Biennial Report 2005-2006

D o i n g D e v e l o p m e n t D i f f e r e n t l y DD3 HeaPSI’s Measurablelth Health Impact

PSI is unusually focused on the bottom-line are an internationally accepted measure impact of its activities. Its philosophy is that of health impact and allow disparate although how interventions are done matters, interventions to be measured against each the positive impact they have on the lives of other. At the same time, each intervention the poor and the vulnerable is more important is assessed independently to estimate how still. As a result,Impac all interventions are measured many lives have been saved or improved. t and reported — often by a variety of means. These graphs provide a At a global level for internal use, PSI measures few examples of PSI’s For more information the number of Disability Adjusted Life Years estimated health impact on PSI’s health impact: (DALYs) gained across interventions. DALYs over the last five years. www.psi.org/health-impact

HIV Malaria HIV Infections Averted Malaria Episodes Averted

Child Survival Reproductive Health Diarrhea Episodes Averted Unintended Pregnancies Averted Nigeria

Contents

2 Report from the President○○○○○○○○○○○○○○○○○○○○○○○

Democratic Republic

4 Malaria ○○○○○○○○○○○ of Congo ○○○○○○○○○○

6 Reproductive Health ○○○○○○○○○○○ Family Planning Maternal Health

8 Child Survival ○○○○○○○○○○○○○ Safe Water Child Nutrition ○○○○○○○○○○○○ Dominican Republic

10 HIV ○○○○○○○○○○○○○○○○○○○○○○○○

12 Strategic Partnerships ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○ ○○○○○○○○○○ 14 Program Map

16 Board of Directors Senior Staff Thailand Country Representatives/Managers

17 Financial Report

NOTE: Starting on the next page, we present an image from every country where PSI serves, from Angola to Zimbabwe. All of these photos come from PSI or PSI-affiliated programs. They show the faces of our staff or the people we are reaching with health products, services and Uganda behavior change messages. Report from the President Doing Development Differently: D3

How Does PSI Do Development? • PSI catalyzes the marketplace to help poor people meet their health needs. We provide health products and services by making them widely available through a variety of private sector outlets, packaging them attractively, making them affordable through a subsidy and promoting them through communication, education and advertising. We raise consumer awareness and demand for products and services where little or no market existed previously. Most poor people cannot afford commercially- priced health products but the private sector can play an important role in meeting their health needs, and PSI mobilizes market forces to that end.

• We train employees of the companies and s the cover of this report indicates, PSI does organizations with whom we partner, development differently. A key element of enhancing capacities and helping them this is using commercial markets to help develop new health technologies, such as A low-income and vulnerable people meet insecticide-treated nets and household water their health needs. treatment. We franchise health providers and train them to perform better and Has It Worked? provide additional services. In 2005, PSI, in more than 60 countries Members of PSI’s with more than 7,000 employees, • We support national health programs of Board of Directors, prevented an estimated: the countries in which we work, follow the left to right: policies and regulations of their Malcolm Potts, • 212,000 HIV infections governments and interact regularly with Frank Carlucci, • 6.5 million unintended pregnancies them. Increasingly, we sell health products William Harrop, • 117,000 child deaths from malaria and services, particularly insecticide-treated John Pepper, and diarrhea nets, through public health clinics as this Frank Loy (chair), • 21 million malaria episodes can help us reach lower-income and rural Gail Harmon, people who do not have access to private Sarah Epstein, And we gave many more low-income sector outlets. M. Peter McPherson people the opportunity to avoid death and and Richard Frank. disability from other common diseases. •␣ PSI has a distinct bias toward action. We do our homework in the form of consumer 2

ANGOLA BELIZE BENIN BOLIVIA BOTSWANA research and then we act. Our research is a eventually deliver tangible results. Two prelude to action, not an alternative to action. examples of that innovation are that we now market more insecticide-treated nets •␣ We measure incessantly. Our than any organization and are a global leader measurement models, designed by health in household water treatment. experts, are among the best available, and we work constantly to refine and improve •␣ PSI benefits from a variety of strategic them. They help us answer the important partnerships (described in more detail on questions: what measurable impact was a Page 12). For example, we have joined forces direct result of PSI’s work, what is our with Procter & Gamble to distribute one of

efficiency, what is our rate of improvement its health products, PUR Purifier of Water. Photo by Tom Williams and which interventions have the greatest Another example is our YouthAIDS program PSI Board Member health impact? Recent efforts by others to that not only stimulates charitable Ashley Judd and judge the cost-effectiveness of health contributions to support HIV prevention, but Dr. Anthony Fauci interventions show clearly that PSI’s health also attracts celebrities, most notably our both testified on interventions are among the most cost- YouthAIDS Global Ambassador Ashley Judd, HIV/AIDS issues effective in the world. who has promoted good health and HIV/ before the Senate AIDS awareness on visits to PSI programs in Foreign Relations •␣ Efficiency is another element of doing Cambodia, Central America, Kenya, Committee in 2005. development differently. More than 93 cents Madagascar, South Africa and Thailand. of every dollar of PSI revenue goes directly to programs. Efficiency also means we focus D3 Works for Us on what can be replicated at significant We do not claim that our approach is the scale, thereby reaching the largest numbers only or best way to do development, or that of people possible at the lowest cost. every organization should do it. But we have found that it has worked for us in virtually •␣ PSI gives its overseas staff a great deal of every country where we have tried it. latitude. That attracts and retains the best Whether we are preventing malaria, HIV, talent available. These managers know that unintended pregnancy, diarrhea or anemia, good intentions alone do not translate into our private sector approach allows us to results. Their job satisfaction comes from serve the health needs of low-income and knowing that PSI’s products, services and vulnerable people effectively, efficiently and communication campaigns have significant successfully. results. For example, the insecticide-treated nets we market actually reach poor children and pregnant women and protect them from malaria.

•␣ We pride ourselves on innovating and Richard A. Frank experimenting, yet these innovations must President 3

BURKINA FASO BURUNDI CAMBODIA CAMEROON CENTRAL AFRICAN REPUBLIC 4 Photo by Greg Allgood, P&G CHINA COSTA RICA CÔTE D’IVOIRE DEM. REP. OF CONGO DOMINICAN REPUBLIC Malaria

Between 350 and 500 million episodes of delivered at heavily subsidized prices through malaria occur each year, resulting in between the commercial sector. In Asia, doses for older one and two million deaths. Most deaths occur children and adults are also subsidized as they among rural African children under five who too are at risk of malaria death. Product do not sleep under insecticide-treated nets packaging in both markets is developed in local (ITNs) and whose parents can’t obtain languages and includes low-literacy instructions. treatment in a timely manner. Private sector drug providers are trained using In addition to distributing ITNs to prevent locally developed curricula adapted from the illness, which accounts for the majority of national malaria guidelines. Product delivery is the 21 million malaria episodes that PSI supported by intensive estimates its programs averted in 2005, PSI behavior change also makes accessible effective products that campaigns to improve PSI’s 2005 Estimated Health Impact treat the most vulnerable. PSI is scaling up its treatment-seeking malaria treatment efforts in 2006 and 2007 and behavior (e.g. expects an increasing amount of its malaria symptom recognition 84,000 health impact to come from the treatment and prompt response) side. However, several issues must be dealt and adherence to the with in order to ensure that the most treatment regimen. Child Deaths vulnerable have access to effective treatment: In 2005, PSI distributed over 3.6 Averted • Typically, most people obtain treatment million malaria outside the public health sector, such as treatments in Africa pharmacies and drug stores. Therefore, in order and Asia and is rapidly expanding home-based for home-based management of malaria — malaria management programs in Africa in 2006 recommended by the World Health Organiza- and 2007. tion — to be successful, treatment must also On the prevention side, PSI works in be made available through the commercial partnership with ministries of health, Roll Back sector. Malaria partners and donors. In 2005, PSI delivered over 8.4 million ITNs, most of which • The treatment itself must be upgraded from were long-lasting nets like PermaNet in Nigeria less effective monotherapies, such as (photo, left). These nets, which have been shown chloroquine, to the more effective artemisinin- to reduce mortality by 18% in children under five based combination therapy (ACT). years, were delivered through public sector clinics, commercial outlets and other appropriate • And, since ACTs are about 10 times more channels. In particular, PSI’s ITN programs in expensive than the monotherapies they Malawi and Kenya will ensure that those replace, a heavy subsidy is essential. governments achieve the Abuja ITN coverage target by 2010. In addition, PSI delivered PSI is addressing each of these issues in 10.5 million net retreatment kits in 2005 For more information Africa by developing multi-dose, pre-packaged to ensure that non-permanently treated on Malaria: ACT products for children under five to be nets already in use remain effective. www.psi.org/malaria 5

EL SALVADOR ETHIOPIA GHANA GUATEMALA GUINEA 6 Photo by Greg Allgood, P&G HAITI HONDURAS INDIA KAZAKHSTAN KENYA Reproductive Health

Every year, there are 66 million unintended men and young adults. Combining information and pregnancies and more than 500,000 women services is also more convenient to clients, reducing die from pregnancy-related causes. Almost all the need for visits to other health offices. For ex- of these deaths take place in developing coun- ample, PSI/Myanmar’s Sun Quality Health Clinics tries, where the lifetime risk of pregnancy- offer both family planning and HIV/AIDS services. related death averages one in every 65 women. Since the launch of male condoms in Kenya in PSI’s reproductive health programs focus on 1972, PSI’s family planning portfolio has grown to improving the lives of families in the develop- include a range of oral and injectable contraceptives, ing world through family planning and mater- IUDs, emergency contraceptives, vasectomy and nal health products and services. natural family plan- ning methods such as Family Planning the Standard Days PSI’s 2005 Estimated Health Impact Healthy timing and spacing of pregnancies Method using is recognized as a significant health-improving CycleBeads. In 2005, and life-saving measure for mothers and PSI programs provided 6,500,000 children. PSI’s programs in reproductive health 11.4 million couple increase knowledge of birth spacing and access years of protection to a range of affordable, quality reproductive against pregnancy, Unintended health products and services, including natural averting an estimated methods. 6.5 million unintended Pregnancies Averted In the coming decade, rising demand for pregnancies and 12,000 contraceptives is expected to surpass donor maternal deaths. funding. Contraceptive social marketing represents one promising and cost-effective Maternal Health approach that can help fill this gap, acting as a PSI also offers products to address specific aspects bridge between free or highly subsidized public of maternal health. The WHO estimates that 43% of sector programs and commercial approaches. all women of reproductive age living in developing Products and services are sold rather than countries suffer from iron deficiency, so PSI markets given away. When those who are able move multivitamins with iron and folic acid to women of away from public sector subsidies by assuming reproductive age in the Dominican Republic, India, a small share of the cost, limited public sector Pakistan, Paraguay, Togo and Zambia. funds can be channeled to help individuals A significant portion of the four million worldwide with other needs. neonatal deaths are caused by sepsis acquired during PSI is maximizing scarce family planning childbirth. In countries with the majority of births resources through greater integration of family happening in homes, clean delivery kits provide a planning with other health programs, such as sterile razor to cut the umbilicus and a clean clamp or HIV prevention or voluntary HIV counseling cord tie which prevent tetanus-causing spores and and testing. In addition to increasing cost- other infections. Additional contents effectiveness, this allows PSI to reach audi- include a clean plastic sheet, sterile For more information on ences that might otherwise be overlooked by gloves, soap and pictorial instructions Reproductive Health: traditional family planning programs, such as on infection prevention. www.psi.org/reproductive-health 7

KYRGYZSTAN LAOS LESOTHO MADAGASCAR MALAWI 8

MALI MEXICO MOZAMBIQUE MYANMAR NAMIBIA Child Survival

In the developing world, dehydration caused by Water Treatment Tablets: This solid form of safe diarrhea kills roughly 1.8 million children every water solution is easy to transport, has a long year. Rampant micronutrient deficiencies among shelf life and can be sold in small quantities. infants and young children can cause irreversible cognitive and physical impairment. And soil- As of December 2005, these PSI products had transmitted parasitic worms cause wasting and treated over 23 billion liters of household other conditions. PSI’s child survival programs drinking water, averting an estimated 36.2 offer knowledge and products that save lives and million cases of diarrhea and more than 100,000 improve the health of children. child deaths.

Safe Water Treating Dehydration Caused by Diarrhea Preventing Diarrhea through Oral Rehydration Salts and Zinc Supplements: Household Water Treatment Since 1985, PSI has treated dehydration through Despite the billions of dollars spent on oral rehydration salts (ORS). ORS rapidly re- infrastructure each year, more than one billion stores lost body people still lack access to clean water. PSI fluids and electro- addresses this problem with three innovative, lytes. In Cambodia PSI’s 2005 Estimated Health Impact practical and cost-efficient water quality inter- in 2006, PSI ventions: safe water solution, PUR and water started marketing treatment tablets. zinc supplements, 11,000,000 which can reduce Safe Water Solution: A dilute chlorine solution the severity and developed by the U.S. Centers for Disease duration of diar- Diarrhea Episodes Control and Prevention, safe water solution rhea. provides clean drinking water for a family of six Averted for a penny or less per day. The product is Child Nutrition manufactured entirely in the country where it is Sprinkles: distributed. PSI conducts communication Sprinkles flakes are mixed into children’s campaigns to encourage proper water treatment, porridge or milk to prevent iron deficiency that storage and hygiene. can lead to impairment of cognitive growth.

PUR Purifier of Water: Developed by Procter & De-worming: An estimated 300 million people, Gamble, PUR is a powder that purifies water and 50% of them school-aged children, are severely ill extracts solid matter including parasites, worms or suffer from micronutrient deficiencies due to and heavy metals. PUR uses the same technol- worm infections. A single-dose tablet taken twice ogy as a water treatment facility in a developed per year is a highly cost-effective intervention. country, but is individually packaged, allowing the user to treat water easily and affordably in For more information the home. PUR is especially effective in areas where people take their water from surface or on Child Survival: muddy sources. www.psi.org/child-survival 9 Photo by Greg Allgood, P&G

NEPAL NICARAGUA NIGERIA PAKISTAN PANAMA 10

PARAGUAY REPUBLIC OF CONGO ROMANIA RUSSIA RWANDA HIV

In 2005, almost five million people were newly- campaign developed by PSI and running in 17 infected with HIV and 3.1 million died from African countries promotes the concept that AIDS. PSI’s prevention programs in more than “real men” do not coerce women into sex, that 60 countries increase knowledge and self-risk real men respect women. perception while promoting healthy social Similarly, throughout Eastern Europe, norms such as respect for women, sexual where injecting drug use is driving the responsibility and compassion for those living epidemic, PSI has developed social marketing with HIV. programs that target the social norms that lead PSI uses balanced strategies that are youth to experiment with injecting drug use. appropriate for different groups. Abstinence and Such programs delay of sexual relations are promoted to young involve traditional people not yet sexually active. PSI programs tools of marketing, PSI’s 2005 Estimated Health Impact promote fidelity for monogamous couples in including mass which both partners have confirmed their HIV- media, interpersonal negative status. Condoms are promoted to high- communication and 212,000 risk groups and members of the general the use of billboards population exhibiting high-risk behavior. and printed materials. Voluntary HIV counseling and testing is Another key HIV Infections encouraged for the general population, and aspect of PSI’s HIV sometimes, as with truck drivers in India, for behavior change Averted certain high-risk groups. programs is how they PSI focuses on changing destructive and are targeted at unhealthy social norms that encourage specific audiences. For instance, in transactional and violent sex. Sexual violence concentrated epidemics, where few in the and sexual relationships between older men and general population are at risk of HIV infection, younger women, dubbed “cross-generational PSI targets high-risk groups such as sex,” generally are driven by social norms commercial sex workers and their clients, which debase women. The impact of these injecting drug users and mobile populations. deeply rooted norms results in HIV infection In high-prevalence settings, where everyone is rates among young women which are up to six at risk, PSI is likely to focus on both high-risk times higher than those of their same age male groups and the general public. Communication peers, as well as high levels of sexual violence channels are carefully selected in order to and coercion among of women of all ages. To ensure reception by the particular groups change these destructive norms, a regional targeted.

For more information on HIV: www.psi.org/HIV 11

SÃO TOMÉ & PRÍNCIPE SOUTH AFRICA SOUTHEASTERN EUROPE SUDAN SWAZILAND Strategic Partnerships

Strategic partnerships play a crucial role in PSI’s success product plus various packaging and delivery costs, in six worldwide. The type and scope of these partnerships countries (as of July 2006). It is called the “miracle vary greatly — public and private, national and product” because it transforms even the dirtiest water international — and the possibilities are almost endless. into clear and potable water in just 25 minutes. Two examples of international partnerships — one with But the partnership is about much more than a Procter & Gamble, the other through PSI’s YouthAIDS product: cause-related marketing initiative — have added greatly to PSI’s impact around the globe. • Many of P&G’s 140,000 employees have learned about PSI through a corporate blog and lent their personal Procter & Gamble support to PSI for disaster relief after the Asian tsunami PSI’s partnership with Procter & Gamble joins the and the Pakistan earthquake. respective talents and strengths of the world’s largest consumer products company with those of the world’s •␣ The alliance has brought John Pepper, the former largest social marketing organization to bring PUR chairman and CEO of P&G, onto PSI’s Board of Purifier of Water, a life-saving household water Directors. treatment product, to lower- income people in the developing world. This is the first time in its corporate • A group of retired P&G senior officers has spearheaded history that P&G has permitted an outside entity to a fund-raising drive that has provided more than handle its brand. The partnership leverages P&G’s $600,000 to support PSI’s water programs. cutting edge technology with PSI’s knowledge of markets in the developing world. P&G provides PUR to •␣ The alliance has attracted support from the United PSI at cost, which is then sold by PSI, at the cost of the States Agency for International Development, the British Department for International Development and UNICEF.

•␣ Through a cause-related marketing plan, 50 million American households will have the opportunity to buy a PUR water filter at a local retail outlet and, as a result, provide PSI/Kenya the means to give children in Kenya a year’s worth of safe drinking water.

•␣ The P&G Fund has supported PSI hygiene education in the Democratic Republic of Congo, Ethiopia, Kenya and Uganda.

The Wall Street Journal and the Associated Press have written about the innovative collaboration. Top business schools like Harvard and INSEAD are writing case studies on it.

Photo by Greg Allgood, P&G In addition to P&G, PSI is proud to be partnering Ugandan youth use Procter & Gamble’s PUR product with other leading corporations in HIV/AIDS and 12 to quickly and easily cleanse contaminated water. malaria prevention including Alcoa, British Petroleum, Coca-Cola, ExxonMobil, Merck and Pfizer.

TAJIKISTAN TANZANIA THAILAND TOGO TRINIDAD & TOBAGO/CARIBBEAN YouthAIDS black-and-white images shot by world-renowned YouthAIDS, an education and prevention initiative photographer Peter Lindbergh that portrayed the of PSI, uses media, pop culture, music, theatre and sport celebrities and “Empowerment Tags” in unexpected and to prevent HIV infection among youth by providing a provocative ways. global platform for corporations, the entertainment The Empowerment Tags were engraved with industry and individuals to contribute to the fight “Hear,” “See” or “Speak” on one tag, and the AIDS against HIV. ribbon on the other. The tags were sold at ALDO stores Since the inception of YouthAIDS in 2001, it has and on www.youthaids-aldo.org with 100% of the net forged strategic partnerships with corporations and the proceeds benefiting YouthAIDS. The result: over media industry that create inspiring and informative $1,000,000 raised and over one billion media vehicles for messages of hope and protection from HIV impressions. infection. Consumer activism is a rising trend: Following on that according to the 2004 Cone Corporate Citizenship success, ALDO and Study, eight out of ten Americans say that corporate YouthAIDS collaborated support of causes inspires their trust in that company, a again in 2006. Within the 21% increase since 1997, and 86% say they will switch first two months, over from one brand to another if the other brand is $800,000 had been raised associated with a cause. and millions of media YouthAIDS develops cause-related marketing impressions reported. campaigns, proprietary program initiatives and event In addition to corporate sponsorships to raise awareness and critical funding for marketing, YouthAIDS PSI programs targeting youth. The benefits of these rallies support from leading strategic partnerships for the corporations include celebrities to participate in access to target markets such as women and youth ages their mission. Actress and 15-24, improved brand recognition and public image, PSI Board Member Ashley celebrity endorsements and enhanced employee Judd serves as the satisfaction. Successful cause-related marketing YouthAIDS Global campaigns have been developed with corporations Ambassador, promoting including Roberto Coin, Kiehl’s Since 1851, Levis, PSI’s youth-targeted HIV Anthropologie and the ALDO Group Inc. programs through media In 2005, YouthAIDS achieved massive success with interviews, appearances, global fashion footwear and accessories brand ALDO. fundraising and celebrity “Hear No Evil, See No Evil, Speak No Evil” was a global endorsements. She was cause marketing campaign seen by millions in major joined by other YouthAIDS celebrity supporters such as markets including Johannesburg, London, Los Angeles, Wynonna Judd, Josh Lucas, Emmy Rossum, Juanes, Montreal, New York, San Francisco, Singapore, Sydney Avril Lavigne, Christina Aguilera, Cindy Crawford and and Toronto. Salma Hayek (above, in a poster from the ALDO The campaign, to which Hollywood elite and the campaign). music industry’s leading talent donated their time, For more information sought to educate and empower young people regarding on YouthAIDS: HIV. The centerpiece of the campaign was a series of www.youthaids.org 13

UGANDA UZBEKISTAN VIETNAM ZAMBIA ZIMBABWE PSI Countries PSI Country Programs

Angola and their Products and Services Belize (As of July 2006) Benin Bolivia Bosnia/Herzegovina Botswana Bulgaria Burkina Faso Burundi Cambodia Cameroon Central African Republic China Congo-Democratic Republic Congo-Republic

Costa Rica ¥ PSI/Washington Côte d'Ivoire Croatia Dominican Republic El Salvador Ethiopia Ghana Guatemala Guinea

Haiti MEXICO Honduras India

Kazakhstan DOMINICAN REPUBLIC Kenya HAITI Kyrgyzstan BELIZE Laos GUATEMALA HONDURAS Lesotho Madagascar EL SALVADOR NICARAGUA

Malawi TRINIDAD & TOBAGO/ CARIBBEAN Mali COSTA RICA Mexico PANAMA Mozambique Myanmar Namibia Nepal Nicaragua Nigeria Pakistan Panama Paraguay Romania Russia Rwanda São Tomé and Príncipe South Africa BOLIVIA Sudan 14 Swaziland Tajikistan Tanzania PARAGUAY Thailand Togo Trinidad & Tobago/Caribbean Uganda Uzbekistan Vietnam Zambia Zimbabwe RUSSIA

¥ PSI/Europe

ROMANIA CROATIA

BOSNIA/ KAZAKHSTAN HERZEGOVINA ¥

BULGARIA UZBEKISTAN KYRGYZSTAN

TAJIKISTAN

CHINA

NEPAL PAKISTAN

INDIA

MYANMAR

LAOS MALI

THAILAND VIETNAM SUDAN

BURKINA FASO CAMBODIA

GUINEA NIGERIA

GHANA ETHIOPIA

CôTE D'IVOIRE CENTRAL AFRICAN REPUBLIC

CAMEROON

UGANDA TOGO CONGO-DEMOCRATIC REPUBLIC KENYA SÃO TOMÉ/ PRêNCIPE RWANDA CONGO-REPUBLIC BENIN

BURUNDI TANZANIA

ANGOLA

MALAWI HIV/AIDS ZAMBIA Reproductive Health Family Planning MOZAMBIQUE Maternal Health ZIMBABWE 15 NAMIBIA Malaria MADAGASCAR Child Survival BOTSWANA Safe Water Child Nutrition

SWAZILAND

SOUTH AFRICA LESOTHO Board of Directors Senior Staff Country Representatives/Managers

Frank Loy, Chair Richard A. Frank Angola: Tim Neville Former Under Secretary of State for President and Chief Executive Officer Benin: Brian Dotson Global Affairs Soumitro Ghosh U.S. Department of State Peter Clancy Botswana: Washington, DC Chief Financial Officer (acting) Burkina Faso: Mary Warsh (Program Chief Operating Officer Manager) Rita I. Bass Executive Vice President, Programs Burundi: Isabelle Walhin Chief Executive Officer Regional Director, Nigeria MEDIBANC, Inc. Cambodia: Andrew Boner Denver, Colorado William Warshauer Cameroon/Central African Republic: Executive Vice President, Resources and Theresa Gruber-Tapsoba Frank Carlucci Strategy Caribbean: Pamela Faura Chairman Emeritus The Carlyle Group Sally Cowal Central America: Michael Holscher Washington, DC Senior Vice President, Child Survival Central Asia: Marty Bell and Public Affairs China: Grace Hafner Sarah G. Epstein Regional Director, Eastern Europe, Côte d’Ivoire: Didier Adjoua Population Consultant Latin America and the Caribbean Washington, DC Dominican Republic: Elizabeth Beachy David Reene Democratic Republic of Congo/Republic Richard A. Frank Senior Vice President of Congo: Sean Mayberry President and Chief Executive Officer Regional Director, Asia Ethiopia: Daniel Crapper Population Services International Washington, DC Steven Chapman Guinea: Angelika Kobilke Vice President, Research Haiti: Sam Nganga Gail McGreevy Harmon India: Tim McLellan Partner Kate Roberts David Walker Harmon, Curran, Spielberg & Eisenberg, Vice President, Cause-Related Marketing Kenya: LLP Laos: John Deidrick Washington, DC Jill Shumann Lesotho: Daniella Fanarof Vice President Madagascar: Doug Call William C. Harrop Regional Director, West and Central Former U.S. Ambassador to Guinea, Africa, Haiti Malawi: John Justino Israel, Kenya and Zaire and Inspector Mali: Steve Lutterbeck General of the U.S. Department of State John Berman Mexico: Olivier Le Touzé and the Foreign Service Senior Director, HIV/AIDS Division Mozambique: Brian Smith Washington, DC Françoise Armand Myanmar: Guy Stallworthy Adriaan Jacobovits de Szeged Director Namibia: Libet Maloney Former Netherlands Ambassador to the Nepal: Steve Honeyman United States Desmond Chavasse Nigeria: Bright Ekweremadu The Hague, The Netherlands Director, Malaria Control Pakistan: Victor Lara (acting) Ashley Judd Donna Diane REsulTS Initiative: Dhaval Patel Actor/Activist Controller Romania: Clayton Davis Franklin, Tennessee Russia: Anna Fedorova Chastain Fitzgerald M. Peter McPherson Director, New Business Rwanda: Staci Leuschner Founding Co-Chair, Partnership to Cut São Tomé and Príncipe: Brian Wagner Hunger and Poverty in Africa and Jeff Govert South Africa: Katie Schwarm President Emeritus, Michigan State Director, Information Services Alison Malmqvist University and Facilities Sudan: Washington, DC Swaziland: Agai Jones Brad Lucas Tanzania: Nils Gade Gilbert Omenn, M.D. Director, New Product Development Thailand: John Hetherington Professor of Internal Medicine, Human Genetics and Public Health David McAfee Togo: Manya Andrews University of Michigan Regional Director, Southern Africa Uganda: Rodio Diallo Ann Arbor, Michigan Vietnam: Chris Jones David Negus Zambia: Cynde Robinson John E. Pepper Director, Overseas Financial Operations 16 Former CEO and Chairman Zimbabwe: Michael Chommie Procter & Gamble David J. Olson Cincinnati, Ohio Director, Public Affairs Bolivia: Ramiro Claure Malcolm Potts, M.D. Grace Roache Bixby Professor, School of Public Health Director, People Paraguay: Sonia Marchewka University of California, Berkeley Berkeley, California Lisa Simutami Director, Procurement and Logistics Mechai Viravaidya Chairman Barry Whittle Population and Community Develop- Regional Director, East Africa ment Association Bangkok, Thailand Financial Report

PSI Administrative Costs As a percent of Revenue t Commodities included

Population Services International Statements of Activities For the years ended December 31, 2005 and 2004 2005 Totals 2004 Totals Revenue, gains and other support: Grants, fees, program income and other support from: U.S. government $122,642,406 126,643,863␣ ␣ Non-U.S. governments 101,184,433 78,291,758␣ ␣ International organizations 35,871,637 21,157,293␣ ␣ Foundations and corporations 12,711,448 8,487,814␣ ␣ Other sources 13,353,581 8,922,972␣ ␣ Contributions 7,715,325 3,166,514 ␣ ␣ Total grants, fees, program income and other support 293,478,830 246,670,214 ␣ ␣ Investment and other income 875,168 307,900␣ ␣ Foreign currency translation gains (losses), net (2,442,010) 1,617,465␣ ␣ Total support, other revenue and gains 291,911,988 248,595,579␣ ␣ Expenses: Program services expenses 262,536,329 220,921,656␣ ␣ Management and general expenses 17,241,299 14,740,956␣ ␣ Fundraising expenses 1,138,661 847,585 ␣ ␣ Total expenses 280,916,289 236,510,197 ␣ ␣ Change in net assets 10,995,699 12,085,382 ␣ ␣ Net assets, beginning of year 35,809,569␣ ␣ 23,724,187 ␣ ␣ Net assets, end of year* $ 46,805,268 35,809,569␣

*Note: Approximately fifteen percent of PSI’s 2005 net assets are restricted for program activities in future years. Of the remainder, approximately $35 million is used as working capital, and the balance to launch new initiatives or sustain ongoing programs facing funding gaps.

The figures above have been excerpted from statements and schedules issued by PSI’s external auditors. Copies of our audited statements are available upon request, from PSI in Washington, DC. Population Services International 1120 19th Street, NW Suite 600 Washington, DC 20036 Phone: 202-785-0072 Fax: 202-785-0120 E-mail: [email protected] www.psi.org

PSI/Europe 2nd Floor, Downstream Building Mezzanine 2 1 London Bridge London SE1 9BG United Kingdom Phone: +44 20-7022-1880