Two decades of work delivering health care in poor communities provide a standpoint from which to challenge conventional doctrines in human rights and public health. These orthodoxies include the priority often assigned to civil and political rights over economic and social rights and a narrow concept of cost-effectiveness in public health policy. An analysis based on economic and social rights underscores, for example, that effectively treating infectious diseases in poor communities requires ensuring that people receive adequate food. The challenge of maternal mortality in low-income settings similarly shows the need for an approach to rights that is simultaneously comprehensive and pragmatic. In many settings, paying community health workers for their efforts on behalf of their neighbors can also be seen as a critical strategy to realize rights. Across contexts, the yield on the expanded and pragmatic view of health and human rights adumbrated here may be considerable. In forthcoming issues, Health and Human Rights will continue to investigate the conceptual, but above all the practical aspects of such issues, seeking to shift the health and rights agenda in a way that may make sense to the world’s poor and marginalized, the chief victims of contemporary human rights violations.