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 with 20 programs across four Health areas. 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 overtook these diseases as the largest cause of global mortality by an infectious disease.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 2022, 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 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.other highlights of chai's infectious disease program work in 2022 include: a 10-country partnership to introduce covid oral antivirals and national test-and-treat programs in africa and southeast asia. The covid treatment quick start consortium supports governments to introduce and scale up Access to new and effective covid-19 oral antiviral therapies in high-risk populations. Kick-started with a donation of originator treatment courses, the program will shift to using quality-assured, low-cost generics when they become available to facilitate wider adoption. Working with various tech companies to lower the price for hiv self-tests to us$1. The price is over 30 percent below the current lowest-priced who-prequalified test. The who recommends countries implement self-testing as a part of a differentiated and comprehensive approach to hiv testing services. Reducing the cost of rifapentine-based treatments (1hp and 3hp) to prevent tuberculosis in low- and middle-income countries. 1hp and 3hp both contain rifapentine and isoniazid and are two of several regimens recommended for latent tb treatment. The regimens significantly reduce duration of treatment and pill burden, making patients more likely to take and complete the full treatment cycle.

Non-communicable diseases: see schedule o for continuationnon-communicable diseases: non-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. Deaths from ncds in low- and middle-income countries account for at least 77 percent of all deaths globally.chai works with the american cancer society and other partners to lower the cost of lifesaving chemotherapies, increase Access to diagnosis and treatment, and help governments develop plans to comprehensively manage cancers. Chai's work has helped lower the cost of treatment for 30 cancers, including breast cancer - the most commonly diagnosed cancer globally - which is expected to generate savings of 60 percent on purchased medications. Chai also supports global efforts to eliminate cervical cancer by helping to substantially increase the number of women screened for precancerous lesions and appropriately treated. In 2022, unitaid-funded programs, including ours, reached an important milestone in burkina faso, cote d'ivoire, malawi, nigeria, philippines, rwanda, and senegal, reaching 90 percent treatment targets for women identified with pre-cancerous lisions just two years after the launch of the who cervical cancer elimination strategy seven years ahead of schedule.

Women & children's Health: see schedule o for continuationwomen & children's Health: wwomen 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 nigeria, india, uganda, and kenya, 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.

Achieving universal coverage: 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 135 global agreements to lower 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 treament tld, 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, signficantly, climate change and assistive technology.

Innovation.