This in-practice article describes the processes involved in the development and functioning of the KwaZulu-Natal Primary Health Care Transformation Committee (PHCTC) as a collaborative learning governance structure. The PHCTC brings together the Department of Health policy-makers, University of KwaZulu-Natal academics, the Office of the Premier, non-governmental organisations, civil society representatives and other sectors. This platform has facilitated multi-level planning and mobilisation informed by a co-developed theory of change towards strengthening primary healthcare (PHC); generated co-developed and impactful public health research that has informed the adoption of evidence-based approaches, innovations and implementation strategies for strengthening PHC; and enabled contextually relevant teaching programmes in line with PHC. Key considerations for similar academic multistakeholder generative, collaborative structures to the PHCTC include the importance of cultural brokering, mutual capacity building, shared values and multi-level long-term planning and service-level agreements to promote sustainability.