This introduction to the special issue aims to conceptualize the structural and super-structural relations between global capitalism and health, incorporating both historical and contemporary capitalism. Capitalism is an all-encompassing global phenomenon that interacts with health at multiple scales and via a range of 'vectors' that analysts must engage, examine and understand. We highlight some of the key structural and institutional conditions that shape global health outcomes. Deep and underlying structural effects of capitalism on health are evident at multiple scales and underpin new health challenges of the twenty-first century. At present, macro political economy-neoliberalism and market fundamentalism-profoundly shape governance of global health through regimes and institutions in areas such as trade and investment policy, austerity programs, pharmaceutical and food governance, and the rules that support globalized production and consumption. We develop an account of capitalism in which this overarching global system generates health outcomes like no other system, viewing it as structurally pathogenic with negative impacts on human health.