The global health governance (GHG) literature frames health variously as a matter of security and foreign policy, human rights, or global public good. Divergence among these perspectives has forestalled the development of a consensus vision for global health. Global health policy will differ according to the frame applied. Fundamentally, GHG today operates on a rational actor model, encompassing a continuum from the purely self-interest-maximizing position at one extreme to a more nuanced approach that takes others’ interests into account when making one’s own calculations. Even where humanitarian concerns are clearly and admirably at play, however, the problem of motivations remains. Often narrow self-interest is also at work, and actors obfuscate this behind altruistic motives.