Can Clinton global health charity survive loss of former president’s clout?

Bill Clinton has promised to leave the board of the Clinton Foundation, Hillary Clinton, if elected president, but his output potential of another charity Clinton could have much greater consequences for global health.

Although it is less known than the foundation, the Clinton Health Access Initiative has played a central role in reducing drug prices in the developing world and help governments in Africa and Asia to build systems of health care.

Known as CHAI, is based largely on the former president, say global health experts, that his departure would pose a fundamental dilemma for the influential organization: Can work in a meaningful way without the influence of Clinton? Global health experts fear that the gains could be reversed won both the authority of the absent Bill Clinton and his ability to wring commitments oriented corporate leaders the bottom line.

CHAI achievements have been all about “Bill lever,” said Laurie Garrett, an expert in global health with the Council on Foreign Relations. Without it, he said, not much.

Bill Clinton announced last week that if his wife becomes president, to resign from the board of the Clinton Foundation, the foundation would “accept contributions only US citizens, permanent residents and independent foundations in the United States, “and he is no longer personally raise money for the group. Clinton said he also would fall off the board CHAI and other changes in CHAI “to ensure that their vital work will continue” will be announced later.

If CHAI were forced to stop or greatly reduce operations, “I do not know that picks up the slack,” said Dr. Ashish K. Jha, director of the Institute for Global Health at the University Harvard. No other organization “brings the kind of confidence that the Clinton name carries a lot of countries (and) a lot of national leaders,” saving many thousands, if not millions of lives, he said.

“We, as global health community will have to figure out who will take in the future,” Jha said.

Clinton Health Access Initiative
Sayyid Azim / AP Chelsea Clinton visited the District Hospital Mbagathi in Nairobi, Kenya, where the Access Initiative to the Clinton Health was to educate families about the treatment of diarrhea in May 2015.

Chai, a nonprofit organization whose directors include Bill and Chelsea Clinton, began in 2002 as a project of the Clinton Foundation . It was spun off in 2010 as an independent, however, he maintains close ties with his father.

In addition to Clinton, Bruce Lindsey – campaign manager Bill Clinton’s 1992 presidential, White House lawyer, and staff leaders – serves on both boards. The executive of Chai is Ira Magaziner, lifelong confidant of former president and chief executive and architect of the plan of care health failed Bill and Hillary Clinton.

It is not clear from the documents available to the public the amount of financial support, if any, the Clinton Foundation gives Chai. In its most recent annual report, the foundation said it spent $ 143 million in CHAI as a “spending program” in 2014 -. More than 57 percent of its budget for that year

But spokeswoman Regan Lachapelle CHAI argues that, as well as the annual report lists CHAI 2014 total revenues of $ 142 million that year. Said CHAI accepted a loan from the Foundation when it separated in 2010, but paid again, and has not received any support from 2013.

The Clinton Foundation did not respond to repeated inquiries for clarification looking STAT.

Lachapelle said Chai, incorporated in Arkansas and based in Boston, is completely separate from the foundation.

CHAI has largely escaped criticism directed at the base for taking foreign contributions, but shares much of the dependence of the base on a base of heavy donor foreign governments, foreign, and foreign foundations, but he has not made a decision about whether to refuse such donations under president Clinton. Its board will soon address possible conflicts involving the Clintons, Lachapelle said.

taxpayers abroad accounted for more than half the budget of CHAI since 2014, and foreign sources dominate the top of the donor list. Between January 2010 and June 2016, 7 of the 8 largest sources of cumulative donations of $ 25 million they were from outside the United States. CHAI among donors between $ 5 million and $ 25 million, 8 of the 11 were foreign entities or individuals, including Sheikh Mohammed Hussein Ali Al Amoudi, who Forbes magazine lists as the second richest citizen of Saudi Arabia.

Critics of Clinton have stated that some foreign donors do not disclose enough about their own operations to alleviate concerns that are trying to influence Hillary Clinton. One of the largest, The ELMA Foundation, provides an example of such secret concerns. His holding company ELMA Philanthropies Services La, is headquartered in downtown Manhattan and recorded in New York. However, its Executive Director, Robyn Calder, said in an email that ELMA is a “group non-US base” and has no obligation to disclose government information, the names of its directors, or even what country is the group will be in.

“It is difficult to see CHAI as separate from the Clinton or Clinton Foundation,” Jha said. “There may be a (non-profit) that is working directly with foreign governments, however, it is funded, which bears the name of the session the President of the United States? I think it will be very difficult for CHAI to operate in the way that it has. “

CHAI has helped more than 11 million people with” negotiated by CHAI for drugs against HIV / AIDS rates, “according to its annual report for 2015, and” It implements programs vaccines, malaria, strengthening of health systems and maternal and child health in more than 30 countries around the world, “according to documents on its website.

Andrew Hurst, a spokesman for donors CHAI UNITAID, said work CHAI “had a very significant impact on the effectiveness and scale of the international response to the AIDS pandemic,” particularly for children and those who need medicines “second-line” after the first round of failed treatments.

The group helped Indian companies to get permission from major pharmaceutical companies to produce generic versions of HIV drugs. He also worked to boost the detection of tuberculosis in India and elsewhere in the developing world.

Garrett said among the philanthropic efforts of Clinton, chai “is where there have been big wins.”

“Bill has often … declared a sort of mea culpa – that had failed to recognize the seriousness of the epidemic (AIDS) and what would make the African continent,” when he was president, Garrett said . CHAI has worked diligently to correct that, exploiting prestige and power of the former president, he added.

The work of Clinton to push down drug prices in the nations developing inspired other organizations to be creative about finances global health, Garrett said. UNITAID, one based in Switzerland, a subsidiary of the World Health Organization, many nations pressed to put a small tax on airline travel by plane in practice. This tax now raises hundreds of millions of dollars annually for health programs worldwide.

CHAI has also helped developing countries improve their health systems and funding. an innovative process that allows local authorities collect health data from many sources, then analyze the information to identify gaps and inefficiencies and increase access to care was developed. In Malawi, the program has saved millions of dollars by streamlining various systems of parallel drug supply.

is an area that most of the major players in global health, which tend to focus on vaccines and drugs against scourges like AIDS and malaria, have rarely been tackled head on.

Experts are concerned that this work will reoffend if CHAI is dissolved, partly because no one else influences peerless Clinton. Jha, Harvard said no other organization is seen as an obvious candidate to take over the leadership on the ground in Africa – even the giant Bill and Melinda Gates , which has focused on technical solutions health problems worldwide. A spokesman for Gates said the foundation had no comment.

UNITAID and other organizations could intervene to a degree, but a success in the global health workforce could be one of the most significant losses, according to Garrett. “(CHAI) has served as an entry point for idealistic young children, leaving graduate programs and schools of public health, wanting to make a difference,” he said. “That’s all going to disappear.”

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