1 WHERE WE WORK

2 4 ANNUAL REPORT 2016 We go. We make house calls. We build health systems. We stay. dear friends,

When first responded to the government’s invitation to go to , we weren’t thinking much about cancer. We certainly weren’t thinking of Contents it as a disease that we could treat effectively with our most basic infrastructure still in its infancy, in a country without a single oncologist, without diagnostic pathology, and with no available chemotherapy.

But from the moment we opened our doors there, in 2005, cancer patients flooded Together in from all over—many of them children with advanced disease. It was an unusual position for PIH to find itself: our organization had grown used to running toward the We . We make . We build . We . go house calls health systems stay 4 fire, and now the fire was running toward us. We had to find a way to treat cancer where few had before. Snapshot One of our early patients was a 7-year-old named Sibo Tuyishimire. He’d spent two years feeling hopelessly ill before his family was able to bring him to our A look at our work in Liberia. 14 hospital. PIH doctors soon diagnosed him with Hodgkin’s lymphoma and set him on course to a full, if difficult, recovery. CEO Dr. Gary Gottlieb visits Peru for the site’s 20th anniversary celebration. You + Sibo was kind enough to drop by our office over the holidays. Now, nearly Photo by William Castro Rodríguez a decade in remission, he’s applying to high school here in the U.S. It’s pretty You make our work possible. 16 remarkable that he’s alive—and it’s thrilling that he is thriving with a great future ahead of him. It’s even more remarkable that our cancer program in Rwanda, today a beacon of hope for all of East Africa, might never have existed if not for Sibo and his Financials family—and many people like them—having the guts to stand up, walk through our Our fiscal year summary. 28 door, and say, “This is what we need.” Thank you all for hearing that call and answering it with your own unfettered support, in Rwanda and all around the world. The stories that follow in this year’s Leadership annual report testify, in many different ways, to the power that grows from the Our board, officers, and country directors. act of listening. It is the most essential element of empathy and the backbone of 32 accompaniment and caregiving. With these pages we offer our gratitude for the privilege of knowing each patient’s voice, collecting it with yours, and forging in their union a better way to spread care and kindness to the people who need it most.

In solidarity and with great warmth,

.

Previous page: (from left) Social worker Laurence Mukantaganda, oncology program coordinator Jean Bosco Bigirimana, and a community health worker walk to a patient’s home in Burera District, Rwanda. Photo by Cecille Joan Avila Dr. Gary L. Gottlieb, M.D., MBA Chief Executive Officer 7 Together

We go We make house calls We build health systems We stay

8 Social worker Laurence Mukantaganda visits breast cancer survivor Elisabeth Nyiramana in her home in Burera District, Rwanda. 9 Photo by Cecille Joan Avila We go We TOGETHER, WE GO / We make house calls / We build health systems / We stay

hen Hurricane Matthew began lashing a father with HIV, that’s an emergency. And when Partners In Health works in remote places where is limited or barely exists. ’s southwest corner last October, there are no to fight a teenager’s cancerous Wwe—like many of you—knew the tumor, that’s an emergency. devastation would be profound. And indeed it was: 1,000 lives lost, 15,000 people displaced, and a sharp spike in the number of people needing health care— PIH isn’t a disaster relief organization by including those suffering from cholera. conventional standards. But to most of our patients, we are that and more. Because of our long history in the country, we could respond immediately, partnering with local and national Haitian officials to support Les Cayes’ Immaculate Conception Hospital, the sole public The disasters we see are generational, and that’s why facility for that region’s 1.5 million people. We your partnership is so vital. With your support this repaired the roof and other structures damaged year, we’ve been able to continue solving complex, by the storm, purchased a generator that provides longstanding health challenges in ways that improve electricity 20 hours a day, and installed a chlorine lives and communities. machine that helps decontaminate and maintain sanitation in wards. We’re using new tools, for example, to battle an often deadly strain of tuberculosis. As collaborators in a We also supported a nearby cholera treatment center project called endTB, we’re bringing the first new by providing medications and supplies. Perhaps tuberculosis drugs developed in 50 years to patients most significantly, we helped Haiti’s Ministry of in 14 countries—this year in Peru, Lesotho, and Health in its vaccination campaign against cholera. In Kazakhstan. November, 729,000 people received a vaccination— which means mothers, fathers, and children are safe We also began a new partnership with the Sicangu from a diarrheal disease that can kill within 24 hours. Lakota Nation, applying what we’ve learned in the Navajo Nation to help strengthen the health care That’s impact. system of this 27,000-member tribe in southern South Dakota. Partners In Health isn’t a disaster relief organization by conventional standards. But to most of our Your help enables us to go where we’re needed. patients, we are that and more. When a mother Together, we’re showing how comprehensive, doesn’t have enough food for her malnourished child, sustainable health systems can transform lives all that’s an emergency. When there is no doctor to treat over the world.

10 PIH co-founder Dr. Paul Farmer stands with Mirlande Estenale in front of her collapsed home in Les Cayes, Haiti, following 11 Hurricane Matthew. Photo by Elizabeth M. Campa We go / We make house calls / We build health systems / We stay

TOGETHER, WE MAKE HOUSE CALLS Partners In Health visits patients in their homes to deliver medication and guide them through treatment.

ur efforts to tackle the Ebola virus in West proved vital in finding these survivors and getting Africa were among the most challenging them to treatment. Ultimately, we screened 3,058 Oin our history. When the number of new Ebola survivors and treated 379 for uveitis. Ebola cases finally dropped in Sierra Leone, it was a welcome relief. These are the transformations we strive for, and see, daily. And it’s because of our community-based But soon we learned of a new problem facing Ebola model that our care is successful. In our work around survivors. An increasing number suffered from an eye the world, we visit people in their homes to check disease called uveitis, an inflammation of the eye that, vital signs, encourage them to take their , if left untreated, can lead to blindness. and determine when they need more advanced care. Then we connect them with that care. Thousands of people had survived one of the worst epidemics in the world, only to face the loss of their vision. “People helping people. That’s what I We needed to find as many Ebola survivors as do,” says Mohamed Lamin Jarrah, a possible and screen them for uveitis. Roughly 100 of community health worker in Kono our community health workers, many of them Ebola District, Sierra Leone. “There are survivors themselves, fanned out across the district in thousands like me, willing to do the which we work to spread the word about uveitis and hardest work there is.” its risks.

Going house to house, they convinced neighbors and community members wary of doctors and hospitals “People helping people. That’s what I do,” says to come to an eye clinic we had established with the Mohamed Lamin Jarrah, a community health worker Ministry of Health. In just one month, we screened in Kono District, Sierra Leone. “I have witnessed the 277 people and successfully treated 50 more for darkest moments of my neighbor’s life, and I have uveitis. seen the joy of relief in their eyes. There are thousands like me, willing to do the hardest work there is.” Based on our success, we worked with government and international partners to expand this work You are an integral part of this work. With your nationally. In June, we coordinated screenings and partnership, we provide the kind of one-on-one care treatments for Ebola survivors across the country, in that heals and saves lives. As you accompany us, we every district. Again, our community health workers accompany our patients.

12 Community health worker Mohamed Lamin Jarrah transports Elizabeth Mbayoh to the Lengema Health Clinic for medication. 13 Photo by Jon Lascher Partners In Health works closely with national governments and other partners to improve and expand health services. We go / We make house calls / We build health systems / We stay TOGETHER, WE BUILD HEALTH SYSTEMS

he baby boy arrived 14 weeks early and medicine, family medicine, and pediatrics. Last year weighed less than 2 pounds. Thamar Julmiste, alone, 37 residents enrolled in the programs. We’re Ta nurse at St. Thérèse Hospital in Hinche, Haiti, also training nurses and community health workers in immediately noticed he wasn’t breathing. Luckily, she Liberia and elsewhere. and a colleague knew what to do. They performed CPR on the tiny newborn and were relieved to see his birdlike ribcage rise and fall on its own. Everyone deserves the best level of “People didn’t think he was going to live,” Julmiste care. But that’s only possible when recalled. But he did. health professionals receive the best level of training. Julmiste followed what she and her colleagues learned during a training for nurses in neonatal intensive care. Two more groups of nurses from around the country have since studied the same theory and clinical skills We’re expanding our non-clinical education as in a free training at University Hospital in Mirebalais. well. Last year, our first class of students at the They are the first among a growing group of neonatal University of Global Health Equity in Rwanda began and pediatric intensive care nurse specialists in Haiti. their graduate degree in Global Health Delivery, which focuses on how to create national health care Like Julmiste’s tiny patient, everyone deserves the systems in developing countries. Lecturers from the best level of care. But that’s only possible when Ministry of Health, , and health professionals receive the best level of training. other institutions taught students everything from Because strong health systems depend on strong epidemiology to budget management. Nearly 250 “human systems,” we are intent on bringing the professionals from around the world have applied resources of leading medical institutions directly for 27 spots in the third class, which will start in to the communities we serve, building each local September. workforce of health professionals according to the highest standard of care. This is lasting work, made possible by compassionate, committed people like you. Thank you for giving Besides trainings for nurses, our medical residency your time and resources. Because of you, we are programs in Haiti continue to welcome new doctors well-positioned to deliver high-quality global health every year in specialties such as surgery, emergency training in some of the world’s poorest communities.

14 Nurse Thamar Julmiste, who is known for singing to her tiny patients, attends to a newborn in St. Thérèse Hospital in 15 Hinche, Haiti. Photo by Cecille Joan Avila We go / We make house calls / We build health systems / We stay TOGETHER, WE STAY

nfrastructure Manager Steve Mtewa watched to Pleebo Health Clinic and a nearby referral facility, as people streamed into Dambe Health Center J.J. Dossen Memorial Hospital. on its opening day in Neno, Malawi, last year. I Partners In Health makes long-term commitments to the people we serve. He knows what people in his rural community In Haiti, we opened the Stephen Robert and Pilar face when they’re sick. Getting ill is possibly the Crespi Robert Regional Laboratory, which sits next worst challenge because reaching clinics is time- to University Hospital. The proximity means that consuming and costly. oncology patients who previously waited three months to receive a diagnosis can now get one in We treated 108 people that day, among them five three weeks. patients with such severe hypertension they were at risk of stroke, four with suspected tuberculosis, and 47 who tested positive for malaria—and it wasn’t Our investments in infrastructure, even malaria season. equipment, and operations are evidence of our long-term commitment to the This center will serve 30,000 people in and around communities we serve. Dambe; the staff at other facilities we built and renovated around the world this year will care for hundreds of thousands more. By investing in In Rwanda, we began construction on a 250-acre infrastructure, mobilizing equipment and medicine, campus for the University of Global Heath Equity. and providing clinical expertise, we are prepared to When complete, classrooms, administrative respond to immediate and long-term crises. buildings, a library, and dorms will drape a picturesque hill in northern Burera District. New maternity waiting homes in Malawi, Haiti, Thousands of students and health professionals Lesotho, and Mexico provide safe, clean places from around the world will learn not only how to expectant mothers can stay before and after treat patients, but how to build health systems— delivering their babies. When it comes to delivery, eventually enabling them to run the provision of women have access to trained midwives and, if health care in their home countries. complications arise, they are referred to a nearby facility for lifesaving procedures. That is the goal that drives our work. Whether a new waiting home, refurbished hospital, or cutting- We worked with the Ministry of Health to improve edge university, these investments are symbols of infrastructure and care at the National Tuberculosis our long-term commitment to the communities we Hospital in Monrovia. We also began improvements serve.

16 Masentebale Letima (far left) and other expectant mothers spend their final month of pregnancy at a maternal waiting 17 home in Nkau, Lesotho. Photo by Rebecca E. Rollins Our investments in health care systems around the world changed people’s lives in 2016. PIH prevented diseases, cured illnesses, SNAPSHOT: PIH LIBERIA healed injuries, and more. Below, a snapshot of just some of the progress in a single location where we work, Maryland County, Liberia. J.J. DOSSEN HOSPITAL 19 HEALTH CLINICS

A C B New equipment & upgrades % of deliveries accurately monitored

A C 100 D Emergency Room OR and Sterilization + blood bank space + scrub areas 80 71% + patient waiting area + pre-op space + X-ray machine + waiting area 60 + GeneXpert + autoclave + intake road + anesthesia machine 40 24% B D 20 Maternity Electrical + infant warmers + generator PIH made major infrastructure changes to J.J. Dossen Hospital. + roof + wiring 0 Sarah Dennis is among hundreds of women who received improved maternal health Photo by Rebecca E. Rollins 2015 2016 services at clinics where we work. Photo by Rebecca E. Rollins % of deliveries with completed partograph PLEEBO HEALTH CENTER PATIENT HOMES

Number of babies delivered Number of tuberculosis patients Number who completed treatment 300 272 250 2015 267 333 (98%) 200

150

100 2016 84 18 824 19 50 19 (23%) Pleebo is one of the busiest health centers, offering care to women before 0 Junior Doe, an 8-year-old with tuberculosis, is examined in his home by Dr. Paul and after pregnancy. Photo by Rebecca E. Rollins 0 200 400 600 800 1000 2015 2016 Farmer and a team of clinicians. Photo by Cate Oswald You

You make our work possible. + Thank you.

20 21 Partners In Health extends heartfelt gratitude to partners and supporters who made gifts of $10,000 and more during our 2016 fiscal year, July 1, 2015, to June 30, 2016.

$1 million and above Anonymous (3) Gilead Sciences, Inc. Microsoft Abbott Fund Al and Diane Kaneb Paul G. Allen Ebola Fund Josh and Anita Bekenstein Theo and Wendy Kolokotrones The Skoll Foundation Bill & Melinda Gates Foundation The Leona M. and Harry B. Helmsley W.K. Kellogg Foundation The Crown Family Charitable Trust Charlotte and Herbert Wagner Cummings Foundation, Boston Margaret A. Cargill Foundation $100 thousand to $1 million Anonymous (19) Elton John AIDS Foundation Scott and Laura Malkin AbbVie Foundation FACE AIDS MASS Design Group Advent International Ford Foundation Medtronic ALDO Group Ltd. * GlaxoSmithKline Richard and Ronay Menschel All Life Foundation Greif Packaging Charitable Trust Pfizer Foundation Robert and Michelle Atchinson Frederic and Jeanne Groos Pfizer, Inc. Franco Baseggio and Rebecca Sokolovsky Jay Grossman Ted and Karen Philip Marjorie Benton Ronald McDonald House Charities Blossom Foundation * Bob and Mary Grace Heine The Ruth and David Levine Charitable Fund Bill Bower Dr. Judith Hellman The Samuel Family Foundation * The Breast Cancer Research Foundation The Hellman Foundation Sauer Foundation Fund Brigham and Women’s Hospital Barry and Connie Hershey The Segal Family Foundation Caerus Foundation, Inc. Izumi Foundation Barbara and Edward Shapiro The Cameron and Jane Baird Foundation J.P. Morgan Charitable Giving Fund The Slaight Family Foundation * The Carson Family Charitable Trust Jeff Gordon Children’s Foundation Robert and Hope Smith Charina Endowment Fund Jericho Road Community Health Center The Spector Fund at the Boston Michael Chastain Jessica and Charles Myers Charitable Foundation Jack and Eileen Connors Gift Fund Stevie and David Spina Pierre Cremieux and Denise Jarvinen John D. and Catherine T. MacArthur Stephen and Emily Stanley Dana-Farber Cancer Institute Foundation Ker and Michael Thompson Deerfield Partnership Foundation Christopher and Lisa Kaneb University of Pennsylvania Eric and Barbara Dobkin Steven and Judith Kaye Wasserman Foundation Doris Duke Charitable Foundation G. Barrie Landry Westwood Holdings Group Marco Drago Landry Family Foundation The William Kaiser Family Foundation Wes and Lynn Edens Legacy Venture Member Stephen and Ellie Wise Educo Richard and Terry Lubman The Wooden Nickel Foundation The Eli Lilly and Company Foundation, Inc. M.A.C AIDS Foundation

22 Nurse Mariama Gbangba cares for a patient in the maternity ward of Koidu Government Hospital in Sierra Leone. * PIH Canada donor 23 Photo by Jon Lascher $25 thousand to $100 thousand $10 thousand to $25 thousand Anonymous (23) Joan Egrie Kathleen O’Connor Anonymous (29) Elizabeth and Nathaniel Carr ElectricAid A Mitchell Adams F Michael and Barbara Eisenson The O’Connor Family Foundation A Rob Abbot and Claire Cifaloglio Patrick and Carolyn Carr Ray Escoffier AJG Foundation The Elias Foundation Christine Olsen and Robert Small Abe Littenberg Foundation, Inc. Darren and Rene’ Carroll F Jean Wilkins Faddis American Cancer Society G Elmo Foundation Open Road Alliance * Patricia Allen Carrollton School of the Sacred Heart Steven and Paula Fee Jim and Karen Ansara Faber Daeufer & Itrato PC Paul and Didi Farmer Family Foundation, Inc. American Academy of Orthopaedic Mary Warren Case and Stanley Case James Feldman and Natalie Wexler B Benjamin Auspitz The Flatley Foundation Q The Paul Bechtner Foundation Surgeons Sara Case Luis Miguel Fernández The Baobab Fund Russell and Sherry Galloway R Martha and Mark Pentecost ASCA Foundation Colin Cash Dr. Steve Ferracuti and Dr. Kristy Gammon * Sheldon Baskin and Judy Wise/Baskin Chris and Susan Gifford The Philanthropic Collaborative B Matthew and Margaret Balitsaris The Cedar Street Foundation Leslie Fleming Family Foundation Girl Rising Fund of Tides Foundation Ann and Rob Quandt Dr. Claire Barnett Chapelwood United Methodist Church The Frances Lear Foundation The Betty L. West Mending Fund of Tides Global Impact Jeremy Reff and Ashley Gorski Sheila and James Barry Foundation G Thomas Gamble Foundation Goldman Sachs Gives S Reusing & Cole Family Trust Kimberly Bayless The Charles Engelhard Foundation Dr. Judith Gans and Dr. Jospeh Kalt Jan and Larry Birenbaum H Google Inc. Anthony and Kyra Rogers William and Debbie Becker Child Relief International/Andrew and Claudia Ganz The Blue Foundation Gary L. Gottlieb and Derri Shtasel Colin Rust and Jeannie Tseng The Benjamin Bryant Mathews Fund Bonnie Weiss The Gardner Grout Foundation C.D. and Nicole Boothe Alva Greenberg Paul and Martha Samuelson Karl Berggren and Rebecca Younkin Michael Chisek The George & Dorothy Babare Family The Boye Foundation, Inc. Lisa Gregg and Randy Mitchell Sanders Family Foundation Susan Bernstein Christ Church of Greenville Foundation Bresky Foundation Linda Hanson and Jon Wallach Michael Sherman Berwind Fund Robert and Kathryn Clark George Wasserman Family Foundation Christine A. Brown J Bambi Hatch The Shifting Foundation The Betsy McCormack Fund Rosemary Colgate Sarah and Michael Gerstenzang C William and Jenny Butler Julie and Bayard Henry Silver Mountain Foundation for the Arts Joanna Bichsel Linzee and Beth Coolidge The Gladys & Ralph Lazarus Foundation Kathleen Byers and William Farr * K Rob and Lyn Houk Elizabeth Skavish and Michael Rubenstein Chris Bierly and Margaret Boasberg Allison P. Coudert GlobalGiving UK Gary and Christine Cahn James C. Hudspeth, M.D. The Spurlino Foundation Becky Bilodeau-Dewey Moira Cullen Robert and Francine Goldfarb The Carole Carney Charitable Giving Fund John Jamieson Drs. Mark and Mary Ellen Stinski Howard Blane D Daedalus Foundation, Inc. Lynda Goldstein The Caswell Jin Foundation Julie Marie Chavez Corporation T Lise Strickler and Mark Gallogly Dr. Sally Blower and Dr. Nelson Freimer Alexandra DeLaite and Tom Kuo The Grace Jones Richardson Trust Catherine and Paul Buttenwieser Foundation Matthew and Kathryn Kamm Laurie and Mason Tenaglia Kathleen and Darrell Boff Timothy and Karen Dennison Grasshopper Shop Concord Michael and Germaine Choe Luke Kelly Samuel Test Boone County Mental Health Association Carolyn Deodene Ellen Grobman The Christopher McKown and Abigail L Lesley and William King U Tres Chicas The Bourneuf/Dougherty Family Trust Mark Dionne and Cynthia Mason Maria Gutierrez and Gabriel Orozco Johnson Fund Jill Kirshner Unitarian Universalist Service Committee Scott and Robyn Bradley David DiVincenzo and Barbara Terhal H Haiti Cardiac Alliance Club Penguin M Barbara Kravitz V Vanguard In memory of Catherine Brannen David and Catherine Dixon Gene and Nancy Haller D Construction for Change KSM Business Services Inc. The Vistex Foundation Constance Britton DMMN Foundation C. Michael and Susan Hazard craigslist Charitable Fund N Leerink Partners, LLC Jennifer and Brian Vosburgh Timothy Broas Simon Doonan and Jonathan Adler Kathleen Healy Gerald and Jeanne Curtis The Lynch Foundation W The Walt Disney Company Foundation Leslie Brunner and Ryan Wise Steven Dorfman Elizabeth Hebert Massachusetts General Hospital The Wasily Family Foundation John and Jennifer Bu The Ducommun and Gross Family The Hersher Family Foundation, Inc. Ophelia Dahl and Lisa Frantzis Malcolm and Dana McAvity David and Leslie Weiland C C.A.N. Foundation Foundation Howard Hiatt Daniel E. Ponton Fund for the Neurosciences O Nancy Peery Marriott Foundation, Inc. In memory of Marian Meyer Wilpers Perry Caicco * Michael and Kate Duffield Moira Hintsa E at Brigham and Women’s Hospital Molly's dear grandchildren Joel Wittenberg and Mary Ann Ek Michael and Ronda Callister The DuGan Family Trust James and Anna Hoag Samuel DeFabbia-Kane Network for Good Robin and Marc Wolpow Martha Campbell E Nancy Ebb and Gary Ford Jean Holder DeLaCour Family Foundation New York University Y Teresa and Kabir Yamana The Carl Marks Foundation Inc. Karen Eddy Holthues Trust Mary and Robert Eccles P New York University School of Medicine Z The Zanmi Beni Foundation, Inc. Caroline Blanton Thayer Revocable Trust Gerry and Gail Eiselman Daniel Horn and Debra Cheung 24 * PIH Canada donor * PIH Canada donor 25 $10 thousand to $25 thousand continued $10 thousand to $25 thousand continued Andy Huibers and Martha Man, M.D. David and Anne Lee Pamela Parker Sara and Michael Schnitzer Marilyn and Eugene Stein V H. C. and Katherine Van Schaack The Hunter-White Foundation Paul and Eileen LeFort P Stephen and Anne Peacher Schulte Roth & Zabel, LLP Jim and Debby Stein Sharpe Van Strum Foundation I The Hutton Family Foundation The Leslie Peter Foundation Matthew and Lucia Pearson Sharpe Family Foundation/Sarah Angell Donald Stirling and Mary Sundberg Stirling W Elizabeth and Joseph Walters The InMaat Foundation Jay and Tammy Levine Eric Penanhoat Sharpe Susan Strome Jane Wang Ira N. Langsan & Lillian Langsan Philanthropic Marc and Kay Levinson The Peter and Jocelyn Schultz Fund Michael Singer and Baharak Asefzadeh Maxwell and Ann Sturgis Brian Wegner Fund of the Jewish Communal Fund Liberty Mutual William Polonsky Sarah Singh Ramie Targoff and Stephen Greenblatt Ken and Audrey Weil J The Island Foundation, Inc. The Llewellyn Foundation Presbyterian World Service & Arne and Ruth Sorenson T The Teamtrio Fund Alice White Jacob Friedman Charitable Fund MaryAnn and Jamie Lockard Development * Finnegan Southey Kimberly and John Thacker Michael and Elizabeth White Keith and Karen Jacobson Loring Wolcott & Coolidge Marcel Przymusinski Jerrold and Carol Spady The Theodore A. Von Der Ahe, Jr., Trust Whittier Trust Company Jacques Perold and Amy Boesky Foundation Teresa Luchsinger Jairaj A. Puthenveettil and Vickie Langohr Brian, Kathleen, Matthew, and Olivia Spear Jane Thorne Ann Wiedie and Keith Hartt Janssen Pharmaceuticals, Inc. Cathie Lutter and Todd McCreight Dr. F.R. Quinn and Dr. K.N. Bradley * Dr. George Spellman and Ellen Spellman Charles and Susan Tilford Winky Foundation Harriet Johnson Jeff and Robin Lyall Q R Charitable Trust Hans Spiller Trinity Church Barbara E. Workman Charles and Mary Juster M MacKay Shields, LLC Joshua Rabinovitz Stamos Capital Partners, L.P. Union for International Cancer Control Daniel and Brienne Wright JustGive.org James and Heather Magliozzi R Geoffrey and Andrea Ralston Margaret Stavropoulos U University of California, Los Angeles K Kaufman Family Foundation Jeff M. Masters The Randi and Clifford Lane Foundation, Inc. Steven and Kathryn Keefer Christopher and Kathryn McCormack Gregory and Jan Ranger Mr. and Mrs. Michael Keiser Donor Denise and Mike McFall The Rathmann Family Foundation Advised Fund Maurice Meslans and Margaret Holyfield Red Mountain Fund Michael Kendall and Alexandra Haagensen Linda and Michael Mewshaw Regis College John Kern and Valerie Hurley Judith Mich G. Herbert and Marguerite Repass The Kerrigan Family Charitable Foundation Pamela and Don Michaelis William and Eleanor Revelle Steve Kessel and Sibyl Frankenburg Mark and Goldi Miller Walter and Judy Rich KeyBank National Association The Miller-Wehrle Family Foundation Richard A. Busemeyer Atheist Foundation Janet Kinnane and Conrad Smith Rebecca and Stephen Milliken Richard P. and Claire W. Morse Foundation Susan Kirk The Milner Family Foundation Robert and Bobbie Ritchie Knafel Family Foundation Christina Minnis Nina Ritter Richard A. Koffman Tracey and Gregory Morzano Stephen Robert and Pilar Crespi Robert, David and Ginger Komar The Moskowitz Family Foundation trustees of Source of Hope Foundation Marc and Donna Kozin Christine and Patrick Murray Emerson and Judy Robinson Emily Kunreuther Mushett Family Foundation, Inc. Rowan T. O’Riley Family Foundation L John Lang New Generation Advisors, LLC Thomas A. and Georgina T. Russo Lang Foundation N Evelyn B. Newell Henry and Elizabeth Salzarulo Wendy F. Lang Judy Nichols and Peter J. Barrer Zal Sarkari and Caroline Greene Kevin and Lisa Lange Howard and Patsy Norton S Haun Saussy and Olga Solovieva Craig Lapp * O.L. Pathy Foundation, Inc. Paul and Carolyn Sax Linda and Robert Lawrence O J.M. and Jane O’Neal Kevin and Corrine Sayler Stephen and Lisa Lebovitz The O’Shea Family Foundation John Scheide 26 * PIH Canada donor * PIH Canada donor Oksana Kustova (right), a PIH social worker in Russia, plays with Elizabeth, who was born three months 27 premature. Her mother, Elena Gavrilova (left), is HIV-positive and started taking antiretrovirals before the birth of her daughter, who has tested negative for the virus. Photo by Elena Devyashina for Partners In Health Gifts In Kind Abbott Dana-Farber Cancer Institute The Novartis Foundation for Sustainable Axios International Direct Relief Development Baystate Health eResearch Technology Pfizer, Inc. BD Faber Daeufer & Itrato PC Sakura Finetek USA, Inc. Blue State Digital Global Healing Schulte Roth & Zabel LLP Brigham and Women’s Hospital Kirk Humanitarian Susan’s Special Needs Brigham and Women’s Hospital Pathology Medtronic TOMS Shoes Department Microsoft US Fluid Tech Corp. Continental Office Mission Relief Services

Government, Multilateral, and Other Institutional Partners European Union Korea International Cooperation Agency U.K. Department for International FHI 360 Médecins Sans Frontières Development GDS Services International Ltd Northrop Grumman U.S. Agency for International Development Global Communities Pathfinder International U.S. Centers for Disease Control and The Global Fund to Fight AIDS, Patient-Centered Outcomes Research Prevention Tuberculosis and Malaria Institute (PCORI) U.S. National Institutes of Health GOAL Global Peru National Fund for Scientific, UNITAID Grand Challenges Canada Technological Development and United Nations Children’s Fund Harvard Global Health Initiative Technological Innovation (FONDECYT) United Nations Development Programme Instituto Nacional de Salud del Niño President’s Emergency Plan for AIDS Relief University of Toronto Interactive Research and Development (PEPFAR) University Research Corporation Japan International Cooperation Agency Primates World Relief and Development World Bank Jhpiego Fund (PWRDF) * World Health Organization

Global Health Partnership Boston Children’s Hospital Dana-Farber Cancer Institute Massachusetts General Hospital Brigham and Women’s Hospital Harvard Medical School Partners HealthCare Dana-Farber/Brigham and Harvard T.H. Chan School of Public Health Regis College Women’s Cancer Center Harvard University The University of California, San Francisco

* PIH Canada donor

28 Village health worker Eneles Manyamba (right) accompanies Violet Paulo and her 6-week-old daughter, Vanessa Joseph, to a 29 check-up at Chifunga Health Center in Neno District, Malawi. Photo by Jeanel Drake Tom’s Circle Tom’s Circle continued For more than 20 years, co-founder Tom White Anonymous (27) Jean Wilkins Faddis Elaine LaChapelle Gayle and Peter Schack supported Partners In Health and created a A Mitchell Adams George and Mary Ferger Kathleen Leslie, M.D. and Sanford Jill Shallenberger lasting legacy for this organization. While Myn Adess Elissa Fernandez Leslie, M.D. Leila and Edward Shapiro he is no longer with us, our work remains a Robert and Maureen Aievoli David Findlay ◊ Lisi Oliver Estate ◊ James and Paula ◊ Shaud testament to his belief that all people deserve Diane Alden Leslie Fleming Carolyn and Robert Lohman Bruce and Glenna Smith high-quality health care. It is our pleasure Dick Anderson Kara Flyg Jean Lootz George V. Station ◊ to recognize the individuals listed here as B Anandamayi Baker Clare Forbes Barbara Lovett Taimoon and Robert Stewart Professor Barbara Ann Banoff Dayve Forman Rebecca Lowe and Sam Bertron, III Drs. Mark and Mary Ellen Stinski members of Tom’s Circle. Like Tom White, they Evelyn Baum ◊ G Don Foxworthy and Sharon Siwiec Susan Lucas William and Annriette Stolte are helping save lives in the world’s poorest Trey Beck Emily Garlin Peggy Lucey and Bill Noel Deanne Stone places for generations to come. Patricia Berkov William Garmany M Elizabeth Lyman T Nancy Strickland Dan and Pat Berman Mr. and Mrs. John A. Gilmartin Jennifer M. Mackey Fernande Sylla ◊ Members of Tom’s Circle support the Gene C. Bernardi Margaret Glaser Tammie Mak Kenneth J. Tager continuation of our work by naming PIH in their Nancy Binder Jim Goodridge and Joan Riley Lewis and Dina Marcus Suzanne Taleghani wills, trusts, retirement plans, life insurance Peter Blank III ◊ The Gracey Luckett Bradley Charitable Wendy and Stanley Marsh Zoe Taylor policies, annuities, or through other planned Robin Bloomgarden Lead Unitrust Barbara and Stephen Massey John and Gayle Thompson gifts. For more information about leaving a Linda Brandenberger H Irene K. Guman Richard and Margaret McCann Ron and Janet Thompson legacy gift to PIH, or if you should also be listed Allan Brender * Christopher L. and Sherrie G. Hall Anita McDonald U Jennifer Tiffany among the members of Tom’s Circle, please Elizabeth E. Brusco Jack Hicks Kathleen M. McDonald, In memory of V Flo M. Triendl contact us at [email protected] or Kevin Buckley Tamara Keta Hodgson Cecilia E. Enright Linda Umans 857-880-5717. Peter H. Burian Reid Hoffman and Michelle Yee Ann McDonnell Beth and John van Bladel C Sara and John Cashion Karen and Philip Hofmann Maurice Meslans and Margaret Holyfield W Gretchen Van Gessel Sudhir Chamarthi Sharon D. Horvath and Andy Pike Peter and Betty Michelozzi Lynne Vogel Michael Chastain I Irene Buynoski Trust ◊ Estate of Eleanore Moore ◊ Heather Wade Ingrid Christiansen J Robert J. Jasper N Hermine S. Muskat, Ed.D. Dan and June Walcott Erin Cooney Walter Johnson and Joanne Leslie O Anthony Nash Marue E. Walizer D Emily Dalgarno Donald F. Johnstone ◊ P Amy E. Ouellette Hollace Westfeldt Beverley Davis K Judith Kadden Laurence Pagnoni Mary H. White, M.D. Christine DeCourtney Clair Kaplan Marian Parmenter Walter E. Wilkins ◊ Michael and Sheryl DeGenring Grace Kelly Rolf and Silvia Pfisterer Priscilla Wilson Patricia Devitt Austin and Rita Kerr R Donna Pignatelli Y Dorothy Winkey Annie Dillard and Robert Richardson Alleyne P. Kess Mary Rafferty Robert and Joyce Wolcott Gloria Duday Mary E. King ◊ Liz Rantz Emerald Young Reginald Dyck and Kaori Fujishiro Margo J. Krasnoff◊ S Diana I. Rigg E Lee and Carolyn Engdahl Robert Kruse Anne Scarff F L

◊ ◊ 30 PhotoEn by route Jeff Marvin to visit new partners in the Sicangu Lakota Nation in South Dakota. * PIH Canada donor Deceased * PIH Canada donor Deceased 31 Photo by Sonya Shin Financials

Our fiscal year summary.

32 Community health workers Yadira Roblero (left) and Magdalena Gutiérrez walk along rugged terrain to visit their patients' 33 homes in Chiapas, Mexico. Photo by Aaron Levenson Fiscal year 2016 financial summary Revenues by source Revenues 6% In fiscal year 2016, PIH received $113.2 Revenues June 2016 June 2015 16% individuals and family foundations million in revenue. Of this, $58.1 million contributions, grants, and gifts in kind governments and multilateral organizations came from individual donors, $18.4 million individuals and family foundations 58,088 120,411 Revenues came from foundations and corporations, foundations and corporations 18,402 32,904 $113.2 51% foundations and corporations and $30.1 million came from the public governments and multilateral organizations 30,072 39,282 million gifts in kind and other gifts in kind and contributed services 4,289 3,505 sector. In addition, PIH recorded $4.3 million other income 2,383 915 27% in gifts in kind and contributed services, and

dollars in thousands dollars total revenues 113,234 197,017 $2.4 million in other income. This contrasts with $197 million of total revenue in 2015, Operating expenses which included a large one-time gift to program services 134,966 125,384 the board-designated T.J. White Fund and development 3,284 2,322 funding from multiple sources to support general and administration 9,270 6,012 2% 1% PIH’s expansion into West Africa during the

Statement of activities Statement total operating expenses 147,520 133,718 Expenses by program Ebola epidemic and immediately thereafter. 3% operating surplus (deficit) (34,286) 63,299 4% 4% haiti endTB 6% Assets June 2016 June 2015 33% multisite clinical peru Expenses Expenses program support cash and cash equivalents 30,758 84,630 6% malawi PIH expenses increased from $133.7 million $147.5 rwanda contributions receivable 4 81 lesotho in fiscal year 2015 to $147.5 million in 2016, a 8% million sierra leone grants and other receivables, net 5,725 13,934 navajo nation/mexico 10% increase. The majority of this increase is prepaid expenses and other assets 5,250 3,185 development and russia/kazakhstan due to PIH’s expansion into Liberia and Sierra 9% 12% administration investments, at fair value 29,828 1,434 Leone. In fiscal year 2016, 92% of funds 12% liberia property and equipment, net 6,945 6,588 were for direct program costs and 8% went dollars in thousands dollars total assets 78,510 109,852 to fundraising and administration. Liabilities and net assets total current liabilities 11,814 8,706 net assets Surplus (deficit) foreign currency translation adjustments (697) (533) Allocation of expenses 6% 2% PIH ended fiscal year 2015 with a surplus undesignated 9,602 9,602 of $63.3 million, attributable to the board-designated: Thomas J. White Fund 35,088 57,603 program services aforementioned extraordinary revenue. PIH total unrestricted net assets 43,993 66,672 administration Expenses ended fiscal year 2016 with a $34.3 million development total temporarily restricted net assets 17,868 34,474 $147.5 92% deficit, which reflects a planned spend- total permanently restricted net assets 4,835 0 Statement of financial position Statement million down of the fiscal year 2015 surplus to total net assets 66,696 101,146 support the development of new programs in West Africa and growth of key programs total liabilities and net assets 78,510 109,852 elsewhere. 34 35 Board of Trustees Officers Country Directors

Ophelia Dahl, Chair * F Joanne Kagle Ophelia Dahl Alex Godwin Coutinho Jody Adams Albert Kaneb * Chair, Board of Directors Executive Director, Rwanda Mitch Adams Diane Kaneb * Paul E. Farmer Kerry Dierberg Chief Strategist Executive Director, Sierra Leone Joelle Adler Luke Kelly Gary Gottlieb Luckson Dullie José (Joe) Almeida Tracy Kidder Chief Executive Officer Executive Director, Malawi Gregg Alton Lesley King * Sarthak Das Bryan Eustis Marika Anthony-Shaw Fr. Fritz Lafontant E Chief of Policy and Public Executive Director, Liberia E Sector Partnerships Bob Atchinson Becky Levin Hugo Flores Karen Ansara E Mark Levin Sheila Davis Executive Director, Mexico Chief Nursing Officer Anita Bekenstein * Scott Malkin Fernet Leandre Wendy Bennett Michael Masters Ken Himmelman Co-executive Director, Haiti Chief Program Officer Marjorie Craig Benton Anne McCormack Leonid Lecca Louise Ivers Executive Director, Peru F Donald Berwick Todd McCormack * Senior Health and Policy Advisor Abera Leta Tim Broas Elizabeth G. Nabel John Malcolm Executive Director, Lesotho Christine Brown Dan Nova * Chief Development Officer Oksana Ponomarenko Paul Buttenwieser Laurie Nuell Cynthia Maltbie Executive Director, Russia Chief Human Resources Officer Edward Cardoza Joan O’Connor Sonya Shin Carole Carney Ted Philip * Joia Mukherjee Executive Director, Chief Medical Officer Navajo Nation Régine Chassagne Steve Reifenberg Ted Philip Loune Viaud Michael Choe * Joe Rhatigan Chief Operating Officer Co-executive Director, Haiti Chelsea Clinton Paul Samuelson Ann Quandt Jack Connors, Jr. * Lawrence N. Shulman Chief Financial Officer Mark Brender Pierre Cremieux Bryan Stevenson Joseph Rhatigan National Director, Canada Stephanie Dodson E Cecilia Stone E Chair, Global Health Delivery Partnership Team Jonny Dorsey Deborah Hayes Stone Rebecca E. Rollins Lynn Edens Max Stone Chief Communications Officer Paul English Jeffrey Swartz Cassia van der Hoof Holstein F Paul E. Farmer * Rien van Gendt Chief Partnership Gary Gottlieb * Loune Viaud Integration Officer Danny Greenberg Charlotte Cramer Wagner * Antoinette Hays David Walton * Robert Heine Ellie Wise Howard Hiatt E

36 * Director E Emeritus Member F Founder 37 38