This chapter argues that the current global health agenda has failed to put people and their rights at the center. With communities unable to have their voices heard, challenge injustice, and hold decision makers to account, states are ill-equipped to realize the Sustainable Development Goals (SDGs), including SDG 3 to ensure healthy lives and well-being for all. The chapter articulates a shift from a discretionary development paradigm to a rights-based paradigm for global health, building on rights-based approaches that have been proven to work—as in the AIDS response. Seven reforms are proposed, addressing: (1) priority-setting, (2) systems for health, (3) data and monitoring, (4) access to justice, (5) the need to safeguard the right to health across sectors, (6) partnerships, and (7) financing. These reforms call for a broad social movement for global governance for health, advancing and operationalizing rights-based approaches across the SDGs.