The organisation’s journey mirrors Nigeria’s own battle against one of the most devastating health challenges of the modern era—the HIV/AIDS epidemic.
From Harvard Project Office to Independent Nigerian Institution
APIN’s origins can be traced to the year 2000 when it was established as a programme management office for a grant awarded by the Bill & Melinda Gates Foundation to the Harvard T.H. Chan School of Public Health. At the time, Nigeria faced mounting concerns over HIV prevalence, which was approaching the critical five per cent threshold often regarded by public health experts as a danger signal.
For six years, APIN operated under Harvard’s framework, helping to develop systems and expertise in HIV programme implementation. However, 2007 marked a turning point. The organisation incorporated as an independent Nigerian non-governmental organisation and soon secured its first direct five-year grant under the United States Centers for Disease Control and Prevention (CDC)-President’s Emergency Plan for AIDS Relief (PEPFAR).
That milestone opened a new chapter. APIN would subsequently complete four additional PEPFAR HIV grant cycles, cementing its reputation as a leading health intervention organisation in Nigeria.
Fighting an Epidemic at a Critical Moment
The establishment of PEPFAR under former United States President George W. Bush was widely regarded as one of the most ambitious global health interventions of its time. Africa became the focal point of the initiative, with Nigeria occupying a strategic position because of its large population and rising HIV burden.
As Nigeria edged dangerously close to the HIV prevalence threshold that alarmed public health authorities worldwide, organisations such as APIN were selected to help drive interventions aimed at reversing the trend.
Today, the results tell a different story.
No longer operating as a Harvard-managed project, APIN has emerged as a fully Nigerian institution governed by a local board and funded directly by international partners and development agencies.
Correcting the Narrative on HIV/AIDS
One of the defining moments in APIN’s history came when the organisation sought to challenge widespread misconceptions about HIV prevalence in Nigeria.
Speaking during the launch of a book documenting Nigeria’s progress against HIV/AIDS, APIN’s Chief Executive Officer, Professor Prosper Okonkwo, explained why the organisation felt compelled to tell its story.
“We need to publish that book to show the whole world that rather than HIV/AIDS prevalence increasing in Nigeria, it was in fact decreasing, and people were getting more and more educated and informed about the virus,” Okonkwo said.
According to him, some reports suggesting a worsening epidemic were inconsistent with scientifically verified data being collected across the country.
Expanding Beyond HIV Treatment
APIN’s early work concentrated largely on tertiary health facilities across Nigeria’s six geopolitical zones. However, between 2008 and 2013, the organisation significantly broadened its reach.
Access to antiretroviral therapy (ART) expanded beyond major hospitals into urban, semi-urban, rural, and peri-urban communities. The programme increasingly integrated tuberculosis treatment, maternal and child healthcare services, prevention of mother-to-child transmission (PMTCT) initiatives, and paediatric HIV care.
Community-based support systems also became central to APIN’s approach. Home visits, peer-led treatment assistance, and adherence support programmes were introduced to ensure patients remained engaged in care.
The organisation simultaneously strengthened laboratory systems nationwide to support viral load monitoring in line with evolving PEPFAR guidelines.
Overcoming the Burden of Stigma
Despite its growing achievements, APIN faced a unique challenge: public perception.
As the organisation became synonymous with HIV interventions, many people began to define it solely through the lens of the epidemic.
Deputy Chief Executive Officer (Programmes), Dr. Jay Osi Samuels, recalled that period as one in which APIN struggled with a form of institutional stereotyping.
“People simply saw us as ‘the HIV organisation,’” Samuels said during a recent media interaction.
The perception prompted a strategic shift.
The 2016 Rebranding and a Broader Public Health Vision
In September 2016, APIN rebranded as APIN Public Health Initiatives, signalling a deliberate expansion beyond HIV/AIDS programming.
The new identity reflected a more holistic understanding of health and wellbeing. Programmes began incorporating family planning, nutrition, non-communicable disease management, and broader health system interventions alongside HIV services.
The organisation also adopted more patient-centred service delivery models, including multi-month drug dispensing and community-based ART refill systems designed to reduce the burden on patients while improving treatment outcomes.
At the same time, APIN intensified efforts to strengthen health systems through investments in data analytics, health information systems, supply chain management, and quality improvement mechanisms.
Governance structures expanded to include government agencies, donors, civil society groups, and representatives of traditional, religious, and community institutions to enhance accountability and sustainability.
Building a National Footprint
Today, APIN’s influence extends far beyond HIV programming.
The organisation has implemented interventions across 30 of Nigeria’s 36 states, addressing HIV/AIDS, malaria, tuberculosis, reproductive health, non-communicable diseases, and emerging public health threats.
It has also established research collaborations with leading academic institutions within and outside Nigeria, including Harvard T.H. Chan School of Public Health, Northwestern University, Rice University, Emory University, and Nigerian universities such as Lagos, Ibadan, and Jos.
Currently, APIN provides technical and administrative oversight to more than 440 HIV-supported healthcare facilities and supports approximately 320,000 patients receiving care and treatment.
The organisation also manages three major PEPFAR-funded projects, covering HIV prevention and treatment services across five states, operation of the national HIV public health information and data repository system, and support for Nigeria’s national reference laboratory through the Reliance Project.
Additional initiatives focus on neonatal healthcare technologies, cervical cancer prevention and treatment, and integrated disease surveillance systems.
Progress Toward the 95-95-95 Targets
APIN’s contribution to Nigeria’s HIV response is perhaps most visible in the country’s progress toward the globally recognised 95-95-95 targets.
The first target seeks to ensure that 95 per cent of people living with HIV know their status. Nigeria has already achieved this benchmark.
The second aims for 95 per cent of diagnosed individuals to receive treatment. Nigeria is steadily approaching that goal.
The third target focuses on ensuring that 95 per cent of people receiving treatment achieve viral suppression, thereby reducing transmission risks and improving quality of life. On this measure, health experts say Nigeria continues to record encouraging progress.
Creating Jobs and Strengthening Health Infrastructure
Beyond health outcomes, APIN’s impact can also be measured through its contribution to human capital development and employment.
The organisation currently supports nearly 4,000 jobs, including more than 400 direct employees and over 3,000 indirect workers.
Its support for 443 healthcare facilities nationwide has also strengthened service delivery at tertiary, secondary, and local government levels. Nearly 200 of those facilities receive direct assistance in capacity building and human resource support.
The ripple effects extend to household incomes, workforce development, and healthcare access across multiple communities.
A Model for Local Ownership
One of APIN’s most remarkable achievements has been its successful transition from foreign project management to local ownership.
Historically, international organisations receiving donor funding often established project offices in Nigeria while retaining administrative control abroad. Harvard adopted a different approach, investing heavily in Nigerian talent and local capacity development.
Rather than transferring samples overseas or relying on expatriate staff, the goal was to establish world-class healthcare systems and expertise within Nigeria itself.
Dr. Osi Samuels explained that this model ultimately aligned with changing donor priorities.
“These American organisations have what they call statutory charges for overhead. For every $1m they get, 40 per cent or even 60 per cent goes to overhead. So, if it is $100 they got from the US, they take about $60 or thereabout and use the remaining to do the work.”
He continued:
“At some point, the US government became dissatisfied with that because they wanted every dollar to be used on what it was meant for. So, they started encouraging the policy of asking the US institutions to transition to local partners so that the overheads would be eliminated, and more funds would be freed for the projects to be executed.”
When the transition policy took effect, APIN became the first Nigerian organisation to fully assume project management responsibilities previously handled by Harvard.
Between 2010 and 2012, financial management responsibilities were progressively transferred to APIN, culminating in direct funding from the US government.
Looking Ahead
A quarter-century after its establishment, APIN stands as a testament to what local capacity, strategic partnerships, and sustained commitment can achieve.
From its beginnings as a Harvard-managed project office to its emergence as a nationally recognised public health institution, the organisation has played a pivotal role in transforming Nigeria’s response to HIV/AIDS while broadening its reach to address wider public health challenges.
As it prepares to celebrate 25 years of service, APIN’s story is no longer simply about fighting HIV/AIDS. It is about building systems, developing people, strengthening institutions, and shaping the future of public health in Nigeria.
If the first 25 years were defined by survival, growth, and transformation, the next chapter may well be defined by even greater innovation, sustainability, and impact.