Over the past three decades, health systems have made significant strides towards achieving universal health coverage. However, household out-of-pocket payments for medical care still remain high, and disparities in financial risk protection and healthcare quality continue to give rise to pervasive health inequalities, and some Western countries exhibit a slowdown in life expectancy. The COVID-19 pandemic has shown that global health systems need to be both (i) resilient to shocks and (ii) sustainable in their ability to provide for basic healthcare needs. However, the challenge that health systems in ageing societies face today include how to overcome staffing shortages, waste of resources, and poor regulation, as well as the incomplete integration of long-term care programmes into the main insurance package. Interventions include the expansion of the fiscal space, more efficient allocation of public funding, designing policies to provide high-quality care, and institutions to regulate the diffusion of new, generally costly, healthcare technologies and drugs, and limiting expenditures on waste and corruption.