The ITM blows out a hundred candles this fall. On 6 October 1906, the first Belgian course of tropical medicine started in the “School for Tropical Diseases”, situated in an old villa in Brussels. The school was established by King Leopold II, who had shrewdly acquired the Congo Freestate as his personal possession. In the same decade, tropical institutes were also established in the UK, Germany, Portugal, France and Holland. In 1908, the state of Belgium - rather reluctantly - took over the bankrupt Belgian Congo as well as the ITM.
The school was transferred to Antwerp in 1934, after some political and even - typically Belgian - linguistic bickering. The building at the Nationalestraat was erected close to the “Congo Docks” (later filled in to become the “Sinksenfoor” square), so that patients arriving by boat from the tropics could be easily transferred. The new school was named “Prince Leopold Institute of Tropical Medicine”, after crown prince Leopold. Unlike Leopold II, the later King Leopold III had travelled extensively in Congo and urged its government to take care of the health of the local populations. In the next few decades, an extensive though paternalistic health system was indeed set up that included curative as well as preventive care and the control of endemic diseases such as sleeping sickness.
Until 1960, the Institute remained part of the Ministry of Colonies with as main duty to train colonial doctors and to treat patients with tropical diseases. Research was less important, and remarkably enough the Institute had little direct links with the field. The colonies had their research laboratories and epidemiological stations, and field trips from Antwerp took months to years. Most of ITM’s professors were retired from the colonial services.
After the hasty decolonisation in 1960, the ITM was transferred to the National Ministry of Education as an autonomous institute, separated from the universities and still without a clear academic statute. Its main mission remained the training of young physicians, nurses, veterinary doctors and technicians before going to the tropics. Indeed, the Belgian Cooperation Agency and NGO’s sent out scores of expatriates to work in Central Africa and other regions until late in the 20th century. In the 1970s, Belgium became a federal state and education and science was devolved to the regional level. Because of its location, the ITM was now a - still poorly defined - part of the academic landscape of Flanders, while retaining a federal role in training, health care and development cooperation. The statutes and structures of the ITM took a long time to adapt to the new national and international realities, and so did the generational turnover of staff.
However, part of the ITM staff had realised from early onwards that training experts from the South, which could take over public health responsibilities in their own country, had become a major duty. The CIPS/ICHD saw the light in the 1960s, to be joined later by International Veterinary Courses and the MSBT which transformed into the MDC. Other staff increasingly focused on research as a way to better understand the biological and socio-economic determinants of health, and to develop new tools and strategies to improve health care and disease control. The disease focus was complemented by modern scourges such as HIV and Ebola. However, the classical tropical diseases were not neglected and health systems research became another major subject. The role of the ITM in developing countries shifted from the implementation of projects to scientific support, partnership and capacity strengthening.
The last ten years, the ITM has undergone further profound reforms and has invested heavily in the future, in bricks and equipment as well as in people, ideas and partnerships. Its academic, medical and international role in the complex federal state of Belgium is now unequivocally established. The number of scientists has tripled and includes a large proportion of research fellows from the South. In terms of research impact, the ITM ranks in the top-15 of all universities and academic institutes in Europe. The diploma and master courses have been reformed, an extensive PhD programme was set up and the ITM continues to attract a strong body of students from all over the world. New campuses have been (re-)built for the Departments of Tropical Veterinary Medicine and of Public Health, and for the international master courses. The research laboratories have been completely refurbished. In collaboration with the Belgian Ministry of Development Cooperation, the ITM has established a great programme of capacity strengthening and partnership, involving 23 institutes and hundreds of scientists in 20 countries in Africa, Asia and South-America. As all these (r)evolutions were not accompanied by increased subsidies, managerial efficiency and external funding had to increase sharply.
Most of all, the ITM’s commitments to the populations and colleagues in developing countries are firmer than ever. Rather than remaining a mere centre of excellence, we have become a node in a network of excellence with a common mission: scientific progress to achieve “Health Care for All”. 

Bruno Gryseels
Director ITM