International strategic alliances and partnerships are complex linkages among and between firms and institutions, often designed to reduce the costs, risks and uncertainty associated with the development, production and marketing of new products and processes. This paper addresses industrial alliances and R&D collaborations in health biotechnology sub-sectors in Kenya, South Africa and Zambia to determine their characteristics, drivers, trends and interactions with other factors such as foreign direct investment (FDI) and international trade. We observe that specialized regional networks are perceived to be more effective than bilateral institutional arrangements in building research and development capacity, and mobilizing donor support. In turn, donor support appears to be a major driver of R&D collaboration. However, industrial alliances are largely influenced by market opportunities and trends in investment and international trade. The linkage between international science and technology agreements and international health biotechnology collaborations seems weak.