CHAI contracted with Big Pharma companies for AIDS drugs to be distributed in developing countries. In return, the group agreed to resist efforts to bring similarly lower cost and generic drugs to the US.
The email is a reaction to "comments President Clinton made on lowering domestic AIDS drugs prices at the World AIDS day event":
We have always told the drug companies that we would not pressure them and create a slippery slope where prices they negotiate with us for poor countries would inevitably lead to similar prices in rich countries.
[...] If we do try to do something in this area, we suggest that we approach the innovator companies that can currently sell products in the US with the idea of making donations to help clear the ADAP lists. For a variety of reasons, the companies will likely favor a donation approach rather than one that erodes prices across the board.
[...] I would guess that they would also likely favor a solution that involved their drugs rather than an approach that allowed generic drugs from India to flood the US market at low prices or one that set a precedent of waiving patent laws on drugs.