In this strategic paper, the African Capacity Building Foundation shows how African countries can tackle the brain drain by understanding the emigration of medical personnel from Malawi, which in ways mirrors the wider African experience but is also unique. Like much of Sub-Saharan Africa, Malawi has poor health indicators, reflecting its low capacity to deliver quality health care. This situation is due in part to the limited capacity for training physicians and in part to the massive emigration of health workers, especially in the 1990s and early 2000s. The paper's objectives are threefold. First is to understand the state and extent of the brain drain challenge in Africa with an appropriate country case study. Second is to map the strategies, approaches and initiatives countries undertake to address brain drain issues. Third is to identify lessons and good practices in addressing the key capacity needs, specifically defining the roles of state and non-state actors.