During the Global Health Summit, hosted by Italy on May 21^st, the G20 and the European Commission (EC) co-signed the Rome Declaration. We applaud their recommitment to strengthening health systems for global health security and Universal Health Coverage (UHC). However, in our opinion, the Declaration is not bold nor concrete enough on effective global health cooperation, strengthening health systems and intellectual property rights. It also fails to critically assess the importance of public financing and governance in health systems, and lacks urgency on solving the global health workforce crisis. We raised these points during the EC/G20’s consultations with civil society organisations a month before the Summit. Looking at the final Declaration, we identify some missed opportunities.