In 1978 in the city of Alma Ata of the former Soviet Union, the World Health Organization declared its intention to provide "health for all by the year 2000." In the third world, this was to be achieved through the integration of "traditional and modern medicine." In the case of Senegal, the prescription was ahistorical. It did not take into account several centuries of integration in all areas, including health care. The central argument here is that four centuries of activity have made integration an historical fact for the peoples of Senegambia. The results of that integration are manifested in the inadequacies of the current health care system which evolved through the contestations of various political economic polities for control of the Senegambian region.