“Health care is a human right”, proclaimed the World Health Organization at its founding in 1948. Governments in dozens of countries have since launched programmes for universal access to medical treatment at no charge. Yet much of the world’s population still lives in countries with limited coverage. In countries without universal coverage, people rely on health insurance, charity or self-care, or they suffer through their afflictions. WHO estimates that over half of the world population does not have access to essential full services. Conventional public–private partnerships for healthcare in developing countries have mostly failed. Most of the spending is wasted due to treatments that lack evidence of efficacy, inefficiencies in providing care, frequent preventable medical errors, and inflationary costs due to misaligned incentives in pricing and reimbursement. The Vitality philosophy builds on the insight that 80 per cent of healthcare costs are driven by modifiable factors relating to lifestyle choices.