For many years regional organisations were regarded as entities driven mainly by the goals of trade liberalisation, market creation, and in certain instances security communities. After the 1990s many regional organisations widened their mandates to also incorporate elements of social policies including health. This paper looks at these changes within the Southern African Development Community (SADC) and the Union of South American Nations (UNASUR). It is argued that these regional organisations, although distinctive in term of governance and practice, are examples of regional formations increasingly embedding new health mandates and pro-poor commitments in their normative frameworks, projects, forms of cooperation, and governance. The paper sheds light on regional health governance and policy as embraced by both UNASUR and SADC and on the different relationships, networks practices, and institutional and legal foundations by which regional arrangements hold competence in each region. In this respect, the analyses advanced here proposes at least the value of devoting more attention to the linkages between regionalism and poverty reduction through effective, context-specific, policy interventions, as well as for further analysis of the role regional organisations play as actors in global health politics.