The world is increasingly globalized, and has seen major economic and demographic changes. These factors have dramatically changed the global burden of disease, shifting from mostly rural pediatric infections in low income countries to mostly urban adult comorbidity from noncommunicable diseases (NCDs) in middle income countries. As countries become less reliant on development assistance for health to support their individual needs, the globalization of disease will need a new type of global health engagement. Global functions- those functions that transcend national sovereignty and provide dispersible benefits to all- will take increasing importance as countries grapple with providing universal coverage to high quality care for NCDs.