R4D and JHU Continue Series on Sustainable Development Financing with Event on HIV Transition in India

May 29, 2015

WASHINGTON –  R4D and the Johns Hopkins University’s Bloomberg School of Public Health hosted the third event in their series on sustainable financing for development. Hosted at JHU’s Rome Building in Washington, D.C., the event, held on May 28th, was titled “Transitioning from Donor Support to Government: The Avahan Experience in India.” The discussion followed the model of past events on immunization and family planning to focus on the transition of the Avahan HIV prevention program in India from the Bill and Melinda Gates Foundation to government funding and management over a four-year timeframe.The panel featured Rob Hecht, R4D Managing Director, Dr. Sara Bennett, JHU/Bloomberg Associate Professor of International Health, and Matangi Jayaram, Gates Foundation Senior Program Officer for the Avahan program, and was moderated by Lisa Carty, UNAIDS U.S. Liaison Office Director. Dr. Neeraj Dhingra, Deputy Director at India’s National AIDS Control Organization (NACO), was unable to attend in person but delivered a prepared statement via video. The audience of roughly 35 included representatives from the Gates Foundation, USAID, OGAC, UNAIDS, PSI, CSIS, the Kaiser Family Foundation, amFAR and other organizations.The discussants focused their presentations around the transition of the 190 HIV prevention interventions that made up the Avahan program, including clinical services, behavior change communications, distribution of key commodities, and HIV testing. Although they identified challenges, including early setbacks in the phased approach, all agreed that the Avahan program transition was remarkable in its success. The Indian Government took over the funding and management of almost all elements of Avahan in the agreed-upon timeframe without compromising the quality of service delivery.The panelists identified several factors that made the Avahan transition successful and could be applied to other attempts to transition large programs from an external funder to a country government:

  • Establishment of a concrete transition timeline (but allowing for some flexibilities);
  • Early, thorough planning, including alignment of pre-transition programs with post-transition government processes and structure;
  • Commitment to the transition from both the Gates Foundation and the Indian Government;
  • Clear communication between the two parties.

Rob Hecht hailed the Avahan transition process as an example for other transitioning programs to follow, noting, “Too often, not enough time is spent thinking about the exit. The Gates Foundation and Government of India have provided evidence of the critical factors that must be addressed when attempting this kind of transition.”Additional information on the transition can be found in an article published by Health Affairs, “How the Avahan HIV Prevention Program Transitioned from Gates Foundation to the Government of India.” The next event in the series will focus on polio and will take place in early July.

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