This visual essay considers the links between medical research and securitization, and asks how they reconfigure local landscapes in East Africa. Humanitarian aid, including global medicine, has emerged as a ‘military therapeutic complex’, especially in African nations where the HIV/AIDS epidemic has drawn enormous contributions from states and transnational NGOs (Nguyen 2009; Fassin and Pandolfi 2010). One unintended effect of this therapeutic assemblage is a concern with security, particularly for US state institutions conducting research or providing treatment. US research facilities and laboratories are fenced, with access mediated by security guards and locked gates. State actors working overseas live in approved housing, bound by a complex set of regulations about safety and security. This essay and photographs reflect the ways in which physical structures transform local landscapes as part of the global health industrial complex and raise a number of questions about the politics of spaces, both private and public, in humanitarian projects.