The Westphalian sovereigntist scheme is inherently deficient to provide for non-voluntary international coordination. The level of compliance that the handling of global public goods may require is hardly delivered by such a scheme. Globalization, and its intense densification during the last half-century, inflicted a serious crisis in that mainstream scheme. With the gradual shift of centers of power and decision-making to transnational fora and institutions, the paper analyses the global health arena through lenses of the World Health Organization, which is responsible to promote the highest possible level of health to the world’s population, and the Bill and Melinda Gates Foundation, the private philanthropic institution turned into one of the most important players in global health. The paper problematizes the leadership role of the WHO in a crowded global health governance context.