The Architecture of Decolonial Partnerships in University Global Health Program Development

<i>Background:</i> Processes and best practices for initiating and growing university global health programs in high-income countries (HICs) synchronously and symbiotically with partners in low- and middle-income countries (LMICs) are not abundantly described in the medical literature. In particular, programs that do not have university partners in LMICs may struggle to develop sustainable, ethical, and anticolonial community and governmental partnerships. <i>Methods:</i> This article reviews existing literature and describes the challenges in the contemporaneous development of university global health programs and community/governmental partners. The paper goes on to describe the creation of the Office of Global Health at Rush University in conjunction with the inception and development of its partner non-governmental organization (NGO), Community Empowerment in the Dominican Republic. The success and opportunities in the evolution of this ongoing relationship are described. Guiding principles for others attempting similar work are provided. <i>Results:</i> Creating these entities simultaneously promotes the establishment of relationships with equal power and authority from the inception, facilitates the creation of customized programs that capitalize on the strengths of the university and infrastructure of the partner country/community, and allows both entities to grow together in scope and impact. Challenges include identifying and nurturing like-minded university, NGO, and community/government partners; securing bilateral sustainable funding; ensuring quality of clinical services and educational/scholarly activities; and consistently promoting anticolonial practices. <i>Conclusion:</i> Developing university global health programs in HICs simultaneously with a partner NGO can result in mutual and commensurate growth and outcomes as well as strong and equitable relationships. This paper describes the author's own experience at Rush University building connections with community partners and colleagues in the Dominican Republic and outlines strategies to achieve these results.