Health is higher on the international agenda than ever before. Concern for the health of poor people is a central development issue. In addition to its intrinsic value for individuals, investment in health is an important and previously underestimated means of economic development; substantially improved health outcomes are a prerequisite if developing countries are to break out of the cycle of poverty. This DAC Reference Document on Poverty and Health, jointly published by the Organization for Economic Co-operation and Development (OECD) and WHO, extends the analysis and recommendations of the DAC Guidelines on Poverty Reduction by setting out the essential components of a pro-poor health approach. It provides a framework for action within the health system - and beyond it, through policies in other sectors and through global initiatives. The Reference Document is aimed at a broad range of development agency staff working in policy and operations, at headquarters and in the field. The recommendations are also relevant for policy-makers and planners in partner countries.