Academic partnerships for family medicine and primary health care education: a global narrative review 7 years after Astana.

The 2018 Declaration of Astana reaffirmed Primary Health Care (PHC) as the foundation for universal health coverage and the health-related Sustainable Development Goals, yet the workforce, curricula, and research infrastructure required to deliver that vision remain unevenly developed across regions. This narrative review, prepared in line with the SANRA reporting standard, examines the global field of academic partnerships for family medicine (FM) and PHC education during the 7 years that followed Astana. We synthesize peer-reviewed and gray literature from 2010 to April 2026 across PubMed, Semantic Scholar, ERIC, and the principal FM and global health journals, and we map the evidence to the World Health Organization three-component PHC framework and Starfield's 4Cs of primary care. We propose a five-modality typology, the AP-PHC Typology, that distinguishes bilateral North-South capacity-building partnerships, multi-institutional North-South networks, South-South peer-learning networks, triangular partnerships, and multilateral convening platforms. Each modality is mapped to its distinctive contribution across the 4Cs and to the WHO components of integrated services, multisectoral action, and community empowerment. The evidence shows that South-South networks such as PRIMAFAMED, the Iberoamerican Confederation of Family Medicine, AfriWon Renaissance, and the South Asian primary care research community have produced contextually grounded curricula, faculty development pathways, and emerging research traditions. North-South initiatives, in turn, have made measurable but uneven contributions to faculty capacity, often constrained by short donor cycles and asymmetric authorship, with cultural translation rarely fully achieved. Academia is the engine room of post-Astana implementation, but only when partnerships are governed by explicit ethical principles, equitable authorship norms, and sustained financing aligned to country priorities. We close with a falsifiable proposition: where academic FM partnerships explicitly embed the Besrour ten ethical principles and demonstrate equitable LMIC-led authorship, program sustainability beyond donor cycles is significantly more likely than where these conditions are absent. Testing this claim should anchor the next decade's research agenda.