The Universal Health (UHC) movement in its latest iteration, has adopted key objectives of Primary Health Care (PHC). This is a notable shift in the right direction but achieving what appears to be simple targets is a highly complex endeavour across both wealthy and less wealthy countries and jurisdictions. Improving health for all targets requires political-economic, bureaucratic and alignment with bottom-up grass-roots agencies. Despite present successes, there is a need to adapt to constant challenges including pandemics, adverse climate phenomena and political-economic shifts.