COVID-19 has exposed weaknesses in global health, and the deployment of COVID-19 vaccines has brought the importance of global cooperation to the forefront of the pandemic. Since its writing, I have rethought the vision I advanced in my lead paper (Kohler 2021b), as recently Canada has shown its preference for a “my nation first” approach in turning to COVAX to secure vaccines for Canadians, undercutting its moral leadership and commitment to global health. We remain without a strong global public health leader who is able to ensure that public health cooperation advances during this pandemic. While the authors of the commentaries differ on where and how the WHO requires changes, there is agreement on the critical need for its institutional reform. If global health goals are to be achieved, a genuine commitment to global health equity and global health coordination is urgently needed.