The document analyzes the structural obstacles to achieving universal health coverage in Burkina Faso, and stresses the need for strong leadership from the top. It highlights conceptual confusion within the ministries concerned, where UHC is often reduced to universal health insurance, to the detriment of a global approach including equitable access to quality services. The main obstacles identified are the inadequacy and uneven distribution of health human resources, weak infrastructures and disparities between urban and rural areas. Data quoted show a high concentration of general practitioners and specialists in the Centre region, while many primary healthcare centers do not meet minimum staffing standards. Trends in the number of CSPSs and in staffing compliance reveal significant gaps in beds and in the presence of qualified personnel. The text also points to root causes such as weak multi-sectoral coordination, the absence of clear policy guidelines, insufficient budget allocation and misalignment of partner funding. These shortcomings persist due to limited decision-making leadership at the Ministry of Health and competing interests. The central recommendation is to establish a coordinated multi-sectoral strategy at the highest level of government to define departmental roles, improve accountability and optimize the use of resources in order to move towards universal health coverage. The summary points out that international financial support accompanies the effort, but does not replace the urgently needed national reforms.