The United Nations and its associated organizations were formed at a time when the European colonial empires were still largely intact, if under fire. After the UN’s founding, the imperial powers started to incorporate economic development objectives into their colonial policies to help legitimate their rule. As Pearson’s probing account makes clear, this quickly put them at odds with the UN’s fledgling development architecture. Focusing on the area of public health, Pearson shows that France sought to reap the benefits of the World Health Organization’s operations in Africa, even as it pursued its own health-care policies in its colonies. France’s efforts, Pearson argues, succeeded in maintaining French influence over UN policies in West Africa even after the country’s former colonies had won their independence.