BACKGROUND: In April 2000, the Council of the Baltic Sea States established the Task Force on Communicable Disease Control in the Baltic Sea region (the Task Force). A successor structure, the Northern Dimension Partnership in Public Health and Social Wellbeing, was established in autumn 2003. This article, a follow-up study to a series of evaluations of the Task Force evaluation, examines whether the Northern Dimension has succeeded in developing the achievements of the Task Force and ensuring the sustainability of regional health collaboration. METHODS: The study is qualitative, relying on documentary analysis and semi-structured in-depth interviews with key actors. Relevant literature and key programme documents were consulted, and approximately 100 interviews were conducted. RESULTS: The short history of the Northern Dimension Partnership shows that many of the problems encountered in the Task Force are reappearing. Interstate rivalry, most prominent between Nordic countries, still hampers progress, with resulting scarce funding. The Partnership emphasizes the need to anchor future collaboration in centrally placed agencies in all participating countries. This is a time-consuming process, and has the inevitable effect of slowing down project work. CONCLUSION: Although epidemiological data clearly illustrate the need for continued multinational support to communicable disease control in Northeast Europe, the above-mentioned factors impede progress in this respect. While there are good reasons for cultivating partnerships with Russian federal agencies in terms of sustainability, this focus does represent a loss of momentum that may be difficult to overcome.