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Member states of the United Nations have prioritised the achievement of universal health coverage (UHC) by 2030, setting it as a target in the Sustainable Development Goals in 2015 and reaffirming this commitment in subsequent declarations in 2019 and 2023.1 2 Yet progress towards UHC has stagnated since 2015, with minimal or no improvement in nearly every service coverage area.3 In 2021, about 4.5 billion people lacked access to essential health services.3 Progress in protecting households against financial hardship due to medical expenses has also regressed. The proportion of global populations experiencing impoverishing out-of-pocket (OOP) health expenditure increased by 4.9% at the relative poverty line between 2000 and 2019, and the proportion with catastrophic OOP health spending increased by 3.9% during the same period.3 These indicators present a world moving increasingly off track to reach UHC by 2030.