For Kelechi Ohiri, director-general of the National Health Insurance Authority (NHIA), the answer begins with people. It was a simple statement, delivered without rhetorical flourish, yet it captured a philosophy that has defined his career across medicine, global development and public policy. Unlike many healthcare leaders who see hospitals, insurance schemes and disease control as ends in themselves, Ohiri views healthcare as economic infrastructure. For years, Nigeria’s health insurance system struggled with low enrolment, fragmented financing and widespread public scepticism. For Ohiri, the distinction between health policy and economic policy is therefore largely artificial.