This paper suggests that growth alone is not enough to spur health gains in poor countries, noting that the poor are sick not because they are poor, but because of other social organizational failures, including health delivery, which are not automatically ameliorated by higher incomes. The author argues that the direct benefits of growth on poverty reduction cannot be denied but that policymakers cannot expect economic growth to deliver the “double-blessing” of poverty reduction and improved health. The paper also underlines the problem posed by lack of good and reliable data. In many of the poorest countries of the world, and particularly in Sub-Saharan Africa, measures of adult mortality are little more than projection and conjecture. Although the paper does not conclude that the international picture is seriously misleading, it does say researchers and policymakers lack the instruments to evaluate programs in a sector that is crucial for the well-being of millions.