The Sustainable Development Goals retain the form of the Millennium Development Goals, but on a scale which privileges inclusiveness over actionable priority-setting. An expansive sustainable development agenda creates further pressure points for many other global health issues. Many of the most affected low-income countries are heavily dependent on official concessional flows, which will be under pressure in donor countries facing their own fiscal challenges. A number of the Sustainable Development Goals are ‘big ticket’ issues: key among these are climate change, sustainable cities and human settlements, and demanding funding commitments of a size and duration that will inevitably have an impact on the sums available for health. Moreover, the expansion of global health priority areas to encompass diseases of affluence will move prioritisation for development in a geographical sense to thematic issues, which are global and applicable to all countries. Against that background, the right to accessible, high-quality sexual and reproductive health and rights services is clearly fundamental.