In line with HAI’s commitment to support and strengthen local public health leadership, as of October 2021, HAI has fully transitioned our global operations and active programs to locally-based, locally-led NGOs. This transition—unanimously supported by HAI’s Board of Directors along with headquarters and in-country leadership—represents a shift away from a pervasive practice in global health that centers decision-making authority and donor relationships outside of the Global South; and a shift toward local autonomy and equity in global health.

For more than three decades, HAI’s partnership model and health system strengthening approach  underscored our commitment to local priority-setting and leadership in global health. When HAI took on our first “district adoption” program in Mozambique in 1987, we worked in solidarity with the newly independent nation’s National Health System, demonstrating our unwavering support of local institutions against apartheid-backed insurgents and bringing our resources and expertise to the table as collaborators. Each decade since, we have evolved and grown, letting our values drive us closer to our mission through reinvention of our structure and operations.

What began as a small organization staffed by a handful of Americans working in Mozambique and Seattle, by 2020 had grown into a global organization. Over 90% of our staff were locally-hired public health and nonprofit management professionals leading the highly successful implementation of a diverse portfolio of health promotion, education, and research programs.  We are extremely proud of the growth and impact of our mission on human lives, on public health systems, and on the practice of global health.

But, as with the rest of the world, 2020 presented us with an opportunity to reflect on how we adapt to change. 

In fact, global health has been changing for some time. Following a long history of parallel, foreign-led interventions that often circumvent local public sector health systems, funders of global health are increasingly looking to local expertise and local systems to help integrate public health interventions and drive impact to achieve universal health coverage. As this change takes place, iNGOs like HAI are being justifiably asked to make the case for maintaining expensive, global systems of operation following years of local capacity building efforts.  This is especially true when decision-making authority about how funds are employed is concentrated in headquarters offices, located outside countries of operation.

HAI spent more than three decades successfully building collaborative, productive partnerships with our implementing and funding partners who we know see the continued value in our mission, model, and approach. But, we also spent decades investing resources in our country office staff, building experience and strengthening expertise to successfully manage and implement large, complex grants.  Their responsiveness, flexibility, determination, and professionalism shone particularly bright in 2020 as had the quality of their work under HAI’s most recent Country Directors.

With our Côte d’Ivoire program approaching the end of its active funding in 2021, HAI’s board and leadership took the opportunity to consider the future of HAI’s remaining programs. As a result of much thoughtful consideration and planning, in October 2021, HAI once again evolved in service of our mission and values.  At that time, with the support of our funders, HAI-Mozambique programs and staff transferred to Comité para a Saúde de Moçambique (CSM) and HAI-Timor-Leste programs and staff transferred to Asosiansaun Hamutuk Nasaun Saudavel (HAMNASA). And in February 2022, we were thrilled to introduce Health Alliance Côte d’Ivoire (HA-CI), a local Ivorian NGO founded by former HAI Côte d’Ivoire Country Director.

CSM, HAMNASA, and HA-CI are independent, locally-registered NGOs with a board, leadership, and staff that reflect the communities they serve.  All three organizations—with years of support from HAI—have the systems and structures required to take on a wide range of funding opportunities.  And, importantly, all three organizations embrace HAI’s public sector collaboration model and health system strengthening approach and will continue to work collaboratively with HAI’s long-time partners, including Ministries of Health, National Institutes of Health, and the University of Washington.

The future of HAI’s values, model, and commitment to global health equity, solidarity, and action is the future of CSM, HAMNASA, and HA-CI.  And so, in April 2022, HAI will complete its 35-year journey.

While this brings mixed emotions for all of us, we are confident that HAI’s commitment to strengthening public sector health services will live on through CSM, HAMNASA, and HA-CI. And we are proud knowing that this transition embraces our values and vision of a more equitable model of global health led by local expertise.

Please join us in celebrating the beginning of what we expect to be a very long, very successful future for CSM, HAMNASA, and HA-CI.

In Solidarity,

James Pfeiffer
Executive Director
Health Alliance International

Anne Evens
Board Chair
Health Alliance International

CSM is an independent, locally-registered Mozambican nonprofit led by a board and staff with experience executing hundreds of health systems strengthening and research projects in collaboration with Mozambique’s Ministry of Health. Based in Maputo, with active programs throughout Mozambique,  CSM expertise spans from community-based health promotion, to health information and care delivery systems improvement, to training Mozambique’s future public health leaders in a collaboration with the University of Washington.


HAMNASA’s founders envisioned a local organization run by Timorese with high capacity and integrity to bring together the priorities of Timor-Leste’s local communities and public health sector. HAMNASA leadership and staff have decades of combined experience supporting clinical and community-based health training, quality improvement, and innovative intervention. HAMNASA’s vision of a health and happy Timorese people is underscored by its commitment to equity, shared vision, and collaboration.


Health Alliance Côte d’Ivoire (HA-CI) is an independent, locally registered Ivorian nonprofit led by HAI’s former Country Director. HA-CI’s staff have decades of experience collaborating with Côte d’Ivoire’s Ministry of Health and Public Hygiene on HIV/AIDS programs and other health systems strengthening work.  Based in Abidjan, HA-CI’s vision is to carry on the legacy of HAI in the region by continuing to serve the Ivorian community and strengthening public health access and services for all.


Stand with HAI

Stand with HAI

Our Mission

Our mission is to promote policies and support programs that strengthen government primary health care and foster social, economic, and health equity for all. Our vision is a just world that promotes health and well-being, including universal access to quality health care.

Our History

Health Alliance International began in 1987 as a US-based international solidarity organization committed to supporting the public sector provision of health care for all.  Over 35 years, HAI conducted programs in 17 countries, with flagship programs in Mozambique, Côte d'Ivoire, and Timor-Leste.

Our Evolution

In line with HAI’s commitment to support and strengthen local public health leadership, as of October 2021, HAI fully transitioned global operations and active programs to locally-based, locally-led NGOs. Learn more about this shift toward local autonomy and equity in global health.

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