The past 25 years have produced a contradictory and conflicting context for health development. While global NGOs were enunciating a progressive political discourse promoting equity in health and development, elected conservative governments put in place measures that not only impoverished developing countries but also reduced international aid from richer countries. As a result, the structural adjustment policies of the past 25 years have decimated health and education services in poor countries. Recent international documents indicate a strong will by NGOs to regain leadership in the area of support to social development. In this effort to promote health as a human right and development as an avenue for achieving that goal, public health associations throughout the world should prepare for a leading advocacy role to rally partners in this endeavour.