Strengthening health systems and clinical development capacities through effective partnerships: a case study of DNDi’s collaboration with the Leishmaniasis Research and Treatment Center in Ethiopia (2003–2022)

Introduction Neglected tropical diseases (NTDs) remain marginalized within the global health innovation system, with limited investment in research and development for diagnostics, treatments, and vaccines adapted to low- and middle-income country needs. This study aimed to examine the initiation, evolution, and outcomes of clinical capacity strengthening at the Leishmaniasis Research and Treatment Center (LRTC) and to derive lessons for future initiatives in Ethiopia and other Leishmaniasis East Africa Platform countries (Sudan, South Sudan, Uganda, and Kenya). Method This study analyses the trajectory of visceral leishmaniasis (VL) treatment and research activities at LRTC and the role of the partnership with the Drugs for Neglected Diseases Initiative (DNDi) in strengthening research and health system capacity for VL in Ethiopia. Using a qualitative case study design, we conducted key informant interviews with a semi-structured interview guide to capture diverse perspectives from stakeholders involved in the partnership. Participants were selected purposively based on their involvement as a beginning, mid, or mature phase partner. We used conventional content analysis. Results The DNDi–LRTC partnership substantially strengthened Ethiopia’s capacity to address VL. Key findings were organized into three themes: health system strengthening, partnership successes, and partnership challenges. The collaboration improved infrastructure and advanced training, fostering a stronger foundation for clinical research and enabling more rigorous research outputs. Additionally, effective treatment protocols were developed and integrated into national health policies, leading to better patient outcomes. Through awareness and advocacy, research findings were successfully embedded into national strategies, securing additional resources for VL management. The partnership also facilitated productive collaborations with other stakeholders in clinical research, clinical trials, and action on access, broadening its overall impact. However, challenges such as bureaucratic delays, communication gaps, and infrastructure limitations were identified, pointing to areas where further capacity strengthening would benefit future efforts. Conclusion The DNDi–LRTC partnership significantly enhanced clinical research capacity, treatment outcomes, and policy uptake for VL in Ethiopia. Despite these achievements, structural and operational challenges remain. Addressing these will be essential to sustain impact and optimize future partnerships. This case study provides practical insights for designing effective and sustainable collaborations in NTD research and health system strengthening.