Throughout the world, we need a better lens to clarify who the poor are. They are disproportionately the rural populations, the landless, the sub-sistence farmers of the developing world, a population which still dwarfs the urban populations especially in SSA, a geographic area that is landlocked and dissimilar from those Asian countries which have mitigated poverty in rural sectors. Geography, country dynamics and access to trade are very real factors that hinder SSA. It is in the rural areas throughout the globe, even in the middle of the United States where the indigenous native Americans live, often without electricity and with difficult access to remote hospital care which is at no cost. In SSA, it is all about capacity: social infrastructure that is absent (hygiene, sewage treatment, electricity, communication, roads that can access primary health care and markets, employment, care of people disabled by the prolific tropical disease pathogens that prey on poorly nourished people vulnerable to p. falciparum malaria/soil based helminths, etc). There is so much work to be done and the people who are the rural poor wish for the capacity to access decent livable lives for themselves and their children. Public health interventions need to be based on the tenets of Florence Nightingale and Dr. John Snow who understood that environmental issues as well as country-based standards of supplemented nutrition...these are key to mitigating diseases that feed rural poverty. It is all about disaggregating the key issues around poverty, disease and slow or stagnant development. Political will and reconsidering neoliberal economics will be key as will a new arrangement that brings the periphery of the world into the great pool of human knowledge and technical interventions. It is do-able.