After losing the importance it had held around 1900 both as a colonial power and in the field of tropical medicine, Germany searched for a new place in international health care during decolonisation. Under the aegis of early government ‘development aid’, which started in 1956, medical academics from West German universities became involved in several Asian, African and South American countries. The example selected for closer study is the support for the national hygiene institute in Togo, a former German ‘model colony’ and now a stout ally of the West. Positioned between public health and scientific research, between ‘development aid’ and academia and between West German and West African interests, the project required multiple arrangements that are analysed for their impact on the co-operation between the two countries. In a country like Togo, where higher education had been neglected under colonial rule, having qualified national staff became the decisive factor for the project. While routine services soon worked well, research required more sustained ‘capacity building’ and did not lead to joint work on equal terms. In West Germany, the arrangement with the universities was a mutual benefit deal for government officials and medical academics. West German ‘development aid’ did not have to create permanent jobs at home for the consulting experts it needed; it improved its chances to find sufficiently qualified German staff to work abroad and it profited from the academic renown of its consultants. The medical scientists secured jobs and research opportunities for their postgraduates, received grants for foreign doctoral students, gained additional expertise and enjoyed international prestige. Independence from foreign politics was not an issue for most West German medical academics in the 1960s.