This chapter presents the background, mandate, and reason for existence of international occupational health organizations and the role they play as drivers of change. The main focus is on the International Labour Organization (ILO) and the World Health Organization (WHO) because they are intergovernmental and thus more influential than nongovernmental organizations. International occupational health organizations have played important roles in the struggle for peace and social justice for more than 100 years. Today they face dilemmas and problems, including silo-thinking and insufficient funding, but there are also reasons for optimism, such as growing political recognition of decent work and occupational health. The recent suggestion to make occupational safety and health one of ILO’s fundamental principles and rights at work is potentially very promising for the future of international occupational health organizations as drivers of change.