iiinova — where your digital self keeps evolving

Reposted by Bibhav Acharya, MD

Gregg Gonsalves @gregggonsalves.bsky.social · 21/06/2026

And here @elizabethginexi.bsky.social explains what you need to do to write a comment. Lots of great stuff on her Substack on this. Let's get busy. You have until sunset tonight! end/ elizabethginexi.substack.com/p/what-we-ne...

elizabethginexi.substack.com

What We Need to do NEXT: OMB’s Proposed Federal Financial Assistance Rule (OMB-2026-0034)

What OMB’s Proposed Federal Financial Assistance Rule Means in Practice

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Bibhav Acharya, MD @bibhav.bsky.social · 10/06/2026

This home visit taught me that my training had nothing to offer Devi, who was trapped in daily violence. This short story describes the reality of millions who can't leave abusive relationships. It ends with an idea that we're testing with 100s of families. www.acpjournals.org/stoken/defau...

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Reposted by Bibhav Acharya, MD

ACLU @aclu.org · 02/06/2026

BREAKING: We're suing the Department of Justice for demanding a New York City hospital turn over private medical records about trans youth who've received gender affirming care. The goal of these baseless subpoenas is clear — pressuring providers into dropping patients and obeying President Trump.

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Bibhav Acharya, MD @bibhav.bsky.social · 02/06/2026

Just submitted one of the first NIH PF5 applications for global health. It was confusing, overwhelming, and we nearly gave up. So we wrote down everything we learned. Please share to reach people doing global health research👇 drive.google.com/file/d/1OMnS...

drive.google.com

PF5_Advice.pdf

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Reposted by Bibhav Acharya, MD

Stephanie M. Lee @stephaniemlee.bsky.social · 21/05/2026

NEW: They Got the Best NIH Scores of Their Careers. A Year Later, They Still Don’t Have Funding. As the NIH bankrolls new research at a significantly slower-than-usual pace, I talked to scientists left in the lurch about the toll on their research and careers: www.chronicle.com/article/they...

chronicle.com

They Got the Best NIH Scores of Their Careers. A Year Later, They Still Don’t Have Funding.

The NIH’s spending on new medical research is significantly slower than in previous years, leaving confused scientists in the lurch.

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Bibhav Acharya, MD @bibhav.bsky.social · 14/05/2026

Join us at @ucsfhealth.bsky.social for two presentations on integrating mental health into routine care, and the challenges that presents. - Perinatal depression into pregnancy care - Depression and anxiety care into routine care for hypertension and diabetes. ucsf.zoom.us/meeting/regi...

A community health worker is already very busy. Will she also want to deliver mental health care?

And if she does, will her patients want therapy? What if they insist on a pill because it feels faster and stronger?

Who will pay for this when it is difficult to measure therapy's delivery and impact?

Join us for two presentations that will answer these (and many other) questions based on real-world experience in integrating mental health into routine care.

Sabitri Sapkota Devkota, RN, MPH, PhD, Executive Director and Senior Scientist Possible, will share learnings from integrating perinatal depression care into routine pregnancy and maternal care services delivered by community health workers in rural Nepal.

Kripa Sigdel, a psychologist and mental health researcher at Possible, will share findings from our National Institutes of Health-funded R01 study to integrate behavioral interventions for depression, anxiety, diabetes, and hypertension.

📅 May 28 at 8 a.m. PT on Zoom (link below)

Thank you University of California, San Francisco UCSF Institute for Global Health Sciences for hosting this for Mental Health Month.

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Reposted by Bibhav Acharya, MD

Jenna Norton @jenna-m-norton.bsky.social · 02/05/2026

This was fitting news to receive on May 1, international workers day. I will be returning to work on Monday after being kept on retaliatory administrative leave for 5 months and 3 weeks. I return along with the brave Katrina Declaration signers from FEMA, also reinstated this week. 🧵1/?

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Reposted by Bibhav Acharya, MD

Jenna Norton @jenna-m-norton.bsky.social · 22/04/2026

NIH is not okay. @nytimes.com highlights how grant-making & ability to obligate funding is at risk from staff shortages and time consuming screening processes designed to censor research to align with the administration's political ideology. www.nytimes.com/2026/04/22/s... Some highlights:

nytimes.com

Pace of N.I.H. Funding Slows Further in Trump’s Second Year

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Reposted by Bibhav Acharya, MD

Jeremy Berg @jeremymberg.bsky.social · 22/04/2026

New York Times article about the slow pace on NIH grant making as well as enforcement of political constraints. [Gift Link] www.nytimes.com/2026/04/22/s... 1/4

nytimes.com

Pace of N.I.H. Funding Slows Further in Trump’s Second Year

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Bibhav Acharya, MD @bibhav.bsky.social · 22/04/2026

What if we could prevent domestic violence instead of waiting until a crisis? I’m sharing our experiences and results during Grand Rounds at @ighsatucsf.bsky.social We'll talk about tackling intimate partner violence and mental health in rural Nepal + lessons we can draw for programs everywhere

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Bibhav Acharya, MD @bibhav.bsky.social · 18/03/2026

In this short story (published in @annalsofim.bsky.social) I wrote about what I tried, what didn’t work, and what ultimately worked: www.acpjournals.org/doi/10.7326/... (subscription needed but free with HINARI in LMICs). If you still can’t get access, please let me know.

acpjournals.org

Behind the Seen: Searching for Peace in a House With Violence | Annals of Internal Medicine

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Bibhav Acharya, MD @bibhav.bsky.social · 18/03/2026

...just on the woman but also on her environment. What’s hurting and more importantly, what can help? - Don’t rely just on formal systems and professional roles but also on (non-professional, informal) family/social relationships that can support her.

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Bibhav Acharya, MD @bibhav.bsky.social · 18/03/2026

- If the woman says she can’t leave, don’t keep insisting she should. - You’re not in her shoes; she is. Try to see the world the way she does. - Look for others nearby who don’t have violence. What are they doing differently? - Don’t focus...

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Bibhav Acharya, MD @bibhav.bsky.social · 18/03/2026

I felt helpless when she told me her husband hits her every day. I had nothing to offer other than saying she should leave. But she couldn’t leave. So, I stepped back and learned from women who did NOT have violence at home. The common link was surprising and taught me many things:

Screenshot of an article in the Annals of Internal Medicine.
Title: Behind the Seen: Searching for Peace in a House with Violence

The house is unremarkable: thatched roof over walls of compacted clay. She’s sweeping the porch with a twig broom. On the hike to her home in rural Nepal, I had mulled options for her severe depression: new antidepressants, intensive therapy.
“Namaste, Devi,” I announce. “I’m a doctor of the mind. I teach at the local clinic. Your regular doctor asked me to see you.”
She produces a joyless smile to gesture welcome. We sit on straw mats on her porch as Devi’s six-year-old daughter steers her toddler brother from chasing the chickens in the yard.
Every night her husband drinks...

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Bibhav Acharya, MD @bibhav.bsky.social · 13/03/2026

“Should I even do global health?” I’m hearing this from the young generation. I get it. Funding slashed, worries about unequal relationships, and now the common refrain: “why are we helping abroad when people suffer here?” Global health was supposed to...

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Bibhav Acharya, MD @bibhav.bsky.social · 09/03/2026

3. 1984: Next in line. May be a little less accessible but the first two books should provide a good foundation. Will see what he thinks. Any other suggestions?

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Bibhav Acharya, MD @bibhav.bsky.social · 09/03/2026

2. Maus: He accidentally picked this up thinking it was a fun read. I wasn't sure but he is already exposed to WW2 materials so I let him read. Later he told a friend that yes Hitler was bad but so were the people who supported him because Hitler couldn't have personally threatened everyone.

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Bibhav Acharya, MD @bibhav.bsky.social · 09/03/2026

Starter pack for raising a tween in 2026: 1. Ray Bradbury's Fahrenheit 451: There is a graphic novel version of this classic. Son was a bit puzzled by the storyline but a few weeks later, made connections with themes in the news...

Stack of three books:
1. Ray Bradbury's Fahrenheit 451
2. Maus
3. 1984

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Bibhav Acharya, MD @bibhav.bsky.social · 04/03/2026

"screening for food insecurity, or whether people have access to enough nutritious and safe food, as a top priority for medical schools. Mr. Kennedy’s curriculum does not explicitly emphasize the topic. ...Trump administration’s cancellation of the government’s annual survey of food insecurity"

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Bibhav Acharya, MD @bibhav.bsky.social · 04/03/2026

“You’re as healthy as an ox!” Over and over, doctors said this to me. I tried to explain that I wanted more intensive screening but they said I was lean and didn’t smoke, so the guidelines said I was healthy. I would cite studies showing that South Asians have... magazine.ucsf.edu/heart-risks-...

“You’re as healthy as an ox!”

Over and over, many doctors said this to me. I tried to explain that I wanted more intensive screening but they said I was lean and didn’t smoke, so the guidelines said I was healthy.

I would cite studies showing that South Asians have higher risk of diabetes and heart disease despite being thin and not smoking, but hey, can’t argue with clinical guidelines and “evidence-based” risk calculators, even when they were developed without including S. Asians.

I ultimately found a South Asian doctor and she understood immediately. As this article says, all South Asians know someone who had a “surprise” heart attack at a “young age” and so did she.

We did deeper screening (Lipo A, ApoB) and had a careful discussion about risks and benefits, and decided to start a low dose statin, even though the calculators said I was low risk.

Kudos to Alka Kanaya and her team at University of California, San Francisco for studying this and helping change guidelines. There is still more work to be done (e.g., even in these studies <1% are from Nepal and Bhutan) but I hope South Asian patients will now get receive appropriate screening and treatment for diabetes and heart disease.

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Bibhav Acharya, MD @bibhav.bsky.social · 23/02/2026

In public health and medicine, we often focus on what is not working. Which families have domestic violence? What is wrong in the families or communities that is causing this problem? However, we learn a lot by looking at families that do NOT have that problem. While working in rural Nepal...

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Bibhav Acharya, MD @bibhav.bsky.social · 17/02/2026

More people are living with multiple health conditions: high blood pressure, diabetes, depression, and anxiety. Busy doctors prescribe medications, even though counseling and should be tried first. Our latest paper for our 700-person randomized controlled trial of a novel intervention called BECOME

More and more people are living with multiple health conditions: high blood pressure, diabetes, depression, and anxiety. Busy doctors prescribe medications, even though counseling and behavior change should be tried first.

Our study will answer two related questions:
1. Can community health workers improve health by delivering counseling techniques that are selected based on both simplicity and effectiveness?

2. Can empowering CHWs to use digital technology, having them train doctors, and showcase their work in front of healthcare leaders increase the likelihood of sustaining the program beyond the research grant period?

Check out our team’s latest paper outlining the procedures of our 700-person randomized controlled trial of a novel intervention called BECOME.

Congratulations to Kripa Sigdel for leading the paper and my co-Principal Investigator Sabitri Sapkota Devkota. Thank you to collaborators at Possible, University of California, San Francisco, Wheaton College, and the municipal governments in Chandragiri and Bardibas in Nepal for this The National Institutes of Health-funded R01 study.

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Reposted by Bibhav Acharya, MD

Melody Schreiber @melodyschreiber.com · 09/02/2026

I met a nurse who works two jobs caring for disabled and elderly people. His work is sorely needed in a caregiving crisis that is only going to worsen bsky.app/profile/adri...

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Reposted by Bibhav Acharya, MD

Melody Schreiber @melodyschreiber.com · 06/02/2026

Did you look at TrumpRx to find medications? I'd love to hear from you today: melody.schreiber@theguardian.com (please share!)

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Reposted by Bibhav Acharya, MD

Eileen Clancy 🧿 @clancyny.bsky.social · 24/01/2026

New York Times home page at 4:30 pm (ET) main story Videos Appear to Contradict Federal Accounts of Fatal Shooting It's very unusual for NYT to publish a video analysis, esp. one contradicting a govt account, so quickly, within 6 hours. But NYT had two of their most capable analysts on it.

New York Times home page
Nameplate

Saturday, January 24, 2026
Today's paper

Minneapolis Shooting Just Now U.S. Winter Storm 1m ago

[largest headline on the page]

Videos Appear to Contradict
Federal Accounts of Fatal Shooting

LIVE Just Now

Agents Kill 37-Year-Old
Man in Minneapolis

• Democrats condemn shooting as
senators prepare to consider
funding for ICE. 30m ago

• Trump and other federal officials
try to put blame on local officials
and man who was killed. 45m ago

• In Minnesota, citizens with firearm
permits can openly carry
handguns. 2h ago

See more updates ›

Video Shows Moments in Which
Agents Killed a Man in
Minneapolis
2 MIN READ

other story on page is a local real estate story

How a Family of 5 Lives
on $140,000 a Year in
Morningside Heights
New York City is among the most
expensive cities in the world. Here is
one family's strategy for making it
work.

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Reposted by Bibhav Acharya, MD

ACLU @aclu.org · 22/01/2026

The people are saying it loud and clear: ICE is dangerous, violent, and operating with impunity. Our elected leaders must seize this moment and take bold action to block any more funding of ICE's operations.

aljazeera.com

Public opinion shifts on ICE as advocates warn of US ‘inflection point’

Amid growing unrest in wake of Minnesota killing, rights observers say US Congress must take action to curtail agency.

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Reposted by Bibhav Acharya, MD

Scott Delaney @scott-delaney.bsky.social · 15/01/2026

UPDATE re SAMHSA: While the Trump Admin signaled they'll undo the terminations, we don't yet have proof. On Jan 13, grantees received revised Notices of Award (NOAs) formally terminating their grants. Until they receive *another* new NOA w/ original terms, we assume grants remain terminated.

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Bibhav Acharya, MD @bibhav.bsky.social · 15/01/2026

When governments, private companies, and non-profits focus only on “sick care” (not *health* care), this will replicate the problematic parts of the US system: severe underinvestment in prevention efforts, while most of the healthcare spending goes toward extremely expensive procedures

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Reposted by Bibhav Acharya, MD

Prof Gavin Yamey MD MPH @gavinyamey.bsky.social · 15/01/2026

Advocacy CAN work 👏 Calling your representatives CAN work 👏 (Also, this is no way to run a health system—cut $2B in essential services suddenly and out of the blue, then hear a public outcry, then restore the funding the next day)

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Reposted by Bibhav Acharya, MD

Emily Mendenhall @emendenhall.bsky.social · 14/01/2026

Thrilled feature Sanjay Basu in @sciencepolitics.bsky.social. I've been influenced by his work for years and it's really a treat to amplify his perspective here. Take a look - it's definitely worth your time if you care about medical care in America. sciencepolitics.org/2026/01/14/m...

sciencepolitics.org

Medicaid Is Under Attack. Here’s How to Rebuild It Right. - Science Politics

The program has always been underfunded and overlooked. The current crisis is an opportunity to reimagine care for those who need it most.

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Bibhav Acharya, MD @bibhav.bsky.social · 08/01/2026

"Every system is perfectly designed to get the results it gets." --Paul Batalden "If you have fire hazards, every so often, you will have fire. We have the necessary conditions for this sort of thing to happen and I must emphasize that it will keep happening." -- Ta-Nehisi Coates

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Reposted by Bibhav Acharya, MD

Mike Hixenbaugh @mikehixenbaugh.com · 08/01/2026

Forensic analysis of objective video evidence. This is how you serve readers searching for clarity.

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Bibhav Acharya, MD @bibhav.bsky.social · 06/01/2026

What happens when you bring the husband, wife, and mother-in-law together to reduce domestic violence? Improved communication, better relationships, mutual support in household tasks. And some backlash when women have more freedom. Our latest paper (free): link.springer.com/epdf/10.1007...

link.springer.com

Daughters-in-law’s perceptions and experiences with MILAP, a family-based intervention to reduce intimate partner violence and improve mental health in Nepal

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Bibhav Acharya, MD @bibhav.bsky.social · 31/12/2025

Three books stood out from my reading list this year: 1. On the Origin of Species: skillful persuasion techniques 2. The Beautiful Struggle: lyrical memoir with a journalist's restraint 3. Elderhood: compelling case for rethinking aging Happy New Year and happy reading in 2026!

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Bibhav Acharya, MD @bibhav.bsky.social · 23/12/2025

We celebrate community health workers. But only half receive a salary. Everyone agrees that doctors deserve a reliable salary. But CHWs’ contribution is often invisible, serving people in their neighborhoods. Funders assume this is simple: raising awareness/teaching. We're testing a new strategy:

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Reposted by Bibhav Acharya, MD

Prof Gavin Yamey MD MPH @gavinyamey.bsky.social · 19/12/2025

I was interviewed for @theguardian.com by the wonderful @melodyschreiber.com, one of the finest health reporters in the world, about what I called a “neocolonialist” study planned by Danish researchers in Guinea-Bissau, funded by RFK Jr. So many red flags 🚩🚩🚩🚩🚩🚩🚩 www.theguardian.com/society/2025...

theguardian.com

US plan for $1.6m hepatitis B vaccine study in Africa called ‘highly unethical’

Experts decry ‘neocolonialist’ Guinea-Bissau study after Trump administration changed advice for US babies

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Bibhav Acharya, MD @bibhav.bsky.social · 19/12/2025

Both @gavinyamey.bsky.social and @meloteaart.bsky.social are wonderful people with a clear and ethical focus on what matters in health/global health. Great to see this!

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Bibhav Acharya, MD @bibhav.bsky.social · 18/12/2025

As I congratulate Possible on this transition, I hope local accountability will keep the hospital from falling apart again. My deepest thanks to all the staff, donors, and volunteers, as we celebrate this milestone while continuing our commitment to focus on challenges ignored by local investments.

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Bibhav Acharya, MD @bibhav.bsky.social · 18/12/2025

In my testimonial for the milestone annual report, I focus on those neglected but essential programs, and on what matters the most: those in pain—the people receiving care from the hospital—should have the power to make decisions about what the hospital does.

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Bibhav Acharya, MD @bibhav.bsky.social · 18/12/2025

Global health now talks of decolonization and self-reliance. Local leadership is wonderful but beware local elite capture. Self-reliance is welcome but beware the willful neglect of services like mental health and community health workers (the government won’t fund after transition).

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Bibhav Acharya, MD @bibhav.bsky.social · 18/12/2025

Awareness programs were aplenty but if you wanted to actually get treatments, you chose between enduring suffering or selling your life savings for a 30-hour trip to the nearest functioning hospital.

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Bibhav Acharya, MD @bibhav.bsky.social · 18/12/2025

We began with an ambitious (foolish) belief: 5 med students in the US could build and run a hospital in rural Nepal We ignored our limitations, overwhelmed by stark health injustice that the region was #1 in: - mothers dying in childbirth - people living with HIV - children stunted by malnutrition

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Bibhav Acharya, MD @bibhav.bsky.social · 18/12/2025

Imagine a hospital built and then abandoned. For 30 years, its only visitors are water buffaloes. In 2008, our nonprofit, Possible, partnered with the Nepali government to renovate Bayalpata Hospital. 17 years later, it is transitioned back to the government. A look back at the changes.

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Bibhav Acharya, MD @bibhav.bsky.social · 17/12/2025

Thank you! "Practical" is the highest compliment for our research

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Bibhav Acharya, MD @bibhav.bsky.social · 16/12/2025

The honor was mine! Grateful to students+faculty for great questions and interest in practical solutions for intimate partner violence Thanks @pcollins-mh.bsky.social + @jkbass.bsky.social for the invitation + dinner Met Dr. Jackie Campbell, whose pioneering work continues to inspire!

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