The French Empire consciously set out to civilize Africa by improving public health as well as building a modern infrastructure. Yet in other European empires – notably Germany's in southwest Africa – colonial rule led to genocide. What was the link from medical science to racial pseudo-science? The imperialists talked of their civilizing mission, but their rivalry ultimately caused world wars that endangered the West's global dominance. Today, have Western aid agencies learned lessons from the past? Or is China in the process of building a new African empire?