The Kilimanjaro Christian Medical Centre (KCMC)-Duke Collaboration began in 1995.  The Collaboration is built upon a true partnership, and involves the research, education and service missions of both partners.  Since 2001 the research agenda has expanded from an initial focus on infectious diseases to include maternal child health, mental health, health systems strengthening, non-communicable diseases, and cancer.  Diversifying the research agenda has been a key strategy in support of a sustainable partnership, and the Collaboration has received research support from five different institutes within the US National Institutes of Health.  Students and trainees from both partners have been engaged in educational efforts.