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Reaching High-Risk Groups
Avahan: Winning Against HIV/AIDS in India
One reason I was very excited to be visiting India recently was to get a chance to check on our foundation’s efforts to support the work of the government of India to halt the spread of HIV/AIDS. India is making good progress and learning lessons that could be helpful in other countries.
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Swathi Mahila Sangha Models Self-Help and Empowerment

In 2003, we worked with Indian partners to launch a project called Avahan, which means “call to action” in Sanskrit, an ancient language of India. The project is a partnership with many Indian NGOs, state and local governments and the national government, which has increased funding for HIV/AIDS and established a national strategic plan that includes community-led HIV prevention.

Indian States with the Highest HIV Prevalence

Avahan’s efforts have been focused on reaching high-risk groups in six states of southern India, where the virus is most prevalent, and elsewhere along the nation’s major trucking routes, long-haul truckers being among those at high risk. Others we’re trying to reach include sex workers, their clients and partners, men who have sex with male partners, and injection drug users.

Chart Showing the Network of Government Agencies and Other Organizations Fighting Sexually Transmitted Diseases

About 2.7 million people in India are infected with HIV, but that number is far below the dire forecasts that some experts predicted for India a decade ago. Avahan and India’s other efforts have contributed to a 50-percent reduction in HIV/AIDS incidence in the past six years, saving $100 million USD in averted health costs and, more importantly, saving many lives. One estimate puts the number of infections averted in the six states at more than 100,000.

A Medical Clinic Located in Kamathipura, Mumbai’s Oldest and Asia’s Largest Red-light District

Avahan is engaged in communities and at the street level, helping local groups deploy peer-to-peer counselors, distribute condoms and provide HIV testing, treatment and care. A big part of the effort is aimed at reducing the stigma that often prevents people from seeking HIV prevention and treatment services.

Bill Gates Visits a Bangalore Community Center

India has taken ownership of its national response to HIV/AIDS and is transitioning the Avahan program to state governments, facilitated by India’s National AIDS Control Organisation. During my recent trip to India I was pleased to congratulate in person a number of the leaders who has been involved in transitioning Avahan and sustaining India’s HIV/AIDS prevention efforts.

Bill Gates Receives a Traditional Indian Welcome at a Community Center

In Bangalore, I got to spend time at a community center that’s part of Avahan. The center, known as Swathi’s Women's Group, was set up by sex workers to help prevent the spread of AIDS in their community. It’s been quite successful at that, and now it does lots more, like running a micro-finance bank and helping members defend their rights. It’s a great self-help success story.

A Project Director at Swathi’s Women's Group

The India program stands out as one of the best examples of effective national scale up of HIV prevention efforts, but those efforts will need sustained funding and government leadership. We’re hoping that what we learn in India will encourage and guide increased prevention efforts in other parts of the world.

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