This paper examines the relationship between workers in the health sector and users of health services as seen through two case studies of trade unions and NGOs working together, one in Malaysia and the other in South Africa. In spite of a history of tensions between these two types of organisations, when they work together effectively, the results can be influential. The Malaysia Citizens' Health Initiative has set up a separate organisation and now has the power to mediate differences between trade unions, NGOs, and the government.