The 2023 Global Health Expenditure Report focuses on health spending in 2021, the second year of the COVID-19 pandemic. Following massive disruptions to health systems, economies and societies with the onset of the pandemic in 2020, 2021 ushered in a critical new phase as COVID-19 infections and deaths rose sharply. Yet 2021 was also a period of adaptation, as economies slowly recovered from the sharp downturn in 2020 and new COVID-19 vaccines were rolled out.