This chapter explores the relationship between international development and global health. Contrary to the view that development implies ‘good change’, this chapter argues that the discourse of development masks the destructive and exploitative practices of wealthy countries at the expense of poorer ones. These practices, and the unregulated capitalist economic system that they are part of, have created massive inequalities between and within countries, and potentially catastrophic climate change. Both of these outcomes are detrimental to global health and the millennium development goals and sustainable development goals do not challenge these dynamics. While the Sustainable Development Goals acknowledge that inequality and climate change are serious threats to the future of humanity, they fail to address the economic system that created them. Notwithstanding, it is possible that the enormity and proximity of the threat posed by inequality and global warming will energise a counter movement to create what Kate Raworth terms ‘an ecologically safe and socially just space’ for the global population while there is still time.