In revising my Ph.D. thesis for publication, I have tried to draw out the relevance of the study to public health issues in Africa today. While I do not concur with the view that history is prescriptive, I do believe there is much that can be learned from the past which can be of help with present-day issues. The history of medicine and public health in Africa, particularly during this century, can assist greatly in understanding some of the issues and problems confronting health workers today. The histories of epidemics, such as those of sleeping sickness, are especially helpful, highlighting as they do a broad spectrum of issues ranging from purely medical ones to political and economic considerations. In this way, the history of sleeping sickness in a region of colonial Belgian Congo, now known as Zaire, has an importance reaching far beyond the confines of African history but is of relevance also to the wider history of health in the developing world. The present epidemic of AIDS has once again reminded us of the complexities involved in monitoring health on a global scale as well as those involved when attempting to intervene in the highly sensitive and deeply entrenched cultural realm of human responses to disease. As I discuss in this volume, the declaration of an epidemic is very much a political act, but not as widely recognised are the political aspects of public health programmes.