Measurement matters: implications of the newly revised Sustainable Development Goal 3.8.2 financial protection indicator for global monitoring

In December, 2025, the latest Universal Health Coverage Global Monitoring Report (GMR) was launched. Like previous GMRs, it reaffirmed that the world is off track to achieve the financial protection component of the 2030 Sustainable Development Goals (SDGs; ie, SDG 3.8.2). At current levels of progress, 24% of the world's population will still face financial hardship in 2030.1 Financial protection and financial hardship are closely related: households facing financial hardship are considered not to have financial protection. What is notable, however, is that the GMR now relies on a newly revised financial protection indicator, leading to fundamentally new narratives of national, regional, and global financial protection progress.1 The new SDG 3.8.2 indicator, endorsed by the 56th UN Statistical Commission in March, 2025, after a comprehensive review process, replaces both the catastrophic and impoverishing health expenditure indicators as the official SDG financial protection indicator. Due to indicator revision, the 2025 GMR now estimates that the proportion of the global population that faced financial hardship in 2019 was 12·7 percentage points higher than previous estimates based on the catastrophic expenditure (CATA, 10% threshold) indicator, and 21·8 percentage points higher based on the impoverishing expenditure indicator (IHE). This disparity translates into an additional 773 million people facing financial hardship in 2019 compared with that previously estimated by the 2023 GMR.2 Whether these new estimates provide us with a clearer picture of progress towards universal health coverage depends on whether the new indicator improves on earlier measurement approaches.