Abstract

BackgroundCollaborations between lower- and middle-income countries (LMICs) and high-income countries (HICs) are often scientifically and structurally driven by the HICs. Here we aim to describe a paradigm shift in collaboration, exemplified by the collaboration between the Universidade Eduardo Mondlane and University of California, San Diego through the Medical Education Partnership Initiative (MEPI), in which the formulation of priorities and administrative infrastructure reside in the LMICs.MethodsWe outline critical features of the MEPI partnership and compare with traditional models of collaboration, key features of success, lessons learned and the way forward.ResultsLMIC programme partners translate broad programme goals and define metrics into priorities tailored to local conditions. Programme funds flow to a LMIC-based leadership group that contracts with HIC-based peers to provide technical and scientific advice and consultation in a reverse funds flow model. Emphasis is placed on strengthening administrative capacity within LMIC institutions and on creating communities of practice with common goals that resulted in expanded collaboration with European, Latin American, and African institutions. A rigorous monitoring and evaluation process modify programme priorities based on evolving opportunities to maximise programme impact.Over five years, more than 63 research projects were designed, 19 of which received external funding and more than 40 manuscripts were published. Mozambican first-authored publications rose from 29% in 2001–2010% to 38% in 2011–2013.Eighteen (18) residents completed internal medicine specialty training between 2010 and 2014. This represents a fourfold increase from over 1991 to 2000. Three (3) Master’s programmes were created at Lurio University and 50 students successfully finished dissertations.ConclusionVesting LMIC partners with the responsibility for programme leadership and building administrative capacity in LMIC institutions substantially enhances programme relevance, impact and sustainability, and facilitates continuing acquisition of research and training funds to support professional development and institutional capacity building.

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