ABSTRACTRegional organisations are moving away from traditional market-based goals to embrace issues of welfare, yet the role they play in social policy formation, and their contribution to the embedding of alternative approaches to development, is poorly understood. This article explores whether and how the Union of South American Nations (UNASUR) and the Southern African Development Community (SADC) advance pro-poor norms and policies in national and global governance. Whilst not coherent citizenship-centred projects of regionalism, SADC and UNASUR have developed institutional competences to address the health–poverty nexus, though their policy development practices and methods take quite different forms. Theoretically, the paper develops a framework addressing three key claims: (i) poverty and welfare need to be brought in to the study of regional governance, (ii) the agency of Southern regional organisations in the generation and diffusion of norms needs to be taken more seriously in the literature an...