The cities of Manipal, India and Loma Linda, California officially became twins in ceremony under the auspices of Sister Cities International on May 6, 1982. Manipal is very similar to Loma Linda, in that they both contain universities and advanced medical facilities within their boundaries and are similar in other respects as well.

The Loma Linda City Council, at the meeting of December 10, 2002, did approve an "Agreement of Fraternity" between the Cities of Libertador, San Martin, Argentina and Loma Linda. The cities share a common origin, stemming from an institution of the Seventh-Day Adventist Church and each city housing a university. Libertador is home to the Adventist University del Plata, which established an Agreement of Academic Cooperation with Loma Linda University on September 26, 1998. There are important familiar bonds between the people of both communities, with many people currently residing in Loma Linda having emigrating from Libertador.