For decades, communicable disease experts had warned of future pandemics with unimaginable consequences. With the onset of SARS-nCoV-2 (COVID-19), these warnings became a reality. This chapter examines the effectiveness and functioning of the global health system’s institutional arrangements, addressing the World Health Organization (WHO) and its International Health Regulations. It describes the evolution of the pandemic and key actions taken by the WHO, Chinese government, and other global health system stakeholders, from December 1, 2019 to June 30, 2020. By highlighting the role and functioning of the global health system, different institutions, and political actors during the early stages of the pandemic, it demonstrates how various courses of action either enabled or constrained measures to combat the virus or curb infection rates. The metrics used to identify key events were based on the collective cognition of risk model (cognition, communication, coordination, control), adapted to capture COVID-specific issues that emerged as patterns. The chapter concludes with recommendations for reforming the supranational governance mechanisms that enable the functioning of global health and disaster management systems. The corrective actions suggested would restore trust in the WHO’s ability to coordinate and lead a response to a future pandemic.