SOFA-2 represents meaningful progress toward a more inclusive and equitable global sepsis assessment framework

The updated Sequential Organ Failure Assessment (SOFA-2) score introduces important improvements in clarity, reproducibility, and global representation. By incorporating explicit scoring rules and data from a limited number of low- and middle-income countries (LMICs), it begins to address long-standing concerns regarding variability and applicability. However, substantial imbalances in data representation and health system capacity persist, and the extent to which these advances translate into improved calibration across diverse settings remains to be established. We argue that while SOFA-2 is a meaningful step forward, future sepsis frameworks must integrate context-specific evidence, account for structural constraints, and prioritize equitable participation in model development to ensure globally valid and clinically actionable tools.