The sustainability of any gains made by research activities hitherto led by international research organisations requires the effective transfer of knowledge and skills to local research collaborators or partners. However, the state of affairs in many international health research projects in Malawi does not reflect this vision. Local researchers have little or no knowledge of how study samples are managed, i.e. how the samples are analysed, which tests are used, who really owns the samples and when the samples will be destroyed, among other considerations. To achieve this, the Ministry of Health (MoH) needs to ensure availability of well-drafted, implemented and monitored agreements between international research organisations and local collaborating research institutions. The continuity of programmes and full realisation of expected outcomes should be direct benefits of such meaningful collaborations. This policy brief analyses the policy options that can make skills transfer a reality and recommends appropriate policy actions.