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Fertility and population growth are highest in the world's poorest countries, with the least-developed countries estimated to triple their populations from 600 million in 1995 to 1.8 billion by 2050. Dealing with population and reproductive health concerns within the broad framework of the UN Millennium Goals is crucial to achieving sustainable development objectives. This report reviews some key issues involved in progress to tackle global poverty including: the many dimensions of poverty; demographics and macroeconomics; gender inequality; health differentials and financing; HIV/AIDS; and access to education. It outlines a development framework for action including: better programme targeting to ensure benefits reach the poor, especially the most vulnerable; the extension of microcredit schemes; and the need for better monitoring and data systems.