AIDS Prevention Initiative in Nigeria, Ltd./Gte.

1. AIDS Prevention Initiative in Nigeria, Ltd./Gte. Prosper Okonkwo MD Chief Executive Officer APIN Ltd./Gte. Abuja, Nigeria 6th Annual PEPFAR Track 1.0 Program Meeting Washington, DC August, 2008

2. Introduction • AIDS Prevention Initiative in Nigeria (APIN) was established in 2000 with a grant from the Bill & Melinda Gates Foundation to HSPH • The Harvard PEPFAR(APIN Plus) Program commenced in 2004 building on the gains of the Gate’s funded APIN program • APIN LLC was incorporated in November 2007 as a local NGO to gradually take over the functions of HSPH in Nigeria.

3. Triggers to NGO Formation • Need to diversify funding base (Sustainability plan) • HR Management challenges with large local staff • Visionary leadership by the Principal Investigator • Support from the Government of Nigeria • Growing complexity of the program outside of Harvard traditional mandates - required transfer of clinical care by March 2009 • Discussion with HRSA and CDC - followed by Transition plan in November 2007

4. Categories of Company Registrations in Nigeria • Public Limited Companies • Private Limited Companies • Unlimited Companies • Companies Limited by Guarantee • Incorporated trustees APIN was already an accepted “BRAND” in the HIV/AIDS field in Nigeria and so we agreed to retain the name for the NGO

6. Honourable Minister of Health Professor Lambo launches the AIDS in Nigeria book for APIN Abuja, April 12, 2006

7. APIN supported NGOs including AIDS Alliancea national PLWHA network since 2002AIDS on Line - a weekly television program on AIDS

8. APIN - health clinic on Kuramo Beach Lagos, 2004

9. Companies Limited by Guarantee • Availability and reservation of name • Completion of registration forms • Payment of stamp duty to FIRS ($35) • Submission of MemArt of Association together with registration forms for verification and assessment • Getting the consent of the Attorney General of the Federation • Payment of filing fees to the Corporate Affairs Commission ($200)

11. AIDS Prevention Initiative Nigeria, Ltd./Gte. Mission Statement: To provide leadership in HIV/AIDS prevention, treatment, care and support in Nigeria through innovative strategies/programs and provision of evidence based and strategic information for service delivery and impact mitigation.

12. Governance • Multi layered Governance Structure (n=18) • Members (Trustees) • Directors • Officers (Non-Voting) • Transition Committee (n=6) • Temporary liaison between APIN Board and Harvard administration • Program Management team (n=50)

13. Shared Governance • The board and management engage in shared governance • All 3 governance modes applied by the board • Fiduciary • Strategic • Generative • Play significant advocacy roles with other key stakeholders Management Engagement High Board Engagement Low

14. Governance • Members and Directors • Represent Nigerian academic institutions, research institutes, non-governmental organizations and Persons Living with HIV/AIDS • Representatives from Senegal and Tanzania - bring expertise in HIV/AIDS implementation programs - provide south-south perspective • Harvard faculty members serve in their individual capacity and bring experience in HIV/AIDS research collaborations and PEPFAR programs in Africa

15. Organizational Governance Members (5) Directors (10) Officers (4) MEMBERS Professor Adetukunbo Lucas Professor Ibironke Akinsete Professor Souleymane Mboup Professor Michael Reich Professor Richard Marlink

16. Organizational Governance DIRECTORS Prof. Oladapo Ladipo Prof. John Idoko Prof. Saidi Kapiga Dr. Emmanuel Idigbe Dr. Jean-louis Sankalé Prof. Rob Murphy Prof. Wafaie Fawzie Dr. Wole Odutolu Mr. Farouk Mohammed Prof. Phyllis Kanki

17. Transition Committee • Temporary committee during transition period • Membership includes members of HSPH administration and APIN Ltd management • Deliberates on all issues pertaining to the implementation of APIN Ltd’s current subcontract with Harvard • Communication link between Harvard and APIN Ltd Board.

19. APIN Ltd committees Strategic Planning Committee Develop short and long term strategic plans Recommendations for technical, administrative and financial policy Fund-raising/Development Committee Advise Board on fundraising goals and priorities Develop fundraising plan Develop public relations and recognition program

20. Accomplishments - systems • A functional HR management system in place • HR policy manual • Pay structure with health and pension benefits • Financial management system strengthened • APIN Financial manual • Experience from multiple external financial audits (PWC) • Program Monitoring and Evaluation team • Regular quality improvement assessments at all sites • Monthly reporting by APIN - other reports are generated jointly with HSPH • Logistics Management Team • Drug and lab supply - supply chain management

21. Accomplishments - funding • APIN Ltd successfully applied for CDC RFA 07 - 730 as a PEPFAR care and treatment partner • APIN Ltd plans to expand from 2 to 6 sites for COP’09 submission • Successfully coordinating Harvard PEPFAR program in Nigeria as a sub-contractor • Applied and a provisional sub-recipient for Global Fund Round 8 funding • Finalizing discussion with Chevron Nigeria to provide technical support in Laboratory development

22. Challenges with……… • Delays in RFA funding • Uncertainties in funding from Global Fund • Difficulties with transition from Harvard to APIN Ltd. • Harvard and APIN Ltd lawyers are negotiating subcontract terms • Sustaining scale-up and high quality program during the transition

23. The Future • Continue to build systems and human capacity • Maintain the highest level of good business practice and high quality care and treatment • Improving access to services at the lower levels through APIN Ltd • Competing for funding to support operational research

24. Thank You