Table of contents

Approximate read time: 15 minutes

The House of Lords is scheduled to consider the following question for short debate on 17 September 2026:

Lord Crisp (Crossbench) to ask His Majesty’s Government what steps they are taking to ensure that their international partnerships with organisations in African and Asian countries support the development of healthcare in those countries.

Lord Crisp is a patron of Global Health Partnerships (GHP), formerly the Tropical Health and Education Trust (THET), a UK charity that works to establish partnerships between healthcare organisations in the UK and those overseas.[1]

1. Key points

  • Since the 2000s, successive UK governments have funded schemes to support partnerships between health organisations in the UK and in Africa and Asia. Recently, some government schemes have ended without the announcement of successor programmes.
  • Evaluations of these programmes identified benefits for health workers and participating institutions in the UK and partner countries. However, evidence of wider and sustained health-system effects is more limited.
  • The UK government has also established its own direct partnerships with organisations in Africa and Asia to support the development of healthcare in those countries. Ongoing programmes include partnerships with individual countries as well as with organisations such as the Association of Southeast Asian Nations and Africa Centres for Disease Control and Prevention.
  • Evaluations of previous government partnerships identified success factors, such as alignment with local priorities and community engagement, as well as challenges, such as unpredictable funding and leadership changes.
  • The Burnham government has signalled that its approach to this topic is broadly aligned with that of the Starmer government. This has been indicated through reaffirming existing partnerships and pursuing more equal international partnerships.

2. Partnerships between health organisations in the UK and in Africa and Asia

The UK charity Global Health Partnerships (GHP) defines health partnerships between organisations in different countries as follows:[2]

Health partnerships are long-term, institutionalised relationships between health institutions in different countries, built on shared purpose, mutual benefit and reciprocal learning. They aim to strengthen health services, workforce capacity and health systems through the exchange of skills, knowledge and experience between partners. Partners work together to identify priorities that are aligned with nationally identified priorities, co-design interventions and programmes and share responsibility for implementation, learning and improvement.[3]

Organisations involved may include public health bodies, academic institutions, professional organisations, NHS trusts or individual hospitals.[4] Partnerships between organisations in the UK and those in Africa and Asia are commonly established to strengthen health systems and build health workforce capacity.[5]

Such partnerships may involve a range of initiatives to achieve these objectives. An example can be seen in the long-term ongoing partnership between Birmingham Women’s and Children’s Hospital and the Queen Elizabeth Central Hospital in Malawi, established in 2004.[6] Projects have included UK staff providing teaching and training in Malawi and bilateral exchanges of nurses and doctors on temporary placements.[7] It also involved the co-development and delivery of a nurse paediatric assessment skills course in Malawi.

The World Health Organization (WHO) promotes such partnerships between health organisations in developed and developing countries for mutual learning.[8] It argues they are particularly useful for improving healthcare during recovery from health events such as the Covid-19 pandemic. WHO initiatives such as the ‘African partnerships for patient safety’ (APPS), which ran from 2009 to 2014, and the ongoing ‘Twinning partnerships for improvement’ have been established to support these partnerships.[9]

WHO’s evaluation of APPS, which was focused on five partnerships with NHS hospitals, concluded that there was evidence that all partnerships resulted in some improvements in patient safety for the UK and African partner hospitals.[10] For example, African partners gained access to UK-developed technologies and received training on topics including safe surgery and healthcare waste management. Reported benefits to the NHS included strengthening of leadership skills, resource awareness and problem-solving capabilities.[11] There was also evidence of “reverse innovation” where a partnership with a hospital in Ghana involved the refinement of a data connection tool that was brought back to the NHS.[12] The report also identified numerous barriers to effectiveness of partnerships, such as lack of resources, high staff turnover destabilising partnerships, difficulties obtaining visas and institutional and individual resistance to change.[13]

2.1 UK government schemes to support international partnerships between health organisations

UK health institutions have a long history of involvement with African and Asian countries.[14] More recently, GHP began supporting international partnerships between health organisations in the 1990s.[15] Support for partnerships grew through the 2000s and, in 2006, the Blair Labour government commissioned Lord Crisp to carry out a review of how the UK could contribute to health in developing countries.[16] The review was primarily focused on Africa and India. The report’s recommendations included those aimed at addressing staffing crises in developing countries as well as those to strengthen health systems through partnerships and learning.[17]

Following the Crisp report, successive UK governments established schemes to fund and support health partnerships. While some programmes are ongoing, others have recently concluded without successor schemes.[18]

2.1.1 Previous government schemes

Following recommendations from Lord Crisp’s review, the Brown Labour government established the ‘International health links funding scheme’ (IHLFS), which ran from 2008 to 2011.[19] This was intended to support links between health institutions in the UK and developing countries to facilitate a reciprocal transfer of skills and knowledge.[20] Most projects took place in Uganda, Zambia and Malawi. The scheme was funded with £1.25mn per year from the Department for International Development (DFID) and the Department of Health.[21] It was managed by GHP and the British Council.[22]

An independent review of the IHLFS focused primarily on the scheme’s impacts in African countries. Overall, partners reported capacity development benefits at both individual and institutional levels.[23] Some projects were also able to demonstrate changes in mortality and morbidity, although it is challenging to determine how much of this can be attributed to IHLFS.[24] The review also highlighted numerous challenges faced by these partnerships.[25] A commonly reported issue was insufficient capacity building of administrative functions, such as those related to project management, planning, budgeting, monitoring and evaluation, and proposal development.

Building on the IHLFS, the ‘Health partnership scheme’ (HPS) ran from 2011 to 2019.[26] This £30.2mn programme was funded by DFID and managed by GHP. The scheme was focused on DFID’s thematic health priorities—reproductive, maternal, and newborn health, and malaria.[27] Over eight years, 191 partnerships were formed and 210 projects were delivered under the scheme, mostly in Africa and Asia.[28]

An independent evaluation of the HPS commissioned by DFID found that it was effective in enhancing partnerships and that the partnerships generally brought benefits for both countries involved.[29] Projects were considered to be well aligned with UK government commitments and the priorities of the partner countries.[30] Key success factors were found to be longevity, experienced UK partners, long-term volunteers, empowering behaviour and supportive management structures. However, the report also noted that there was “less evidence of wider outcomes such as strengthening human resources financing, recruitment, deployment and retention”.[31] It argued that projects missed opportunities to strengthen the wider health systems in partner countries through coordination with other HPS projects and aid programmes.[32]

‘UK partnerships for health systems’ (UKPHS) was a similar Foreign, Commonwealth and Development Office (FCDO) scheme launched in 2019 to fund health partnerships with organisations in Africa and Asia, again managed by GHP. Originally planned to run to 2023, funding ended in 2022, reportedly due to the economic impacts of the Covid-19 pandemic.[33]

FCDO’s own evaluation of UKPHS concluded that the programme did not achieve its central aim of “improv[ing] capability of the health system to address national priorities, especially to meet the needs of the poor and most vulnerable populations” due to its early closure.[34] Nevertheless, it noted that the partnerships supported through the programme had positive impacts on health worker and health service performance across the eight countries.

2.1.2 Ongoing and recently concluded government schemes

The government’s ‘Global health workforce programme’ (GHWP) ended in March 2026. Funded by the Department of Health and Social Care (DHSC) and implemented by GHP, this scheme supported partnerships with health organisations in Kenya, Nigeria, Ghana, Ethiopia, Malawi and Somaliland from 2023.[35] In response to a question regarding the closure of GHWP made in February 2025, Parliamentary Under Secretary of State at FCDO Chris Elmore stated that “with less money, we must make choices and focus on greater impact”.[36] The minister added that the government remained “committed to international development and will continue to support countries to build resilient, sustainable health systems”.[37]

The ‘International health regulations strengthening programme’ (IHRSP) has been running since 2016 and is planned to finish in 2029.[38] The programme is focused on supporting countries in Africa, the eastern Mediterranean and Southeast Asia to prepare, prevent, detect and respond to global health threats. In June 2025, Ashley Dalton, then parliamentary under secretary at DHSC, pointed to IHRSP as the key UK government programme that would continue to support bilateral health partnerships after the conclusion of the GHWP.[39] Ms Dalton also pointed to the Starmer government’s continued commitments to multilaterals such as Gavi, the Vaccine Alliance, the Global Fund to fight AIDS, Tuberculosis and Malaria, and WHO.

Since Prime Minister Andy Burnham took office in July 2026, the government has not announced any changes to programmes to support international partnerships between health organisations.

2.1.3 Impact of reduced UK ODA spending

In recent years, government partnership schemes have taken place against a backdrop of reduced UK official development assistance (ODA).[40] The coalition government committed the UK to spend 0.7% of gross national income (GNI) on ODA from 2013.[41] Then, in 2020, the Johnson Conservative government reduced the government’s target to 0.5% of GNI, citing economic challenges arising from the Covid-19 pandemic.[42] In February 2025, the Starmer Labour government announced it would reduce ODA funding further to 0.3% of GNI by 2027/28 to fund increased investment in defence.[43] The Burnham Labour government has stated that it intends to return ODA funding to 0.7% of GNI “as soon as fiscal circumstances allow”, but has not provided any details.[44] Some warn that reduced global overseas aid funding may result in reduced government funding to support international partnerships between health organisations.[45]

2.1.4 NHS England schemes

NHS England has also funded programmes to facilitate health partnerships.[46] For example, the ‘Global capacity building programme’ was a three-year, £1.8mn initiative delivered by GHP that supported health partnerships between UK institutions and counterparts in Uganda, Zambia and South Africa.[47] NHS England’s SCALE (strengthening healthcare workforce capacity through global learning) partnerships also facilitates health worker exchange between the UK and East Africa.[48] In addition, the technical collaboration and consultancy service collaborates with global partners, such as those in India and Kyrgyzstan, regarding human resources for health.[49]

3. UK government partnerships with organisations in Africa and Asia

3.1 Previous partnerships between the UK government and organisations in Africa and Asia

Successive governments have established partnerships directly with organisations in Africa and Asia to support the development of healthcare in those regions. Evaluations of these have identified numerous success factors and challenges to creating sustainable benefits for healthcare systems.

For example, an independent evaluation of FCDO’s health systems strengthening (HSS) programmes in Nigeria concluded that they “achieved transformational changes” between 2004 and 2024.[50] It noted improvements on multiple health indicators over the period of FCDO support, including child mortality, HIV/AIDS prevalence and women’s access to healthcare. The report concluded that programmes worked best when they “were well aligned to federal priorities and state governors’ agendas”.[51] Most programmes that did not sustain initial successes were not sufficiently tailored to local contexts. Other factors found to hinder the sustainability of transformations included inconsistent government support, unpredictable funding, staff shortages, governance issues and financial inefficiencies.[52] The report concluded that “though HSS initiatives made a real difference, sustaining their impact will require stronger government ownership, steady funding and accountability measures that keep reforms moving forward”.[53]

Similarly, an independent evaluation of the ‘Better health in Bangladesh’ (BHB) programme (2019–2025), part of the UK-Bangladesh development partnership, identified further success factors and challenges.[54] Key factors that drove the effectiveness of the programme included “agility in adapting to evolving health priorities, collaboration with government, a data-driven approach, leadership at all levels, engaging with communities and additional workforce for supervision, monitoring and mentoring”.[55] Key implementation challenges included leadership changes within government agencies and limited follow-up mechanisms for research-based interventions, which led to underutilisation of research findings.

3.2 Recent changes in the UK government’s approach to direct partnerships with organisations in Africa and Asia

The Labour government under Sir Keir Starmer made several announcements regarding changes in the government’s approach to partnerships with organisations in Africa and Asia. The few announcements made on this topic under the leadership of Andy Burnham have indicated generally continuity regarding the UK’s overall approach to such partnerships.

In July 2026, the Starmer Labour government published ‘The UK’s modern development approach’ policy paper.[56] This stated that the government would be pursuing more equal partnerships with local partners leading projects, including healthcare projects. Specifically, it said ODA spending on health would focus on “getting behind country priorities to build resilient and sustainable health systems which deliver equitable health outcomes, harnesses human capital, and strengthen UK and global health security”.[57]

This approach was promoted by David Lammy, then deputy prime minister, at the May 2026 Global Partnerships Conference, which was co-hosted by the UK.[58] The conference was intended to “establish new partnerships for international cooperation based on modern and diverse coalitions”.[59] It brought together governments, international organisations, philanthropists, investors, innovators, civil society, business and technology leaders. The resulting Global Partnerships Compact affirmed a need to develop “respectful partnerships that enable country and community leadership”.[60]

The Starmer government also announced ‘The UK’s new approach to Africa’ in December 2025, which argued a need for more equal partnerships in this region in particular.[61] It listed seven priorities including the UK shifting from “donor to investor” as “partnerships will place mutual growth at the centre”.[62] Investment in healthcare was highlighted as another priority, particularly vaccine manufacturing, disease prevention, and sexual and reproductive health and rights.

The Burnham Labour government reasserted that “the UK’s modern approach to development is based on partnership not paternalism” and signalled continued support for some partnerships established under the Starmer government in July 2026.[63]

3.3 Ongoing government partnerships with health organisations in Africa and Asia

In November 2025, the Starmer government reaffirmed its partnership with the Africa Centres for Disease Control and Prevention (Africa CDC).[64] As part of this, the government made specific commitments such as deepening collaboration on emergency preparedness, prevention and response, scaling up genomic and antimicrobial-resistance surveillance, and strengthening primary health care and workforce development. The communiqué also set out arrangements to support Africa-led initiatives and national ownership, as well as Africa CDC’s leadership in advancing continental frameworks, such as the African Strategy for Health Security and Universal Health Coverage. The Burnham government has since announced further support to combat Ebola in the Democratic Republic of the Congo, and pointed to the importance of the UK-Africa CDC partnership in supporting regional responses.[65]

Similarly, in July 2025, the government launched a partnership with Association of Southeast Asian Nations (ASEAN).[66] This five-year programme provides grant funding for projects in Southeast Asia “to improve health systems, enhance access to healthcare and strengthen ASEAN capacity to respond to new threats, like the health impacts of climate change”.[67] The first grant recipients were announced in June 2026, spanning government, academic and civil society sectors in countries including Indonesia, Timor-Leste and Vietnam.[68] These projects cover areas such as antimicrobial resistance, climate-related health risks and pandemic preparedness. The programme also works to establish partnerships between institutions in ASEAN and the UK. Finally, the programme supports the ‘ASEAN one health joint plan of action’ to help address global health issues such as antimicrobial resistance. The Burnham government reaffirmed its commitment to this programme in July 2026.[69]

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References

  1. Global Health Partnerships, ‘Founder and patron’, accessed 3 September 2026; and Charity Commission for England and Wales, ‘Global health partnerships’, accessed 3 September 2026. Return to text
  2. Global Health Partnerships was called Tropical Health and Education Trust (THET) prior to 6 November 2024. Return to text
  3. Global Health Partnerships, ‘Health partnership model’, accessed 11 September 2026, p 1. Return to text
  4. As above, p 2. Return to text
  5. Tropical Health and Education Trust, ‘Partnerships for an interconnected world: THET strategic plan 2022–2027’, 2022. Return to text
  6. Birmingham Women’s and Children’s Hospital, ‘Birmingham Women’s and Children’s Hospital, UK—Queen Elizabeth Central Hospital, Malawi Global Health Partnership report’, 2025. Return to text
  7. As above, pp 3 and 6–9. Return to text
  8. World Health Organization, ‘Twinning partnerships for improvement: Building quality health services for Covid-19 recovery and beyond’, 2023. Return to text
  9. World Health Organization, ‘African partnerships for patient safety’, accessed 10 September 2026; ‘Twinning partnerships for improvement’, accessed 10 September 2026; and ‘Partnership development and continued strengthening: Japan and Liberia’, 18 November 2016. Return to text
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  12. As above, pp 48–50. Return to text
  13. As above, pp 46–7. Return to text
  14. Department for International Development, ‘Health partnership scheme: Evaluation synthesis report’, October 2016, p 5. Return to text
  15. Global Health Partnerships, ‘Our history’, accessed 9 September 2026; and Department for International Development, ‘Health partnership scheme: Evaluation synthesis report’, October 2016, p 11. Return to text
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  17. As above, pp 13–17. Return to text
  18. Kat Lay, ‘UK government axes flagship global health project’, Guardian, 12 March 2026. Return to text
  19. Department for International Development, ‘Health partnership scheme: Evaluation synthesis report’, October 2016, p 13. Return to text
  20. Capacity Development International and Tropical Health and Education Trust, ‘International health links funding scheme evaluation’, September 2012, p 4. Return to text
  21. As above, p 2. Return to text
  22. As above, p 2. Return to text
  23. As above, p 4 Return to text
  24. As above, p 6. Return to text
  25. As above, p 2. Return to text
  26. Tropical Health and Education Trust, ‘Health partnership scheme impact report 2011–2019’, 2019. Return to text
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  32. As above, p 6. Return to text
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  51. As above. Return to text
  52. As above, p x. Return to text
  53. As above. Return to text
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