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The Initiative's decision-making body is the Council of Foreign Ministers (Adriatic-Ionian Council). The Council's agenda is prepared by periodic meetings of Senior Officials (Three times per year).
The Chairmanship rotates every May/June according to an alphabetical criterion. The current Greek AII Presidency will conclude its activities at the end of May 2009, when Italy will take it over.

A Permanent Secretariat was inaugurated in Ancona the 19th of June 2008 in order to strenghten the cooperation among the states and to make the initiative more "project oriented".
The Adriatic and Ionian Initiative is connected with several regional organizations in SEE, namely the Central European Initiative (CEI), the Regional Co-operation Council (RCC), and the South East European Cooperation Process (SEECP). the Black Sea Economic Cooperation (BSEC), the Danube Co-operation Process (DCP).

The AII – PS has started a cooperation with the Adriatic and Ionian Fora which already operate in the region, namely the Forum of A&I Chamber of Commerce, UniAdrion and the Forum of Cities and Town of A&I. Periodical meetings are foreseen to take place with these bodies.

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