Are there grounds for optimism for the future of global health?

In the past decade, the field of global health has faced severe challenges and intense scrutiny concerning its legitimacy and effectiveness. A longer-term perspective-200 years rather than 10-offers grounds for guarded optimism about the future of global health. A review of the history of international health reveals that although the self-interested agendas of industrialised states have been the dominant driving forces in the field, these pursuits have been tempered by the gradual cross-national diffusion of cosmopolitan norms and initiatives concerning the right to health for all and government responsibility to improve population health. The grounds for hope are not that progress is inevitable. Rather, universalist commitments might have become sufficiently widespread and institutionalised to withstand periods of political backlash without reversing long-term expansion. The key to sustaining progress will be that actors who are committed to these norms persist in defending them.