 This paper analyzes the Ugandan experience of health financing reforms from a political economy perspective. It finds that the current political environment is not conducive to implementing a universal health coverage system with widespread financial protection due to the lack of a strong government stewardship and dominant interests and ideologies. Furthermore, the health financing landscape remains highly fragmented, and community-based initiatives to improve health coverage are not supported by a clear government stewardship. This article was authored by Maria Nanini, Mario Biggeri, and Giovanni Piototo.