The past five decades have seen numerous health policies and development plans in Nigeria, culminating in the National Health Act of 2014.8 The Act provides for a range of responsibilities, instruments, and institutions, covering but not limited to: responsibility for health, eligibility for health services, and establishment of a national health system; financing; health establishments and technologies; rights and obligations of patients and healthcare personnel; national health research and information system; human resources for health; control of blood, blood products, tissue and gametes in humans; and regulations and miscellaneous provisions. It is, potentially, a very consequential Act. To understand what needs to be different for this Act to succeed where prior national policies mostly under-achieved, it is worth examining the context and some key drivers of Nigeria’s health.