W i l l i a m J. C l i n t o n F o u n d a t i o n a n n u a l R e p o R t 2 0 0 8

Intelligence, ability, and aspiration are evenly distributed across societies –

organization, investment, and opportunity are not.

The William J. Clinton Foundation seeks to bridge this gap

by using a business-oriented approach to address

some of the world’s greatest challenges. Our work is based

on the belief that seemingly intractable problems,

such as HIV/AIDS, global climate change, and extreme poverty,

can be overcome through collaborative and systematic effort.

Across all of our programs, we work with likeminded partners

to deliver measurable and sustainable results

that put the highest possible value on individual human lives.

Message from President Clinton

Building a Foundation

Where We Work

Year in Review

Clinton Global Initiative

Clinton HIV/AIDS Initiative

Alliance for a Healthier Generation

Clinton Climate Initiative

Clinton Hunter Development Initiative

Clinton Giustra Sustainable Growth Initiative

Clinton Economic Opportunity Initiative

Clinton Presidential Center

Bush Clinton Coastal Recovery Fund

Support Our Work

Financial Highlights

Closing Message

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CONTENTS

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Justin Sullivan / Getty Images for the Clinton Foundation

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As I write, we are already halfway through 2009, and the world is a much different place than it was a year ago. America has a new president and a new spirit of optimism and purpose. The Olympic Games in Beijing showcased China’s economic and technological progress and affirmed, as the games always do, our common humanity. New discoveries, from clean energy technologies to uncharted territories of the human mind, continue to expand the limits of what is possible.

Unfortunately, the negative forces of interdependence have also been raging. The financial meltdown, which started in the United States, spread across the globe, leaving millions of people out of work. Conflicts in the Middle East, Afghanistan, and South Asia continue to drain hope and elude solutions. Iran and North Korea persisted in their nuclear programs. And every new scientific report says the planet is warming more quickly, with even more consequences than previously thought. Meanwhile, the world remains burdened by persistent inequality: 1 billion people living on less than $1 a day; 1 billion chronically hungry; and more than 2 billion without access to clean water or sanitation. AIDS, TB, malaria and water borne diseases still claim millions of lives that could be saved, and well over 100 million children do not go to school. Even in the United States, before the financial meltdown, poverty was higher and median income lower than at the beginning of the decade.

The modern world is unequal, unstable, and unsustainable. The good news is we can do something about all these challenges, and we can emerge from the financial crisis with a more balanced economy, a stronger, safer, more just world. The question we all must ask is how – how can we turn our good intentions into positive changes?

“How” is the most important question of the 21st century, and I spend most of my life working with my Foundation to answer it. How to keep HIV/AIDS and malaria from killing people? How to empower and educate the poor? How to reverse childhood obesity in the United States? How to fight climate change and increase economic opportunity? How to get the largest numbers of other people working on these problems through the Clinton Global Initiative (CGI)?

Our business-oriented approach has achieved tremendous results: 2 million people are now accessing HIV/AIDS treatment under our pricing agreements, including two-thirds of all children in poor nations receiving pediatric medicines; 40 of the world’s largest cities are making progress in the fight against climate change; thousands of farmers in Rwanda and Malawi are improving their food security and increasing incomes; more than 4,300 U.S. schools are creating healthier learning environments, and more than a million children have pledged to lead healthier lives through the Alliance for a Healthier Generation. Members of CGI have made more than 1,400 Commitments to Action valued at $46 billion to improve the lives of more than 200 million people in 150 countries.

Behind each number is a story of a life transformed and hope restored. All this was made possible through the dedication of more than 1,400 staff on the ground in more than 40 countries worldwide, working to find answers to the “how” question.

In the pages to follow, you will read about the problems we’re addressing, the approaches we’re taking, the results we’re achieving, and the people we’re helping. Across all of our initiatives, we are focused on finding the “how.” I hope you’ll be inspired to help us turn even more good ideas into meaningful changes over the next year and in the years to come.

Sincerely,

de a R FRie nd S,

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Buil dinG a F ound at ion

When President Clinton left the White House in 2001, he knew he wanted to spend his life as a private citizen working in the areas he cared about most and where he could make a difference. His vision: a nongovernmental organization that could leverage the unique capacities of governments, partner organizations, and other individuals to address rising inequalities and deliver tangible results that improve people’s lives.

At the International AIDS Conference in 2002, the prime minister of St. Kitts and Nevis asked President Clinton to help build a health care system that would address the pressing HIV/AIDS pandemic. President Clinton knew that the Foundation could be helpful in lowering the cost of treatment for all countries in the developing world. At the urging of Nelson Mandela, he began the Clinton HIV/AIDS Initiative (CHAI), which is now working globally to improve access to care and treatment.

During the same time CHAI began its work, President Clinton was establishing his post-presidential office in the iconic neighborhood of Harlem in New York City, where he saw a great opportunity for his Foundation to help empower local small business owners. This initiative has since evolved into the Clinton Economic Opportunity Initiative (CEO), which helps strengthen small businesses and entrepreneurs across the United States.

Over the next seven years, President Clinton continued to add to the Foundation’s portfolio of work, building on past successes and applying the same business-oriented approach to tackle other pressing challenges. While some initiatives blossomed from his commitment to specific issues – like climate change through the Clinton Climate Initiative (CCI) – others were inspired by life-changing events. In 2005, after undergoing heart-bypass surgery – the result of a lifetime of unhealthy eating – he joined with the American Heart Association to form the Alliance for a Healthier Generation with the goal of ending the childhood obesity epidemic in the United States.

Based on the Clinton Foundation’s proven record of results, two other initiatives – the Clinton Hunter Development Initiative (CHDI) and the Clinton Giustra Sustainable Growth Initiative (CGSGI) – were launched in conjunction with partners who knew the Foundation could effectively allocate financial resources and implement programs to catalyze sustainable growth in Africa and Latin America.

But the most well-known initiative is unlike any other. After a lifetime of attending meetings where issues were discussed but no action was taken, President Clinton started the Clinton Global Initiative (CGI) in September 2005 to convene world leaders, forward-looking CEOs, and philanthropists to commit to take action on pressing challenges including climate change, poverty alleviation, global health, and education. Over the course of four annual meetings, members have made more than 1,400 commitments, which are improving 200 million lives in 150 countries.

In addition to these seven initiatives, the Clinton Presidential Center, in Little Rock, Arkansas, supports the mission of the Foundation. The Center is also home to the University of Arkansas Clinton School of Public Service, the only school in the nation offering a Master’s of Public Service. Both the Center and the School are inspiring others to follow in President Clinton’s legacy of service.

What began as a vision to lower the prices of HIV/AIDS medicines has evolved into one of the fastest- growing NGOs in the world. But the Clinton Foundation wasn’t built overnight, nor was it the result of one individual alone. The collaboration of likeminded partners, visionary individuals, generous supporters, and a dedicated and talented staff on the ground has brought the Foundation to where it is today.

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David Scull / Clinton Foundation

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WHERE WE WORKThe Clinton Foundation works in more than 40 countries on six continents and in all 50 United States. Our impact is felt around the globe, and more than 70 countries are benefiting from our HIV/AIDS drug-pricing agreements.

For more detailed and updated information about our ongoing work, please visit www.clintonfoundation.org.

The allianCe FoR a HealtHieR GeneRation, a partnership with the American Heart Association, is working nationwide to eliminate childhood obesity and inspire all young Americans to develop lifelong healthy habits. PAGE 22

The Clinton GloBal initiatiVe began as an annual meeting of global leaders from all sectors taking action on pressing global challenges. Today, CGI has expanded to include an annual meeting for college students (CGI U) and an online network for private citizens (MyCommitment.org). Its overall impact is felt in more than 150 countries. PAGE 10 CGI MEETING LOCATIONS

The William J. Clinton pReSidential CenteR, located in Little Rock, Arkansas, attracts visitors from all 50 states and from countries around the world. The Center is also home to the University of Arkansas Clinton School of Public Service. PAGE 40

The Clinton eConomiC oppoRtunitY initiatiVe is working to advance economic prosperity in the United States by promoting entrepreneurship and helping individuals and families access affordable financial services. PAGE 38 CITIES WORKING WITH CEO

The BuSH Clinton CoaStal ReCoVeRY Fund was started by Presidents George H.W. Bush and Bill Clinton to help people rebuild and recover after Hurricane Ike devastated communities along the Gulf Coast in 2008. The money raised will go toward building schools, health care centers, and other critical community systems and services in the hardest-hit regions. PAGE 43

The Clinton GiuStRa SuStainaBle GRoWtH initiatiVe is helping industries invest in the long-term improvement of economic and social outcomes for citizens in the developing world, starting in Latin America. PAGE 34

The Clinton Climate initiatiVe works with governments, cities, and businesses around the world to create local solutions to global climate change that are economically and environmentally sustainable. PAGE 26

CITIES WORKING WITH CCI

The Clinton HunteR deVelopment initiatiVe, a partnership with the Hunter Foundation, is working in Rwanda and Malawi to unleash entrepreneurship, strengthen agriculture, develop profitable businesses, and spur sustainable economic growth. PAGE 30

The Clinton HiV/aidS initiatiVe is turning the tide of the global pandemic by working with partner governments and other NGOs to establish integrated care, treatment, and prevention programs. CHAI’s partner Countries, who receive comprehensive assistance, and procurement Consortium Countries, who have access to medicines and diagnostics at reduced CHAI prices, are located in the Caribbean, Latin America, Eastern Europe, Africa, and Asia. PAGE 16

W HeRe W e WoRK

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YEAR IN REVIEWSince 2001, the Clinton Foundation has grown from a small office in Harlem to a worldwide nongovernmental organization. Each year, we build upon our success to find new ways to help more people. Last year was no exception: across each of our seven initiatives, we added additional programs, formed new partnerships, and made great progress. Here are a few of our proudest moments from the year.

CCi | February 16, 2009 CCI announces a partnership with the city of Los Angeles to replace 140,000 streetlights with LED bulbs, a landmark program that will reduce 40,500 tons of carbon emissions per year.

CGi | december 2008 The CGI Asia meeting is convened in Hong Kong.

october 2008 President Clinton and President George H.W. Bush visit areas along the Gulf Coast devastated by a series of hurricanes. The pair head the Bush Clinton Coastal Recovery Fund to help raise money to help people rebuild.

For more, please visit www.clintonfoundation.org.

CGi | September 2008 The fourth annual meeting of the Clinton Global Initiative is held in New York City. More than 250 commitments were made, impacting more than 160 million lives.

april 2008The Clinton Presidential Center hosts the largest Earth Day festival in Arkansas, attracting thousands of visitors to the grounds and underscoring the Center’s commitment to sustainability.

July–august 2008 President Clinton travels to Ethiopia, Rwanda, Senegal,and Liberia to visit Foundation projects addressing health, climate change, poverty, and agriculture. His trip concluded in Mexico City, where he delivered remarks at the International AIDS Conference.

CGi | march 14–16, 2008 The inaugural meeting of the Clinton Global Initiative University is held at Tulane University in New Orleans.

2008 2009

CHai | august 2008 The first woman in Cambodia to undergo CHAI’s full Prevention of Mother-to-Child Transmission program gives birth.

allianCe | September 10, 2008 The American Beverage Association announces that thanks to the Alliance’s voluntary agreement with the beverage industry, 58 percent fewer beverage calories were shipped to schools across the United States between 2004 and 2008.

Ceo | July 2008 CEO launches the OaklandEntrepreneur MentoringProgram to match emergingsmall business owners withsuccessful entrepreneurs.

PHOTO CREDITS, TOP ROW FROM LEFT: Lisa Berg / Clinton Global Initiative, Cranford Johnson Robinson Woods, Barbara Kinney / Clinton Foundation, Juliana Thomas / Clinton Global Initiative, Adam Schultz / Clinton Foundation, Min-Gyu Seong, Adam Schultz / Clinton Foundation.BOTTOM ROW FROM LEFT: Barry Roden / Clinton Foundation, Nisha Sondhe, Anne Depree / Clinton Foundation, Zachary Katz / Clinton Foundation, Ben Asen, Mark Burns, David McIntyre / Clinton Global Initiative, Tyrone D. Washington / LA Mayor’s Office.

CGSGi | march 1, 2008 CGSGI launches initial projects in Latin America, ranging from medical missions to underserved areas in Colombia to programs addressing poverty reduction in Peru.

CHai | april 2008 CHAI announces a set of price reductions of 19 percent for leading generic second-line regimens as well as new formulations for pediatric fixed-dose combinations.

Ceo | october 2008 CEO launches the Harlem Restaurant Program with renowned chef Marcus Samuelsson as the guest speaker.

allianCe | February 19, 2009 The Alliance for a Healthier Generation launches the Alliance Healthcare Initiative, a landmark agreement with insurers and corporations to provide families with obese or overweight children at least four visits with their doctor and at least four visits with a registered dietitian every year.

CCi | november 2008 The first building retrofits initiated by CCI’s Energy Efficiency Building Retrofit program are completed in Seoul.

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Solving our most pressing global challenges will take more than strong governments alone; it will require collaboration among the private sector, nongovernmental organizations, young people, and citizens from around the globe to create a world of shared benefits and opportunities.

After leaving office, President Clinton envisioned a meeting where leaders from all sectors, backgrounds, regions, and generations could brainstorm solutions to the world’s most urgent problems and leave with a specific plan of action. The only requirement? Follow through.

In 2005, this vision became the Clinton Global Initiative (CGI), a unique venue where business, government, and civil-society leaders work together to plan and launch specific projects – Commitments to Action – to address global economic, environmental, and social challenges.

Good Energies

CGI has inspired more

than 1,400 commitments

valued at $46 billion,

which are improving the

lives of 200 million people

in 150 countries.

Clinton GloBal initiatiVe

“HOW CAN WE TRANSFORM GOOD INTENTIONS INTO POSITIVE CHANGES IN PEOPLE’S LIVES?” – PRES IDEN T B IL L CL IN TO N

our approachBy gathering world leaders, top business executives, heads of nongovernmental organizations, and members of the media from a variety of backgrounds and regions, CGI gives members an opportunity to generate collaborative responses to global challenges. By emphasizing action, and measurable results, CGI is more than just an annual meeting – it’s a platform for global citizenship that has a positive impact year-round.

aNNuaL MEETINGEach CGI meeting concentrates on challenges and opportunities in specific focus areas – from education and global health, to climate change and poverty alleviation. Meetings are arranged around plenary and working group sessions, which feature expert panelists and allow members to interact and define their Commitments to Action.

coMMITMENTs To acTIoNAn essential condition of membership, Commitments to Action are new, specific, and measurable initiatives to address global challenges. Some members define their commitments based on the ideas and solutions examined during the Annual Meeting, while others work throughout the year with CGI to formulate their commitments. Many commitments are the result of new and diverse partnerships across sectors, increasing the impact and expanding the reach of individual members and organizations.

CGI is not a grant-making organization and commitments are funded and implemented directly by commitment makers. After making a commitment, members report to CGI on progress.

BEyoNd ThE aNNuaL MEETINGThe CGI community also includes CGI University (CGI U), a forum to engage college students in global citizenship; CGI Asia; and MyCommitment.org, an online portal that gives everyone the opportunity to make a Commitment to Action, connect with others who share the same vision for change, and create global networks to put plans into action. More than 150,000 visitors to the site from more than 200 countries and territories have made almost 2,500 commitments reflecting nearly 430,000 volunteer hours, 45,000 donated items, and more than $5 million in contributions to people and organizations in need.

Almost every child in the world is infected with rotavirus before the age of 5, but in countries like the United States, very few die from it. In the developing world, however, malnutrition and lack of access to effective treatments compound this highly contagious disease, causing the hospitalization of more than 2 million people and the deaths of nearly 600,000 children under the age of 5. Rotavirus infection is typically characterized by frequent diarrhea, vomiting, and fever that can lead to rapid dehydration in infants and young children.

Other than vaccination, there is no effective way to prevent rotavirus disease or its spread. At the 2006 CGI Annual Meeting, Merck & Co., Inc., made a commitment with the government of Nicaragua to help reduce illness and death resulting from rotavirus in developing countries by vaccinating every infant born over the next three years. Through this initiative, 80 percent of eligible infants in Nicaragua have already been vaccinated. Merck has also donated nearly 1 million doses of RotaTeq® – its rotavirus vaccine – and will continue to provide free RotaTeq® for all infants born in Nicaragua through the end of 2009. This program marks the first time that a new vaccine was introduced in a country in the developing world in the same year as it was introduced in the developed world. The commit-ment intends to accelerate the uptake of rotavirus vaccines in countries with the greatest medical need, not just in Latin America, but worldwide.

A child receives a rotavirus vaccine in Nicaragua as part of Merck’s CGI commitment. LEFT PAGE: As part of its CGI commitment, the Solar Energy Foundation installed 1,100 solar systems in Rema Village, Ethiopia, to help stimulate access to health care, employment, and education.

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CGi Commitment | meRCK & RotaViRuS

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CGI |

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our rEsuLTs Over the course of four Annual Meetings, CGI members have made more than 1,400 commitments valued at $46 billion, which are improving more than 200 million lives in more than 150 countries. Commitments made at the 2008 CGI Annual Meeting are expected to affect almost 160 million people. Among other results, these commitments have:

Cut the equivalent of 40 million metric tons of CO• ₂ emissions

Provided 34 million people with access to treatment for neglected •

tropical diseases

Reduced malnutrition among more than 42 million children•

Provided more than 4 million people with access to clean-energy •

services in the developing world

Provided more than 8 million children with access to schooling•

Provided access to safe drinking water for 3 million people in Asia•

Funded more than 270 microfinance institutions, empowering •

3 million entrepreneurs with access to microfinance

fuTurE MEETINGsCGI will hold its fifth Annual Meeting on September 22–25, 2009. Given the current economic challenges impacting all corners of the planet, this year’s meeting will help members focus their shared knowledge and resources to find economically-sustainable solutions to global challenges in education, energy and climate change, global health, and poverty.

A revitalized program will highlight opportunities for collaboration between the private sector and public sector and improve core business operations while creating jobs and strengthening communities. Discussion topics will include innovation, finance, human capital, and infrastructure.

In December 2008, more than 400 influential business, government, civil-society, and philanthropic leaders from Asia met at the CGI Asia meeting to develop solutions for the most urgent issues in the region. President Clinton hosted this two-day meeting in Hong Kong to provide local leaders with an opportunity to further strengthen social responsibility on the continent. The meeting featured panels and workshops that examined education, energy and climate change, and global health at the local, regional, and international levels. Members partnered together on nearly 70 Commitments to Action, with an overall estimated total value of $185 million. When fully implemented, these commitments will have a positive impact on more than 10 million lives.

S p o t l iGH t | CGi a S i a

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“[President Clinton] helped create a model for individual responsibility and collective action through the Clinton Global Initiative, and it is a model that all of us are going to be studying for a very long time.”

– PRESIDENT BARACK OBAMA

CGi BY FoCuS aRe a

22% poVeRtY alleViation

22% eneRGY & Climate

21% otHeR

20% GloBal HealtH

15% eduCation

CGI members have focused their action to address four pressing challenges: global health, poverty alleviation, energy and climate change, and education.

Microinsurance – insurance policies sold in high volumes at low prices – is one of the most untapped markets and greatest means to help vulnerable communities, allowing people to recover from shocks more quickly and increase their incomes. At the 2008 CGI Annual Meeting, President Clinton announced the launch of LeapFrog Investments, the world’s first investment fund to focus on the insurance needs of low-income people. Through its Commitment to Action, LeapFrog plans to invest $100 million in operations and businesses that provide affordable and high-quality insurance and financial services to 25 million individuals in Africa and Asia. Andrew Kuper, the firm’s president and founder, tells us about his commitment.

Q: CGi CommitmentS to aCtion aRe neW, SpeCiFiC, and meaSuRaBle. WHat maKeS YouR Commitment uniQue?

A: LeapFrog is the world’s first investment fund to focus on the microinsurance market. It will grow and support businesses that provide affordable, quality, and relevant insurance products to poor communities as well as to those who are excluded from conventional insurance services such as people with disabilities or HIV/AIDS. Our initial targets are households in India, Pakistan, South Africa, Ghana, Uganda, and Kenya, where demand for microinsurance products is high.

Q: WHat inSpiRed You and YouR paRtneRS to maKe tHiS Commitment?

A: Each of us was convinced that there is no need to choose between being innovators in business and change makers in society. As CEOs and social entrepreneurs with decades of collective experience in insurance and investment in emerging markets, we recognized that microinsurance could protect and enable the poor and offer nonmarket-tracking financial returns to those who invest in it. We wanted to take this exciting new alternative asset class to the next level by creating a for-profit fund that also generates sustainable social change.

Q: HoW HaS todaY’S eConomiC CRiSiS aFFeCted YouR momentum?

A: In uncertain times, the demand for microinsurance products could increase. In any case, given the size of this market and the intensity of demand, the microinsurance sector is well-positioned to endure financial storms. LeapFrog and large insurers are entering the microinsurance sector at unprecedented scale, leading the charge to reach an estimated market of 1 billion people. So investment in microinsurance, even in hard times, is poised for massive growth.

Ceo Q & a | andRe W KupeR, le apFRoG inVeS tment S

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A young boy walks to school in the Kibera slum on the outskirts of Nairobi, Kenya, a community that could greatly benefit from microinsurance.TOP: President Clinton stands with Dr. Andrew Kuper and Dr. Jim Roth of LeapFrog Investments at the 2008 CGI Annual Meeting.

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1. A commitment made by The Global Fund for Children invests in grassroots organizations in the developing world that provide early childhood programs for vulnerable children to ensure healthy development and prepare them for formal schooling. 2. Through its Second Step commitment, Trickle Up is helping successful microentrepreneurs around the world take a permanent step out of poverty by assisting them in expanding and developing their businesses. 3. The Community-Led Education Programs for Women and Children commitment by the American Jewish World Service will support 26 community-based organizations in Sri Lanka, Burma, and Guatemala to help improve access to nonformal education for 10,000 children and women.2

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Cl in t on Gl oBa l init iat i V e

CGI |

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2008 aNNuaL MEETING hIGhLIGhTs The 2008 CGI Annual Meeting took place in New York City on September 23–26. Convened just weeks before the U.S. presidential election and in the wake of financial collapses on Wall Street, the meeting featured President Barack Obama, President George H.W. Bush, Senator John McCain, former Vice President Al Gore, Queen Rania Al-Abdullah of Jordan, Bono, Lance Armstrong, New York Mayor Michael Bloomberg, President Ellen Johnson-Sirleaf of Liberia, T. Boone Pickens, Bill Gates, and other distinguished speakers. Participants discussed the urgent need to solve problems of poverty, health, education, and climate change, and strengthen the global economy and communities around the world. By the end of the Annual Meeting, CGI members had made 250 new Commitments to Action that are valued at nearly $8 billion.

Commitments announced at the Annual Meeting include the Adolescent Girls Initiative for Economic Empowerment by the Nike Foundation, the World Bank, and the governments of Liberia and Denmark; the Global Plastic Shopping Bag Waste Reduction Initiative by Wal-Mart in partnership with the Environmental Defense Fund; and a “mega-commitment” to address issues in Haiti by Partners In Health, Procter and Gamble, Good Energies Foundation, Digicel, Wyclef Jean, Matt Damon and Frank McKenna from the One by One Foundation, TOMS Shoes, and the government of Haiti, among many other CGI members.

By the end of the 2008 CGI Annual

Meeting, CGI members had made

250 new Commitments to Action,

valued at nearly $8 billion.

TOP LEFT: Juliana Thomas / Clinton Global Initiative. TOP RIGHT: Todd France / Clinton Global Initiative. MIDDLE LEFT: Paul Morse / Clinton Global Initiative. BOTTOM RIGHT: Paul Morse / Clinton Global Initiative. BOTTOM LEFT: Todd France / Clinton Global Initiative.

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CGi u Commitment | a’S & aCeS

In 2008, Anna Monhartova – then a student at Tulane University – co-founded A’s & Aces to introduce tennis to underserved and at-risk children in post-Katrina New Orleans. Anna attended the inaugural meeting of CGI U, where she committed to expand the program to reach students who would not otherwise have the opportunity to play tennis and receive educational support in a structured environment.

The fun of learning tennis has caught on: A’s & Aces served about 350 children during the 2008–09 academic year. Since no New Orleans Recreation Department tennis facilities have yet reopened after Hurricane Katrina, kids play using foam balls, small rackets, and portable nets that quickly create “mini-courts” appropriate for K-4th grade students.

But A’s and Aces is doing more than just teaching a new sport – the program is improving the scholastic, physical, and character development of public school youth by teaching life skills, focusing on good citizenship, and providing academic support, such as computer skills, tutoring, and homework assistance. In communities affected by gang violence and high drop out rates, the program aims to give kids an alternative afterschool and summer activity that can have a lasting impact.

In the future, Anna hopes the program will add middle school and high school tennis teams to its roster to help prepare students to develop the skills and educational opportunities needed to obtain college scholarships. But for now, the program focuses on giving younger kids the chance to have fun and learn.

As one second grader remarked, “I wish we could do this every day!” He paused and added, “Except for Friday.”

Students in New Orleans line up to hit tennis balls at an A’s and Aces afterschool program, started through a 2008 CGI U commitment. LEFT PAGE: The 2008 CGI Annual Meeting featured Mayor Michael Bloomberg, Bono, Former Vice President Al Gore, Queen Rania Al-Abdullah of Jordan, President Ellen Johnson Sirleaf of Liberia, and Bill Gates. During the closing plenary session, members made a mega-commitment to “build back better” in Haiti.

Students help clean a park during a service project at the 2009 CGI U meeting in Austin, Texas.

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At the meeting, President Clinton honored Jennifer and Peter Buffett, Julio Frenk, Xiaoyi (Sheri) Liao, and E. Neville Isdell at the Clinton Global Citizen Awards ceremony for their ongoing commitments to leadership in philanthropy, civil society, public service, and the corporate sector.

The meeting also featured the launch of new technologies and events to encourage partnerships among members. CGI Connect gives members access to an online community that includes a member directory, a messaging system, member biographies, and commitment information. CGI Exchange – a public exhibition of commitments – showcases member accomplishments and allows them to explore new partnerships.

cLINToN GLoBaL INITIaTIVE uNIVErsITyWhen more than 3,000 students applied to attend the second meeting of the Clinton Global Initiative University (CGI U) in the midst of a global economic recession, President Clinton didn’t think it was a coincidence. “Over the last year in America, we have seen a remarkable resurgence of energy on the part of young people…in service activities involving their campuses, their communities, and efforts all across the globe,” he told the group of 1,000 students and almost 100 university presidents and directors of national youth organizations – representing all 50 states, more than 50 countries, and 280 universities – who were accepted to attend the meeting at The University of Texas at Austin in February 2009.

Over the course of the three-day meeting, attendees participated in forums, skill sessions, and working sessions, and on the final day, took part in a wide range of community-service activities at the Rosewood Park and Recreation Center in East Austin with President Clinton and Matthew McConaughey. NFL star Nnamdi Asomugha, Natalie Portman, Luke Russert, and Morgan Spurlock also participated in the meeting.

Like members of CGI, the students at CGI U made Commitments to Action addressing one or more of CGI U’s five focus areas: education, energy and climate change, global health, peace and human rights, and poverty alleviation. From providing literacy training to women in Bolivia to establishing programs on campuses that offset carbon emissions, CGI U commitments are proving that young people can make a big difference.

Since the inaugural meeting of CGI U in March 2008 at Tulane University, more than 1,700 CGI U commitments have been made. To assist in these efforts, the Wal-Mart Foundation and the Pat Tillman Foundation are helping to fund exceptional student commitments with grants totaling $400,000.

Clin t on Gl oBa l init iat i V e

CGI |

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Ilvy Njiokiktjien / Partners In Health

Today, despite the great progress that has been made, the HIV/AIDS pandemic is growing faster than the number of people put on treatment, and developing countries are bearing the majority of the disease burden.

Many of the challenges in establishing and expanding HIV/AIDS prevention, care, and treatment are common across developing countries: HIV-positive mothers are transmitting the virus to their newborn babies at rates of up to 45 percent, and half of the children who test positive are “lost” throughout the health system and are not currently receiving treatment.

Other challenges are unique to particular countries or regions: Zambia has 28,000 fewer health care workers than needed by the Ministry of Health. In Liberia, laboratory services were wiped out by civil war, limiting access to testing and other essential diagnostic services.

Multipronged responses are needed to reduce HIV transmission rates, strengthen health systems, and curb a pandemic that continues to destabilize economies and take the lives of 2 million people each year.

33 million people are living with HIV/AIDS.

6 million people in immediate need of treatment are not accessing it.

For every 2 people who gain access to treatment, 5 more are newly infected.

Clinton HiV/aidS initiatiVe

our approachSince 2002, the Clinton HIV/AIDS Initiative (CHAI) has worked with governments and other partners to increase access to high-quality HIV/AIDS care and treatment. CHAI is not just another donor or implementer; instead, CHAI focuses on improving the management and markets needed to increase care and treatment for the most vulnerable populations in the world.

CHAI’s work is concentrated in two areas: Access Programs and Country Operations. Access Programs aim to increase access to drugs and diagnostics for HIV/AIDS and other diseases. Country Operations assist governments in making complex health systems work more efficiently. By helping to organize commodity markets and better manage national health programs, CHAI significantly leverages resources to save lives and develop sustainable solutions that can be owned and maintained by local partners.

accEss proGraMsA cornerstone of CHAI’s approach is improving the marketplace for key health products such as drugs and diagnostics. CHAI works to facilitate quick access to high-quality, optimally designed products at affordable prices. Rather than acting as a buyer or seller, CHAI plays a crucial coordinating role across suppliers, purchasers, and international agencies, helping partners to work together to overcome barriers that no single entity could overcome alone. In recent years, CHAI has been asked to expand its access work into new disease and product areas, including malaria medicines and ready-to-use therapeutic food for severely malnourished children.

Diagnostic Access. Access to laboratory testing is essential to enable high-quality care and treatment for HIV/AIDS. CHAI began its diagnostic work through efforts to reduce the price of the most costly diagnostics for national treatment programs. CHAI quickly discovered that high prices, while significant, are not the largest barriers to access for most diagnostic products. Instead, the central challenges have been weak national laboratory systems and highly centralized testing services that do not reach patients in remote areas. In response to this finding, CHAI supports countries in all aspects of lab-system strengthening, including lab technician training, sample transport, quality assurance, data management, and supply-chain management. CHAI has also started to facilitate the introduction of key new technologies that bring testing to patients even in the most isolated communities.

“HOW CAN WE CLOSE THE GAP IN ACCESS TO QUALITY HEALTH CARE FOR PEOPLE LIVING IN THE DEVELOPING WORLD?” – PRES IDEN T B IL L CL IN TO N

S toRY oF Hope | eRneS t, z a mBia

In December 2004, at the Family Support Unit at the University Teaching Hospital in Lusaka, Zambia, Ernest, then age 11, was diagnosed with HIV. Ernest understood his diagnosis. When he took his seventh-grade examinations and scored the highest marks at his school, he told his mother, “I am not intelligent for nothing, Mummy. I know everything. All I don’t want is to be treated differently. I should be treated like any other child.”

In February 2006, after baseline tests showed his CD4 count was low, Ernest was referred to the University Teaching Hospital’s Pediatric Antiretroviral Treatment Clinic.

Ernest is one of approximately 8,000 children who have received care and treatment for HIV/AIDS at the Pediatric Center of Excellence at University Teaching Hospital, an entity of the Department of Pediatrics and Child Health supported by the United States Centers for Disease Control and Prevention and the International Training Center for AIDS Care and Treatment Programs of Columbia University. The Pediatric Center implements a family-centered, multidisciplinary team approach and provides comprehensive care and treatment for children.

Today, at 15 years old, Ernest is still on treatment purchased at prices negotiated by CHAI, and his CD4 count has increased significantly. He has high aspirations for his future and hopes one day to become a cancer researcher.

Ernest, an HIV-positive 15 year old, now receives medicines purchased under pricing agreements negotiated by CHAI. LEFT PAGE: A child sits with his mother at a hospital outside of Rwinkwavu, Rwanda, built and supported by the Clinton Foundation, Partners In Health, UNICEF, and the Global Fund.

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Drug Access. When CHAI began its drug access work in 2002, the price of HIV/AIDS drugs was preventing developing countries from providing treatment to millions of people in need. Today, more than 70 countries are eligible to access CHAI pricing through agreements that have dramatically lowered the price of adult and pediatric HIV/AIDS drugs. CHAI’s early price-reduction efforts focused on transforming a low-volume, high-margin drug marketplace into one with much higher demand volume and lower production costs that still resulted in profit margins. Over time, CHAI’s approach to price reductions has become more comprehensive. For example, in order to achieve significant price reductions for the critical first-line antiretrovirals (ARVs) tenofovir and efavirenz, CHAI facilitated the entry of new suppliers to increase competition, helped suppliers improve process chemistry for drug synthesis, and assisted partner manufacturers in optimizing their sourcing arrangements for key raw materials.

CHAI has expanded beyond efforts to reduce drug prices and now fosters a healthy and sustainable drug marketplace that is characterized not only by competition and affordable prices but also by the ability of patients to quickly access high-quality formulations that meet their needs. CHAI has also begun efforts to expand access to the best available malaria medicines – artemisinin combination therapies (ACTs) – by addressing volatility in pricing and supply.

Malaria. Malaria is the single greatest killer of African children, claiming roughly 1 million lives each year. In addition to its terrible toll on families, malaria overwhelms struggling health systems, accounting for as many as half of all hospital admissions in some countries and costing African countries an estimated $12 billion every year in lost productivity. Building on its HIV/AIDS efforts, CHAI has been invited to work with countries to pursue innovative approaches to combating malaria. For example, CHAI piloted a drug subsidy in Tanzania to make high-quality ACTs – the most effective but most expensive malaria drugs – accessible to people living in poor rural communities. The pilot study found that the subsidy could reduce ACT prices to patients by 95 percent and increase access for young children at the greatest risk of malaria from near-zero levels to more than 50 percent in one year.

“I love the Clinton Foundation because they have what every organization in the field should have – the sense that every minute you lose, you lose another life. If it hadn’t been for the Clinton Foundation’s negotiation around the generic drugs, I don’t know how many more hundreds of thousands of people would have died unnecessarily.”

– STEPHEN LE WIS, CO-DIRECTOR OF A IDS-FREE WORLD

& FORMER U.N. SPECIAL ENVOY FOR HIV / A IDS IN AFRICA

President Clinton meets Jean Pierre (right), a boy living with HIV/AIDS, in a village near Rwinkwavu, Rwanda. Jean Pierre is visited by Beatrice, his health care worker supported by CHAI, each month.TOP: Health care workers package malaria medicines for transport in Morogoro, Tanzania.

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CHAI has brokered significant price reductions that allow countries to do more with limited resources. For one of the most important adult first-line regimens³, CHAI has reduced pricing over the last two years by 66%, relative to the best initially available market price.

¹Originator “access” prices for TDF+FTC+EFV in low Human Development Index (HDI) countries plus medium HDI countries with adult HIV prevalence of 1% or greater. ²2009 CHAI price for TDF+3TC+EFV³TDF+3/FTC+EFV

CHai’s impaCtPRICE REDUCTION IN HIV/AIDS MEDICINE

$613 BEST ORIGINAL PRICE¹

$210 CHAI PRICE²

couNTry opEraTIoNs To ensure that countries can aggressively and sustainably expand access to care and treatment for HIV/AIDS, CHAI works with national governments in more than 20 countries to develop sound health care policies, strengthen management capacity, and develop cost-effective, practical systems. CHAI’s role varies by country but focuses on the core areas of pediatric HIV services, mother-to-child transmission of HIV/AIDS, supply-chain management, building capacity of human resources for health, rural health care, and laboratory systems.

Pediatrics. CHAI’s pediatric program focuses on building and strengthen-ing the systems needed to deliver effective care and treatment to children. When CHAI’s pediatric program began in 2005, pediatric treatment in many countries was almost nonexistent. Since then, CHAI and other partners have helped triple the number of children on treatment globally. Through a partnership with UNITAID, CHAI also enabled the introduction of pediatric fixed-dose combination pills in 26 countries and reduced pediatric ARV prices by an average of 64 percent since 2006. Future action aims to ensure that retention is on the policy agenda internationally, as well as in the countries where CHAI works.

Prevention of Mother-to-Child Transmission. Each year, half a million children are infected with HIV. More than 90 percent of these infections result from mother-to-child transmission. Without intervention, there is a 20–45 percent chance that an infant born to an HIV-infected mother will become infected. The only way to effectively stop this transmission is to ensure that national health care systems enable both mother and child to access a full cascade of prevention services. CHAI will work with the governments in more than seven developing countries over the next three years to ensure access to quality pre-test counseling, adequate testing and prenatal care, affordable and effective medicines for HIV-positive mothers, safe delivery, early treatment for HIV-positive infants, guidance on feeding options, and continued maternal and child care.

Supply-Chain Management. Effective supply chains are essential for the delivery of drugs and diagnostics to patients – and a poorly functioning supply chain undermines all areas of the health system. CHAI helps establish effective and sustainable supply chains in countries by providing expert advice to governments on the uptake of new products, forecasting demand, procuring drugs and diagnostics, and managing inventory and distribution. In 2009, CHAI will continue to advise on supply-chain policies and procedures, and will begin three new interventions in five countries: reinte-gration of vertical supply chains, decentralization, and development of long-term strategies.

S toRY FRom tHe Field | tHeiBo, leSotHo

Maeve Magner has traveled all over the world as a supply-chain manager with CHAI, working with ministries of health to help bridge gaps and strengthen supply-chain management. During a visit to a clinic supported by CHAI in Lesotho, she met a remarkable young boy:

I first saw Theibo in a rural clinic in Lesotho. He looked remarkably relaxed for a little boy sitting in the waiting room at a doctor’s office. For months, he has made the 20-mile journey for his monthly check up to get a new batch of medicine that will help keep him alive. He is only 9 years old and HIV-positive.

The clinic administrator told me Theibo is an orphan, which isn’t unusual in many rural areas of Africa. His mother died while giving birth, and his father died from AIDS last year. His grandmother, who cares for him, didn’t have enough money for both of them to take the bus to the clinic, so he came alone.

I happened to be in the treatment room when the doctor called Theibo’s name. I watched as he listened carefully as the doctor explained his latest blood cell count results and gave instructions on how to take regimens of medicines. He left with a plastic bag of medication and a bandage on his arm from where blood was drawn.

He had no money for his return trip. I gave him the equivalent of a few dollars from my pocket, and the doctor told him that some of the money was to be spent on his bus home and the rest on some oranges for his lunch. The grateful look on his face will stay embedded in my mind forever, as I think about my nieces and nephews in Ireland and Australia who never worry how they will get home from school or a doctor’s appointment.

But in the developing world, Theibo is one of the luckier ones. He is smiling as he leaves the clinic, promising to be back next month.

Maeve (second from the left) works to strengthen supply-chain management, a key component of strong health systems.

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our rEsuLTs In 2008, CHAI launched new programs and strengthened existing efforts.

accEss proGraMsIn partnership with UNITAID, CHAI struck deals to further lower •

the prices of ARVs, building on the cumulative price reductions achieved by CHAI and UNITAID in low income countries since 2006, which have lowered prices by 64 percent for pediatric medicines and 45 percent for second-line treatments. These prices are accessible to the more than 70 countries in CHAI’s Procurement Consortium.

CHAI broadened the scope of diagnostic agreements, including CD• 4% tests. CHAI extended an agreement with one diagnostic supplier to offer CD4% testing at a reduction of more than 50 percent from the supplier’s developed-world pricing.

CHAI completed agreements to increase access to malaria ACTs by •

reducing the price volatility of the main ingredient by 70 percent and lowering the price of one of the most common ACT combinations, by more than 30 percent.

Based on the success of a malaria study pilot in Tanzania, CHAI was •

asked to take the lead in helping 11 high-burden countries access the first phase of the Global Fund’s international ACT subsidy, as the ACT subsidy concept is rolled out globally. This work, if successful, could help treat more than 60 million additional malaria patients every year.

couNTry opEraTIoNsThrough its pediatric program, CHAI supported the expansion of sites •

offering infant diagnosis using DNA PCR technology, from 200 in 2006 to nearly 3,000 by the end of 2008. CHAI also expanded access to testing and helped reach more children with treatment. By the end of 2008, CHAI and UNITAID were supporting the treatment of 195,000 children in 34 countries.

CHAI responded to the challenge of mother-to-child transmission of •

HIV in developing countries by initiating programs to dramatically reduce transmission in Cambodia, Ethiopia, Lesotho, Malawi, Tanzania, and Vietnam.

CHAI has assisted several governments • in building the systems necessary to reach more people with high-quality health care. To build human resource capacity in Malawi, CHAI worked with the government to improve the efficiency of pre-service training, doubling the number of lab assistants in a single year. In Rwanda, CHAI and the government worked together to develop detailed operational and funding plans for the scale-up of comprehensive health care for all 27 districts outside Kigali.

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Kanagaraj, a truck driver, receives second-line HIV treatment and medicines at the Government Hospital for Thoracic Medicine in Chennai, India.TOP: A pregnant woman leaves a hospital in Rwinkwavu, Rwanda, built and supported by the Clinton Foundation, Partners In Health, and the Global Fund.

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In the last three years, CHAI, in partnership with UNITAID, has made a major contribution to increasing global access to pediatric treatment.

S toRY oF Hope | tHeReSia and BaBY louiS, tanz ania

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Louis was born – and remains – healthy after his HIV-positive mother accessed services to prevent the transmission of the disease to her son. TOP: A young girl draws at the Samudaya Arogyavahini orphanage in Mangalore, India, where 32 HIV-positive children live and play.

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Theresia Siprian Mwangata was three-months pregnant in April 2008 when she tested positive for HIV at the Sokaine Regional Hospital in Lindi, Tanzania. She had a 20–45 percent chance of passing the infection to her unborn child, so at seven months into her pregnancy, she began a treatment regimen that aligned with World Health Organization standards and was recommended by the Tanzanian government.

Two months later, she gave birth to a boy, Louis Amri Jabir. She was given medicine to administer to Louis as another precaution in preventing transmission and was counseled on proper feeding methods. Although there was still a chance of transmitting HIV through breast-feeding, the risk was greatly reduced.

Theresia returned to the hospital with Louis a few weeks later, and to her relief, tests revealed he was still HIV-negative. But as long as Theresia was breast-feeding Louis, he was still at risk, so doctors advised Theresia to come back for additional tests eight weeks after she completed breast-feeding. Nine months later, Louis was still free of HIV.

Theresia is one of the many women with HIV who have benefited from the collaboration between CHAI and the Ministry of Health and Social Welfare in Tanzania to support implementation of prevention of mother-to-child transmission (PMTCT) programs. Through CHAI, HIV-exposed infants like Louis in the PMTCT program pilot region receive the care and appropriate support they need to ensure they are born without the disease and aren’t infected in early life.

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One in three kids in the United States are overweight.

More kids are developing health conditions normally associated with adults.

This generation of children could live shorter lives than their parents.

Randi Tetenbaum / Clinton Foundation

Childhood obesity is one of America’s leading health threats. Obesity rates have rapidly increased among children of all age groups over the last 40 years, nearly five times among those ages 6–11. Today, almost one in three kids and teens in the United States are overweight or obese. More and more kids are developing conditions and diseases normally associated with adults, including high-blood pressure, elevated cholesterol, and type 2 diabetes.

Difficult economic times compound these problems. Families must make tough choices about their budgets, and many kids are filling up on empty calories often resulting in modern-day malnutrition. Consuming foods with no or minimal nutritional value leaves children without the nutrients they need to develop healthy and strong. At the same time, one in four children do not participate in free-time physical activity, instead spending more time in front of the television, video games, or computers.

Some experts believe if these trends continue, the current generation of children will become the first in American history to live shorter lives than their parents.

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our approachThe William J. Clinton Foundation and the American Heart Association partnered in May 2005 to form the Alliance for a Healthier Generation with the goal of eliminating childhood obesity in the United States and empowering kids nationwide to make healthy lifestyle choices. The Alliance combines the scientific expertise of the American Heart Association with the unique ability of the Clinton Foundation to assemble partners across the different sectors that influence a child’s health: schools, health care, industry, and kids.

schooLsSince one in five Americans spend at least 30 hours a week in school either as a student or employee, schools have a unique opportunity to reduce childhood obesity by creating healthier environments. The Alliance’s Healthy Schools Program helps principals, teachers, and parents promote healthy eating and physical activity in classrooms, hallways, gyms, playgrounds, and cafeterias. Schools that implement best-practice programs and policy changes can receive national recognition. The Program supports schools in all 50 states, reaching more than 4,300 schools and more than 2.3 million students.

hEaLTh carEThe health care industry spends $61 billion a year to treat obesity-related ailments – giving doctors, insurers, and other employers a strong incentive to stop weight gain before it causes serious health problems. The Alliance has brokered voluntary agreements with health insurers, self-insured employers, and national medical associations to offer health benefits for the prevention and treatment of childhood obesity.

INdusTryIndustries can significantly impact the fight against childhood obesity and, at the same time, do well by doing good. The Alliance’s Industry Initiative engages industries in voluntary agreements to provide healthier food and beverages for kids in schools. The Alliance has brokered agreements with more than 35 companies and trade associations in the beverage, food, and dairy industries.

KIdsIn the fall of 2008, the Alliance launched the empowerME campaign, a “by kids, for kids” movement that inspires young people to make healthy behavior changes and become advocates for healthy eating and physical activity. To date, more than 1 million kids across the country have made a commitment to eat better and move more. The Alliance is working to double the number of kids committed to this effort by 2010.

He altHY K id pRoFile | auS tin milleR, 11

Austin is 11 years old, and the Holly, Michigan, sixth grader wants to grow up to be a nutritionist, an architect, or a nurse. For now, though, he is a Youth Advisory Board member for the Alliance for a Healthier Generation, and he is on a mission to share with his peers the importance of eating good food and exercising.

Austin’s mother Cindy was diagnosed with diabetes when he was 9 years old. The Millers were warned if the family’s eating habits did not change they would all suffer the same diagnosis. “It’s about the choices you make on a day-to-day basis,” says Austin’s mom, adding her son has always been an inspiration for her. “If you choose to eat potato chips, you’re going to fall off your diet. If you choose to not study, you’re going to get a bad grade – so it’s going to cause you to fall, but you need to learn to get back up, brush yourself off, and make a better choice the next time.”

Austin has made a conscious effort to be healthy and help his family lead a better life. “It was pretty fantastic to see him battling it even at school,” his mother says. When the teachers put Smarties on his paper, “he just turned them away and said, ‘I really don’t want the sugar, I’m trying to help my mom. He would ask for a pencil instead.”

Austin and his family of six have lost over 200 pounds. “We had to change the type of bread we ate, how much meat we ate, what type of potatoes we ate,” says Austin, adding it was hardest to give up junk food, like candy and potato chips. “We had to watch our sugar and calories, and eat more fruits and vegetables.” Now, they eat sweet potatoes instead of white potatoes, and Austin loves to eat pomegranates and Brussels sprouts. His family has started a garden where they grow corn, strawberries, raspberries, and blackberries. He wrestles and is a member of the Boy Scouts.

“HOW CAN WE GIVE ALL KIDS IN THE UNITED STATES THE CHANCE TO LEAD HEALTHIER LIVES?” – PRES IDEN T B IL L CL IN TO N

As a Board member, Austin has encouraged over 500 kids to join the Alliance’s empowerME movement and continues to help his community: “We are planning on doing a community garden to put in plants like tomatoes, green beans, and cucumbers, and we’re going to be giving the produce to the food bank,” he says.LEFT PAGE: Kids celebrate healthy lifestyles at the Clinton Presidential Center.

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our rEsuLTsOver the past year, the Alliance had great success across each of its initiatives:

Thanks to the landmark agreement between the beverage industry and •

the Alliance, a report commissioned by the American Beverage Association and developed by Keybridge Research in September 2008 shows that:

58 percent fewer beverage calories were shipped to schools across the •

United States between the 2004 and 2007–08 school years.

65 percent fewer full-calorie soft drinks were shipped to schools.•

79 percent of beverage contracts with schools are now compliant with •

the Alliance’s beverage guidelines – up from 35 percent in 2007.

More than 4,300 schools in 50 states are now enrolled in the Alliance for a •

Healthier Generation’s Healthy Schools Program and new enrollments are ongoing – more than 2,200 enrolled in 2008 alone.

More than 75 percent of schools involved in the Healthy Schools Program •

made substantial improvements during 2008.

The • Alliance’s empowerME campaign enrolled more than 1 million kids, with a goal of expanding to more than 2 million by 2010.

The Alliance Healthcare Initiative announced its first major agreement with •

insurers in 2009. Under these agreements, almost 1 million kids will have access to at least four visits to their doctor and at least four visits with a dietitian this year. The Healthcare Initiative’s goal is to extend this coverage to more than 6.2 million children in the next three years.

Youngsters stay cool and eat healthy in Little Rock, Arkansas. TOP: President Clinton and leaders from the health care industry announce an initiative to support preventative measures to fight childhood obesity in February 2009.

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“Aetna is pleased to join the Alliance Healthcare Initiative in a collaboration where, for the first time ever, insurers, employers, and the medical community are working together to address childhood obesity before health complications occur.

It is a testament to the strong leadership of the Clinton Foundation and the American Heart Association that they were able to bring such diverse stakeholders together to make a positive impact on the health of our nation’s young people.”

– RONALD A. W ILL IAMS, CHA IRMAN & CEO, AE TNA

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States with on-site Relationship Managers in schools All 50 states have schools supported by the Alliance’s online resources

When Mary Beth French, a physical education teacher at Henry M. Brader Elementary School in Newark, Delaware, decided to speak up at a staff meeting about the need to do more to address wellness, she admits she was nervous: “It’s a little scary to ask elementary teachers to take on one more thing. They teach all of the subjects, so every minute is crunch time.” Mary Beth felt it was important to show other teachers the data on obesity and how child health is linked to academic success. Although some staff members were hesitant at first to take on something new, many agreed that they needed to do more for the health of their students.

Brader Elementary School now has an active School Wellness Council that includes teachers, administrators, a school nurse, a cafeteria manager, and a parent. The council placed stationary bicycles in the library, common areas, and hallways, and everyone is participating: teachers are encouraged to send kids out to the hall or the library to “read and ride.” Additional bikes have been placed in the gym so that kids who are unable to participate in the physical education program have another way to keep active throughout the class.

But what is most unique and innovative about Brader is that they have “created a permissive environment for kids to be active throughout the school day, which is a very impressive and rare accomplishment,” says Lisa Perry, physical activity and physical education manager for the Healthy Schools Program.

Brader Elementary is one of more than 4,300 schools in all 50 states receiving online or on-site support to help create healthier learning environments for students and staff from the Alliance’s Healthy Schools Program. Other schools have made improvements that include healthier menu items, increased opportunities for physical activity, and school wellness programs that engage students, staff, and parents.

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Students grab a book and a bike to stay healthy. TOP: Students eat yogurt and oranges, healthy options at their school’s cafeteria.

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our approachThe Clinton Climate Initiative (CCI) takes a holistic approach to address the major sources of greenhouse gas emissions and the people, policies, and practices that impact them. Working with governments and businesses around the world to apply local solutions that are both economically and environmentally sustainable, CCI focuses on three strategic program areas: increasing energy efficiency in cities, catalyzing the large-scale supply of clean energy, and working to address deforestation.

cITIEsCities occupy only 2 percent of the world’s land mass yet contribute more than two-thirds of global greenhouse gas emissions. For these reasons, CCI has partnered with some of the world’s largest cities to reduce their carbon emissions in ways that also create long-term cost savings and green jobs.

In 2006, CCI became the implementing arm of the C40, a group of large cities around the globe committed to reducing greenhouse gases, and has since formed partnerships with additional cities. The C40 network has powerful influence through its combined purchasing power, resources for best practices, and biannual summits that foster a shared purpose and healthy competition.

CCI’s Cities programs include building retrofits, outdoor lighting, waste management, and CO2 measurement, with additional projects under development in transportation and ports. Because each city has its own degree of technical expertise and experience, CCI begins some projects start from scratch to build the necessary infrastructure and political will, while in others, CCI promotes advanced solutions that bring efficiency to the highest standards and enable economic growth.

cLEaN ENErGyViable renewable energy solutions must be developed as urgently as emissions from fossil fuel power generation must be reduced. CCI’s Clean Energy program focuses on helping to develop integrated projects using technologies that can deliver clean energy on a significant scale by 2020 and have long-term commercial potential.

In its early stages, the program is focusing on two technologies: carbon capture and storage, which isolates the carbon emissions of fossil fuel- fired power plants, and concentrated solar power, which harnesses the sun’s heat to run conventional turbines. CCI aims to demonstrate that these technologies can achieve economies of scale that lower their cost and accelerate the pace of deployment.

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empiRe State BuildinG, neW YoRK CitYWhen the Empire State Building opened its doors in 1931, it was an icon of what could be achieved in the race to build the world’s tallest skyscraper. Today, this landmark building is making its mark in another race – this time against climate change.

With more than 100 floors and thousands of tenants using lights, air conditioners, computers, and elevators, the Empire State Building consumes a lot of energy and in turn emits significant amounts of greenhouse gases into the atmosphere. In cities like New York, 70 percent of carbon emissions are generated by buildings. Retrofitting the Empire State Building’s windows, lighting, and heating and cooling systems – and improving tenant space design – should reduce utility costs by an estimated $4.4 million annually, energy consumption by 38 percent, and emissions by 105,000 metric tons over the next 15 years. To amplify these savings, the windows will be remade and upgraded in the basement of the building, eliminating the carbon emissions that would have been released by transporting the windows to another facility. CCI played a critical role in connecting the owners of the Empire State Building with experts and energy-service contractors, including Johnson Controls Inc., Jones Lang LaSalle, and the Rocky Mountain Institute, to make these improvements a reality.

StReetliGHtS, loS anGeleSIn early 2009, President Clinton and Los Angeles Mayor Antonio Villaraigosa announced plans to replace 140,000 streetlight fixtures across the city with LED units. This landmark project has the potential to save energy by a minimum of 40 percent, reduce carbon emissions by approximately 40,500 tons per year, and generate significant cost savings for the city of up to $10 million per year in energy and maintenance costs. Through energy savings, the project will pay for itself in just seven years.

“HOW CAN WE FIGHT CLIMATE CHANGE AND ExPAND ECONOMIC OPPORTUNITY?” – PRES IDEN T B IL L CL IN TO N

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Experts agree global climate change will have a devastating impact on the face of the planet and the future of our children unless we reduce greenhouse gas emissions by 80 percent by 2050. Rising temperatures and changing weather patterns will disrupt natural and economic systems and exacerbate intense poverty and health pandemics. With global populations expected to grow from 6 billion to 9 billion before 2050, the challenges posed by depleting natural resources and increasing energy use will only intensify. Our future depends on swift action on a large scale.

Too often, governments and businesses have viewed measures to reverse climate change as drags on economic growth. In reality, powering the economy and protecting the environment are not mutually exclusive – in fact, increasing energy efficiency, developing renewable sources of energy, and avoiding deforestation can ultimately stimulate economic growth and save money for governments, businesses, and individuals.

Cities are responsible for more than two-thirds of global greenhouse gas emissions.

Fossil fuels – the source of most of our energy today – account for about 60 percent of global emissions.

Deforestation represents nearly 20 percent of global emissions.

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forEsTsEach year, more than 13 million hectares of forests are lost to development and slash-and-burn agriculture. Because forests are essential to the absorption of carbon dioxide from the atmosphere, deforestation is a major contributor to climate change, representing nearly 20 percent of global emissions. When added to the subsequent impacts of agriculture and other forms of land use, this number rises to more than 30 percent.

CCI’s Forests program aims to find actionable and sustainable solutions to deforestation. CCI is creating a unique software measurement system that credibly values forests based on their natural carbon absorption and storage abilities, and enables countries to attract project financing, participate in carbon markets, and meet international agreements to stop deforestation. CCI is also developing a portfolio of projects that include avoided deforestation, reforestation, and agroforestry in partner countries. This will ensure tropical forests are managed sustainably, greenhouse gas emissions are reduced, and communities dependent on forests are able to advance beyond poverty.

our rEsuLTs Over the past year, CCI has seen dramatic gains across its program areas. Here are some of the highlights:

To date, CCI• has helped explore opportunities for more than 250 retrofit projects encompassing over 500 million square feet of building space in more than 20 cities around the world. These projects reduce both greenhouse gas emissions and energy costs for building owners.

In 2008, many retrofit projects were initiated in government offices, •

schools, hospitals, housing complexes, and commercial offices. For example, the Greater London Authority (GLA) has started construction on 42 of its own transport, fire, and emergency service buildings. When completed, these retrofits will yield 25 percent energy savings and payback within seven years. The GLA will soon begin to retrofit a second, larger group of buildings. Other CCI building projects include the retrofit of Mahindra Towers, an office complex in Mumbai, and the convening of partners to retrofit the Empire State Building.

CCI created the Carbon Measurement Collaborative, a panel of •

world-renowned experts in carbon modeling and global forest carbon measurement, with the purpose of implementing National Carbon Accounting Systems.

CCI launched Project • 2° software which allows cities to establish a baseline on their greenhouse gas emissions, manage inventories, create action plans, track the effectiveness of their emissions reduction programs, and share experiences with each other (see opposite page).

“The Clinton Climate Initiative is an outstanding partner in the fight against climate change. The extraordinary support C40 cities receive from CCI’s city directors has meant significant progress on greenhouse gas reductions.”

– MAYOR DAV ID MILLER

C40 CHA IR & MAYOR, CIT Y OF TORONTO

The Seoul Metropolitan Government hosted the biennial C40 Summit in May 2009, where mayors and officials from 70 leading cities around the world met for four days to explore how cities can take action against climate change despite the current economic crisis. Topics of conversation included low-carbon cities, sustainable city developments, and increasing green-energy use. CCI has supported the energy efficiency retrofit of 21 public buildings in Seoul, comprising over 2 million square feet of space across the city.

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AFRICA CCI is working with the city of Lagos to replace open dumps with an integrated solid waste management technology park, avoiding the emission of 400,000 tons of CO² annually.

NORTH AMERICA CCI is helping the city of Chicago to create an innovative loan fund to finance the energy efficiency retrofit of up to 5,500 affordable housing units.

EUROPE In London, CCI is helping the city develop procurement and financing frameworks to retrofit large numbers of public and commercial buildings across the city and beyond.

SOUTH AMERICACCI and the government of Guyana are creating a low-carbon economic development strategy to protect 18 million hectares of local forest. AUSTRALIA CCI is assisting the

government to develop carbon capture and storage and solar projects in Australia.WHeRe CCi WoRKS

SuCCeS S S toRY | pRoJeCt 2º

Project 2° is a new tool enabling cities to plan meaningful actions that save both energy and money, while making a profound impact in the fight against climate change.

Through this web-based emissions-tracking software, cities can uniformly calculate the carbon footprint of both municipal operations and the communities they service and also input the data on emissions-producing activities such as fuel and electricity consumption, vehicle traffic, waste production, industrial processes, and air and sea vessel fuel use. The data is converted automatically into units of CO²-equivalents. Cities can then manage inventories, create action plans, track the effectiveness of their emissions-reduction programs, and share experiences with other cities. Cities can also produce a standardized report showing graphs, charts, and comments, and slice data by sector and jurisdiction.

Designed to be compatible with internationally accepted protocols, Project 2° is the first global, multilingual emissions measurement toolset available 24 hours a day, seven days a week via the web.

Project 2° is a collaboration of the Clinton Climate Initiative, Microsoft Corporation, Autodesk, and ICLEI – Local Governments for Sustainability. Additional expertise was provided by the Ascentium Corporation and the Center for Neighborhood Technology (CNT).

The name Project 2° stems from a United Nations’ estimate that 2° Celsius is the maximum allowable change in global temperatures without catastrophic consequences.

To learn more, visit www.project2degrees.org.

2007 neW YoRK CitYWide Co² emiSSionSTOTAL EMISSIONS = 61.5 Million Metric Tons

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Justin Sullivan / Getty Images for the Clinton Foundation

Today, more than half of all people in Africa live on less than $1 a day. Despite billions of dollars in foreign assistance, the majority of people living in Africa still lack access to life-sustaining necessities including clean water, sanitation, adequate nutrition, and quality health care – the basic building blocks that empower people to lift themselves from poverty.

Two-thirds of Africans rely on agriculture for survival, but many farmers are facing soil depletion and insufficient access to fertilizer, seeds, and other inputs that ensure strong and profitable harvests. Those who grow enough to sell often cannot access the markets that will pay a fair price for their goods. These factors contribute to declining yields and food security, vulnerability to predatory pricing for harvests, and incomes that are not commensurate with effort. Without markets and inputs, farmers cannot sustain their incomes, put food on the table for their families, or send their children to school – continuing the cycle of poverty for the next generation.

More than half of all people in Africa live on less than $1 a day.

Two-thirds of Africans rely on agriculture for survival, but many farmers lack access to fertilizer, disease-resistant seeds, and other inputs that ensure a strong and profitable harvest.

Clinton HunteR deVelopment initiatiVe

“HOW CAN WE CREATE ECONOMIC DEVELOPMENT IN AFRICA THAT CAN BE SUSTAINED BY NATIONAL GOVERNMENTS AND LOCAL COMMUNITIES?” – PRES IDEN T B IL L CL IN TO N

our approachThe William J. Clinton Foundation partnered with the Hunter Foundation in 2006 to launch the Clinton Hunter Development Initiative (CHDI), which is working to catalyze sustainable economic growth in Africa. CHDI is working in Rwanda and Malawi – at the invitation of these countries’ governments – to strengthen agriculture, develop agribusinesses, and increase access to quality education and health care in ways that can be locally sustained.

To ensure these efforts continue long into the future, CHDI is designing and implementing an integrated rural-development model that is founded on, and sustained by, the establishment of profitable businesses. CHDI seeks to identify large-scale business opportunities, develop the market research and business plans to support them, and then actively invest in the businesses alongside local co-investors. CHDI maintains a hands-on involvement through construction and implementation phases, lending management, technical, and marketing expertise. These large agri-based business development projects will create employment and stimulate demand for crops that are supplied by local farmers. In return, these farmers are supported through access to inputs and technical advice, and with firm contracts with the newly created business in order to ensure they have a dependable customer and will get a fair price for their crops. CHDI reinvests any financial benefit from the original investment into related projects or infrastructure improvements in surrounding communities. Across all projects, CHDI seeks to enable local management, operation, and ownership whenever possible.

rWaNdaResponding to the recommendations of the Rwandan government, CHDI has focused efforts in the Eastern Province, a particularly dry and poor region of Rwanda that is home to more than 1.5 million people.

Projects in Rwanda have focused on strengthening agriculture, including assisting the government of Rwanda to purchase and distribute nearly 40,000 tons of fertilizer, 100 tons of maize seed, 5.7 million cuttings of disease-resistant cassava, and 150 tons of improved bean seeds to farmers. CHDI has also helped train thousands of farmers on advanced planting techniques, which 80 percent of farmers in Rwinkwavu have since adopted. Through these projects, CHDI helped to increase farmers’ yields by 240 percent on average, growing their incomes and feeding 30,000 people. In 2008, CHDI set its target on establishing the groundwork for a number of high-impact business development projects, which will lead to the expansion of particular crops such as soy, coffee, and cassava, and improve the livelihoods of Rwandan farmers and their families.

MaLaWIAt the request of the government of Malawi, CHDI has focused efforts on the Dowa, Neno, and Chitipa Districts, which have a combined population of about 584,000 people.

Projects include strengthening Malawi’s agricultural self-sufficiency by expanding commercial farming and increasing the production and sales of soy, sunflower, wheat, potatoes, and cotton. CHDI has also helped construct health care facilities, water supplies for health centers, and clean water and sanitation programs for schools and dozens of communities.

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Recently certified by the government, the Kamphiripiri Junior School in Malawi will begin receiving more teaching materials, previously nonexistent or donated by the local community in Neno. TOP: A farmer waters small mango seedlings at a nursery in Malawi. LEFT PAGE: President Clinton greets cassava farmers in Rwinkwavu, Rwanda, in August 2008.

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our rEsuLTs Highlighted accomplishments from 2008 include:

Established the plans and developed investor relations to enable the creation of •

three new business development projects in Rwanda – a soy-processing factory, a coffee-roasting and packaging factory, and an irrigated commercial farm.

Launched Rwandan Farmers Coffee brand in the United Kingdom, currently •

on sale in 1,000 stores – a prelude to the establishment of an in-country facility to supply the highest quality Rwandan coffee in Africa, the Middle East, and Europe.

Began development of a commercial farm in western Malawi, growing soy to •

serve local demand and replace imports, and provided access to bulk pricing and markets for 250 surrounding smallholder farmers. This first “Anchor Farm” project is the centerpiece of CHDI’s plan to use large commercial farming operations to bring needed supply and market efficiencies to large numbers of smallholder farmers. Project goals are to assist smallholders in significantly improving yields, reversing depletion of soils, gaining streamlined access to markets, and raising smallholder incomes.

Assisted the NELI Cotton Growers Association in its application for •

certification as a producer of Fair-trade cotton and linked the cotton growers with international buyers supplying retailers of Fair-trade cotton clothing.

Introduced an improved-quality potato to a group of potato farmers, •

emphasizing seed multiplication and expanding a project in Neno, Malawi. Partnered in this work with Universal Industries, a large Malawian food-processing company that previously was importing high-quality potatoes from South Africa for a potato chip business. Following its plan, CHDI has turned over operational and financial responsibility to Universal.

Joined with Partners In Health to build a 120-bed District Hospital in Neno, •

Malawi, and to construct 22 houses for hospital staff. Developed the sanitation system and piped water supply for the hospital and housing development.

Began construction on a second, smaller hospital in Lisungwi, one of the •

poorest and most sickness-prone areas in Malawi.

Managed the funding, design, and construction of the 220-bed Ethel Mutharika •

Maternity Hospital at Lilongwe’s Kamuzu Central Hospital complex. The facility will open in the summer of 2009 and provide a significant improvement in maternity care in a country with one of the world’s highest rates of childbirth complication and maternal mortality.

Worked with John McAslan Partners, an architectural firm in the United •

Kingdom, to create an improved design for primary school classroom blocks and teacher housing. Managed construction of prototype schools and houses in the Dowa and Mzimba Districts in Malawi. CHDI is working with the Ministry of Education to adopt the improved design for use in school construction across Malawi.

Raised 2.5 million fruit and forest-tree seedlings in central nurseries in Rwanda. •

Seedlings are being incorporated into community planting programs in support of the government’s national-scale reforestation program. Thousands of smallholder farmers will create additional income by selling carbon credits and by growing fruit and other goods for sale to the food-processing and lumber markets.

President Clinton drinks a cup of Rwandan Farmers Coffee with the Misozi farmers who work at a coffee-washing station in Gisenyi, Rwanda.TOP: Austin Ngwira, the director of agriculture for CHDI, addresses farmers in Nambuma, Malawi.

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“The Honourable William Jefferson Clinton has actively supported Rwanda’s socioeconomic transformation efforts over the years, mainly through the Clinton HIV/AIDS Initiative and the Clinton Hunter Development Initiative (CHDI), established with Sir Tom Hunter. CHDI continues to have considerable impact in improving seeds, farming techniques, and usage of fertilizer in our Eastern Province. This initiative’s success is rooted in its inclusive, holistic, and empowering approach, which we as a country espouse. I congratulate CHDI on its exemplary work with Rwandan farmers, and look forward to a long-term and highly productive partnership.”

– H.E. PAUL K AGAME, PRESIDENT OF RWANDA

SpotliGHt | SoY

One of CHDI’s key projects in both Rwanda and Malawi is focused on expanding the production and processing of soy. High in protein and low in fat, soy can provide both food security and incomes for communities in developing countries. It grows well in Rwanda and Malawi – but domestic cultivation and processing remain low despite significant and growing markets for products that contain soy.

In Rwanda, for example, the market for vegetable oil is large and growing. Responding to this demand, CHDI has joined with farmers and local investors to create a new business, Soyco, Ltd., which is improving local farmers’ access to the inputs and technical support needed to grow more soy, contracting with them to purchase their crop at a fair market price, and developing a new factory in the Eastern Province that will process the beans into cooking oil and soycake, an animal feedstock. Together, these efforts are helping to increase the incomes of 30,000 farmers, employ 200 people, and further develop the country’s economy.

In the Mchinji District of Malawi, CHDI has joined with local investors to develop a major commercial farm that includes 300 hectares of soy. Leveraging economies of scale, this farm has secured bulk-pricing for soy seed, fertilizer, and inputs,

and has made these resources available to 250 surrounding smallholder farmers. CHDI also has worked with the Ministry of Agriculture to train smallholders in improved farming techniques and effective use of inputs. Finally, to ensure that increased yields translate into increased incomes, CHDI also has negotiated a bulk sale of all soy grown on the commercial farm and by the surrounding smallholders at a price nearly double what the smallholders would have received under the traditional trader system. This insulates smallholders from vulnerabilities in the traditional trading system and gives them an opportunity to develop relationships directly with commercial processors. CHDI is also working to negotiate the sale of an even greater volume of soy produced by both the commercial farm and surrounding smallholders at the end of the 2009–2010 season.

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Farmers in Malawi apply fertilizer to their soya crops to increase yields.TOP: A newly constructed school will replace a grass-roof schoolhouse, which had been damaged during the rainy season in Malawi.

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Jesús Mario Muñoz / Clinton Foundation

Despite economic growth, the gap between the rich and the poor in Latin America is the largest in the world, and growing. Tens of millions of people lack access to quality health care, education, nutrition, and economic opportunities – all of which are necessary for economies and communities to thrive.

Many companies operating in the developing world recognize the important role they can play in addressing these disparities and fostering vibrant economies, but they lack the platform or expertise to implement effective programs on the ground. Wealth creation via entrepreneurship and stable employment is a long-term solution, yet many corporate programs have focused traditionally on activities such as building schools and hospitals. A more systematic approach is needed to help poor and underserved communities obtain the skills, capacity, and market access necessary to sustain improvements in their health, education and economic conditions.

In Peru, 45 percent of people live in poverty, and 40 percent of children under 3 years old are malnourished.

In Colombia, 50 percent of people live below the poverty line, and 34 percent of people do not have access to health care.

Clinton GiuStRa SuStainaBle GRoWtH initiatiVe

our approachLaunched in 2007 by President Clinton and entrepreneur and philanthro-pist Frank Giustra, the Clinton Giustra Sustainable Growth Initiative (CGSGI) is helping industries invest in the long-term improvement of economic and social conditions in communities in the developing world, beginning in Latin America. CGSGI reflects an innovative partnership between the William J. Clinton Foundation, the private sector, govern-ments, local communities, and other NGOs, with a shared mission to increase the scope, scale, impact, and sustainability of social and economic development efforts in areas where poverty is widespread.

Ultimately, CGSGI is attempting to transform the way business is done in the developing world by creating opportunities and models for all industries to work responsibly in those regions. CGSGI provides project leadership and deploys funds from the private sector to programs that strengthen markets, small businesses, health care, nutrition, and education. While CGSGI originally partnered with the natural resource industry, the initiative has broadened relationships within the private sector, including a partnership with the Fundación Carlos Slim. In all projects, CGSGI focuses on measuring the efficiency and impact of efforts, in order to reduce costs and deliver results in the most effective manner possible.

our projEcTsStrengthening Small Businesses. Launched projects with the government of Colombia and NGO partners to develop sustainable, market driven businesses in the poorest areas of Colombia. The first project in Chocó will upgrade and expand TANA, a promising organic spice business (see page 37).

Investing in Small Businesses. In partnership with the Fundación Carlos Slim, CGSGI formed a $20 million investment fund in Colombia to make investments in small and medium enterprises that are underserved by existing capital markets and are looking to expand or scale up. The aim of this fund is to enable sustainable job creation and income generation with innovative access to capital.

Connecting Local Suppliers with Markets. Together with the National Hotel association of Colombia and other NGOs, CGSGI began developing a local supplier network for several hotels in Cartagena. Shifting to local suppliers will generate 350 new jobs over 14 months for residents of poor communities in and around Cartagena (see sidebar).

SpotliGHt | inVeRSe tRade FaiR, ColomBia

On a sweltering Sunday in Colombia in March 2009, 150 people representing 55 local providers of goods and services from the impoverished outskirts of Cartagena participated in a trade fair designed to expand their access to new markets. This event connected small, local suppliers to six of the largest hotels in the area that previously had been purchasing the majority of their goods and services from elsewhere in the country. Inverted from traditional trade fairs, the hotels displayed their purchasing requirements and the suppliers had opportunities to present their capabilities and identify new business opportunities. Many of the suppliers were brought to the fair by NGOs that work with the disabled, teen mothers, and other disadvantaged groups. While CGSGI does not partner directly with these NGOs, the trade fair was a natural opportunity for its participation, resulting in the broadening of NGO cooperation without incremental financial investment.

The goods and services offered by the local suppliers included fruits, vegetables, bread, hotel uniforms and linens, candy, dolls made by women cancer survivors, and other souvenirs. CGSGI is working to provide capacity-building assistance to these local producers so they can become reliable sources of supply. The hotels – Hotel Santa Clara, Hotel Capilla del Mar, Hotel Las Américas, Hotel Estelar Almirante, Cartagena Hilton, and Hotel Charleston Santa Teresa – are aiming to purchase more from local suppliers, thereby strengthening communities around Cartagena.

“HOW CAN BUSINESSES EMPOWER COMMUNITIES TO LIFT THEMSELVES FROM POVERTY?” – PRES IDEN T B IL L CL IN TO N

President Clinton speaks with local producers and buyers at an inverse trade fair in Cartagena, Colombia. LEFT PAGE: President Clinton greets students at the Escuela Pies Descalzos in Baranquilla, Colombia, where CGSGI is supporting nutrition and vocational training programs.

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WHeRe We WoRK

“One of our main objectives is to create jobs that support small businesses. Along with CGSGI, the Slim Foundation focuses on providing support and resources to these businesses to generate more opportunities of sustainable growth and the well-being of our societies.”

– CARLOS SL IM DOMIT, FUNDACIÓN CARLOS SL IM

Poverty Reduction and Alleviation Programs. In November 2008, CGSGI and Compañía Minera Antamina S.A. launched a collaborative expansion of the Poverty Reduction and Alleviation (PRA) program in the Ancash region of Peru. In March 2009, a similar three-year PRA program was launched in the Cajamarca region of Peru in cooperation with mining partners Minera Yanacocha and Gold Fields. These projects seek to expand market-driven economic development with an emphasis on diversifying and enhancing sustainable economic activities in the agriculture, agribusiness, and tourism sectors.

Remote Medical Missions. Through a partnership with Colombian NGO Fundación Angelitos de Luz, CGSGI supported 30 medical missions through June 2009 that delivered much-needed health services to approximately 50,000 people in isolated rural areas of Colombia who lack regular access to basic health care. Improving the general health of these communities enables greater productivity.

Cataract Surgeries. CGSGI and the Fundación Carlos Slim launched a project to dramatically increase the number of cataract surgeries in Peru’s underserved populations. The program will provide the necessary resources to increase the number of cataract surgeries by 50,000 over four years, expanding on a Peruvian Ministry of Health campaign for Ocular Health that began in 2007. This project will reverse or prevent blindness among thousands of Peruvians, improving their productivity.

School Nutrition and Vocational Training Program. In conjunction with Fundación Pies Descalzos, CGSGI began implementing a two-year, $4 million initiative that seeks to contribute to the development of school-age children in some of the most vulnerable communities in Colombia, focusing on education, child nutrition, vocational training, and microenterprise development at schools in Bogota, Quibdo, and Barranquilla. This project will help meet the nutritional needs of 4,000 children in their formative years, raise their self-confidence, and provide them and their families with practical entrepreneurial skills.

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CGSGI allocates its resources to programs that represent the building blocks of economic growth: health, economic development, and education.

SuCCeS S S toRY | tana SpiCe ColleCtiVe

Jesús Mario M

uñoz / Clinton Foundation

In Mexico City, President Clinton, Frank Giustra, and Carlos Slim Helú announce projects to expand CGSGI’s work in Colombia, Peru, and Mexico. RIGHT: Two students at the Escuela Pies Descalzos wait in the lunch line in Baranquilla, Colombia. TOP: Students in Peru show off vegetables grown in their local garden.

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TANA promotes job creation and provides a source of income for women in the Choco region of Colombia.

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Maritza Parra Córdoba always dreamed of managing her own business, but never thought her dream would become reality in the impoverished region of Choco, where she grew up. To make a living and provide for her four daughters, Maritza began cultivating and selling spices – basil, cilantro, ginger, and turmeric – a trade she had learned from her mother as a child.

Over the years, Maritza’s persistence and hard work began to pay off and demand for her spices grew. Maritza decided to expand her business by partnering with other Afro-Colombian women in the area to create La Red de Mujeres para el Desarrollo (the Women’s Development Network), which now includes 75 growers. The results demonstrate the importance and impact that positive leadership can have on a business even in the poorest of communities. Based on this experience, CGSGI hopes to foster leadership skills in other regions where it is helping to cultivate sustainable long-term economic development.

The success and subsequent expansion of Maritza’s business, now known as TANA, is benefiting the community not only by promoting job creation and providing a source of income for other women, but also by serving as an example for other up-and-coming businesses. CGSGI is supporting TANA to ensure that it continues to grow and eventually is able to operate without NGO support, realizing Maritza’s dream of managing a large, independently-operated business.

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The economic downturn that began in late 2008 has spread across America and impacted every corner of the world, forcing small businesses to close and sending millions of Americans to the unemployment line. For a nation already affected by economic inequality and poverty, these challenges have made it harder for families and individuals to get ahead financially. Even before the downturn, millions of people lacked access to basic financial services, such as bank accounts, that could help them keep more of the money they make.

People living in inner cities have faced unique challenges that have only grown in the recession. Given that 99 percent of inner city establishments are small businesses, which account for 80 percent of inner city jobs, the success of these communities is closely intertwined with the success of businesses and their owners. But it’s not always easy for new businesses to survive – according to the Small Business Administration, only 31 percent survive more than seven years.

The typical unbanked worker can spend $40,000 cashing paychecks over the course of a career.

28 million people do not have a bank account.

72 million people spend approximately $11 billion annually on alternative financial services.

Adam Schultz / Clinton FoundationClinton eConomiC oppoRtunitY initiatiVe

“HOW CAN WE GIVE MORE FAMILIES AND ENTREPRENEURS THE OPPORTUNITY TO ACHIEVE THE AMERICAN DREAM?” – PRES IDEN T B IL L CL IN TO N

our approachThe Clinton Economic Opportunity Initiative (CEO) works to help families and individuals in the United States succeed and businesses in America’s underserved communities grow through programs that focus on two primary areas: keeping families in the financial mainstream and helping entrepreneurs succeed.

fINaNcIaL MaINsTrEaM proGraM CEO’s Financial Mainstream program works with governments, communities, and the private sector to support efforts to help people access lower cost, safer financial services and develop good financial habits. In 2009, CEO is focusing on developing solutions through public-private partnerships to enhance the availability of affordable financial products to low- to moderate-income families.

In 2008, CEO performed a Neighborhood Financial Services Study of two neighborhoods in collaboration with the New York City Department of Consumer Affairs’ Office of Financial Empowerment. This study led to the creation of the first Financial Empowerment Center in Melrose, Bronx. In Seattle-King County, Washington, CEO provided ongoing advice and technical assistance that resulted in the launch of Bank On Seattle-King County. In Savannah, Georgia, CEO conducted a financial services gap analysis of Savannah’s Poverty Census Tracks. This became the primary business case for developing the Bank On Savannah Campaign, which launched in early 2009.

ENTrEprENEurshIp proGraMs CEO’s entrepreneurship programs promote entrepreneurship as a tool for lasting economic development in communities across the United States. The Entrepreneur Mentoring Program, a partnership between CEO and Inc. magazine, pairs entrepreneurs running high-growth companies in inner city communities with successful business leaders and mentors. Mentors aim to help entrepreneurs develop a deeper understanding of their businesses and industries, become stronger leaders, sharpen their business acumen, and make better decisions on the issues facing their companies. The programs are based on a model of business-to-business public service, leveraging business skills and experience to maximize the impact of entrepreneurial success on community renewal and social progress.

In 2008, the Entrepreneur Mentoring Program launched efforts in Oakland, California, and Chicago, and is building programs in several cities across the United States including Philadelphia, New York, and Newark. CEO also worked with Booz & Co. and New York University’s Stern School of Business to create the Harlem Restaurant Program, an eight-month self-directed professional development and business improvement effort for established restaurateurs. This program provided highly interactive, small-group workshops run by industry experts to restaurant owners in Harlem to enhance their business knowledge and skills.

mentoRSHip pRoFile | minH t Sai

Four years ago, Minh made the difficult decision to leave his professional career and start his own business – a dream he had since soon after he arrived in America from Vietnam in 1981.

“When I came to the US at the age of 11, I immediately saw how hard my parents worked and made sacrifices for the family,” he says.

“Their work ethic inspired me to seek out opportunity to learn, grow, and be independent. Starting a business for me is a natural extension of capitalizing on all the learning and growing I have done academically and professionally.”

His vision for the company – Hodo Soy Beanery – was simple: introduce the San Francisco Bay Area to a line of fresh organic tofu products with exceptional quality and flavor produced using sustainably farmed organic soy beans.

He knew emerging entrepreneurs faced great challenges, especially in the Bay Area. But he was determined to strategically grow his business by making smart decisions, finding a likeminded business partner, maintaining the high quality of products, cultivating loyal customers, hiring the best people – “tofu ambassadors” – and giving back to the community.

To do this, he knew he would need the help and support of successful local businesses. In 2008, he enrolled in the newly launched Oakland Entrepreneur Mentoring Program. “The program provided our business an opportunity not only to be mentored by more established companies in our area, but also opportunity for us to meet and learn from other start-ups going through growth as we are,” he says.

The program matched him with mentor Reem Rahim, one of the founders of Numi Tea, who oversees the company’s marketing and public relations. “Though our businesses are different, Reem has provided us some valuable advice in determining our marketing/PR effort, particularly on how we can wisely spend money to increase sales,” Minh says. In Summer 2008, Minh’s company will open its new 13,000 square-foot manufacturing facility in an Oakland Enterprise Zone and continue to hire employees from the local community.

“Inner City Advisors is pleased to work with CEO to give local entrepreneurs managing fast-growth companies in Oakland’s inner cities an opportunity to learn from a knowledgeable and experienced mentor to facilitate revenue and job growth.”

– JOSÉ CORONA , INNER CIT Y ADV ISORS

Supporting small businesses such as Minh’s can have lasting impacts on communities like Oakland. LEFT PAGE: A group of restaurateurs in Harlem discuss their businesses at a meeting of the Harlem Restaurant Program.

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The William J. Clinton Presidential Center & Park, located on the banks of the Arkansas River in Little Rock, Arkansas, attracts hundreds of thousands of visitors from around the world to its grounds each year. Opened in 2004, the Center is home to the William J. Clinton Presidential Library and Museum, the University of Arkansas Clinton School of Public Service, and the Little Rock offices of the Clinton Foundation. The Center also plays an active role in the Little Rock community, hosting a number of events, lectures, and conferences throughout the year. The Center was instrumental in bringing more than $2 billion in economic development to the area, including renovations of the nearby historic River Market district.

The Clinton Presidential Center works to support the mission of the William J. Clinton Foundation. In 2008, the Center hosted several events that promoted the Clinton Foundation’s global work including Earth Day, Worldwide Day of Play, World AIDS Day, and the announcement of a partnership between the Clinton Climate Initiative and the state of Arkansas.

President Clinton and Governor Mike Beebe of Arkansas announce a collaborative effort in December 2008 to retrofit buildings in Arkansas to improve energy efficiency.

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our yEar IN rEVIEWEarth Day Festival. In celebration of Earth Day 2008, the Center was the site of the Arkansas Earth Day Festival, where Specialized Bicycles’ “Innovate or Die” contest-winning Aquaduct bicycle made its public debut. The Aquaduct prototype design harnesses “pedal power” to transport and filter water and is intended for use in developing countries. The Aquaduct design team also collaborated with locally based global nonprofits on the Aquaduct’s design and its potential applications. These activities underscore the Center’s commitment to addressing environmental concerns while providing a day of entertainment and education for visitors.

Healthy Schools, Healthy Kids. The Center welcomed the Alliance for a Healthier Generation for two events honoring new schools joining the Healthy Schools Program and existing member schools for their achievements in combating the rise of childhood obesity. In September, the Alliance celebrated “Go Healthy Month” at the Center by promoting healthy eating and physical activity at “Recess by the River,” a field day and family event.

World AIDS Day. On World AIDS Day 2008, the Clinton Foundation, Heifer International, and Winrock International held an educational event at the Center. During this meeting, Stephen Lewis, the former U.N. Special Envoy for HIV/AIDS in Africa, provided the keynote address and served on a panel discussion that also featured the leaders of each organization’s HIV/AIDS program.

Climate Partnership. In December, President Clinton and Arkansas Governor Mike Beebe announced a new partnership between the state of Arkansas and CCI that builds on CCI’s existing work with the C40 Large Cities Climate Leadership Group. CCI will work with Arkansas to retrofit several state-owned buildings in order to reduce energy consumption and greenhouse gas emissions.

Special Exhibits. The Center proudly hosted American premieres of two unique exhibits. In June, Breaking the Veils: Women Artists from the Islamic World opened with Her Royal Highness Princess Wijdan Al-Hashemi, Ph.D., founder and director of the Royal Society of Fine Arts of Jordan in attendance. The exhibit, designed to challenge contemporary stereotypes about the lives of women in the Islamic world, featured art from 51 different artists representing over 20 countries. In September, the Center presented Art of the Chopper, an exhibit showcasing 30 custom motorcycles displayed throughout the Center. These “rolling sculptures” celebrate the craftsmanship and engineering of unique American artists and reflect the Center’s dedication to featuring innovative exhibits.

SpotliGHt | eduCational pRoGR a mS

President Clinton’s commitment to learning across a lifetime continues each day at the Clinton Presidential Center. With a generous grant from Bank of America, a new educational tour, “Ideas Matter: A Special Tour for the Leaders of Tomorrow,” was launched in 2008. The custom-designed “Ideas Matter” guidebook leads students through the Center’s exhibits and helps them learn about America’s achievements during President Clinton’s time in office while also challenging them to apply their own leadership abilities to positively impact the world around them.

Ongoing educational efforts at the Center include programming for students and educators of all ages. Special tours featuring professional storytellers, and programs for Boy and Girl Scouts, serve to educate and inspire children. The Center has partnered with City Year to present educational activities and events that highlight the merits of public service. Collaborating with the Arkansas Governor’s School, a program initiated by President Clinton during his time as governor of Arkansas, the Center invites select groups of high school students to participate in special programming during the summer months. A number of professional development workshops, accredited by the Arkansas Department of Education, are also offered.

“HOW CAN WE EDUCATE AND INSPIRE FUTURE PUBLIC SERVANTS?” – PRES IDEN T B IL L CL IN TO N

A school group takes a special tour of the Clinton Presidential Center.LEFT PAGE: The view from inside the Clinton Presidential Center, overlooking the policy alcoves and timeline.

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On September 13, 2008, Hurricane Ike made landfall on the coast of Texas, destroying buildings, leveling homes, and disrupting the lives of millions in its path. To help families recover from the storm and “build back better” – an approach President Clinton first championed as U.N. Special Envoy for Tsunami Relief – President Clinton and President George H.W. Bush teamed up once again to launch the Bush Clinton Coastal Recovery Fund at the 2008 Clinton Global Initiative Annual Meeting.

As of Spring 2009, nearly $2.5 million has been raised from mostly small- donor and grassroots support, and will be allocated toward building schools, health care centers, and other critical community systems and services in the hardest-hit regions along the Gulf Coast. President Bush’s former Secretary of State, Jim Baker, has been overseeing the Bush Clinton Coastal Recovery Fund’s day-to-day operations, and an advisory committee of community leaders are helping to raise money to assist the places that need it most.

For example, one grant of more than $250,000 has been allocated toward rebuilding fences in Chambers County, where Hurricane Ike’s storm surge submerged an estimated 600 square miles of ranch land. When the saltwater receded, almost 4,000 cows were dead or missing, and thousands had been swept away far from their ranches. While the cattle have been retrieved, more than 800 miles of fencing were destroyed, carrying a price tag of $8 million to repair, an expense not covered by FEMA. With these fences in place, ranchers will once again be able to return the cattle to their land.

President Bush and President Clinton have joined together twice before to help victims after natural disasters – first by raising more than $10 million to help recovery efforts after the tsunami hit South Asia in 2004. In 2005, they formed the Bush Clinton Katrina Fund, which raised more than $130 million for communities to build back after Hurricane Katrina. At the core of all of these efforts has been President Clinton’s belief that there is opportunity in the wake of natural disasters to not just repair what was damaged, but to establish new systems that will help communities thrive far into the future.

To learn more about the Bush Clinton Coastal Recovery Fund and to make a donation to help people still in need, visit www.bushclintoncoastalfund.org.

BUILDING BACK BETTER AFTER HURRICANE IKE

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Presidents Bill Clinton and George H.W. Bush tour the wreckage in the aftermath of Hurricane Ike in Galveston, Texas.TOP: A single home is left standing among the devastation following Hurricane Ike in Gilchrest, Texas.

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cLINToN schooL of puBLIc sErVIcE The University of Arkansas Clinton School of Public Service is the nation’s first school to offer a Master of Public Service. Students prepare for a career helping people locally and abroad and have engaged in projects in the Mississippi River Delta as well as in countries such as Bolivia, Vietnam, and Sudan.

At the Clinton Center, the school hosts guest lecturers from all over the world to speak about current topics. The Clinton School readies their students with the proper skills and knowledge to be competitive candidates in the nonprofit, government, private, and volunteer sectors. Through the curriculum, the students learn important lessons involving civic engagement and global leadership, which they use in the field and in their careers.

New citizens take the Oath of Allegiance at the Clinton Presidential Center.

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“The Clinton Presidential Center has become a world-renowned landmark for Arkansas, an anchor of our capital city, and an international example of outreach and public service.”

– MIK E BEEBE, GOVERNOR OF ARK ANSAS

Naturalization Ceremonies. The Center hosted the largest naturalization ceremony in the state of Arkansas in 2008. This partnership with the United States District Courts will continue, with four ceremonies scheduled to take place in 2009.

Family Fun. The Center has earned a reputation as an outstanding family-friendly destination that offers an array of experiences for visitors of all ages. In 2008, the Center hosted the Easter Family Festival, Fourth of July Festival, and American Classics Festival. Each was attended by thousands of visitors. Additionally, four free admission days are offered annually celebrating Presidents’ Day, the Fourth of July, President Clinton’s birthday, and the anniversary of the opening of the Clinton Center.

Lecture Series. The Frank and Kula Kumpuris Distinguished Lecture Series, a partnership between the Clinton Foundation and the University of Arkansas Clinton School of Public Service, brought world-class speakers to the Center. In 2008, speakers included noted Lincoln scholar Harold Holzer, veteran actor Sam Waterston, Nobel Peace Prize Laureate Dr. Wangari Maathai, and Civil Rights activist Marian Wright Edelman. The Distinguished Lecture Series was established by a generous gift from the Kumpuris Family and is presented by the Clinton School of Public Service, the Clinton Foundation, and AT&T Arkansas.

Permanent Exhibits. The Center continued to attract visitors from across the nation and around the world in 2008. The Clinton Library, the centerpiece of the Center campus in Little Rock, features a compelling permanent exhibit of interactive displays chronicling President Clinton’s time in office and a variety of diverse temporary exhibits.

President Clinton speaks with students following graduation at the Clinton School of Public Service. TOP: Kumpuris Distinguished Lecture Series Speaker Dr. Wangari Maathai gives a talk in the Great Hall of the Clinton Presidential Center.

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The Clinton Foundation’s work is largely dependent on the involvement and generosity of individuals like you. Each donation, of any size, makes a tremendous difference as we meet new challenges in additional regions of the world and expand our programs. We hold immeasurable gratitude to those who have so generously supported the Foundation’s work over the past year.

The Foundation is unique in the way we transform small investments into the largest possible impact on people’s lives. Much remains to be done. With greater support we can:

Save More Lives. We can help more people living with HIV/AIDS access the treatment and care they need to survive. Just $15 provides a life-saving package for an HIV-positive child for one month.

Give Hope to More Children. We can inspire more kids to lead healthier lives. Right now, one in three children and teens in the U.S. is overweight or obese. We can turn that statistic around.

Better Protect Our Planet. As the climate crisis grows, we can do more to protect our planet by helping cities reduce their carbon emissions. At the same time, we can create jobs even in the poorest countries.

Help More Families Thrive. In these tough economic times, we can help more American families and entrepreneurs stay afloat.

If we don’t take action now, we risk facing the worst consequences of global warming, health pandemics like HIV/AIDS and malaria, and extreme poverty. Your support is more important than ever.

Our development department is reaching out to engage friends of the Clinton Foundation in new ways. We will be offering exciting new options for giving in upcoming months, including engaging youth through the latest social networking tools. To fulfill our global mission, we are always looking to expand our network of supporters. Please tell friends and family about the Clinton Foundation and the many ways we work to better the common good in our world.

coNTacT usA member of our development team would be happy to answer any questions you might have and discuss how you can become more involved. To learn more, please contact Margaret Martinello, Director of Development, at 646 . 775 . 9175 .

Get involved today by signing up for email updates at www.clintonfoundation.org/signup.

YOUR COMMITMENT IS VITAL TO OUR SUCCESS

ouR CatalYtiC impaCt

CHAI’s approach to improving training institutions for health workers in Zambia has achieved significant leverage with a $1.5 million investment.

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BASKET FUNDS

GLOBAL FUNDS

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HoW You Can Help$80 ensures that eight community health workers can provide monitoring of adherence and medication intake for all HIV-positive people in a Malawian village for a week.

For $100 you can support the start of at least one physical activity or nutrition program for a class of 28 students in 2009.

For $20 you can provide online tools and resources to help 20 kids commit to a healthier lifestyle and develop basic skills for good nutrition and daily physical exercise.

Charity Navigator has awarded its highest level of four stars to the Clinton Foundation. We work continually to ensure that yourcontributions are used most effectively in our program areas.

95.9% pRoGRamS

2.5% adminiStRatiVe CoStS1.6% FundRaiSinG CoStS

2008 e xpendituReS

SuppoR t ouR WoRK

ThE MILLENNIuM NETWorK President Clinton has often said he believes this generation of young leaders holds more power than any before it to solve the pressing issues of our world.

To give young philanthropists a platform to make a difference, he established the Millennium Network, which engages the next generation of leaders and public servants under the age of 40 in the work of the Clinton Foundation.

The Millennium Network holds events in major cities around the United States – and eventually around the globe – giving members the chance to meet one another and learn more about the seven initiatives of the Clinton Foundation. Members also have the ability to connect through online forums, plan and participate in networking and fundraising events, and access the most updated news and information about the Foundation’s work.

After successful events in New York, San Francisco, and Los Angeles, in April 2009, the Network now stands at more than 5,000 members strong and will continue to grow as it expands to new cities around the world.

Ultimately, the goal of the Network is to give its diverse members, who come from all backgrounds and walks of life, a clear way to give back and form a “how” generation that strives to answer the important questions we face in the 21st century.

“HOW CAN WE ENGAGE THE NExT GENERATION OF LEADERS IN SOLVING OUR WORLD’S MOST PRESSING CHALLENGES?”

– P R E S I D E N T B I L L C L I N T O N

President Clinton addresses a group of young philanthropists in April 2009 at the Millennium Network event in Los Angeles, California.

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sTaTEMENT of acTIVITIEs

Year Ended December 31, 2008 | GAAP Basis

rEVENuE aNd supporT

Contributions $88,320,000

Grants $143,275,000

Other Revenue $3,235,000

Total Revenue $234,830,000

ExpENsEs

PROGRAM SERVICES

HIV/AIDS Programs $140,047,000

Clinton Global Initiative $19,631,000

Clinton Climate Initiative $12,543,000

Clinton Hunter Development Initiative $7,587,000

Clinton Giustra Sustainable Growth Initiative $1,402,000

Other Programs $15,098,000

Management and General $5,187,000

Fundraising $3,324,000

Total Expenses $204,819,000

(68.4%)

(9.6%)

(6.1%)

(3.7%)

(0.7%)

(7.4%)

(2.5%)

(1.6%)

2008 FinanCialS

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2008 Fin a nCia lS

sTaTEMENT of fINaNcIaL posITIoN

As of December 31, 2008

assETs

financial assets

CASH AND CASH EQUIVALENTS

Unrestricted $3,646,000

Committed $18,257,000

Restricted $6,938,000

Restricted - UNITAID and Other Grants¹ $94,200,000

Multi-year Pledges $21,400,000

fixed assets and other

Clinton Presidential Center² $119,753,000

Other Fixed Assets $3,100,000

Inventory and Accounts Receivable $1,020,000

Prepaid Expenses $1,050,000

LIaBILITIEs

Accounts Payable $6,100,000

Deferred Grant Income¹ and Accrued Expenses $101,200,000

¹ Represents funds received for grants that have not been disbursed.

² The Clinton Presidential Center is run by the National Archives under a capital lease with the Foundation for which

no fee is paid to the Foundation.

cLINToN GLoBaL INITIaTIVE MEMBErs haVE MadE 1,400 coMMITMENTs To

IMproVE MorE ThaN 200 MILLIoN LIVEs IN oVEr 150 couNTrIEs. ThE cLINToN

huNTEr dEVELopMENT INITIaTIVE proVIdEd WaTEr suppLIEs for hEaLTh

cENTErs aNd cLEaN WaTEr aNd saNITaTIoN proGraMs for schooLs aNd

docTors IN coMMuNITIEs IN MaLaWI, IMpacTING 16,000 pEopLE INcLudING

7,000 sTudENTs. ThE cLINToN EcoNoMIc opporTuNITy INITIaTIVE has proVIdEd

72,000 hours of pro BoNo coNsuLTING sErVIcEs IN ThE NEW yorK cITy arEa,

VaLuEd aT MorE ThaN $15,000,000. ThE cLINToN cLIMaTE INITIaTIVE Is ExpLorING

opporTuNITIEs for MorE ThaN 250 rETrofIT projEcTs ENcoMpassING 500

MILLIoN squarE fEET of BuILdING spacE IN MorE ThaN 20 cITIEs. ThE aLLIaNcE

for a hEaLThIEr GENEraTIoN has MorE ThaN 4,300 schooLs ENroLLEd IN ITs

hEaLThy schooLs proGraM. ThE cLINToN prEsIdENTIaL cENTEr has BEEN

aN aNchor for EcoNoMIc rEVITaLIZaTIoN, hELpING To BrING $2 BILLIoN IN

EcoNoMIc dEVELopMENT To doWNToWN LITTLE rocK. ThE cLINToN huNTEr

dEVELopMENT INITIaTIVE WorKEd WITh 9,500 coffEE farMErs IN rWaNda

To sTrENGThEN ThEIr producTIoN, INcrEasING ThEIr rEVENuEs By 30%

WITh farMErs coLLEcTING 100% of profITs. MorE ThaN 1,000,000 KIds

haVE pLEdGEd To “Go hEaLThy” ThrouGh ThE aLLIaNcE for a hEaLThIEr

GENEraTIoN. a carBoN-NEuTraL facILITy, ThE cLINToN prEsIdENTIaL cENTEr

usEs 34% LEss ENErGy ThaN oThEr BuILdINGs of ITs KINd aNd aLL EMIssIoNs

arE 100% offsET By ThE purchasE of rENEWaBLE-ENErGy cErTIfIcaTEs.

2,000,000 pEopLE – haLf of aLL pEopLE oN TrEaTMENT – arE NoW accEssING

hIV/aIds druGs aT rEducEd prIcEs purchasEd uNdEr ThE cLINToN hIV/aIds

INITIaTIVE’s aGrEEMENTs. as a rEsuLT of a coMMITMENT MadE aT ThE cLINToN

GLoBaL INITIaTIVE uNIVErsITy, MorE ThaN 3,800 NEW rEcycLING coNTaINErs

WErE pLacEd oN coLLEGE caMpusEs. ThE cLINToN GIusTra susTaINaBLE

GroWTh INITIaTIVE Is parTNErING WITh ThE NGo aNGELITos dE LuZ To

supporT MEdIcaL MIssIoNs ThaT dELIVEr Much-NEEdEd hEaLTh sErVIcEs

To 60,000 pEopLE IN ruraL arEas Who LacK rEGuLar accEss To hEaLTh carE.

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deaR SuppoRteRS,

I hope that the preceding pages have given you a sense of the size and scale of our work at the Clinton Foundation over the past year. More than that, I hope you have a better understanding of “how” we approach our mission and answer some of the most difficult questions that currently define our 21st century world. If so, I think you are as proud as I am of everything we’ve accomplished in 2008.

In all areas, we have continued to work with a sense of determination and urgency, dedicated to our mission of helping people confront global issues that once seemed intractable. As President Clinton often says, we know that a moment wasted is a life that could have been saved or made better through our efforts. With your help, we are able to continue to actively build upon our victories – both large and small – and look for new ways to make an impact and reach even more people.

We’ve lowered the prices on HIV/AIDS medicines by another 20 percent, struck new deals on diagnostics and malaria medicines, and reached tens of thousands of additional children with treatment. Last September, we hosted our most successful Clinton Global Initiative (CGI) meeting to date, and we look forward to celebrating our fifth annual CGI Annual Meeting in September 2009. Through our climate initiative, we completed our first building retrofit project in the city of Seoul in November, which has the potential to reduce carbon emissions by 747 tons annually.

In the United States, through the Alliance for a Healthier Generation, we now have 4,300 schools committed to creating healthier environments, and over 90 percent of these schools have already made meaningful changes toward reaching their goals. We have expanded our Entrepreneur Mentoring Program, as well as helped communities across the country develop programs connecting working people to banking services.

Now, in 2009, we find ourselves tightening our belts like everyone else and redoubling our efforts to ensure – as we always have – that the resources we do spend are used effectively and efficiently. I speak for everyone at the Clinton Foundation when I say thank you for helping to make this work possible, especially in these tough economic times. Our need is great and our efforts more important than ever. We hope you’ll give what you can. Together, we will make sure no one is left behind.

Sincerely,

BRUCE R. LINDSEY Chief Executive Officer

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This report was printed at Pictorial Offset, a carbon-neutral company, on Domtar Cougar, part of Domtar’s EarthChoice® family of products. Cougar® is FSC-certified, endorsed by the Rainforest Alliance, and contains 10% post consumer waste, reflecting the Clinton Foundation’s commitment to protecting our

Children play at the home of a Clinton HIV/AIDS Initiative “expert patient” – a person who lives openly with HIV and is on treatment for the disease. These expert patients now promote awareness about testing and treatment to others in their communities. Photo: Ryan Nesbitt / Clinton Foundation. Cover: During his visit to a clinic in Lesotho, President Clinton kneels to talk to a boy who is receiving treatment at the clinic, supported by the Clinton HIV/AIDS Initiative. Photo: Ralph Alswang / Clinton Foundation.

W W W . C l i n t o n F o u n d a t i o n . o R G© 2009 W ILL IA M J . CL IN TON FOUNDAT ION