This chapter provides a case-based neo-institutionalist interpretation of the United Kingdom’s Department for International Development's (DFID) influence on development assistant for health. It presents a brief overview of neo-institutionalist theory and then situates DFID in the context of global health governance. The chapter argues that DFID can be characterised as a norm entrepreneur not just broadly with regard to poverty reduction, but also more specifically in the area of global health. The ‘political structure’ within which DFID has been operating since 1997 was singled out in all interviews. Another informant also credited DFID’s in-house expertise with the department’s ability ‘to swim in the same sort of waters as the Bill & Melinda Gates Foundation, perhaps to a higher degree than other official donors’. DFID’s strategic focus on systems rather than specific problems equally informed the department’s negotiations in the context of global health governance forums.