Our History: CHAI Milestones


In July 2002, President Clinton addressed the International AIDS Society in Barcelona, along with President Nelson Mandela. President Clinton set the agenda for his foundation’s emerging efforts in the HIV/AIDS community, saying:

“We cannot lose the war on AIDS and win our battles to reduce poverty, promote stability, advance democracy and increase peace and prosperity.”

In October 2002, CHAI was created to bring care and treatment to people living with HIV/AIDS and to strengthen health systems in resource-poor countries. In accordance with these goals, after its inception, CHAI initiated the first programs in Africa and the Caribbean that aimed to scale up HIV/AIDS care and treatment throughout entire countries. Eventually, CHAI would help over 30 countries to scale up AIDS care and treatment.


In 2003, CHAI negotiated to lower prices for first-line HIV drugs by over 60 percent and enabled 60 countries to access these low prices.


In 2004, CHAI negotiated 50-90 percent reductions in the price of CD4 tests and other tests used for AIDS patients worldwide. Coupled with CHAI’s technical support, these price reductions enabled the nationwide scale up of CD4 testing in over 40 countries.


Starting in 2004 and 2005, CHAI led a global effort to scale up treatment for children with AIDS in 34 countries, from 15,000 to over 600,000 on treatment. As a result of working with UNITAID, which was formed under the leadership of the French government with CHAI’s assistance, prices of first-line pediatric AIDS drugs were reduced from over US$600 per child per year to around US$60 per child per year. CHAI also worked to scale up the deployment of specialized tests needed for small children from 50,000 to over 1 million tests per year.


From 2005 to 2007, working with UNITAID, CHAI negotiated agreements to lower the price of second-line AIDS drugs by over 75 percent and accelerated the roll out of these drugs in over 30 countries to AIDS patients whose treatments were failing on first-line drugs.


From 2005 to 2008, CHAI assisted governments in Southeast Asia to scale up care and treatment programs for AIDS including in Papua New Guinea and West Papua Indonesia, which have the highest AIDS rates in Asia and are among the most remote places on earth.


Beginning in 2009, CHAI assisted the government of South Africa, the nation with the highest HIV burden in the world, with the largest scale up of HIV care and treatment ever attempted, from 800,000 people in 2009 to over 2.3 million people today. CHAI helped negotiate agreements to lower HIV and TB drug prices that have saved the South African government almost US$1 billion. These savings are now being used to treat more people within existing budges. With assistance from CHAI, South Africa scaled up its AIDS care and treatment facilities from less than 500 in 2009 to over 3,300 to enable treatment expansion.


Beginning in 2010, CHAI has been working to scale up access to rapid diagnostic tests in places where malaria cases are treated but where diagnosis is not currently available. Most recently, CHAI has facilitated procurement of nearly 2 million low cost tests across Kenya and Tanzania.


Since 2011, CHAI has worked to lower the cost and increase the availability of injectable artesunate, a malaria medicine that can dramatically decrease malaria mortality, particularly in children. CHAI started working to increase access to injectable artesunate in Nigeria and Uganda in 2011, Malawi and Zambia in 2012, and Cameroon in 2013. In Nigeria alone, switching to injectable artesunate has the potential to avert 50,000 deaths annually.

Since 2011, CHAI has been pioneering strategies in Ethiopia, Kenya, Malawi, and Tanzania to roll out new vaccines, such as pneumococcal and rotavirus, more quickly and effectively. Working with the Bill and Melinda Gates Foundation, CHAI negotiated a landmark deal to lower the price of rotavirus vaccine by 67 percent, from US$15 per child to US$5 per child, saving the global community over US$800 million, and negotiated a 50 percent reduction in the price of pentavalent vaccine, saving the global community an estimated $160 million over the next five years.

Since 2011, CHAI has helped the government of Rwanda move towards establishing a world-class health system by implementing a program to educate Rwandese doctors, nurses, and health managers in Rwanda. CHAI helped the Rwandan government develop its human resource plan and facilitated an arrangement for 20 US universities to send over 100 faculty members per year to Rwanda for the next several years to work with their Rwandese colleagues to develop a world-class health education system. Over the course of the program, enough Rwandese medical education professionals will be educated to world-class standards that the foreign presence is no longer necessary. In addition, CHAI is assisting the government to invest in equipment to upgrade its teaching hospitals and schools.


In 2012, CHAI negotiated an agreement to lower the price of implantable long-acting reversible contraceptives from US$18 to US$8.50 per implant and is now helping to accelerate the roll out of these products. This effort will save the lives of over 45,000 women, will prevent over 200,000 children from being stillborn, and will empower women to protect themselves from unwanted pregnancies. The agreement will save over US$400 million.


In 2013, CHAI worked to scale up access to and usage of zinc/ORS, as the recommended treatment for diarrhea, in India, Kenya, Nigeria, and Uganda by building demand and increasing availability in both the public and private sectors. CHAI supported governments to lower the cost of zinc/ORS products. As a result of these efforts, wholesale prices have reduced by approximately 60 percent. CHAI is working to accelerate the usage of these products in several African countries and in India.