2007 Safety, Security and International Affairs

John F. Vertefeuille and Brian D. Wheeler

Led a six-fold increase in the United States’ AIDS relief efforts in Nigeria.

U.S. Ambassador to Nigeria John Campbell says, “You don’t come to Nigeria and work in the health sector for anything other than love … it’s just too hard.” He adds, “It requires idealism that is also shaped by political savvy. Otherwise you won’t get anywhere in this tough environment.” John Vertefeuille and Brian Wheeler of the Centers for Disease Control and Prevention (CDC) have proven the Ambassador right. There is no question that Vertefeuille and Wheeler bring an uncommon passion and skills to their work, without which they would be unable to survive in Nigeria, much less succeed. And these two civil servants have proven that with their talent and dedication, no challenge is too hard. You can always make a difference if you are immensely talented and do your best, and that’s exactly what Vertefeuille and Wheeler are doing.

Vertefeuille and Wheeler were dispatched in March 2005 to lead the CDC delegation implementing the President’s Emergency Plan for AIDS Relief (PEPFAR) initiative in Nigeria. Working with seven other federal agencies, their mission was to tackle the HIV/AIDS pandemic in the nation with the third highest number of HIV-positive people in the world. Building on CDC’s work with PEPFAR, they also increased capacities for detecting and treating polio, tuberculosis and avian flu in Nigeria. Despite the seemingly overwhelming nature of the tasks and a steady stream of logistical, political and financial hurdles, they have thrived.

Vertefeuille and Wheeler’s CDC team initially consisted of 8 people working with a budget of about $50 million. But thanks to a combination of strategic vision and leadership, diplomacy and financial expertise, the two have expanded the staff to more than 50 and worked diligently to strengthen the interagency team that implements PEPFAR. These efforts resulted in a rapid expansion of HIV services for the Nigerian population and paved the way for a substantial increase in available funds for the program, which has a current annual budget of more than $300 million. In just two years, their work has substantially expanded the ability of Nigeria’s medical system to respond to HIV/AIDS, tuberculosis, avian flu and polio, directly affecting hundreds of thousands of HIV-positive Nigerians and indirectly helping millions more.

Much of Vertefeuille and Wheeler’s success has depended on the strength of their working partnership and complementary abilities. Wheeler, the CDC Nigeria Deputy Director, successfully crafted a budget that reflected the compromises that evolved from a series of intense diplomatic negotiations between various agencies. Vertefeuille, a PhD in epidemiology and CDC Nigeria’s Chief of Party, has cultivated a strong reputation for his strategic abilities and his consistent track record of securing top talent for the organization. The two invested significant effort and exercised high levels of diplomacy in fostering interagency relationships that are a cornerstone of PEPFAR implementation, resulting in streamlined planning and implementation of the program.

While the sheer magnitude of Vertefeuille and Wheeler’s work is impressive, their accomplishments are multiplied many times over when one considers the difficulties of working in Nigeria, a nation in which electric utilities, transportation and communications work sporadically, at best. The HIV/AIDS statistics for Nigeria alone are staggering. At the end of 2005, an estimated 2.9 million Nigerians were living with HIV. That same year, 220,000 adults died of AIDS and the number children orphaned by AIDS reached 930,000.

The PEPFAR team in Nigeria wrote a country plan that lays out in extraordinary detail how hundreds of millions of dollars would be spent, along with the expected results. As part of this plan, Vertefeuille and Wheeler’s CDC team acquired warehouses and worked through implementing partners to build a major operation to import, distribute and monitor the provision of retroviral drugs to treat thousands of Nigerians. The PEPFAR Nigeria program has supported HIV treatment for over 90,000 Nigerians and is enrolling more than 4,000 additional patients each month. A reduction of HIV transmission from mothers to children has further saved the lives of an estimated 2,000 children to date. The team also instituted comprehensive controls to account for the vast resources poured into the effort.

In February 2006, avian bird flu was confirmed in Nigeria and spread rapidly. The first human case was confirmed in January 2007. The CDC team swung into action and has devoted tremendous time and attention to combating the avian flu outbreak. It provided training, supplies and oversight to laboratories and epidemiologists in Nigeria. Vertefeuille and Wheeler have spent countless hours in endless rounds of meetings with Nigerian officials, donors and UN agencies and in conference calls with Washington. The quality and impact of their work on avian flu is unmatched by any organization in Nigeria.

Ambassador Campbell said something else about the CDC team that rings true. Campbell said, “As good as John and Brian are as individuals, together, they are greater than the sum of their parts.” This remarkable team has achieved remarkable things, and the lives of thousands of Nigerians are better for it.