Global health policy formation underwent a renaissance period from the late 1990s; however, in 2011, this renaissance underwent a period of crisis of purpose, leadership, and financing in which funding towards key diseases was cut, institutions such as the World Bank reduced their global health portfolio, and the World Health Organization was subject to continuous questions of reform and utility. This chapter explores the short- and long-term explanations for such a crisis of direction and financing and how they link to policy formation. In so doing it highlights issues of policy inertia and the paradox of success in policy formation, hierarchies within multisectoral decision-making, and the dominance of market-based strategies in developing policy. The chapter considers the role of intergovernmental organizations, aid donors, and emerging economies in policy formation while outlining three critical approaches to understanding health policy formation drawn from feminism, biopolitics, and historical materialism. The chapter concludes by offering several recommendations and key policy implications as a means of overcoming the reactionary, repetitive, results-orientated and raising-funds-based nature of global health policy formation.