Bill Gates’s efforts to address the HIV/AIDS epidemic in India

A recent article in Forbes India reports on the outcomes of Bill Gates’s efforts to address the HIV/AIDS epidemic in India.  Gates’ famed 2002 trip to India inspired him to develop a 10-year initiative with a $258-million investment to end the epidemic.  Seven years later, the project, entitled Avahan, is showing little to no major impact on the epidemic.

The major misstep in the initiative seems to be that it was too broad. For instance, Avahan opened 6,000 sexually transmitted infection centers and were eventually forced to downsize to 800. Avahan also started with 50 sites that specifically focused on educating truck drivers, however, they quickly found that only a very small portion of drivers were even aware of their services and even smaller portion actually used their services.  This quickly drove down the sites to 20.  In addition, Avahan’s approach towards the sex workers was ineffective.  They used shiny expensive posters, cars, and offices that the sex-workers were not able to relate to.  Many of the sex workers were afraid that they were linked to the police or government and therefore did not utilize the resource.  Similar NGO’s felt that Avahan’s goal of ending the epidemic was unrealistic, especially because much of their funding was being channeled towards the pay of their executives.  (For more details check out the entire article in Forbes India.)

Avahan’s lack of insight into the world of the sex workers and their mismanagement of funds have made the effort a failure.  In what ways could Gates and Avahan have better managed their funds?  All the executives of Avahan were former business executives from major firms like McKinsey-Phillips.  Would incorporation of individuals who work in the public service fields have been helpful to Avahan?  In addition, would consultation with other NGO’s and sociological experts have been a helpful tool in strategically channeling Avahan’s funding?