Innovation profile: How the avahan HIV prevention program transitioned from the gates foundation to the government of India

Sema K. Sgaier, Aparajita Ramakrishnan, Neeraj Dhingra, Alkesh Wadhwani, Ashok Alexander, Sara C Bennett, Aparajita Bhalla, Sameer Kumta, Matangi Jayaram, Pankaj Gupta, Peter K. Piot, Stefano M. Bertozzi, John Anthony

Research output: Contribution to journalArticle


Developing countries face diminishing development aid and time-limited donor commitments that challenge the long-term sustainability of donor-funded programs to improve the health of local populations. Increasing country ownership of the programs is one solution. Transitioning managerial and financial responsibility for donorfunded programs to governments and local stakeholders represents a highly advanced form of country ownership, but there are few successful examples among large-scale programs. We present a transition framework and describe how it was used to transfer the Bill & Melinda Gates Foundation's HIV/AIDS prevention program, the Avahan program, to the Government of India. Essential features recommended for the transition of donor-funded programs to governments include early planning with the government, aligning donor program components with government structures and funding models prior to transition, building government capacity through active technical and management support, budgeting for adequate support during and after the transition, and dividing the transition into phases to allow time for adjustments and corrections. The transition of programs to governments is an important sustainability strategy for efforts to scale up HIV prevention programs to reach the populations most at risk.

Original languageEnglish (US)
Pages (from-to)1265-1273
Number of pages9
JournalHealth Affairs
Issue number7
Publication statusPublished - 2013


ASJC Scopus subject areas

  • Health Policy
  • Medicine(all)

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