Cuba has long‐standing development partnerships with many African countries. In Nigeria, this includes medical staff training, interventions in malaria disease and death. Using a two‐tiered analytical framework and elite interviews, we problematise ideological conceptualisation of development and its praxis, particularly capability and willingness to explore alternative approaches or partnerships for development. We argue that what occurs between rhetoric and reality of this case is characteristic of entrenched structural and operational dynamics to layers of institutionalised development agenda‐setting sustained by international development policy regimes. This research highlights the need to explore alternative development approaches that engender mutually beneficial and equal partnerships.