Working with Urgency in 2020

In 2020, the global community faced an unprecedented challenge, coming together to combat the COVID-19 pandemic.

Since our foundation in 2002, CHAI has worked with urgency to address the most pressing health issues in low- and middle-income countries. This past year was no exception.

Using our strong relationships with government partners, we worked quickly to help countries respond to the pandemic while ensuring other lifesaving programs continued. We helped global health leaders understand country needs and procure lifesaving diagnostics, treatments, and personal protective equipment, despite worldwide shortages. We supported more equitable access to COVID-19 vaccines, helping low- and middle-income countries prepare for, acquire, and roll them out as they become available.

COVID-19 has had a devastating impact on communities around the world, including our staff who have carried out their work while looking after friends and family and even becoming ill themselves.

Since the pandemic began, we have lost beloved colleagues who dedicated their lives to serving others. CHAI is a family, and we continue to remember their commitment and service as we mourn their loss.

As we move forward, we will continue to work to ensure lifesaving COVID-19 vaccines and treatments are available to everyone, no matter where they live. We will also support our partners to strengthen health systems’ resilience over the long-term.

While this year has tested us in so many ways, it has also recommitted us to our values and our mission to save lives.

Download our 2020 Annual Report

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Spotlight on 2020
Affordable high-quality COVID-19 rapid antigen tests for LMICs
Avg savings for 26 countries on drugs to treat 27 cancers
Avg increase in oxygen therapy across partner countries
Cost of treating a child with generic pediatric DTG - 75% less than standard of care

A CHAI staff member (right) talks to a patient volunteer about a new 3HP regimen at the Jointed Hands Welfare Organisation (JHWO) office. Photo by Eugene Noube, Harare, Zimbabwe.

Health workers attend a meeting at National Hospital Abuja to disseminate cancer patient education materials. Photo by Tony Ayenson, Abuja, Nigeria.

A community member receives a diabetes screening during the COVID-19 vaccination process. Photo by Am Vichet, Tramkak District, Takeo Province, Cambodia.

Health workers from Countrywide Uncedolwabantu Projects distribute condoms to community members. Photo by Earl Abrahams, Johannesburg, South Africa.

A data collector conducts exit interview with a client. Photo by MTE Photography, Kaduna, Nigeria.

Trainers provide hepatitis C screening training for healthcare workers. Photo by Soksamphoas Im, Kampong Chhnang, Cambodia.

A peer mentor provides feedback to a medicine vendor at his shop. Photo by MTE Photography, Kaduna, Nigeria.

A health worker from Countrywide Uncedolwabantu Projects distributes COVID-19 information to community members. Photo by Earl Abrahams, Johannesburg, South Africa.

Our response to the COVID-19 pandemic

The rapid spread of COVID-19 meant public health institutions like the World Health Organization (WHO) needed to act quickly to understand the virus and provide guidance and assistance to countries. On the ground, countries needed to manage supplies, testing and treatment, and target responses to prevent outbreaks.

New tools and systems were needed. CHAI got to work.

• We seconded dozens of staff full-time to ministries of health at governments’ request to support response efforts.

• In South Africa, we helped deploy a free COVID-19 information service on WhatsApp to deliver automated messages to the public, including travel advice, daily situation reports, myth busters, and a tool to assess individuals’ risk. Within days, the service reached two million users with a retention rate of 55 percent.

• The WhatsApp service has since been adopted in seven countries and inspired development of a version for the WHO, which surpassed 12 million unique users within eight days of launch.

• As part of the ACT Accelerator group, CHAI helped negotiate agreements to make available for low- and middle-income countries 120 million affordable, high-quality COVID-19 antigen rapid tests.


We also helped maintain existing services or quickly restarted them following lockdowns and movement restrictions. We collaborated with governments on creative solutions from HIV self-testing and self-administered IUDs to bridging emergency transportation gaps and virtual training for health workers.

"I recognize CHAI's approach to working with urgency as a different but transformative way of saving lives." 

- Zarni Htun, Deputy Country Director, Myanmar

Investing in oxygen to respond to COVID-19 now and create sustainable systems for tomorrow

In 2020, CHAI and the Murdoch Children’s Institute (MCRI) were finalists in the MacArthur Foundation’s 100&Change competition for our proposal to bring lifesaving oxygen therapy to patients worldwide.

Oxygen is needed in every corner of the hospital and beyond - from newborns struggling to breath in neonatal units or patients undergoing even simple surgeries to ambulances, rural health centers, and all across the healthcare system.

But the pandemic brought this need into sharp relief, as medical oxygen is arguably the most important treatment available for COVID-19.

While we did not win the final US$100 million prize, our work with MCRI and partners like the Every Breath Counts Coalition contributed to advocacy that has raised global awareness about the oxygen access gap and encouraged donors to fund efforts to close that gap for good.


"Working with urgency was ingrained from the onset and I embraced it fully." 

- Rosemary Kihoto, Deputy Country Director, Kenya

Increasing access to HIV treatment for children

While there have been tremendous gains made in increasing access to HIV treatment, progress has been unequal. Of the approximately 1.7 million children living with HIV globally, only half are on treatment and approximately 100,000 die each year.

Children often wait years, if not decades, to access the same treatments available to adults. In 2020, CHAI worked with Unitaid and ViiV Healthcare on a groundbreaking effort to make a generic pediatric version of the WHO-recommended dolutegravir (DTG) available in low- and middle-income countries.


As a result, generic manufacturers Viatris and Macleods were provided financial incentives and technical guidance to develop a child-friendly, strawberry flavored generic medication in parallel to ViiV’s innovator product.

Then, the partners announced a landmark pricing agreement to launch the new child-friendly medication at a cost of US$36 per child, per year-- a 75 percent reduction from the existing standard of care. The agreement also lowered the total cost of HIV treatment from US$480 per child, per year to less than US$120.

"CHAI's sense of urgency resonates strongly with my desire to see patients' lived experience become better now." 

- Vivienne Mulema, Senior Manager, Global Cancer

Negotiating better prices for cancer treatment in Africa

In sub-Saharan patients are twice as likely to die from cancer than in the United States. Cervical cancer is of particular concern as 90 percent of the more than 300,000 annual global deaths from the disease occur in low- and middle-income countries.

But if caught early, cervical cancer is preventable. In 2020, CHAI continued work with Unitaid and partner governments to catalyze use of newer, better, and cheaper pre-cancer screening and treatment technologies. We negotiated pricing agreements that brought the price of thermal ablation devices down by about 50 percent.


Under the Cancer Access Partnership program, participating companies have agreed to provide high-quality cancer medicines at affordable prices in select countries. As part of the program, in 2020, CHAI and the American Cancer Society announced agreements with Pfizer, Novartis, and Viatris to expand access to 20 lifesaving cancer treatments in 26 countries in sub-Saharan Africa and Asia. Purchasers are expected to save 59 percent of the cost of medicines produced through the agreements.

The agreements include complete chemotherapy regimens for the three cancers that cause the most deaths in Africa: prostate, breast, and cervical.

Thank you
Thank you to our many partners and donors for their tireless commitment to saving lives and ensuring that all people, no matter where they live, have access to quality, affordable health services.

Download the 2020 Annual Report

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