Article As

people—and the diseases they carry—become ever more mobile, interest in global health issues has grown. Government agencies and foundations have devoted substantial resources for international collaborative projects for health research and education,1,2 and many universities and academic health centers in the United States, Canada, and Europe have established partnerships with medical schools and health centers in low- and middle-income countries.3–5 These partnerships aim to improve professionals ’ educational, research, or clinical abilities; to facilitate student and scholar exchanges; to pool resources for mutually interesting research; and to provide researchers with physical and information access to geographically bounded diseases and their treatment.1 International academic partnerships offer many benefits for the participating institutions, but the interaction of disparate organizational and national cultures may introduce administrative, political, economic, social, and technological challenges. When the partnership involves institutions from both high-income and low- and middle-income countries, additional challenges arise, such as resource disparity and power differentials.6 These challenges affect the motivations, expectations, balance of benefits, and results of the joint projects and can hinder project goals if not addressed.7,8 Some of these attitudes and structural factors have been previously discussed in the literature, in anecdotal reports, editorials, or thematic introductions.3,8,9 The literature still lacks, however, a systematic analysis of the communication and project management processes that affect such partnerships.10 In this article, we present lessons we learned in a multicountry, multiorganizational partnership calle