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This paper draws on a larger project about iThemba Pharmaceuticals, a small South African pharmaceutical company that was founded in 2009 with a mission of finding new drugs for TB, HIV, and malaria. Here, I will draw together two intertwined historical threads from the 1990s and early 2000s that form iThemba’s pre-history: South African scientific exchange initiatives that aimed to foster a multi-racial scientific workforce for the new South Africa’s R&D capacity; and efforts by scientists outside South Africa to bring the young democracy into the international community of drug discovery. These threads highlight interrelated sets of tensions: science in a democratic South Africa as dis/continuous with apartheid-era inequalities; South Africa as both developed/developing; and research and development capacity as simultaneously local/transnational. A broader tension that underlies these is South Africa as a nonracial/multiracial society, democratic and unequal, with the country’s position in Africa and in the world at stake. iThemba manifested the challenge of working within these tensions, and can be read as an endeavor toward realizing Nelson Mandela’s as yet not fully realized vision of science in the service of the people.