Editors’ Note: David Callahan reviews Bill Clinton’s memoir, Citizen: My Life After the White House (Knopf, 2024).

When Jimmy Carter died in late 2024 at 100, many accolades focused on his decades of philanthropic work after leaving the White House. No former president is more closely associated with charitable good deeds than Carter, whose long list of accomplishments includes fighting dread diseases like Guinea worm, promoting human rights, and helping expand Habitat for Humanity. 

Yet while Carter deserves credit for forging a new model of post-presidential public service, his efforts are no longer the most impressive benchmark of such activism. That mantle now belongs to Bill Clinton. 

Through the Clinton Foundation, the Clinton Global Initiative (CGI), and other activities — including donating millions of dollars of his own money — Clinton has compiled a record of philanthropic impact since leaving office in 2000 that is unmatched by any former president and far more extensive than most people realize. 

At the center of that impressive record is the Clinton Health Access Initiative (CHAI), which has helped millions of people gain access to antiretroviral drugs, especially in sub-Saharan Africa, since its founding in 2002. This work has likely saved hundreds of thousands of lives, although even rough estimates of CHAI’s impact are hard to come by. 

However, Clinton’s philanthropic footprint has extended well beyond global health, reflecting his famously broad interests and deep curiosity. Both on his own and with both former Bush presidents, Clinton has helped raise hundreds of millions of dollars for humanitarian disasters — most notably, the devastating 2004 tsunami in Asia, Hurricane Katrina, and the 2010 earthquake in Haiti. His foundation and CGI have also worked on climate change, domestic poverty, education, gender equity, and more. 

Clinton recounts these efforts in detail in “Citizen: My Life After the White House,” his 2024 memoir covering the years since he left office. This book offers the most comprehensive account yet available of Clinton’s philanthropy, which at times has included his wife, Hillary, and daughter Chelsea, who currently serves as the foundation’s vice chair. 

An earlier book, “Man of the World,” by Joe Conason, covers some of the same ground, including an in-depth and often gripping account of the creation of CHAI, which was the brainchild of Ira Magaziner, a long-time friend of Clinton’s who had worked in his first administration on healthcare. 

Reading Conason’s book, published in 2016, fundamentally changed how I saw Clinton. CHAI, which emerged before PEPFAR at the height of the global AIDS crisis, ranks as among the more impactful philanthropic initiatives of all time.

What’s strange, though, is how little people seem to know about the full scope of Bill Clinton’s role as a philanthropic leader — even within the charitable world. Moreover, perceptions of Clinton’s role in this area have long been colored by right-wing attacks on his foundation in the lead-up to the 2016 election, along with confusion about CGI’s model and impact, as well as questions about the former president’s ethical judgment, including his association with Jeffrey Epstein and close ties to Ghislane Maxwell, who played a major role in creating CGI. 

The historical record surrounding Clinton’s philanthropy is complicated — and not unblemished. But the topline here is clear to anyone who cares to look closely: By leveraging his global renown and bottomless Rolodex, starting immediately after leaving office and continuing ever since, Clinton has done enormous good in the world and deserves far more credit than he’s received so far. 

Philanthropy From Day One

The template for Clinton’s philanthropy started to fall in place in the first week after he left office, when an earthquake struck in India, killing 20,000 people and causing widespread destruction. Clinton called the country’s prime minister to offer his assistance. In short order, he had helped catalyze a new nonprofit, the American Indian Foundation, which raised tens of millions of dollars from donors in the Indian diaspora for emergency relief. The money went to build houses, schools, hospitals, health centers, and more. The foundation, which is still in operation today, claims to have raised more than $118 million and “impacted some 12.9 million lives from across 26 states of India.” 

Have you ever heard of this foundation or its story of creation? No, me neither. And there’s a lot else in Clinton’s 2024 memoir that was new to me, despite over a decade of covering philanthropy. For all the splashy CGI summits and press attention, many of Clinton’s efforts have flown beneath the radar, as he’s quietly put together the pieces of ambitious charitable initiatives. 

That’s certainly true of CHAI, which began in 2002 after Clinton appeared with Nelson Mandela at the biannual International AIDS Summit. There, he urged big pharmaceutical companies to lower the prices for antiretrovirals (ARVs) and take other steps to make these drugs more available. 

That basic idea became the basis for a proposal by Ira Magaziner to leverage Clinton’s fame and contacts to expand treatment with ARVs in places where the AIDS epidemic was soaring, including Africa, India, and Russia. (More than three million people worldwide would die of AIDS in 2002.) Clinton agreed, and CHAI began to take shape, with Magaziner initially leading the effort without pay. In his memoir, Clinton describes their partnership this way: “I would raise money and open doors, and Ira would work with government to set up operations and systems to get the best possible prices in the most efficient, least costly way.” 

Over time, this partnership would turn into a powerful organization with global reach. CHAI went from reaching 2000 people at first to treating 800,000 people within its first five years. Along the way, it helped to radically lower the costs of ARVs. It also branched out to treat malaria and other deadly health problems. Today, according to Clinton, 80 countries buy their ARVs off contracts negotiated by CHAI, covering more than 28 million, or more than two-thirds of the adults getting treatment worldwide.  

Top funders to CHAI include the Gates Foundation, which has given it nearly 200 grants totaling almost $634 million, and the Susan Thompson Buffett Foundation, which has contributed at least $73 million, according to data from Candid. A long list of other well-known foundations and major individuals have given millions more. Over the last 15 years, CHAI has raised well over $2 billion from philanthropy and government, with annual contributions exceeding $200 million in recent years. This sum, in turn, is insignificant compared to the many billions that have been knocked off the price of ARVs because of CHAI’s work, including Clinton’s own persistent entreaties to pharma companies and national governments.

Again, though, how much of this story rings a bell? I’m guessing not much. 

Leveraging Soft Power for Impact

CHAI’s success in catalyzing actions across sectors — philanthropy, business, and government — has been made possible in large part by Clinton’s unique public persona and vast network of connections. He’s spent the past quarter-century as one of the most famous people in the world, with nearly unmatched access to elites across multiple countries and various sectors. Even more than Carter, Clinton understood the potential of these assets and leveraged them to maximize social impact. 

While observers of philanthropy tend to fixate on mega donors and foundations with billions in wealth — e.g., hard power — the role of soft power in driving impact gets far less attention. 

There is a rich history of well-known public figures putting their fame to work for social good, going back to the 19th century, when Mark Twain used his sold-out lecture tours to raise money for education and other causes. During the 1960s, movie stars and music icons helped rally donors and public support to the civil rights and anti-war movements. More recently, celebrities like Taylor Swift and Leonardo DiCaprio have emerged as formidable fundraisers for charitable work. 

Still, it’s hard to think of anyone who’s deployed more soft power on behalf of social impact than Clinton. Like Carter, Clinton left the White House with a name known to people worldwide. Unlike Carter, the extroverted, fun-seeking Clinton basked in his fame and excelled at high-level social networking. 

Clinton’s soft power was a key to scaling up CHAI, but this asset was on even more dramatic display in the wake of humanitarian catastrophes. In the aftermath of the 2004 Tsunami, Clinton teamed up with former President George H.W. Bush to help galvanize a global relief effort. The pair toured the devastation together and created the Bush-Clinton Tsunami Fund, which eventually raised more than $130 million from private individuals and organizations in the United States — part of an estimated $2.78 billion that U.S. households gave for tsunami relief. 

Long after the initial wave of fundraising, Clinton continued to play a role in catalyzing action by government aid agencies across devastated regions of Asia, chairing four meetings over the next two years of the Global Consortium for Tsunami Recovery, the main international forum for coordinating aid efforts. He visited the region three more times during this period, and still cared enough a decade later to return to Indonesia on the tenth anniversary of the tsunami. 

Less than a year after the tsunami, Hurricane Katrina devastated New Orleans, and Clinton and Bush came together again to raise money, creating the Bush-Clinton Katrina Fund. Over the next two years, Clinton writes, “George and I raised more than $130 million from more than 100,000 donors in all fifty states and many foreign nations.” As with the tsunami, Clinton would remain involved in the New Orleans recovery work long after public attention had moved on, which disaster philanthropy experts say is crucial to ensuring impact. 

This same playbook guided Clinton’s work in Haiti after the 2010 earthquake. In his memoir, Clinton writes of his longstanding interest in Haiti, which he and Hillary had first visited in 1975. Clinton visited again as president and also in 2003 as part of his work on HIV/AIDS prevention. In 2008, the Clinton Global Initiative created the Haiti Action Network to galvanize different projects in the country.  

After the disaster struck, Clinton teamed up with George W. Bush and helped raise over $54 million in private donations through the Clinton Bush Haiti Fund and was also deeply involved in multilateral government recovery efforts, co-chairing the Interim Haiti Recovery Commission with Haiti’s prime minister. Meanwhile, CGI’s Haiti Action Network turned its attention to recovery, and by 2019, Clinton said it had catalyzed 130 commitments, of which 80 had been completed, valued at $525 million. 

These figures are difficult to independently confirm, along with other statistics about CGI’s impact in Haiti that Clinton shares in his memoir. Meanwhile, the role of Clinton and the Clinton Foundation in post-earthquake recovery work attracted criticism for relying on misguided approaches to development, backing failed projects, and serving as a backdoor for self-interested donors to influence Hillary Clinton. (The foundation denied these charges, as does Clinton in his memoir.) 

Brokering Philanthropy

What makes the Clinton Global Initiative’s impact — in Haiti and elsewhere — hard for outsiders to assess is the organization’s unique nature. It is not a private foundation with its own assets, nor mainly a funding intermediary that raises and grants out money, although it does some of this. Rather, CGI’s main role has been as a convening entity that brings people and institutions together to make commitments to take action on a wide range of global and domestic issues. The fulfillment of these commitments, including many by businesses, is difficult to track, despite CGI’s monitoring efforts. 

This lack of transparency has attracted a range of critics. But before saying more on the controversies around CGI, it’s important to reflect on its groundbreaking model for social impact. Nothing like CGI existed before its creation in 2005, and it’s hard to think of anything quite like it that’s emerged since then. This one-off quality is not so surprising, since CGI has been very much an outgrowth of Clinton’s soft philanthropic power.

Clinton founded CGI after visiting Davos in 2004, one of his many appearances there. He writes in his memoir: “I enjoyed the World Economic Forum, but no one was ever asked to commit to do anything about all the problems we discussed.” 

When Clinton returned from Davos that year, he started talking to his foundation staff about holding a similar meeting during the United Nations General Assembly week in New York. According to reporting by the New York Times and the BBC, Ghislane Maxwell also helped Clinton think through the new initiative and secure funding for CGI’s first convening. Believing that the “world didn’t need another talkfest,” Clinton insisted that every attendee would need to make a commitment to social impact and “report on their progress in keeping it.” 

To underwrite CGI’s costs for the first few years, Clinton enlisted Tom Golisano, the founder of Paychex, who today is a billionaire and major philanthropist, but back then was largely unknown. “In those early days, Tom was the difference between life and death for CGI,” Clinton writes. 

As important as Golisano’s funding was, the real driver of CGI’s early success was Clinton’s far-flung network and convening power. Over the years, CGI’s glitzy annual meeting drew in a long list of leaders from politics, business, philanthropy, and entertainment — many of whom had some connection to Clinton. In short order, it became the go-to venue for unveiling high-profile philanthropic commitments and announcements. 

Clinton writes in detail in his memoir about how CGI worked and its many endeavors over the years, which have spanned a long list of causes, including climate resilience, gender equality, education, global health, economic inclusion, and more. Most of the commitments made at CGI — which paused its flagship meetings between 2017 and 2021 — have been internationally focused, but it has also galvanized significant work in the U.S. 

As of early 2026, CGI says that it has spurred over 4,100 “commitments to action” in 190 countries that have involved more than 10,000 partners from the public, private, and nonprofit sectors and benefitted more than 500 million people. 

Powerful Enemies

While CGI has said it tracks the fulfillment of commitments made at its meeting, this information isn’t publicly available. In any case, the nature of many of these pledges makes them inherently hard to track. For example, when a corporation commits to donating a combination of in-kind products, employee volunteer time, and cash grants to a cause, only the grants can be easily measured, and even this piece can be opaque if the company doesn’t have a private foundation. 

This murkiness has led to persistent questions about CGI’s actual impact. More seriously, CGI and the Clinton Foundation were dogged by questions during the Obama years that business leaders and foreign powers were making donations to curry favor with Hillary Clinton, who served as Secretary of State between 2009 and 2013, before resigning to run for president. 

These allegations have been assessed elsewhere, including by FactCheck.org, and I won’t rehash them here. But two throughlines defined attacks on the Clinton Foundation during the Obama years: first, intense partisanship by critics who saw these attacks as a way to damage Hillary as she competed for the presidency. And second, a high degree of cluelessness about how the foundation and CGI operated. 

The right’s deep animus toward the Clinton’s is well known, and attacks on their philanthropic efforts were just the latest chapter in a smear campaign that extended back to the early 1990s, and has been meticulously documented by Joe Conason and Gene Lyons in their 2000 book, “The Hunting of the President.” After Clinton left office, that campaign — backstopped by millions of dollars in donor support — didn’t end. In many ways, it escalated further, culminating in the attacks on Hillary in the decade leading up to her presidential run, and included not just the attacks on the foundation, but the unending scandal over her emails, fueled by Judicial Watch, a right-wing nonprofit. 

Given Hillary’s narrow Electoral College loss to Trump in 2016, by less than 80,000 votes across three states, it’s fair to say the “vast right-wing conspiracy” against the Clintons succeeded. It’s hard to say exactly how much conservative donors put into this fight, tens of millions of dollars at least, but clearly this ranks as among the high-impact “charitable” investments of all time. 

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The blizzard of misinformation about the Clintons and their philanthropy is probably the best explanation for why Bill Clinton doesn’t enjoy the same halo-like status that Jimmy Carter did before his death, even though Clinton’s record of social impact is far greater. But CGI’s unique model is certainly another. It’s been hard for many observers to fully understand how CGI works, and for those who do look closely, it can be hard to say exactly what it has accomplished. 

Ultimately, though, an exact tallying up of CGI’s impact feels less important than the fact that it exists at all. 

When Clinton was creating CGI, he wondered: “Would people actually pay to come to a meeting which required them to spend even more time and money to help save the world?” The answer to that question turned out to be yes, and Clinton’s unique soft power was a main reason why. Even if CGI has had far less impact than it claims, it remains one of the more innovative and potent philanthropic efforts of our time. In turn, this accomplishment pales in comparison to the true core of Clinton’s philanthropic legacy: saving hundreds of thousands of lives through CHAI.

One final testament to Bill Clinton’s charitable commitments is worth mentioning: the millions of dollars that he and Hillary have given through their personal philanthropy since 2001, the Clinton Family Foundation. As of late 2024, that figure stood at just under $30 million.

-David Callahan

David Callahan is Founder and Editor-in-Chief of Inside Philanthropy, and author of The Givers: Wealth, Power, and Philanthropy in a New Gilded Age (Knopf 2017).