One of the hospital’s most important roles is helping less developed countries treat and manage endemic conditions like malaria, leprosy and tuberculosis. The hospital’s Malaria Centre has a cutting-edge research facility, which can bring the latest equipment to bear on clinical samples sent in from remote areas. Over the years the hospital has expanded its focus to how infectious diseases spread through communities–an area that’s become particularly timely with the rise of bird flu and other global illnesses. Since 1999 the hospital, in collaboration with clinics in Europe, has provided an early-warning system for outbreaks of smallpox, cholera and botulism. It may be a far cry from its roots as a floating hospital, but change has been part of its ethos from the start.