How a Kenyan-American Academic Partnership Is Moving the Needle on Global Health Goals

With fewer than one in ten targets of the United Nations’ third Sustainable Development Goal on track at the halfway point to 2030, a new case study published in the Journal of General Internal Medicine offers something rare in global health: a documented, two-decade-long model that demonstrably moved the needle on some of the world’s most stubborn health problems. The study examines the Academic Model Providing Access to Healthcare, known as AMPATH, a partnership that began in 1989 between Indiana University’s Division of General Internal Medicine and Geriatrics and Kenya’s Moi University, and has since grown to include 21 academic institutions across seven countries. Written by investigators including Caitrin Kelly of Indiana University School of Medicine and William Tierney of the Regenstrief Institute, the analysis traces how collaboration among academic centers, Kenya’s government, and the World Health Organization produced measurable gains in HIV care, maternal and neonatal survival, and health informatics, the very territories that SDG 3 and its health-related offshoots aim to transform.

The framing of the paper is deliberately sober about the global picture. In 2015, UN member states adopted 17 Sustainable Development Goals to be achieved by 2030, with SDG 3 pledging to ensure healthy lives and promote well-being for all at all ages through 12 targets. Across all 17 goals, 33 targets and 57 indicators are classified as health-related. Yet the United Nations’ own 2023 assessment found that less than 10 percent of SDG 3 targets were on track at the midpoint. The global maternal mortality ratio remains more than three times higher than the 2030 target of 70 deaths per 100,000 live births, and nearly three-quarters of countries requiring accelerated progress on under-five mortality are in Sub-Saharan Africa. A systematic review of SDG implementation cited in the study found a striking absence of guidance on how to engage stakeholders, while pointing to academic institutions as underused engines of knowledge generation and policy guidance. AMPATH, the authors argue, is precisely the kind of stakeholder engagement model the global community has been missing.

The partnership’s origin story is rooted in the HIV epidemic. Beginning in 2001, AMPATH launched efforts to expand access to antiretroviral drugs at Moi Teaching and Referral Hospital in Eldoret and in surrounding communities. Backed by philanthropy, the United States Agency for International Development, and the Centers for Disease Control and Prevention, the initiative grew into one of Africa’s largest and most comprehensive HIV care systems, with a network of clinics that has cared for more than 250,000 patients living with HIV or AIDS. What distinguishes AMPATH from many donor-driven programs, the authors contend, is its tripartite academic mission of education, research, and care. Lessons learned from building an HIV treatment infrastructure were subsequently applied to non-communicable diseases, including mental and cardiovascular health, maternal and child health, and cancer, aligning the partnership’s portfolio with SDG target 3.4.

Some of the most technically consequential work has come through the Global Network for Women’s and Children’s Health Research, a collaboration through which AMPATH investigators have contributed to a series of landmark trials targeting SDG goals 3.1 and 3.2 on maternal and child mortality. The Azithromycin Prevention in Labor Use Study, A-PLUS, was a multi-country, double-blind, placebo-controlled randomized trial in six low- and middle-income countries including Kenya. It enrolled 29,278 pregnant women planning vaginal births and randomized them to receive either a single 2-gram oral dose of azithromycin or placebo during labor. The result: intrapartum prophylactic azithromycin reduced observed maternal infection or death through six weeks postpartum by approximately 35 percent. For a single, cheap antibiotic dose administered at delivery, that effect size has few parallels in maternal health.

Equally striking is the AFRINEST trial, which tested whether community health workers could safely manage seriously ill newborns at home in three Sub-Saharan African countries when hospital referral was not feasible. The trial demonstrated that three simplified outpatient regimens of affordable antibiotics, given by injection and by mouth, were as effective as the gold-standard reference treatment in preventing treatment failure among infants with probable sepsis. Follow-up studies confirmed the model’s feasibility elsewhere in the region. The findings fed directly into the WHO guideline on managing possible serious bacterial infection in young infants when referral is not feasible, and have since been incorporated into national maternal and child health programs in the Democratic Republic of Congo, Kenya, and Nigeria. It is a textbook example of the pathway the case study champions: local evidence, generated in the settings where the burden is highest, translated into global guidelines and national policy.

The ASPIRIN trial pushed a similarly elegant intervention into the global mainstream. Across seven sites in six low- and middle-income countries, 11,976 nulliparous women were randomized to daily low-dose aspirin or placebo in early pregnancy. The aspirin group showed significant reductions in preterm delivery and fetal loss. Subsequent analyses established that the regimen is effective even in women without additional risk factors, is safe, is cost-effective, and delays the onset of hypertensive disorders of pregnancy. The data have been used to advocate for low-dose aspirin therapy as a standard of care in low-resource settings and are now reflected in WHO guidance. Meanwhile, the Antenatal Corticosteroids Trial, a cluster-randomized study across Sub-Saharan Africa, Asia, and Latin America, delivered a more nuanced lesson: antenatal corticosteroids for women at high risk of preterm birth reduce neonatal mortality only when delivered within tertiary care facilities where preterm infants and mothers in premature labor can receive specialized care, a caution that reshaped implementation strategies worldwide.

On the neonatal front, AMPATH investigators collaborated with the American Academy of Pediatrics, WHO, and other partners on Helping Babies Breathe, a training program launched in 2010 to teach basic neonatal resuscitation to health workers in low- and middle-income countries. The collaboration extended to curriculum design, evaluation, and the development of digital education and quality improvement tools, including randomized trials of virtual reality and video-based refresher training. The scale of dissemination is remarkable: the program has been rolled out in more than 80 countries, over one million health care providers have been trained, and meta-analytic evidence links the training to reduced stillbirth and perinatal mortality. Because birth asphyxia remains a leading cause of neonatal death, the public health significance of embedding resuscitation skills in frontline providers is difficult to overstate.

HIV work followed a parallel but distinct pathway, one built on data. Through the International Epidemiology Databases to Evaluate AIDS, or IeDEA, a consortium established in 2006 with seven regional data centers, AMPATH investigators lead the East Africa region. The network pools and analyzes clinical data from 1.7 million patients receiving HIV care in 46 countries, using common data exchange standards. In 2014, IeDEA formalized a partnership with the WHO to accelerate the translation of research into policy, a mechanism that bypasses the often lengthy lag of journal publication. Observational data from the network provided evidence that informed the WHO’s pivotal recommendation to offer HIV treatment to all people living with the virus, and has been critical to monitoring progress toward the 90-90-90 goals: 90 percent of people with HIV knowing their status, 90 percent of those diagnosed on treatment, and 90 percent of those treated virally suppressed. Since the partnership began, IeDEA has completed 12 multiregional analyses and supported three global HIV progress reports. AMPATH researchers also supplied WHO working groups with pediatric data showing that self- and caregiver-reported adherence measures can underestimate non-adherence compared with automated monitoring systems and plasma drug levels, findings that shaped WHO recommendations for pediatric HIV care.

The fourth pillar of the case study is perhaps its most quietly revolutionary: informatics. As AMPATH’s HIV clinics multiplied across western Kenya, the partnership built a custom electronic health record with the Regenstrief Institute, the AMPATH Medical Record System, which became essential to achieving viral suppression and prevention targets and was later extended to chronic disease clinics. With funding and support from the WHO, the Rockefeller Foundation, and Partners in Health, that system was transformed into OpenMRS, an open-source electronic health record platform designed for low-resource settings. Today OpenMRS operates at more than 5,500 sites in over 60 countries, including facilities in the United States, Canada, and Europe, supporting care for infectious diseases and non-communicable conditions alike. Reliable electronic records, the authors argue, are not merely administrative conveniences; they are the measurement infrastructure without which progress on the health-related SDGs cannot be tracked, and without which countries lagging behind cannot be identified in time to act.

Taken together, the AMPATH case study makes a claim with implications far beyond western Kenya: that academic institutions, when woven into long-term partnerships with health ministries and multilateral agencies, can fill critical data gaps, test innovations under real-world constraints, and generate the evidence base on which global guidelines depend. Whether the intervention is a two-gram dose of azithromycin during labor, a simplified antibiotic regimen delivered by a village health worker, or a shared database spanning four dozen countries, the mechanism is the same: local evidence, gathered rigorously and shared openly, translated into standards that change practice everywhere. With the 2030 deadline looming and most health targets off track, the authors suggest that replicating this model, rather than inventing new frameworks from scratch, may be the most credible route left for turning the SDG promise into reality.

Subject of Research: Academic global health partnerships advancing the UN health-related Sustainable Development Goals through the AMPATH collaboration in Kenya

Article Title: Progress Toward the Health-Related Sustainable Development Goals: A Case Study of the Academic Model Providing Access to Healthcare (AMPATH)

Article References: Kelly, C. M., Bucher, S. L., Esamai, F., Wools-Kaloustian, K., Vreeman, R., Braitstein, P. K. A., Gardner, A., Carter, E. J., Kimaiyo, S., & Tierney, W. M. (2026). Progress Toward the Health-Related Sustainable Development Goals: A Case Study of the Academic Model Providing Access to Healthcare (AMPATH). Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10732-9

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10732-9

Keywords: AMPATH, Sustainable Development Goals, global health, HIV care, maternal mortality, neonatal health, WHO, OpenMRS, electronic health records, Kenya, health informatics, clinical trials