This 2023 UHC Global Monitoring Report is being released on the eve of the High-Level Meeting on UHC at the 78th United Nations General Assembly, reflecting the vital role of national political commitment in the pursuit of UHC. Achieving UHC is no easy feat, but with concrete and coordinated actions, countries can create the conditions in which the right to health is ensured, upheld, and respected for everyone. This report presents an alarming picture on the state of UHC around the world, even before the COVID-19 pandemic hit. The expansion of health service coverage has largely stalled since the launch of the Sustainable Development Goals in 2015, and financial protection for those who do receive health services has worsened. Based on the most up-to-date data, this report shows that as of 2021, about half the world’s population – 4.5 billion people – was not covered by essential health services, and in 2019 about two billion people experienced financial hardship due to out-of-pocket spending on health, including 344 million people living in extreme poverty.