Clinton Health Access Initiative
Summary and objectives
The Clinton Health Access Initiative (CHAI) has achieved many of its most important successes when seeking to fundamentally change the way the world approaches an issue and pushing the boundaries of what is considered feasible in global health. CHAI recognizes that by scaling up access to the services and medicines required to prevent and manage HBV and to eliminate HCV, millions of lives can be saved.
Since 2015, CHAI has helped governments in seven countries initiate public HCV programs to simplify patient care models and lower the costs of medications. Through market shaping and price negotiations, CHAI has helped lower the cost of treatment by 81 to 97 percent (depending on the country), from an average of US$2,618 to as low as US$60 per cure for WHO-prequalified DAAs. Since the program’s inception, over 100K patients have been initiated on treatment in countries where CHAI works. This initial push has demonstrated effective models that can serve as guides to the countries that follow.
Though HCV has been the main focus of CHAI’s hepatitis work, CHAI has made early strides in improving access to HBV services through joint policy, training, and financing work with HCV and HIV programs. CHAI’s approach has leveraged the achievements and infrastructure of those established programs to catalyze price reductions for HBV diagnosis and treatment, making these interventions affordable enough to launch and grow public sector programs.
Key clinical and programmatic differences in the HCV and HBV landscapes have guided CHAI’s goals and approach for each area:
- HCV: CHAI aims to cure over 16M people in 29 countries, averting more than 1.8M new infections and over 1M deaths in the context of a global elimination program. To help governments eliminate HCV, CHAI will continue:
- Mobilizing global and domestic fundraising and financing efforts to support elimination efforts in low- and middle-income countries.
- Negotiating agreements to lower the price of drugs and diagnostics.
- Assisting Ministries of Health to develop and implement evidence-based plans to effectively diagnose, treat and prevent new HCV infections.
- HBV: CHAI aims to increase treatment rates and reduce mother-to-child transmission of the disease through accelerated introduction of the HBV birth dose vaccine in low- and middle-income countries and increasing coverage to 80% in countries who have already introduced the vaccine. In order to fast-track global progress toward HBV elimination, CHAI will continue:
- Mobilizing financing to support introduction of HBV birth dose in countries that have not yet introduced the vaccine and to mitigate drivers of low coverage in countries that have introduced HBV birth dose.
- Leveraging existing programs (e.g. HIV, Syphilis, EPI) to increase early detection of HBV in pregnant women and promote use of effective PMTCT tools (e.g. HBV birth dose) to close the gap in vaccination coverage and map opportunities to link pregnant women to care.
- Continuing to support market-shaping efforts and leverage changes in the diagnostics landscape to make diagnosis and treatment of HBV more affordable, while mobilizing resources for public treatment programs.