For years, the central question in health financing has been how to mobilise enough resources to provide healthcare for a growing population. But as resources remain limited and medical costs continue to rise, a critical question emerges: How does the health system decide what to spend those resources on? That is where Health Technology Assessment (HTA) comes in. HTA is a structured, evidence-based process that evaluates the clinical effectiveness, cost, equity, ethical, and health-system implications of medicines, devices, diagnostics, procedures before coverage and pricing decisions are made. Inaugurating the National HTA Steering Committee, the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, disclosed that the Steering Committee’s role is to provide strategic oversight and guidance for the national HTA system; support credible and transparent prioritisation of HTA topics; strengthen methodological quality and safeguards around conflicts of interest; encourage active stakeholder and citizen engagement; as well as promote local capacity development and create clear pathways for HTA findings to inform policy, benefit-package design, strategic purchasing, and reimbursement. Responding, the Director General of the NHIA, Dr. Kelechi Ohiri, highlighted that the NHIA’s HTA programme has evolved through institutional steps. The NHIA established a Strategic Purchasing Department with a dedicated HTA Division in 2025: developed core operational tools including the HTA Framework, reference case, process guidelines, terms of reference, conflict of interest policy, and stakeholder mapping: invested in specialised human capital, supporting Nigerian postgraduate researchers at Mahidol University to build local expertise; generating local evidence through the landmark Nigerian EQ-5D-5L valuation study so QALY calculations reflect local preferences, including successfully conducted three pilot HTAs covering kidney replacement therapy, colorectal cancer screening, and sorafenib for advanced liver cancer. The newly inaugurated Steering Committee include Dr. Kelechi Ohiri(DG/CEO, NHIA); Dr Ovuoraye John(Director, PRS, Federal Ministry of Health and Social Welfare Nigeria; Dr. Banji Filani, Chairman, Forum of State Commissioners for Health; Dr. Muhammed Safana, Chairman, Forum of CEOs of SSHIAs; Prof Obinna Onwujekwe; Academic Community / HTA Expert; Prof Moji C. Adeyeye – Director General, National Agency for Food and Drug Administration and Control (NAFDAC); Prof Bala Audu (Representing Public Interest); HTA Secretariat(NHIA HTA Division); @Vivianne Ihekweazu (MD, Nigeria Health Watch; WHO Country Representative in Nigeria & NICE-UK Representative – NICE/UK (Advisor) By embedding HTA into national governance, Nigeria is making coverage and benefit-package decisions systematic, transparent, and defensible.