people who are new to goal-setting tend to use vague words such as “more” instead of specific measures. For example, if your goal is to increase coverage of high school sports in your region because that’s important for your audience and helps to differentiate you from a competitor, then you might be tempted to write a goal to do more coverage beyond football and basketball. But what does “more” mean? How many stories are you doing now on those other sports? What types of additional stories would benefit your audience? How specifically do you plan to increase coverage?

One way to judge a goal is to ask how you will know if you reach or exceed it.

Goal-setting should begin with discussions about what your audience and potential audience need and want from you as a news organization. What are you already doing well? How can you improve?

Maybe you think the newspaper is not doing enough editorials on local issues. Set a goal that will focus your efforts to improve for 2025.

Let’s say you want to set a goal to have “more” names of community members in the newspaper next year, which is an annual goal for some community newspapers. To determine what more means, you’ll need to know how many were published in the past year. But maybe you don’t have enough time now to go back through the past 12 months of newspapers to determine your baseline. Instead, you can review recent newspapers and establish a goal above those numbers. Another possibility is to establish a minimum goal for each issue and increase that number over time.

The point, of course, is not simply to establish numerical goals – but to tie those goals into improving readership, engagement and circulation while establishing the news organization as the leading source for news and information in your community.

Our time is limited, so it’s essential to focus on the most important goals. In my experience, managers and journalists who don’t take time up front to establish goals often waste more time through the year unnecessarily as they get sidetracked by the all-too-many everyday distractions.

Benjy Hamm is director of the Institute for Rural Journalism, which is based at the University of Kentucky. He previously served as editorial director for Landmark Community Newspapers, as an editor for The New York Times Regional Newspaper Group and as a reporter and editor for The Associated Press.

Opinion: Jimmy Carter brought human rights to the forefront and 'made a lasting impact on the U.S. and the world'

Statue of Jimmy Carter outside the
Georgia State Capitol. (Adobe Stock photo)

Jimmy Carter was one of the few U.S. presidents in the past 50 years who grew up in a rural area. He was cherished by many Americans as a man of deep intelligence and wisdom who spent his life actively working to improve the lives of others. In her opinion for The New York Times, Samantha Power reminds readers of Carter's political and personal dedication to humankind. A selection of her thoughts is excerpted below.

"Jimmy Carter’s elevation of human rights in U.S. foreign policy offers many urgent lessons for today. . . . As president, he made a radical break with decades of foreign policy tradition, changed the world’s understanding of America’s aspirations, showed deep empathy for individuals who had suffered human rights abuse and, in so doing, made a lasting impact on both the United States and the world.

"As president, his foreign policy legacy. . . includes the negotiation of the Camp David Accords, which brought about an enduring peace between Israel and Egypt, and the establishment of diplomatic relations with China.

"Carter didn’t just change the way U.S. officials talked; he also changed the way they worked, taking steps no American president had taken. When he assumed office, the United States Agency for International Development had nearly twice as many staff members in Washington as in the field — an imbalance his administration corrected, in addition to significantly expanding the agency’s presence in sub-Saharan Africa.

"He issued Presidential Directive 30, which stipulated that 'countries with a good or substantially improving record of human rights observance will be given special consideration in the allocation of U.S. foreign assistance, just as countries with a poor or deteriorating record will receive less favorable consideration.'

"Carter was the first U.S. president to publicly denounce apartheid in South Africa and the first to make a state visit to sub-Saharan Africa. . . . He was the first president to assert clear American support for a 'Palestinian homeland.' . . . He was the first American president to elevate environmental conservation to a global concern.

"He became president after public trust in government had plunged. More than 70% of Americans believed the Vietnam War was not just a mistake but was 'fundamentally wrong and immoral.' He viewed his embrace of human rights as a means of restoring faith in America.

"As we mourn the loss of Jimmy Carter, we should remember that in doing something so radical for his time — elevating attention to the plight and dignity of individuals in U.S. foreign policy and then living those values until his final days — he changed our world for good."

Samantha Power is the administrator of the United States Agency for International Development.

How one N.C. town is straddling 'ground-shaking development' while maintaining its small-town charm

Siler City, N.C. has been a farming community since the late 1880s. (Siler City photo)

A small North Carolina town known for its "Andy Griffith Show" connections works to embrace big business investments without sacrificing its rural charm. It's a balancing act that many Siler City residents want to see succeed, reports Bill Horner III for Business NC.

The town is a "relatively poor, formerly industrial-rich town fighting for traction, stability and identity. . . .With one caveat: Wolfspeed and Toyota are creating ground-shaking development to the tune of about $19 billion," Horner explains. "Wolfspeed has pledged 1,800 jobs at its $5 billion silicon carbide plant. . . . Toyota’s $13.9 billion battery manufacturing plant is expected to create an additional 1,500 jobs."

Location of Siler City, N. C.
(Wikipedia map)

That's a lot of investment and people for the town of roughly 8,000 residents to manage; however, Siler City officials have already begun to assimilate the town's new prospects. Horner adds, "The changes in Siler City aren’t just in new faces and construction. The town's mayor, Donald Matthews, is enthused about momentum and new initiatives, including a visitors center. . . .The town has signed a service agreement for water and sewer. . . . Downtown-wide Wi-Fi is on the horizon."

To help build retail infrastructure, Siler City officials "hired Josh Harris, the former athletic director at the local high school, to become the town chamber’s first executive director. Nearly 120 businesses have since joined," Horner reports.

Harris told Horner, "It’s a great place to live and enjoy your time, and raise your family. What happens in the next 10 years. . . is hard to predict. But the potential is there.” Horner writes, "Harris recognizes [Siler City's] farming roots and the need to preserve agriculture and grow agribusiness. His family’s Harris Homeplace Farm, in nearby Snow Camp, sells grass-fed meats directly to consumers."

Harris sees incoming businesses and residents as a way to make Siler City a "generational community." He told Horner, "I’m the sixth generation on our family farm, and our family’s been here a long time. . . . I needed to get my hands involved in this because I want this to be a great place to live in 30 years — not for me, but for my kids."

With its $12.98 T-shirt, this company shows how retail apparel production can thrive in the U.S.

American Giant photo via The Wall Street Journal

It isn't fancy -- it's practical. It's sold at Walmart, but it's no import. It's a "Made in America" T-shirt woven with U.S. cotton sold by an American company making a tidy profit off its $12.98 tee, reports Suzanne Kapner of The Wall Street Journal. The T-shirt maker, American Giant, used the "heft" of Walmart's guaranteed sales contracts to garner enough investor support to make affordable "Made in the USA" apparel items possible.

American Giant's success wasn't spurred by tariffs on Chinese imports. Instead, it was Walmart's 2013 pledge to spend more on items that were made, grown or assembled in the U.S. that helped the company grow. Kapner explains, "In 2021, Walmart increased its goal and promised to spend billions more each year through 2030."

Bayard Winthrop, the chief executive of American Giant, said that "without Walmart acting as a backstop by committing to buy a predetermined number of shirts over time, American Giant’s suppliers wouldn’t have had the confidence to make the investments in automation and other upgrades that drove down production costs," Kapner writes. "The T-shirt project brought together what Winthrop has called 'strange bedfellows.'"

The T-shirt is made out of "yarn that is grown, spun, dyed and sewn in the U.S., contracting with suppliers mainly in the Southeast," Kapner reports. "It also owns a cutting and sewing facility in Middlesex, N.C., and is part owner in another sewing facility in Los Angeles, which opened specifically to make the Walmart T-shirts."

Even with its $12.98 price tag, American Giant's Walmart T-shirt competes against similar 100% cotton tees at half the price. American Giant differentiates itself with American emblems, which other apparel makers cannot use. Kapner explains, "Walmart bars suppliers from using the term 'American Made' or the American flag on products that aren’t made in the U.S."

So far, the $12.98 T-shirt boasts solid sales and "American Giant is making 100% cotton sweatshirts for Walmart that will sell for $38.98," Kapner reports. Despite the company's success, "it is unclear how much Americans care about buying products made in the U.S. . . . With the uptick of inflation in recent years, budget-minded shoppers have become even more price conscious."