Global partnerships for local impact: Strengthening HTA capacity in Asia and Africa through collaborative experiences

Health technology assessment (HTA) is recognized as a critical tool for informing health policy decisions and advancing sustainable universal health coverage (UHC). For over a decade, the Health Intervention and Technology Assessment Program Foundation (HITAP) has undertaken systematic efforts to strengthen HTA capacity across Asia and Africa. This study reviews HITAP's experience in capacity strengthening to inform strategies for effective international collaboration and capacity-building in low- and middle-income countries.

A document review of HITAP's capacity-strengthening initiatives from 2010 to mid-2025 was conducted using HITAP's internal documentation. Initiatives were categorized according to the Individual, Node, Network and Environment (INNE) framework and by activity type, with data analyzed descriptively. In addition, key informant interviews (KII) were conducted with key HTA decision-makers from 7 countries who had prior engagement with HITAP, and thematic analysis was applied to the KII data.

A total of 278 HTA capacity-strengthening activities across 25 countries were identified from 2010 to mid-2025. The majority of the initiatives (n = 151) were with countries in Asia, were programmatic (n = 128) instead of ad hoc and involved mostly knowledge sharing (26%) and research and project collaborations (21%). Out of 11 countries in Africa, only 3 had programmatic engagements with HITAP (n = 30), involving mostly advising and mentoring (30%). Analysis of annual activity frequency shows that, in the post-pandemic period (2022 onwards), multi-country engagements have increased as collaborative activities have transitioned to include a larger number of countries within a single event. KII participants reported that these collaborations enhanced awareness and recognition of HTA among key stakeholders including policy-makers, strengthened technical capacity within the Ministry of Health and partner organizations, and generated outputs such as HTA guidelines, publications, dedicated HTA units, a Memorandum of Understanding and institutional or regulatory reforms at all 4 INNE levels.

Collaborations for strengthening capacity for HTA are critical and will shape the next decades as countries strive to achieve and sustain UHC. Contextual approaches, underpinned by a multi-pronged approach, with an emphasis on joint initiatives across countries, are needed to ensure HTA remains relevant and responsive to evolving priorities in the changing international context.