Just over a decade out from the SDG deadline of 2030, many developing countries are not on track to meet Universal Health Coverage (UHC) targets to ensure access to quality, affordable health services to all. People in developing countries pay over half a trillion dollars annually out-of-pocket for health services, which is pushing about 100 million people into extreme poverty each year. The evidence is strong that progress towards UHC would spur not just better health but also inclusive and sustainable economic growth, yet this report estimates that in 2030 there will be a UHC financing gap of $176 billion in the 54 poorest countries. This threatens decades-long progress on health, endangers countries’ long-term economic prospects, and makes them more vulnerable to pandemic risks. This report, launched to inform the first-ever G20 Finance and Health Ministers session in Osaka, Japan in June 2019, lays out an action agenda for countries and development partners to bridge the UHC financing gap, and makes a strong case for a focus on innovation in health financing over the next decade.