This comparative analysis examines how the public health systems of eight major jurisdictions are structured, the key public health challenges exposed by the pandemic, and the kinds of political constraints or policy directions informing public health reforms. The analyses interrogate the extent to which public health reform is constrained or facilitated by the larger international context, the key policy tensions or trade-offs in pursuing public health reform, and the way in which public health reforms fit into wider social and political priorities or narratives.