This chapter examines the transition from International Health to Global Health through Thomas Kuhn’s paradigm shifts while critiquing the notion of radical incommensurability. Despite rupture claims, we argue that both frameworks perpetuate a heuristic depletion—a systemic reduction of health complexities through standardized norms, quantitative indicators, and performative discourses. While International Health relied on vertical, technocratic interventions (e.g., malaria eradication campaigns, smallpox vaccination programs), Global Health reconfigured these practices under new guises: data-driven governance, public–private partnerships, and performative language that constructs realities rather than describing them. Drawing on Hacking’s styles of reasoning and Latour’s chains of translation, the paper shows that despite paradigmatic shifts, both frameworks share a technocratic logic that obscures adaptive, informal practices essential to implementation. The persistence of this logic underscores a principium permanens: the illusion of neutrality in health governance masks enduring hierarchies, privileging global indicators over localized realities.