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Georgia, Moldova, and Ukraine are very different countries, but in 1991 they were three of the fifteen countries that emerged from the collapsed Soviet Union. All three have forged unique paths as independent states, which is reflected in the different approaches they have taken to reform and modernize their health systems so they can better meet the needs of their populations. The Soviet Union organized the healthcare system of all its constituent republics in the same way, and the basic principle was that all citizens should have equal access to free health care at the point of use. However, economic, social, and political disruptions in the 1990s eroded universal coverage in Georgia, Moldova, and Ukraine. Since 2015, health systems are expected, by 2030, to achieve the Sustainable Development Goal (SDG) target of “universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all” [1].