Gates Foundation Increases Funding, Defends AIDS Initiative in India

Bill Gates on Thursday announced an $80 million grant to Avahan, an HIV prevention initiative in India his foundation launched in 2003.

The Bill & Melinda Gates Foundation has already invested $258 million in Avahan, which means "call to action" in Sanskrit. The program includes more than 100 nonprofits in six Indian states and is run by Ashok Alexander, an executive recruited from the consulting firm McKinsey.

Alexander came under fire for comments he made in an interview with Conde Nast in December when asked how his business background has helped him run an AIDS program. "This was a marketing challenge," he told Forbes magazine. "Our 'consumers' were hidden, and the question was how to aggregate them. The women wanted to get into a violence-reduction program, not a condom program. Most HIV programs are supply-side driven: You count treatments and how many condoms are distributed. In this case, the consumer wasn't interested in the product. We had to persuade the consumer it was in her interest to be strong and healthy."

Forbes contended Avahan has largely failed to deliver on its goals because it substituted business expertise for practical health experience.

However, Tachi Yamada, president of the foundation's global health program, responded: "Avahan support has made it possible to provide prevention services to hundreds of thousands of high-risk individuals every month. While it is too early to fully assess Avahan's long-term impact, early signs are encouraging -- data from some projects suggest these efforts are increasing condom use and reducing STD infections."

Key aspects of Avahan will be turned over to the government-run National AIDS Control Organization. During the transition, "Avahan will provide financial and technical support to ensure that prevention programs can be sustained over time," the foundation said.

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