Balance-of-power politics have shaped how countries, especially the United States and China, have responded to the covid-19 pandemic  The manner in which geopolitics have influenced responses to this outbreak is unprecedented, and the impact has also been felt in the field of international law  This article surveys how geopolitical calculations appeared in global health from the mid-nineteenth century through the end of the Cold War and why such calculations did not, during this period, fundamentally change international health cooperation or the international law used to address health issues  The astonishing changes in global health and international law on health that unfolded during the post-Cold War era happened in a context not characterized by geopolitical machinations  However, the covid-19 pandemic emerged after the balance of power had returned to international relations, and rival great powers have turned this pandemic into a battleground in their competition for power and influence  © 2020