Sub-Saharan Africa poses a somewhat ironic strategic dilemma for the United States in the post-Cold War era. Most authorities are quick to acknowledge that the United States has no vital interests in the region, and the end of the Cold War eliminated the East Bloc/West Bloc competition as an incentive for involvement. Yet, over the past decade, Africa has been the recipient of more U.S. military interventions than all other regions of the world combined. The interventions stem, of course, from complex humanitarian emergencies which the developed world cannot ignore. For a variety of reasons, it seems very likely that Africa will continue to suffer calamities which will require expensive humanitarian interventions. Because of the perceived limited national interest in Africa, U.S. "African" policy does not have a strong constituency in the American political process and lacks coherence and focus. U.S. regional involvements tend to be inconsistent and reactive. The result is that the United States invests much more for "cures" to Africa's ills than might be the case if U.S. policy could place more emphasis on "prevention." For their part, at no time in history have African nations been more receptive to U.S. assistance, or more eager for cooperative efforts to address the difficult issues of national development. While the United States may not have vital interests in Africa, the entire world (including the United States) clearly has an interest in durable regional stability. In view of Africa's huge size and substantial resources, it also clearly is in the interest of the United States to see sustained regional economic development and to maintain unfettered commercial and military access throughout the region. But more importantly, tropical Africa is one of the "Hot-Zone" regions from which devastatingly lethal pandemic diseases can emerge with little warning: the most important access could well be that of disease monitoring and prevention. This may, in fact, be a vital "defense of the homeland" interest for the United States. One Army officer, Lieutenant Colonel C. William Fox, Jr., a physician who has had extensive experience in U.S. activities in Africa over the past two decades, has personally supervised operations that have considerable potential as models for future regional involvement. In this publication, he offers a rationale and vision for future DoD activities in Africa. His account also serves to remind us that substantial strategic benefits can accrue to the United States even from small, tailored teams deployed under creative, energetic leaders.