A critical reading of the Progress Update is essential for those in engaged in practice or research in health systems and health policy. This conversation addresses some of the technical challenges of measurement, and implicitly its politics. What we measure as progress is closely related to where we want to go and how we intend to get there. To the average health manager and the health activist this could be heavy reading, but we hope that this conversation helps demystify health metrics, and make for more informed participation in “evidence-based decision making”.