The recent adoption of the 2030 Agenda for Sustainable Development signals a critical juncture in the global community’s approach to development. The agenda reflects a significantly changed context since the Millennium Development Goals were agreed, including shifting poles of influence and wealth, growing connectivity, intensifying global crises and the increasingly global nature of the determinants of health. It recognizes that today’s world is marked not only by deep inequities, but also by an emerging appreciation of our shared values and interdependence. Consequently the new agenda posits that sustainable development demands a much more complex compact of obligations among countries of all income levels.