Six hundred and forty-five confirmed Ebola cases. No approved vaccine. A conflict zone at the center of the outbreak. And eleven African countries identified as highest risk for imported cases. Africa's top disease experts are telling member states the time to prepare is now, before the virus arrives at their borders. The harder question behind the outbreak is one that no press release will answer directly: why, years after Ebola's devastation in West Africa, does the continent still lack the pharmaceutical tools to fight a known variant of a known pathogen? The answer says a great deal about who global health systems are built to protect.