Clinton Health Access Initiative

Our programs aim to save lives and reduce the burden of disease, while helping governments create sustainable Health systems. We operate in over 35 countries and support more than 20 different Health programs. The vast majority of our staff are located in the countries where we work, overseeing implementation and managing relationships with partner governments. The teams on the ground are complemented by a global team of science, business, and technical experts supporting the entire organization and by management, finance, and human resource teams. Infectious diseases: see schedule o for continuationinfectious diseases: for years, four infectious diseases drove most illness and death worldwide: hiv, hepatitis, tubercuosis (tb), and malaria. In 2020, a new illness, covid-19, was added to this list.early on, the pandemic brought many Health systems to their knees, and it continues to expose and exacerbate inequities that already existed between countries, people, and Access to basic Health services. In 2023, chai continued to support countries' longterm response to covid-19 and strengthen Health system reslience to prepare for future pandemics.a core component of this work has been strengthening Access to medical oxygen in healthcare facilities and hospitals in low- and middle-income countries through updating infrastructure (i.e. Building pressure swing adsorption (psa) plants; supporting bedside delivery of liquid oxygen), keep oxygen equipment up and running for its full lifespan and providing Health workers with the right tools, processes, and practices to save lives.at the same time we continue to work on the disease areas that we have focused on for decades, including hiv and advanced hiv disease.for example, our work to introduce affordable, more palatable hiv treatments for children. There have been vast improvements in pediatric hiv treatment in recent years, including the rapid development and introduction of generic pediatric dolutegravir tablets, which dissolve in water and taste like strawberries, dramatically increasing children's adherence to their treatment regimen. Chai is working with partners to drive the development and introduction of more generic versions of best-in-class children's medications.

Non-communicable diseases: see schedule o for continuationnon-communicable diseases (ncds) such as heart disease, cancer, chronic respiratory disease, and diabetes are the leading cause of death globally, exceeding all communicable disease deaths combined.in addition to our ncd program, which supports governments to strengthen and implement their ncd prevention and control strategies, chai is partnering with governments to strengthen cancer care systems by solving critical systemic gaps. We believe by working in close collaboration with partner governments and by anchoring a suite of transformational interventions, we can dramatically improve survival rates of cancer patients in low- and middle-income countries. For example, over the last four years, we have helped shape global markets to rapidly expand Access to high-quality tools to screen and treat cervical pre-cancer, including human papillomavirus (hpv) tests and thermal ablation devices.

Women & children's Health: see schedule o for continuationwomen & children's Health: women and children suffer the greatest burden from disease globally. Chai has significantly increased Access to recommended treatments for diarrhea and pneumonia, the largest killers of children under five; made critical vaccines that protect against childhood illnesses more affordable; is combatting chronic malnutrition; and is dramatially and sustainably reducing maternal and newborn deaths and ensuring women have Access to the tools they need to safely plan ther families to improve Health outcomes and economic wellbeing.for example, when chai began our diarrhea program in 2012, only one-third of children that needed lifesaving oral rehydration solutions (ors) received it. Zinc usage rates were even worse. Through chai's market shaping work, we helped reduce the average cost of zinc/ors treatment by 42 percent. Working with partners in india, kenya, nigeria, and uganda, we also increased the percentage of children with diarrhea receiving zinc/ors from less than one percent to 24 percent.another strong example is chai's work to save the lives of women and newborns. Chai has developed an integrated maternal, newborn, and reproductive Health strategy that has contributed to sustained and signficant reductions in death in countries where we work. This approach was first piloted in ethiopia, before being tested at scale in nigeria, where we saw a nearly 40 percent reduction in maternal mortality and a 43 percent reduction in newborn deaths in a 12- month period in target states of northern nigeria. The program has been rolled out more recently in zambia and uganda with similar results.

Chai's founding mission and ultimate goal is to help countries create high-quality, sustainable healthcare systems that provide universal Health coverage for all people. To achieve this, we work with governments to strengthen national financing systems, including establishing national Health insurance plans, that can be sustained for years to come. We also help develop systems to educate healthcare professionals at all levels and to build sufficient physical infrastructure to deliver Health services. Through this work chai has supported governments to secure over us$4 billion for Health systems strengthening, improved data based decision making, increased system efficiencies, and reduced costs. Chai has helped governments sustainably train and deploy thousands of Health workers in the countries where we work to improve lifesaving care and reduce gaps in the Health system.

Cross-cutting experts: chai works with governments and companies around the world to fundamentally change the economics of global Health. Using a holistic, business-minded approach to secure lower prices for key commodities such as medication and diagnostics, improve laboratories, and connect decision-makers with the high-quality evidence they need to inform Health policy in low- and middle-income countries, chai helps patients Access the care and treatment they need. Our science and business experts work across the organization to support our program and country teams.chai works on both the supply and demand sides of the market to lower costs and increase availability of the best Health products for low-and middle-income countries. Working with the public and private sectors, we help shape markets and realize savings for drugs, devices, and diagnostics in all areas of our work. Chai has negotiated over 140 global agreements to lower the prices of critical medications and other Health tools by 50-90 percent. Twenty-seven million people living with hiv have been reached by one such agreement lowering the cost of the optimal hiv treatment tenofovir disoproxil, lamivudine and dolutegravir, a savings of over $500 million. Through the global Health sciences team, chai aims to reduce costs, improve quality, and increase Access to treatment by helping to develop less expensive and more effective versions of critical medications for adults and children; developing techniques and technologies that advance our understanding and management of diseases; and improve patient care. This work has helped accelerate by over two years development, manufacture, regulatory approval and commercialization of key pediatric hiv products, and saved billions in costs to governments for critical treatments. Several new programs have also been added to chai's portfolio in recent years, significantly, climate change and assistive technology.

Innovation