Market Shaper

70% reduction in price for caffeine citrate—a vital drug for small and sick newborns

Caffeine citrate is the WHO-recommended medication for treating short-term breathing problems in premature babies. The medication is widely prescribed in neonatal ICUs in high-income countries, but rarely accessible in the Global South.

In 2023, CHAI worked with Ethiopia, Kenya, and Nigeria to develop targeted, costed strategies for getting caffeine citrate to newborns. The strategies showed how to address key challenges, such as lack of policies and enabling environments, demand generation, and pricing structures. They also provided detailed steps for engaging suppliers, obtaining regulatory approvals, increasing provider awareness, and planning for procurement.

The work culminated in pricing agreements for government buyers that reduced the cost of caffeine citrate by 70 percent. In Ethiopia and Kenya, the first-ever national tenders for the drug have set a precedent for future access across Africa.

Trusted Strategic Partner

Government-led, CHAI-supported health insurance reforms expand access for 65 million in Africa

User fees remain a significant barrier for many people to access the essential primary health services they need. While many governments have put policies in place to reform their free care or other insurance systems to better protect their populations, putting those policies into action remains a challenge.

CHAI helps with the transition, informing how these systems can be scaled. For example, in 2023, we worked with the Rwandan government to restructure its Community-Based Health Insurance (CBHI) benefits package—which covers 12 million of the poorest citizens—to include free breast and cervical cancer diagnosis, care, and treatment. In fact, across Ethiopia, Nigeria, Rwanda, and Zambia, we supported government-led reforms that increased financial protection for over 65 million of the most vulnerable populations, enabling them to access the essential healthcare they need.

Operational Partner

Malaria cases drop 98% in Cambodia, Lao PDR, and Vietnam; Cambodia reports first month with zero cases

Across Cambodia, Lao PDR, and Vietnam, malaria cases have dropped 98 percent over the decade since CHAI support began in 2013. While this is clearly good news, eliminating malaria is complicated, especially as the disease’s footprint shrinks.

Cases are increasingly focused in smaller—often more remote—geographies. We are on the ground working with provincial governments to tackle the ever-changing logistics and challenges of providing services to hard-to-reach areas and people. And thanks to the toolbox of prevention and treatment interventions we have developed with governments, private and public sector partners, and donors, we are seeing results. In December 2023, Cambodia marked the first-ever month with zero reported malaria cases, illustrating how far the region has come.

Ecosystem Catalyst

400 medical oxygen plants transform healthcare in nine countries

While medical oxygen is a staple of modern medicine, before the COVID-19 pandemic, oxygen systems in low- and middle-income countries were considered too complex and expensive.

However, the pandemic prompted over US$500 million worth of investments in oxygen production and supplies. While CHAI’s work was initially driven by the dire need for oxygen during the pandemic, our efforts to build oxygen production plants and upgrade oxygen infrastructure is now paying off for everyone in the health system.

Together with governments, other NGOs, and donors, we have now helped establish over 400 new oxygen plants across nine countries. These plants don’t just serve COVID patients—they’re a critical part of health systems, providing oxygen for everything from pneumonia and malaria treatment to surgeries and childbirth.