The 1995–99 Houston-Semipalatinsk Healthcare Partnership (HSP) was an international collaboration between healthcare institutions in Houston, Texas, and Semey, Kazakhstan (previously called Semipalatinsk). This partnership was established to create a synergistic exchange that would address public health needs identified by Kazakh institutions and that would be self-sustaining. Semey was the primary site of Soviet-era atomic bomb testing for over forty years, exposing millions of people to sustained radiation. When the Soviet Union was dissolved, Semey’s healthcare infrastructure was insufficient to care for the existing population, let alone deal with the added health effects of low-dose radiation. To address these challenges, the HSP was established with funding through the American International Health Alliance (AIHA), under a cooperative agreement with the United States Agency for International Development (USAID). Houston and Semey partners jointly formulated goals for healthcare reform and mobilized resources across institutions and governments. Through cultural, economic, educational, and technical exchange, the partnership afforded unique advantages as an international program of medical, scientific, and socioeconomic alliances. The many accomplishments of this partnership illustrate the efficacy of this collaborative approach and highlight the crucial need for government support of sustained programming to make transformative progress.