Infectious Diseases Institute Annual Report 2010 27

ForgartyInternational held Infectious annual third its Dar in Summit Diseases es This Salaam in Tanzania. “Returnyear’s theme, The Long on Investment: of Building Impact Term in Capacity Healthcare attractednearly Africa,” from attendees 100 African, Northtwenty European and American, The countries. meeting was held in response to urgencyincreasing in – of the prolonged the face economic crisis – to more the gauge effectively in return on investments health and to guide global More information on Accordia’s Accordia’s informationMore on Mulago and IDI have continued to continued Mulago and IDI have collaborate in the strengthening of the treatment of infectious diseases in Ward rounds joint sessions and Training 4A. IDI clinicians and visiting conducted by place in the ward. to take PIRs continue Accordia Global Health Accordia Global Foundation Accordia Global Health Foundation was IDI players in establishing key one of the serve to continues and in 2004 major a important most one of IDI’s role as and Accordia partners. During the year, work to IDI continued in severaltogether areas: Global Accordia year, this -16 April15 On Health Foundation in partnership with and Institute Diseases Infectious the of Health’s Institutes the US National difficult choices aboutreportA future. resources in the scarce howinvest to was informedthat the summit was also by published. on website on its found can be activities www.accordiafoundation.org. severalmanages Accordia major grants programmesfor being conducted at IDI technical programmatic provides and Accordia IDI and projects. on key assistance Global Health Foundation continue to capacity Africa’s work build to together to fight infectious diseases through training, care and prevention. research, strong indigenous and internationalstrong indigenous and faculty IDI has base, also contributed significantly and writing development in proposal for of Excellence, Center As a the College. supportsIDI also the who are students University Makerere at degrees getting building through research capacity through vibrant also but programmes, lectures guest and conferences weekly from affiliated international faculty. IDI has donated equipment for Mulago for equipment donated IDI has An ultrasound provided unit was Hospital. an yearstwo year and in the last ago The new X-rayadded. machine was X-raythe diagnostic extends equipment a and provides of the hospital, capabilities the originalback-up for X-ray unit. been also upgradesFacility have carried out on Wards Diseases and Gastroenterology) 4A and 4B (Infectious Dermatology Neurology, (Endocrinology, were The wards & Rheumatology). clinical furnishings were repainted, and the lighting and plumbing updated, Similar upgrades improved. systems were are being Ward). carried Surgical and Medical (Emergency, out on Ward 3B Mulago Hospital special a IDI is privilegedhave to partnership Hospital, Mulago with referral national only hospital. Uganda’s Ministry the Uganda by IDI is regarded specialized of Health as one of Mulago’s During the last AIDS clinics. outpatient continued yearstwo IDI have and Mulago to collaborate of areas. in a number Founding Institutional Partnerships Institutional Founding Makerere University College of Health Sciences implement and develop to IDI continues integrationstronger for plans the in on IDI being an integral based college, part of the School of Medicine within This the College of Health Sciences. contributedrelationship has greatly to success. IDI’s MUCHS members have contribute to continued to IDI through a number of Board membershipon IDI’s significant membershipof Directors; Senior Management on IDI’s roles: PrincipalInvestigators Team; and projects; research for Training facilitators the for Programme. also College the and IDI collaborateto in regard Final teaching and training. students medical year a one-week receive to enable at IDI, placement their improve to them in caringskills and people knowledge for undergraduate Both with HIV/AIDS. living and post-graduateparticipate students Education Medical Continuing in weekly journalcase clubs and (switch meetings, The Professor visiting at IDI. conferences) ProgrammeResidence in jointly is Departmentthe IDI and by managed of Medicine. as a member of the Makerere IDI, Universityof Health Sciences, College variouswith interfaces Mulago Schools and in collaborativeHospital projects. research classrooms in teach IDI faculty In addition, and on the wards to strengthen didactic strong on the Building clinical services. and grantsdepartmentmanagement a and IDI seeks to develop long term, mutually mutually long term, IDI seeks to develop beneficial partnershipscomplementary withInstitute. of the those to strengths Partnerships work, criticalare IDI’s to and goals its meet IDI to enabling of the founding Some its impact. expand partnersinstitutional vital are which existence and success include IDI’s for University Makerere of Health College Sciences, Mulago Hospital, Pfizer Inc. and Accordia Global Health Foundation. Pfizer Partnership with IDI

“The success of Accordia every one of IDI’s many successes over the AIDS Foundation, Kelly developed the years. Yet, the company has contributed in first 5-year business/strategic plan and and IDI continues to pay two other important ways which have operating budget for the newly opened dividends to patients, also influenced IDI’s emergence as a Infectious Diseases Institute (IDI), which providers and to the global center of excellence in infectious disease: formed the basis for a multi-year award health community – locally, its talent, and its product. from Pfizer Inc. In addition, she served as a member of the “IDI Transition Team” regionally and internationally. The Pfizer Global Health with other stakeholders, to identify and For our colleagues around Fellows Programme (GHF) resolve key strategic issues in support of the world, it is a source of In addition to its core support of the ultimate transfer of IDI ownership to inspiration and reinforces excellence at IDI, Pfizer also contributes Makerere University. colleague engagement in our substantial expertise through its Karen Barclay mission and commitment Global Health Fellows Programme. This programme is an international Duration: September 2006-Dec to supporting healthcare in skills-based volunteer programme that ember 2006 traditionally underserved places Pfizer colleagues in three to six markets” month assignments with non-profit and Sally Susman, Senior Vice President, Policy, international development organizations External Affairs and Communications, to improve health for underserved Pfizer Inc. populations. During assignments, fellows transfer their professional expertise in Pfizer’s visionary and historic investment ways that promote access, quality or in the future of Africa, as a founder of efficiency of health services. both Accordia Global Health Foundation IDI has received nine Global Health Fellows and the Infectious Diseases Institute, through its partnership with Pfizer and has impacted more than a million lives Accordia Global Health Foundation. Each Karen designed, developed and already, in Uganda and beyond. Pfizer fellow has made important contributions implemented a Preventative Maintenance supported the initial construction and to the growth of IDI and its sustainability. Programme for the IDI Laboratory that core operations of IDI during its critical was manageable, flexible and sustainable start-up years, and encouraged the Carol Plank for the laboratory and maintenance development of diverse partnerships Duration: July 2003– January 2004 colleagues. She also developed a schedule to ensure IDI’s global relevance and to determine frequency of Preventative long term sustainability. Today, Pfizer Maintenance for each piece of equipment. continues to provide essential support Karen set up an inventory process for the ongoing costs of maintaining IDI’s for the IDI laboratory equipment; and uncompromising standards of excellence. updated and created new procedures Pfizer’s commitment to excellence and checklists to maintain the laboratory through this unprecedented investment equipment. has allowed IDI to transform standards of care and training throughout the region Nancy Brady and conduct cutting edge research with Duration: September global implications. Beyond its direct 2008-March 2009 impact of improving access to quality Carol, who was part of the first round of healthcare, Pfizer’s ongoing support of the Pfizer Global Fellows, trained Clinical Staff core cost of excellence at IDI ensures IDI’s in ICH/GCP, clinical trial proficiency and international standards of governance and provided nursing education. financial management, innovative training products, modern, well maintained Kelly Willis facilities, and international collaboration. Duration: June 2004-September As a direct result of Pfizer’s investment in 2004 Accordia’s vision and IDI’s potential, the Institute has now been recognized by the United States Institute of Medicine as a “preeminent center for infectious disease Nancy supported the documentation Infectious Diseases Institute Annual Report 2010 research, training, and treatment… with of success stories of IDI Training Alumni, far-reaching applications for similar disease which are used as an advocacy tool to fighting efforts elsewhere in Africa”. communicate the impact of IDI training Pfizer has also received an award from on individuals’ lives once they have Makerere University in recognition of it’s left training. She was also instrumental contribution to the University. in creating a system for engaging and Pfizer’s investment of core financial In collaboration with Accordia Global retaining information about IDI Alumni. resources has been the foundation for Health Foundation and Pangaea Global

28 Infectious Diseases Institute Annual Report 2010 29

treatment.” because of the because of the this brand would this brand would availability of free of free availability $120 for a month’s a month’s $120 for are practically non- Diflucan. Before the the Before Diflucan. unaffordable for the the for unaffordable Diflucan Partnership existent in the Clinic existent in the Clinic previously cost about cost about previously Programme made this Programme made this provision, Diflucan was Diflucan was provision, cryptococcal Meningitis “Cases of recurrence of “Cases of recurrence of majority of our patients; majority of our patients; Esophageal Candidiasis causes patients to causes patients Candidiasis Esophageal have difficulty in swallowing and in some adherence with problems to leads cases and malnourishment. to treatment CryptococalMeningitis is a serious of the lining fungal infection often fatal of the brain. The Diflucan Programme IDI to achieve has enabled Partnership has and outcomes treatment better of life the quality of drastically improved patients at IDI. Diflucan Partnership Diflucan Programme Pfizer has been Uganda’s fight against HIV/AIDS through actively engagedthe donation of Diflucan to in manage two Since opportunistic infections. HIV-related the launch of the DiflucanProgrammeMinistrythe with of Health Partnership in February 2002, Pfizer’sDiflucan donation to of Uganda is supportingin 300 sites patients AIDS treatment for HIV/ Uganda is – valued at USD $119 million. the second largest donated of recipient Africa. Diflucan after South IDI has been receiving a the DPP since its inception, proud beneficiary In Hospital. through Mulago supplies its of 38 new IDI treated August 2010 alone, ten new candidiasis, cases of esophageal of cryptococcalcases and meningitis treatment to 261 post prophylaxis gave The cryptococcalmeningitis patients. IDI has of the health of clients at quality of availability the to due improved greatly Diflucan as noted by one of the Senior who made this comment: Pharmacists, Lance Heinle August - JanuaryDuration: 2009 Lance implemented several new assays in Ward 4A the Side at an HPLC implemented He also Hospital. Mulago at Lab drug monitor (IDI) to Institute Disease Infectious the levels traineduse the HPLC, to on how IDI scientists in patients, Operating (Standard instituted a series Procedures), of SOP’s on severalconsulted and improve to assessments needs of severalcapability and data quality labs at the IDI. 2009 August - November Duration: Partnerships PartneringCommunication, with the and work strengthened Oonagh’s Department, Advocacy Friends partnerand IDI staff, among communication by clinics templates and tools programmes, implementing and creating She worked with closely supportthat IDI Strategy. the overall Officethe toGIPA develop capacity and streamline activities in regard to financial management andalso supported of a Resource Center in the establishment M&E systems. She where Friendsarea clinic waiting the informationseek and securingby station laptop a created and nine education; donated laptops filling a needs gapfor Friends to gain access to online education and communication. Thomas Schlecht – September 2010 March Duration: During the first part of Thomas hisworked fellowship, with the MU-JHU Core Laboratory conducting a marketthe IDI at that the market for potential where he discovered analysis the MU-JHU Core Laboratory In could be further exploited. basic teaching Thomas was the second partof his fellowship, marketing a strategic skills and helped develop marketing plan training the for programme. Julie Le Chasseur – September 2010 March Duration: Duringthe laboratoryIDI Julie helped at her placement to an instrument establishing by its capacity integratedbuild laboratory develop helped She also information system. and training programmes. procedures, supporting processes, Mitchell Brenda JuneDuration: – December 2010 Brenda is currentlya surveyIDI and has completed at of the The survey clinic nurses at IDI to assess training requirements. She and teamwork. environment included demographics, a traininghopes to develop programme measurable that is whilst ensuring the and sustainable the nurses that have competence and confidence to manage shared care with the have will Brenda of her Fellowship end the By doctorsIDI. at each ensure that to plans development individual developed with potential nurseher/his own to to develop has the ability Oonagh Puglisi the support of training education. and ongoing Finance and Administration

he Finance and Administration IDI Fleet Management department provides financial services, human resources IDI has experienced tremendous growth in project activities and this has created a administration, and facilities need for a separate transport section to manage a fleet of 30 vehicles. The fleet size management for IDI core is still growing due to the upcoming projects that require transport for the successful Tprogrammes and restricted projects. The implementation of activities. This year, a fleet management supervisor was recruited to Head of Department is assisted by three ensure cost effective management of this fleet of vehicles. managers and their respective teams. The fleet is divided into two categories; IDI Core vehicles and Projects vehicles. There Departmental priorities continue to are six vehicles designated for core activities and 24 for project activities. The Fleet focus on development and maintenance Management unit has facilitated cost- effective transport management through a number of systems that support transparent, of mechanisms: cost-effective operations and long term institutional excellence. The Board Audit Committee represents the IDI Board •A daily vehicle schedule is prepared to support adequate planning of activity of Directors and monitors the quality implementation within IDI and effectiveness of financial and risk management. •Vehicle movement log sheets are used to ensure fuel efficiency. The log sheets are filled in by the drivers and show the distance covered and amount of fuel The Institute places a high value on used by each vehicle. This has enhanced fuel efficiency and there has been a maintaining international standards of reduction in the amount of fuel used since this system was established accountability and transparency. Annual external audits are conducted by •Preventive maintenance checks are also scheduled for all vehicles. Drivers Deloitte & Touche, based on International conduct daily mandatory preventive maintenance checks and vehicles are Financial Reporting Standards; and KPMG scheduled for bi-weekly preventive maintenance to preserve the vehicles in is responsible for internal audit. The good mechanical conditions Board Audit Committee directs the risk management process, supported by IDI •Drivers are provided with continuous training to enable them acquire additional management. The Procurement section, driving skills and customer care with three staff, reports through Financial •Fleet of preselected special hires (taxis) are used for emergency needs Services. During the year the Financial Services section added a project audit function, to ensure compliance in the rapidly increasing volume of field-based activity. Facilities The Facilities department continues to be instrumental in the successful implementation of field-based programmes. Over the past year the Facilities team supported the extensive renovation of Ministry of Health clinical facilities in Kibaale and Kiboga district; and currently manages fourteen locations country-wide. Renovations of structures was carried out in 13 health facilities in both districts. As a way of decongesting the IDI Mulago complex and also providing for growth, IDI leased a magnificent three-story office

Infectious Diseases Institute Annual Report 2010 structure at Kitante Close in Kampala to accommodate Training, the IDCAP project, and other functions. The building is referred to as the ‘IDI Learning Hub’. The space recovered in the IDI Mulago building will allow for continued expansion of research activities.

30 Infectious Diseases Institute Annual Report 2010 31

Magdalene Nakalyango Kintu started Nakalyango Magdalene othersleading an at “one who opens means the ‘Nakalyango’ The name early age. she because name this given was she and others”; for door the remembers Magdalene is the eldest girl among eight children. when her childhood as a time she was very and competitive participated in sports against neigbouring contests schools. after banker a become to inspired was she up, growing While with admiration her aunt whom she watched she counted as She pursuedmoney at her the dream bank. and was the first female Branch Manager with three new of opening Pridethe initiative where she spearheaded Microfinance, Uganda Human a as excelled Magdalene joining IDI, Before branches. Francis AdministratorSt. at and Hospital Resource Manager the second largest hospital in Uganda. Nsambya- Hospital, she has a role that is the OperationsMagdalene IDI, at Manager She performedin an exemplary years. two the last for manner attributesworkhard to skills her excellent management with systems; practical to establish her ability hands on supervision, personaltake to and she leads. that people in the interest at Working IDI has Magdalene allowed to meet some of her beyond people manage to able including being goals career of some she taught how at back looks She the work place. and accumulation wealth membersher team saving, about to Three of her team members been able have investment. members team Magdalene’s homes. purchase land and build of their lives in the quality one who is interested see her as to them This motivates workingthe beyond environment. motivated highly are members team ‘My do. they what at excel and often work the required working beyond hours without their salary’. beyond additional pay requesting for Cost effectiveness and efficiency in service delivery are management tools that of dollars IDI thousands transportoptimal ensure to Magdalene systems have establishing hire costs Special by saved She has refersutilisation. to constantly with pride. All while overtime transport/lunchand 90%. 70%, than more by reduced over by reduced Operations refunds for have staff Through facility maintenance, this has been as a result of the rigorous and maintained. has established Magdalene systems that members of team the number minimize to worked that established also Systems were too. of money has been saved lot a overtimestaff with staff in paying amount of money spent the thus reducing providing also and allowances weekend, on the sufficient time to rest. She of operationsposition the up took since Magdalene manager. improved greatly also IDI has at management Facilities supervision learntShe has attributesfrom respecting lot a improved to this materialsof cleaning quality and used. are that been motivated members have Team judgment. making criticallyto time before taking situations and views analyse people’s into consideration.because their ideas are taken consumption energy building, IDI main the of audit energy upcoming the With bright. is IDI at unit Operations the for future The security startedhas plan management approved the of The implementation and 50%. than more reduce by to expected is is expected to reduce cost and improve IDI Fleet security. management policy & that Environment will is ensure underway that guidelines in Safety, The Occupational Health, the availability ofefficiency transport. andoffing will further streamline the all. for environment & conducive a safe IDI provides work juggling task. has not been an easy family and women, many Like is marriedMagdalene mother of three children. a and superviseto 11:00pm at home her when times and building office the of remembersleave closure She to had she when days her has excelled at Magdalene these odds, Against to urgentto attend in hospital her child admitted meetings. she had to leave role as operations manager and watching her team members her a lot of satisfaction. to their full potential gives grow PROFILE: Manager Kintu - IDI Operations Nakalyango Magdalene IDI Collaboration with the Ministry of Health

IDI aims at maximizing linkages with the Government of Uganda with a view to supporting Government policies and plans; and contributing to their further development. The Uganda Ministry of Health (MOH) is one of the key institutions with which IDI works closely, including the following areas.: • During the year the outreach lab services section was part of a team that provided support to the Ministry of Health (Central Public Health Laboratory) in developing a National Lab Policy, Lab Strategic Plan, Lab Quality Master Plan and Lab Certification and Accreditation Plan. • Laboratory linkages and partnerships are critical to strengthening the quality of laboratory services. The laboratory Outreach services team has facilitated the linkage of laboratories within the six rural districts (Kibaale, Kiboga, Masindi, Buliisa, Kyankwanzi and Hoima) and IDI-supported KCC clinics to the Central Public Health Laboratory (CPHL). These partnerships establish referral points for Quality Assurance and highly technical tests, such as Viral Load, DNA-PCR, HIV and TB Drug Resistance which cannot be conducted in most rural labs. Additionally, networking provides access to partner labs in case of prolonged service interruptions or unplanned increase in the workload. • Infrastructure upgrades were also conducted and additional equipment procured and installed within labs of 13 MOH health facilities in Kibaale and Kiboga (2 Hospital labs, 4 Health Center IV labs and 7 Health Center III labs). Comprehensive laboratory quality management systems are also being developed in these labs. • IDI supported the installation of CD4 testing machines in district referral labs (Kiboga and Kagadi). These labs are now being considered by MoH as training/reference labs. • Accreditation is essential in streamlining the provision of quality laboratory services. The Strengthening Laboratories Towards Accreditation (SLAMTA) approach was proposed by WHO and CDC for adoption by laboratories within resource-limited settings. IDI in partnership with CPHL customized the WHO check list and are currently pre-testing it at 25 IDI project sites in the Expanded Kiboga Kibaale Project (EKKP). • IDI provides logistical support through provision of buffer stocks of drugs and supplies to safe guard against stock outs in MOH facilities supported by the IDI-EKKP project and IDI- KCC project. • Drug Provision: One of the key ministry inputs to IDI is the provision of up to two thirds of drugs for the Friends at IDI which in turn provides monthly reports which have consumption and drug projection details. • The MOH and IDI collaborate through their interaction at the National Sub-Committee level. The Head of PCT at IDI is part of the Adult ART Committee and the HIV Drug Resistance Committee, where he contributes towards national treatment guidelines. IDI has also contributed data (as a sentinel site for HIV drug resistance) to the monitoring of HIV drug resistance. • IDI is a significant contributor to the national ART treatment targets with 6,417 patients receiving ART at the institute. The second-line cohort of over 600 patients is one of the largest in the region. IDI clinic receives referrals for advanced and complicated HIV management from other centers in Uganda and occasionally in the region (mostly from the Democratic Republic of Congo). • Research conducted at IDI is used by MOH to inform policy: For example an analysis has been done at IDI for screening people for early cryptococcal meningitis. The EARNEST study (Europe-Africa Research Network For Second-Line Treatment) which has commenced at IDI will share the results with MOH and these will hopefully be used to inform policy. • MOH consults MU-JHU Core Lab on quality assurance policies for the whole country and the MU-JHU Core Lab helps with step- wise accreditation plans. • IDI was part of the team that supported the MOH to develop the National TB Referral System using Information Technology (IT) and Geographic Information System (GIS) tools. The meetings held in November, 2009 came up with a strategy for implementing an electronic Laboratory Information System (LIS) to facilitate data management within the National TB Referral System.

Infectious Diseases Institute Annual Report 2010 • The Training department collaborates with the MOH to ensure that training programme activities are in line with Ministry of Health policies; as well as supporting the MOH in developing Global Fund proposals. • Training health workers: MOH supports IDI in the review and development of training materials used for training health care workers; MOH staff are also part of the IDI training department faculty. IDI was part of the team that supported MOH in training national trainers on the use of Rapid Diagnostic Test (RDTs) kits.

32 Infectious Diseases Institute Annual Report 2010 33

ATIC has been designated by the Ministry by has been designated of Health as a ATIC The dream of becoming a medical doctor for Prof. Katabira was Prof. The for dream of becoming a medical doctor As he watched his father who was born during his childhood. a medical assistant at the in he resolved within their home, basis daily on a patients treat time (equivalent of clinical his heart footsteps. in his father’s and follow to study medicine officer) He rememberswith up to looked people man that a as his dad of professor a Katabira, people. their to bring health to confidence man who is hesitant is a humble University, Makerere medicine at contributions his outstanding for credit to the response to take everythingHIV/AIDS and is resolute that against he has achieved because of the combined efforthas been possible health of fellow workers and the support of the political leadership. The face of HIV has changed significantly during the last 25years He remembers in this struggle. Katabirathat has been involved how shocking it was when he saw the first cases make he would that He decided ofreturning AIDS from England in 1985. after “There was lack of knowledge among his countrymen. a difference and support and stigma among health workers and care givers; Katabira AIDS was very member was of a the founding first high”. co-founder ReferralNational Mulago at clinic in Uganda Hospital; contributed and HIV/ the guidelines for the national to TASO of ProgrammeAIDS Control in Uganda’s the at AIDS response Ministry of Health. people to see many he is delighted As Katabira looks back, with HIV/AIDS; living of people treatment and in the care involved “It is an area that was characterized with shame and contempt. very of ordinary exciting to watch the involvement people at the a long time and shunned for because PLHA were level community ATIC supports care health for medical education in offering the MOH continuing ATIC ART. line nd to 2 st workers through a quarterly of treatment guidelines and dissemination Newsletter. The AIDS Treatment Information Center (ATIC) aims to support aims to workers healthcare Information (ATIC) Center care quality of high in the provision Treatment AIDS The diseases. infectious of HIV/AIDS and related and treatment advises healthcare workers to contact ATIC before making a decision to before The MinistryATIC workers of Health advises healthcare to contact Center. National Switch from 1 switch a patient • PROFILE of IDI Society and Founding Member President of the International AIDS Prof. Elly Katabira: to see that people are willing to help others with HIV gives me so much satisfaction.” He attributesstrides these great that to see that people are willing to help others satisfaction.” me so much with HIV gives effort combined the to has made Uganda of several health workers Commission and AIDS organizations and Uganda such as MinistryUganda’s of Health among others. Prior to becoming president of International AIDS Society (IAS), Katabira participated in HIV of association independent leading world’s the is The IAS various conferences WHO with doorsopened UNAIDS that and IAS. the join to him for professionals that envisions a global movement of people working together to evidence and best practice Its membershipend at every is comprised of the HIV response. of 114 countries. level the HIV epidemic, applying scientific the electronic journalin establishing was involved AfricaHe has served region, the council for as a member of the governing serve as then (2010-2012), period year two a for IAS the of president serve as will He first editors. its among was and IAS; of one term years) guidance and mentorshipimmediate past president for (two providing to the next president. serves of offering he happily hope to those suffering seen his job as a way Katabirais why and that has always as president he will continue He is confident that during his term of office as president of IAS, remuneration. financial of IAS without any trained being professionals from funding solicited increased and more young promoted, being care see evidence-based to research organizations. established Africanpeople of their the healthcare countries for responsibility more take will Katabira future where a Professor envisions and cannot afford people that for paid if governments this is attainable believes He provision. ART less on donorsand rely for and ART access to He also hopes to see improved encouraged a contribution to make to their care. those who can afford to member of IDI and continues He is a founding of trainedan increase in the number personnel. medical and competent IDI research multiple currentlyHe is for Principala Investigator ways. in many development and growth institute’s the impact he talks proud father of three children and grandfather is a of two; He is married, Katabira wears more hats. many projects. and a broad smile. with fondness about his family response global and national the in made been Katabira stridesfor great the at looking but fight long a been has have It that a brighter him great optimism for tomorrow. to HIV/AIDS gives Financial Summary IDI REVENUES IDI is a registered company limited by guarantee, without share capital, and 100% wholly owned by Makerere University. The Institute is registered in Uganda as a 80% Other income Non-Governmental Organization (NGO) Tuition income 60% exempted by Uganda Revenue Authority Sponsored projects from paying taxes on surplus funds. The 40% Unrestricted grants fiscal year is July 1 to June 30. 20% Over the past year the Institute continued the rapid growth of the preceding years, 0% due to further expansion of sponsored 2006 2007 2008 2009 2010 project activities. Sponsored, or restricted, projects refer to funds committed to Fiscal year ending 30 June a specific purpose, as defined by the programme sponsor. Sponsored projects contribute to IDI core programmes Chart 1 through fixed overheads and recovery of core staff effort. The three main core programmes PROGRAM ACTIVITY (Prevention Care and Treatment; Training; and Research) will increase to four in 100% the next fiscal year; with the addition of Management & Admin

the Outreach programme. IDI receives 80% Other Programs a substantial portion of core funding 60% (unrestricted grants) from the Accordia Research Global Health Foundation; the majority 40% of which originates from Pfizer Inc. Core Training funding is supplemented by tuition fees 20% and overhead recovery from sponsored PCT projects, mentioned above. Chart 1 0% demonstrates the rapid growth of self 2006 2007 2008 2009 2010 generated funds over the last five years, Fiscal year ending 30 June and the smaller role of unrestricted grants.

Chart 2 Chart 2 compares relative growth in the three main programme areas over the last five years; and highlights the continued prominence of research EXPENDITURE BY CATEGORY activity. The sudden increase in ‘Other Programmes’ is due to the nascent Outreach currently comprising two large- 100% scale outreach projects. Management and Administration 80% administration costs have fallen to 17% of Facilities expenses total expenditure, compared to 20% in 60% Office expenses the previous year. Transportation 40% Chart 3 represents expenditure by Program expenses category over the last five years for 20% Salaries and benefits combined core programmes and restricted projects. Facilities costs are 0% relatively high for the current year, due 2006 2007 2008 2009 2010 to large-scale renovations and laboratory upgrades in Kibaale and Kiboga districts. Fiscal year ending 30 June Infectious Diseases Institute Annual Report 2010

Chart 3

34 Infectious Diseases Institute Annual Report 2010 35

11% 5% via Accordiavia 14% Gates Foundation Other Accordia via Pfizer Accordia via 19% 6% Gates Foundation European Union 6% Other 3% Tuition 7% US National National US Institutes of Health 4% Uganda 25% further diversifying the funding base to meet current and emerging challenges; management and reporting systems and structuresfunding solicitation, number, improving to respond to the growing diversity and complexity of grants; its support of Uganda in order to continue engaging the Government to IDI seeking opportunities on existing programmes; funding that build for securing construction capital funding for University of a new IDI facility located at the main Makerere campus. PEPFAR Government of • • • • • Notable Notable trends in the sources of revenue since 2008 include less dependence on UgandaPfizer Government funding; commitment to meet all non-personnel clinic costs initially for three Mirroringyears (renewable) and significant funding. recent growth in PEPFAR global trends, the Bill and Melinda Gates Foundation and PEPFAR are the year ending June 2010. in the fiscal respectively revenues most significant funders, contributing 30% and 25% of IDI resource generation prioritiesIn the future, centered on: will be broadly Development of the IDI Funding Base of the IDI Development IDI continues to seek new partnerships and funding agencies to broaden the resource base Funding for its from programmes. Pfizer and Accordia Global Health Foundation has helped IDI to create the necessary of externally June 2010 the number and 2008 period in progress funded projects July between In the two-year infrastructuregenerationfunction. and capacity for a robust resource contribution to value, Out of this total 48 to 60 projects worth from IDI has grown at $25 million. of about value multi-year a signed about 18%. is estimated to be core IDI costs which primarily direct support provides generation to this resource and grantTeam The Strategic Planning and Development management effortsupport and automated manual Many 3 to 8 staff during from has grown this time. and procedures have systems sheet time and allocation time strengthened including generated, funding the of use efficient the maximize to implemented been since In monitoringand Several reporting. and resource generation reporting progress management, developed. been also have tools grantsIDI to pursue selection of suitable for a management tool to aid objective has been introduced. addition, grants/contracts through both direct contributed funding agencies 20 revenue IDI to Approximately sub-grants/sub-contractsand with follows: grouped as are broadly These intermediary organizationsyear ending June 2010. in the fiscal Map of Uganda showing source of IDI trainees

(Source of IDI trainees from Uganda, 1st January 2006 to 30th June 2010) Infectious Diseases Institute Annual Report 2010

36 Infectious Diseases Institute Annual Report 2010 3737

(Source of all IDI trainees(Source at 30th June 2010) as Map of Africa showing source of IDI trainees of source of Africa showing Map Map of Uganda showing Districts where IDI is active Infectious Diseases Institute Annual Report 2010

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Mike Scheld Mike of Internal Mandell Professor L. Bayer-Gerald Medicine International Pfizer Health Initiative Director, Virginia School of Medicine University of David Serwadda of Public and Director of the School Professor University Makerere Health, Wabwire-Mangen Fred of School of Epidemiology, Associate Professor University Makerere Health, Public Hank McKinnell Accordia Global Health Foundation Chair, Board of Directors Inc. Pfizer (Retired) Chairman, Greene Warner Gladstone Institute of Founding Director, Virology and Immunology Nick and Sue Hellmann Distinguished Medicine Translational of Professor Microbiology and Medicine, Professor, San University of California, Immunology, Francisco Health Foundation Accordia Global President, Bob Colebunders Tropical Institute of Diseases, Tropical Professor, Medicine Diseases Infectious Professor, University of Antwerp Moses Joloba Senior Lecturer and Head of the Department College of Health of Medical Microbiology, University’s Makerere Sciences, McAdam Keith Tropical Emeritus of Clinical Professor London School of Hygiene and Medicine, Medicine Tropical Diseases Institute Infectious Former Director, Associate International Director, and Professor London College of Physicians, Royal Thomas Dave of Medicine Professor Diseases Division of Infectious Director, Johns Hopkins University School of Medicine Ceppie Merry Senior Diseases, Consultant in Infectious College Trinity Lecturer in Global Health, Dublin HIV developing Currently based at IDI; AIDS pharmacology and the research Information Center (ATIC) Treatment Gisela Schneider German Medical Mission Institute for Director, MD Schlech, F. Walter Dalhousie University of Medicine, Professor Faculty of Medicine

Professor and Associate International Director, InternationalAssociate Director, and Professor London College of Physicians, Royal Philippa Musoke DepartmentAssociate Professor of Pediatrics College Faculty of Medicine, and Child Health, University Makerere of Health Sciences, Katongole-Mbidde Edward Virus Research Institute Uganda Director, AA Ugandan Member Apuuli David Kihumuro AIDS Commission Uganda Director General, Gideon Byamugisha EasternAmbassador HIV/AIDS for Goodwill and the Horn, Sudan Africa, Friends of Canon Board, Chairman Executive Gideon Foundation Robin Crawford Retired Academic Alliance Members Nelson Sewankambo College of Health Sciences, Acting Principal, UniversityMakerere Jerry Ellner Diseases, Chief of Infectious Boston University Moses Kamya College of of Medicine, Associate Professor University Makerere Health Sciences, Elly Katabira AIDS SupportThe Co-Founder of Organization (TASO) Makerere AIDS Research, Associate Dean for University AIDS Society International President, Mayanja-Kizza Harriet Medicine Professor, Department College of of Medicine, Chair, University Makerere Health Sciences, Mbidde Edward Virus Research Institute Uganda Director, Mugerwa Roy Department and past Chairman, Professor of University Makerere Medicine, Philippa Musoke Department of Pediatrics’ Associate Professor, University Makerere and Child Health, Quinn Tom Health of Medicine and Public Professor Global Johns Hopkins Center for Director, Health Associate Director of International Research, Allergy and Infectious National Institute of National Institutes of Health Diseases, Allan Ronald University Emeritus, Distinguished Professor of Manitoba IDI Leadership Current IDI Board Members Current IDI Nelson Sewankambo Makerere College of Health Sciences, Principal, University Chairman of the Board Alex Coutinho IDI Director, Executive Secretary to the Board Nominations Committee Lillian Tibatemwa-Ekirikubinza Vice Chancellor Deputy Affairs, Academic for UniversityMakerere Audit Committee Quinn Tom Health of Medicine and Public Professor Global Johns Hopkins Center for Director, Health Associate Director of International Research, Allergy and Infectious National Institute of of Health National Institutes Diseases, Nominations Committee Chair, Sam Zaramba WHO Board Current Chair of MOH Outgoing Director General, Rukyalekere Addy Kekitiinwa College of Medicine Baylor Director, Executive Milly Katana New Partners Initiative- Senior Manager, Assistance (NUPITA) Technical Audit Committee Griekspoor Wilfred McKinsey & Company Director Emeritus, Audit Committee Chair, Mayanja-Kizza Harriet Medicine Professor, Department College of of Medicine, Chair, Health Sciences, Department of Obstetrics & Gynecology, UniversityMakerere Mirembe Maureen Florence College of Health Sciences, Professor, UniversityMakerere James Gita Hakim Department of Medicine, Professor of University of Zimbabwe Medicine, Luboga Samuel Abimerech DepartmentAnatomy, of Associate Professor, Makerere School of Biomedical Sciences, University Past IDI Board Members McAdam Keith Tropical Emeritus of Clinical Professor London School of Hygiene and Medicine, Medicine Tropical Former Director, Diseases Institute Infectious Infectious Diseases Institute Annual Report 2010 Infectious Diseases Institute College of Health Sciences Makerere University, Kampala, Uganda

P.O. Box 22418, Kampala, Uganda Tel: +256-414 307 000/312 307 000 Fax : +256 414 307 290 Email: [email protected] Website: http://idi.mak.ac.ug

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