Initially focused on workers’ rights and conditions between 1919 and 1944, the ILO mandate expanded toward the end of World War II to address comprehensive social security: protecting entire populations from socio-economic risks including the financial burden of sickness. The organization’s remit evolved from formulating labor standards to broader welfare architecture. This chapter argues that the transformation of the postwar ILO was precipitated by decolonization of India and Southeast Asia but was constrained by Cold War politics. Between 1947 and 1957—coinciding with the political decolonization of Asia—newly independent nations demanded structural reform of the organization. India—a full member of the ILO since 1922—spearheaded regionalization, insisting that the organization abandon its Eurocentric bias and allocate resources to Asian challenges in agriculture, labor, and raising living standards. By 1948, under the leadership of its Director General David Morse, the ILO metamorphosed from an international standard-setting body into an operationally active organization that rendered technical assistance to underdeveloped countries. In the postwar period, the ILO was the de facto and de jure advisory body that assisted governments on Universal Health Coverage (UHC). However, geopolitical constraints such as the Cold War frustrated effective coordination between the ILO and WHO in implementing UHC across Southeast Asia.