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Avahan: the transition to a publicly funded programme as a next stage
  1. Prasada J V R Rao
  1. UNAIDS, Regional Support Team for Asia and the Pacific, Bangkok, Thailand
  1. Correspondence to Dr Prasada JVR Rao, 9th Floor, Block A, United Nations Building, Rajadamnern Nok Avenue, Bangkok 10200, Thailand; raojvrp{at}

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Avahan the flag ship programme of the Bill & Melinda Gates Foundation (BMGF) for the prevention of HIV in India was projected as a unique business model that brought private sector efficiency to a public health programme. However, within a period of 3 years after its launch, the programme already started planning for a phased withdrawal and a ‘graceful transfer’ into a publicly funded programme.1

Avahan with a US$250 million project cost was effectively complementing the Government of India's efforts to control AIDS through its own publicly funded National AIDS Control Program (NACP). Avahan was tasked to deliver to scale, high quality prevention interventions to high-risk community groups in six high prevalence states and make an impact on the progression of the epidemic in these states.

Six years later, despite its impressive success in rapid scale up and efficient management of programme delivery, Avahan is coming under criticism for trying to wind up early from India, and worse, for experimenting with a model that is high cost in terms of unit costs of intervention. The programme, which aimed at ultimate community ownership of the interventions, has initiated the process of transfer before this objective is fully realised.

The feasibility of Avahan's proposed transition into a publicly funded …

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