With the bank poised to replenish funds to back expansion of healthcare among the world’s poorest people, it needs to measure what matters – and what matters is that billions are being forced into poverty and hardship by the costs of care. Anna Marriott, Rosemary Mburu, Harjyot Khosa and Waiswa Nkwanga on a critical omission from the Bank’s ‘IDA21’ policy package.