I do not believe that world leaders lack the moral capacity to understand or even be personally affected by the human tragedies that often result from their (or lack of) actions. But they are constricted by the fundamental concept of cost-benefit analysis that pervades any policy decision. And politics, unfortunately, remains very much a zero-sum game. When pragmatic solidarity replaces Machiavellian thought as the dominant philosophy in international relations, the world would be a very different place. This transformation, of course, is a quite a lofty goal, but when we look at the moral strides that international relations has taken throughout history, it becomes not so crazy anymore to dream of such a future. It was only decades ago when the leaders of the US and USSR, driven in large part by their personal egos, were frighteningly close to destroying the world. Yet, just today, the two countries signed a treaty as part of an unprecedented effort towards decreasing nuclear proliferation. This is why the challenges in global health must be tackled at the institutional level. Large scale behavioral changes by countries are ultimately driven by systemic reforms that change the playing field for global actors. We should look towards a future when the fight for global health equity is no longer an uphill battle against the establishment; it will be the establishment.