More than a decade has passed since the publication of the report of the Lancet-University of Oslo Commission on Global Governance for Health in 2014. At that time, progress towards the Millennium Development Goals was underway, the Sustainable Development Goals were in sight, and global health progressed mainly in areas of high priority for health security and in countries at risk. The 2014 Commission was anchored in a commitment to health equity and an understanding of health influenced by political factors outside the health sector. She identified five governance dysfunctions that perpetuate and exacerbate health inequalities. These dysfunctions include democratic deficit, weak accountability, institutional adherence, missing institutions and inadequate policy space for health. The article introduces the new Lancet Commission to manage health in a turbulent world.