Background For many medical and allied health students from African countries, the opportunity to undertake a global health elective abroad is unaffordable or inaccessible. Therefore, an imbalance has emerged where many African institutions host students from developed countries but their own students rarely go on electives in developed countries. Global Educational Exchange in the Medical and Health professions (GEMx), a service programme of the Educational Commission for Foreign Medical Graduates (ECFMG) partnered with the African Forum for Research in Health (AFREhealth) to implement a south-to-south student exchange pilot through intra-institutional partnerships. The aim was to provide affordable global-health learning opportunities to African students.