Global health is no longer influenced only by medicine, humanitarian need or public institutions. Pharmaceutical companies, governments, investors, technology firms, manufacturers, donors and multilateral institutions now compete across markets worth vast sums and capabilities carrying strategic importance. Vaccines, medicines, genomic data, health technologies, supply chains and manufacturing capacity can confer economic advantage as readily as public benefit. The pandemic also demonstrated how health products can become instruments of diplomacy and national interest. As commercial interest and geopolitical influence become harder to separate from health, is global health still a collective endeavour, or is it becoming another marketplace through which power is accumulated and exercised?