The President’s Emergency Plan for AIDS Relief (PEPFAR) was first announced by President George W. Bush during his 2003 State of the Union Address. In late 2003, Phyllis Kanki initiated the School’s Rapid Expansion of Antiretroviral Therapy Program application to PEPFAR and in 2004 became the Principal Investigator for the USG funded Harvard PEPFAR program. The grant to the Harvard School of Public Health was the largest government grant in Harvard University’s history. The School received a total of $362 million from PEPFAR for work which provided training, capacity building and targeted evaluation in Nigeria, Tanzania, and Botswana with the goal of scaling up access to antiretroviral therapy. In the first five years of the program, PEPFAR focused on establishing and scaling-up prevention, care and treatment programs and collaborating with local organizations that provided treatment for AIDS patients.

The project in Nigeria developed a comprehensive sustainable clinical HIV care and treatment program through the establishment and continuing support of clinical sites that provide anti-retroviral therapy (ART). Similar sites were established in Tanzania for the purpose of expanding and continuing ART. In Botswana the focus of the project was the development of Master Clinical Trainer Corps as well as the development of a strong national monitoring and evaluation system.

In 2011 the program began transitioning to in-country management with experienced and skilled local personnel facilitating all aspects of program design and implementation with the goal of providing a strong foundation for the long-term sustainability of the program. Success of the rapid scale-up objectives of the PEPFAR program have shown that strong collaborations can foster a culture of mutual respect, open communication, and objectives that support and integrate into national health programs.

In Nigeria the transition culminated in the establishment of AIDS Prevention Initiative in Nigeria (APIN) as an independent NGO, with the aim of building local capacity and sustainability of HIV/AIDS and other diseases programming in Nigeria. Presently, APIN operates as a direct implementing partner to CDC having just completed a 3-year transition from Harvard in line with the US Government’s goal of transitioning programs to local indigenous organizations.  In the four years since its operation as an implementing partner of the CDC, APIN has managed a cumulative budget of more than $50m, a reflection of the growing confidence of the USG that APIN has built enough systems to operate as an independent implementing partner of US funds.

APIN is one of the pioneers in the provision of comprehensive HIV/AIDS care in Nigeria. It currently supports the Federal Government of Nigeria to provide ARV care and treatment directly as a USG implementing partner to more than 74,000 patients in 33 treatment clinics and 75 primary healthcare centers in nine (9) states.  These clinics are equipped with state-of-the-art laboratories with capabilities for diagnosis and monitoring of HIV including CD4, viral load, DNA PCR and drug resistance monitoring (DRM). Similar giant strides have been made in prevention, systems strengthening, as well as in human and infrastructure capacity development efforts.