Implementing Institutions

We are an alliance of governments and allied organizations. Our members engage institutions in effective and sustainable North-South partnerships. Our partnerships strengthen the capacity of the health workforce and institutions to provide quality health services for people in low and middle-income countries. We promote institutional health partnerships through knowledge generation, sharing best practice, collaboration, and advocacy.

The ESTHER Alliance is set in the general framework of the Sustainable Development Goals. We contribute mostly to SDG 3 Good Health and Wellbeing and SDF 17 Partnerships for the Goals. Those two goals taken together highlight not only what we want to achieve (better health for all, or Universal Health Coverage), but also how we want to achieve it (through better, more equal, and balanced partnerships


This is a new tool for institutional health partnerships, EFFECt stands for EFFective in Embedding Change.  The tool specifically focusses on assessing implementation best practice, embedding change and the added benefits to individuals and institutions of using a partnership approach.  The EFFECt tool measures these in relation to capacity building activities irrespective of the focus of the specific intervention. 

Latest Announcements

“You need to know your partners’ motivations”, said Andrew Jones, the Head of Partnerships at the UK’s Health and Education Trust (THET) in the workshop hosted by ESTHER Germany  on October 16th 2017. Jointly, the public and private sectors can work towards the sustainable development goals (SDGs). 


Members and partners of the ESTHER Alliance for Global Health Partnerships and of the health industry gathered in Berlin in a workshop at the World Health Summit in order to get to know each other and explore how institutional health partnerships could be a tool to make innovation accessible in resource-poor settings and a means of working jointly for mutual benefit.


An Innovative Multi-stakeholder Approach to Improve Quality and Access to Care

As a keynote speaker, Farid Lamara from Expertise France and General Secretary of the ESTHER Alliance gave a short introduction to the history, approach and sustainability of ESTHER partnerships: these are long-term partnerships of peer clinicians and other health professionals. Mr. Lamara observes great opportunities in the engagement of the private sector in institutional health partnerships: Private industry can support larger partnership projects targeting the improvement of quality and access to care. In addition to financial means, companies can offer expertise in areas relevant to partnership projects. Moderated by Brigitte Jordan-Harder, a senior technical advisor for GIZ, the panelists engaged in a lively discussion summarized below.

Mr Warnken, Head of the Health Division at Federal Ministry for Economic Cooperation and Development (BMZ) underlined the German commitment to university and hospital partnerships as an innovative cooperation instrument to strengthen health systems and presented the Hospital Partnerships Initiative. The Initiative has been successful since its launch in 2016 – it has already funded 66 health partnerships in 30 countries. The partnerships represent an opportunity to mobilize new actors for development cooperation, particularly hospitals and health staff in Germany. The Initiative is also an example of cooperation with a private foundation, the Else Kröner-Fresenius Foundation, characterized by strong joint commitment for strengthening health services in developing countries.

Mr Madeija, representing the pharmaceutical company Bayer reported on his company’s engagement with the Access Accelerated Initiative. Supported by 22 big pharmaceutical companies, the goal of the initiative is to improve diagnosis and treatment of non-communicable diseases, like diabetes, cardio-vascular diseases and cancer in low- and middle-income countries. To do so companies contribute to building capacity and strengthening health systems in partnership with governments and considering local conditions and policies. For Bayer, ESTHER partnerships are perfect implementing partners to deliver capacity-building measures. Mr Madeija added that his company, as others, has an interest in contributing to stronger economies by improving the health of their populations, given that dynamic economies open new business markets.

Mr Cunnaku, Deputy Director at VAMED agreed on the potential of the private sector for supporting capacity-building in developing countries in areas such as information and communication technology (ICT). E-learning offers great opportunities to improve the skills of health professionals in remote areas. When involved in hospital partnerships, the private sector can offer a wide range of technical solutions to strengthen health systems in the developing world.

Andrew Jones from the British organisation THET added another perspective: THET has been using its Health Partnership approach towards workforce development since 1988. The NGO is part of the ESTHER Alliance. Since 2012, THET has collaborated with the company Johnson & Johnson in specific thematic areas such as surgery, anaesthesia and the development of community health workers. From his experience, a private company’s interest in using a partnership approach lies in the uniqueness of institutional health partnerships: They are an exchange platform between professionals from Southern and Northern countries with an evident impact on health systems. Mr Jones explained the process of developing a tripartite partnership and underlined how important it is to openly communicate about particular interests in order to build trust and ensure a win-win-win environment.

Mr Hemmer from the University of Rostock presented the perspective of a German hospital participating in a long-term ESTHER partnership with Cameroonian hospitals in Limbe and Bamenda and more recently in Kindia (Guinea); both partnerships are funded through GIZ’s regional programme University and Hospital Partnerships in Africa. For their African colleagues, these exchanges offer an opportunity to access state-of-the-art diagnostic and therapeutic practice. Among the German partners involved are notably Departments of Tropical Medicine. Doctors hardly see clinical cases of tropical diseases in Germany. It is therefore a great learning opportunity for both sides.

Overall, there was consensus that the Sustainable Development Agenda and Universal Health Coverage cannot be reached without the private sector playing its part. Discussions on concrete mechanisms and conditions for German partners to cooperate with the private sector to ensure transparency and fair competition will be jointly developed with the public sector.

Background: There is growing international concern over antimicrobial resistance (AMR) which is currently estimated to account for more than 700,000 deaths per year worldwide. Despite the threat presented by AMR, the 2014 World Health Organization (WHO) describe significant gaps in surveillance, standard methodologies, and data sharing, particularly in less well-developed countries. In Africa, this lack of quality data leads to treatment guidelines that are often not adapted to the local context which leads to increased antimicrobial resistance.

Approach: Five ESTHER partnership projects have formed a network to improve surveillance on antimicrobial resistance. These partnerships will work to ensure the availability of microbiological cultures and susceptibility testing at seven hospitals in Tanzania, Kenya, Rwanda, Ethiopia, Côte d’Ivoire and Ghana. Building on the improved surveillance system, the partners will jointly conduct a multi-center research project. This network project adheres to the WHO GLASS initiative (Global AMR ) and it will enable comparable and validated data on AMR among countries. Better data will lead to safer and more effective patient care, and accurate and representative AMR surveillance across countries and partners, to inform treatment guidelines and strategies.


  • University Hospital Frankfurt – Kenyatta National Hospital, Kenya;
  • University Hospital Hamburg – Eppendorf – Hôpital Général Abobo Nord Abidjan and Université Jean Lorougnon Guede, Côte d´Ivoire – Komfo Anokye Teaching Hospital Kumasi, Ghana;
  • University Hospital München – Mbeya Zonal Referral Hospital and Mbeya Medical Research Centre, Tanzania – Jimma University Specialized Hospital, Ethiopia;
  • Charité Berlin – University Teaching Hospital of Butare and School of Medicine of Butare, Rwanda;
  • University Hospital Düsseldorf – Asella teaching Hospital and School of Science and Arsi University, Tanzania;

Our Intervention areas


Community health

Improve health service delivery and community involvement at district level.


Hospital management

Capacity building to improve management of human resources, and medical and pharmaceutical supplies. Strengthening of capacity for better financial management and implementation of quality management systems.



Capacity building to advance education, training, standards, research, and practice in surgical care.


Quality management

Capacity building for the introduction or strengthening of quality management systems including the creation of QM teams, adaptation of standards, and a supportive system of supervision and error management.


Maternal, newborn and child health

Capacity building to improve the quality of care before, during, and after, delivery for women and their babies.


TB Treatment

Improve diagnosis and care of TB patients through strengthening laboratory, medical, and nursing capacity. Improve adherence to treatment.


HIV prevention

Capacity building on HIV prevention (including PMTCT) in medical and non-medical settings such as prisons.



Capacity building for improved pandemic preparedness and response