This chapter assesses the contribution of the 10 strategic priorities selected by the National Health Council for 2004-09 in building a developmental state in South Africa. These priorities include: (1) improve governance and management of the National Health System; (2) promote healthy lifestyles; (3) contribute towards human dignity by improving quality of care; (4) improve management of communicable and noncommunicable diseases; (5) strengthen primary health care, emergency medical services and hospital service delivery systems; (6) strengthen support services; (7) human resource planning, development and management; (8) planning, budgeting, monitoring and evaluation; (9) prepare and implement legislation; and (10) strengthen international relations. The roles of the different spheres of government and the capacity of the state are also discussed.