A version of this blog was originally posted on the Gates Foundation's Impatient Optimists site.
"I thought my career would be in formal medicine or academia, but now my life is here in Nigeria, running a local reproductive and sexual health organisation for young people. It's really true what they say: life is what happens when you’re busy making other plans."
In the ninth grade, my family relocated from Lagos to Far Rockaway in Queens, New York.
I had always intended to return to Africa, and seven years later – during my junior year studying Biochemistry at Wesleyan University– I travelled to Umtata, a small community in the Eastern Cape of South Africa, to conduct HIV/AIDS clinical research under a National Institute of Health grant.
I worked in laboratory at the University of Transkei every day, analysing blood samples taken from expectant mothers in a nearby public hospital maternity ward.
It was a daily tragedy reading the results of those tests. Far too many women were HIV-positive, but I understood how it could happen. After all, I had spent my early teenage years in Nigeria; I was no stranger to the widespread misconceptions and institutionalised social silence that surrounds reproductive and sexual health issues in this part of the world.
There I was, in a white lab coat, peering through a microscope at red and white blood cells, detached from the reality of those women’s lives and experiences. And yet, the connection I felt with them was instant, undeniable and irreversible.
That connection made me abandon any notion of volunteering for 'just a few years' before returning to the US for medical school. Instead, I began the work of starting a sexual and reproductive health charity in Nigeria, Education as a Vaccine (EVA).
"You cannot underestimate the power of the connection when working with people on the ground."
As I started to build EVA from the ground up, there was no longer a lab coat, microscope, or sterilised hospital walls between myself and the people I was serving.
This taught me an incredibly important lesson about local development efforts: when you work on the frontline, you face humanity authentically, and in so doing, you face your true self too.
Everything mattered. My age, my background, my gender, my culture.You don't just call on your academic knowledge, but on the deepest parts of what makes you human as well.
"With local development, you bring everything, every part of you, to the table."
That's how you learn to understand your beneficiaries.
That's how they learn to trust you.
And that's what makes frontline organisations so effective.
Local organisations like EVA have their strength and authority conferred through our communities' acceptance of us. This is our unique advantage in the entire development sector.
But our focus on community needs and service delivery has put us at a disadvantage within the sector as well, leading local organisations to be woefully underrepresented at policymaking level.
The development system and the funding architecture that underpins it have, in our experience, contributed to a fragility of the local civil society sector.
Restricted funding, few resources to build capacity and capped staff pay have seen us lose valuable trained staff to higher-paid positions at INGOs, only for those same INGOs and other funders to criticise us for being inefficient or unsustainable; An obsession with project funding leaves us dependent on donors, unable to hold our national governments – and other actors – to account.
I certainly do see a vital role for INGOs and donors – particularly in intelligence and information sharing, convening and advocacy – but we need to find a more symbiotic relationship that allows for local organisations' expertise and experiences to influence the agenda-setting from the very top.
"'Local' is about more than just geography. It is a ways of seeing the world, and relating to it not just with your head, but with your heart."
Last year, EVA won the Stars Impact Award for Education in Africa-Middle East. The prize recognises some of the most effective local organisations working to transform the lives of children and young people.
This year, we are one of the six beneficiaries of Fund the Front Line, a campaign led by Stars Foundation with support from the Gates Foundation, Charities Aid Foundation, Pears Foundation, GlobalGiving UK and the Guardian.
The point of the campaign is to shine a light on local development actors like EVA, making it clear to the public that we – effective, well-managed local NGOs – do exist, and that it is possible for them to support us directly with crucial flexible funding.
It unlocks our potential and recognises the particular strengths and challenges that local organisations face on the frontline. It is also a more accurate reflection of the different roles donors and local organisations like EVA ought to have in development.
Whether you agree or not, we'd love to hear your thoughts. So please join the discussion on the Guardian microsite, and lend your voice to the debate.
Fadekemi Akinfaderin-Agarau is a co-founder and Executive Director of Education as a Vaccine against AIDS (EVA). EVA is one of Nigeria's leading a non-profit organisation based in Abuja. Fadekemi has served in an advisory role and contributed to the development of HIV/AIDS and adolescent reproductive and sexual health policies in Nigeria. She was Assistant to the Secretary General of the United Nations Special Envoy on HIV/AIDS in Africa between 2002-2004. She has received several awards including the Echoing Green Foundation fellowship; National Institute of Health (NIH) research fellowship, Wadzell Institute Architect of the Future and Compton Foundation Population fellowship. In 2008, Fadekemi was recognised by young Nigerian professionals as one of the "Top 40 Nigerian Females Under 40".
EVA won the 2012 Stars Impact Award in Education. It was one of six beneficiaries of Fund the Front Line, a match funding campaign supported by the Bill & Melinda Gates Foundation that seeks to highlight the experience of local organisations on the front line in the fight against poverty.