title: How the Avahan HIV prevention program transitioned from the Gates Foundation to the government of India.
abstract: 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 donor-funded 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.
authors.affiliation: Integrated Delivery and the Global Health Program, Bill & Melinda Gates Foundation, Seattle, WA, USA. sema.sgaier@gatesfoundation.org
authors.forename: Sema K
authors.initials: SK
authors.lastname: Sgaier
authors.forename: Aparajita
authors.initials: A
authors.lastname: Ramakrishnan
authors.forename: Neeraj
authors.initials: N
authors.lastname: Dhingra
authors.forename: Alkesh
authors.initials: A
authors.lastname: Wadhwani
authors.forename: Ashok
authors.initials: A
authors.lastname: Alexander
authors.forename: Sara
authors.initials: S
authors.lastname: Bennett
authors.forename: Aparajita
authors.initials: A
authors.lastname: Bhalla
authors.forename: Sameer
authors.initials: S
authors.lastname: Kumta
authors.forename: Matangi
authors.initials: M
authors.lastname: Jayaram
authors.forename: Pankaj
authors.initials: P
authors.lastname: Gupta
authors.forename: Peter K
authors.initials: PK
authors.lastname: Piot
authors.forename: Stefano M
authors.initials: SM
authors.lastname: Bertozzi
authors.forename: John
authors.initials: J
authors.lastname: Anthony
mesh_terms: D002017:Budgets; D003906:Developing Countries; D005380:Financing, Government; D005582:Foundations; D006078:Government Programs; D015658:HIV Infections / Q000517:prevention & control*; D006284:Health Plan Implementation; D006801:Humans; D007194:India; D010067:Ownership; D011314:Preventive Health Services; D015397:Program Evaluation
keywords: AIDS/HIV; Global Health Studies; Health Philanthropy; Health Promotion/Disease Prevention; Public Health