AIDSTAR-One Case Study: Avahan-India HIV/AIDS Initiative

8/3/2019 AIDSTAR-One Case Study: Avahan-India HIV/AIDS Initiative

1/16

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2/16

8 ECMW]EX/Ajl tOexgb 8>55


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dlyldw a wgedl/|~ }be} beyl oeml e xled co~eg} aj

}bl l~cmlocg cj }bl xlfcajw vblxl c} vaxkw*

Gaohcje}caj BCY ^xlylj}caj

E} xw}$ Eyebej alxlm e }xemc}cajed ocr a wlxycglw0

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daged ~ex}jlxw ejm ~llx lm|ge}axw$ c} emmlm

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ejm }a lr~ejm je}cajed BCY ~xlylj}caj ~adcgclw ejm

gaoo|jc}s ljfeflolj} lax}w*

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aj }bl de}lw} l~cmlocadafcged ejm ~xafxeooe}cg

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xledc}clw* Eyebej ag|wlw aj }bl xlfcajw OEX^w0

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ejm xl~xlwlj} e flafxe~bcg exle ejm ~a~|de}caj wcpl

wcocdex }a }bl \jc}lm W}e}lw* Eyebej xl~ax}w ~xaycmcjf

oaj}bds ~xlylj}caj wlxycglw }a oaxl }bej 88>$>>>

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}xejwfljmlxlm ~la~dl$ 52$>>> CM\w$ ejm < ocddcaj

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gajmaow

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wlr|ed ~xeg}cglw*

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}bl l~cmlocg cj }bl xlfcajw vblxl

c} vaxkw*


3/16

]bl Eyebej/Cjmce ECMW Cjc}ce}cyl0 ^xaocwcjf E~~xaegblw }a Gaohcje}caj BCY ^xlylj}caj ^xafxeoocjf cj Gajglj}xe}lm L~cmlocgw 7


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eme~}ehcdc}s ejm w}xajf egga|j}ehcdc}s*

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lgajaocg$ ejm ~adc}cged cww|lw }be} elg} bled}b e}

}bl cjmcycm|ed$ gaoo|jc}s$ ejm wagcl}ed dlyldwexl

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]bl Axcfcjw a Eyebej

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co~dlolj}lm }exfl}lm cj}lxylj}cajw }a ~xlylj} BCY*

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de}l 533>w$ oejs ja}lm }bl ~a}lj}ced ax e o|gb

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xao }be} }col ~|} }bl j|ohlx a BCY/cjlg}lm

cjmcycm|edw cj Cjmce e} = ocddcaj$ lexw fxlv }be}

~xlyedljgl ga|dm xlegb < ~lxglj} hs 8>>


4/16

= ECMW]EX/Ajl tOexgb 8>55


Icjedds$ Eyebej cw e dlexjcjf oamld* Eyebej o|w}

eme~} }a xlw~ajm }a gbejfcjf xledc}clw cj }bl ldm cj

axmlx }a w|ggllm* Iax lreo~dl$ }bl GO^ vew xlycwlm}bxll }colw cj }bl ~xa`lg}w xw} ~bewl$ eddavcjf ax

cjjaye}cajw e} }bl daged dlyld }a hl gbejjldlm hegk }a

}bl Eyebej ~xafxeo dlyld* Oejeflxw dcw}lj gdawlds }a

w}e}l co~dlolj}cjf efljgclw ejm JFAw ejm em`|w}

}blcx e~~xaegblw ejm w|~~ax} vblj }bls blex }be}

ej ew~lg} a }bl ~xafxeo cw ja} vaxkcjf a~}coedds*

Eyebejw w}e}l ~ex}jlxw ~xaycml emmc}cajed w}e w|~~ax}

ejm }xecjcjf }a JFAw }be} wdc~ cj xlegbcjf }blcx }exfl}w*

Eyebejw ]lgbjcgedE~~xaegb

Eyebejw }lgbjcged e~~xaegb cjyadylw }bl }exfl}

gaoo|jc}clw }a mlylda~ c}w cj}lxylj}cajw$ |wcjf bcfbds

~ex}cgc~e}axs e~~xaegblw }a cmlj}cs ba}w~a}w ejm xcwk

fxa|~w$ }a mlwcfj e ~egkefl a ~xlylj}caj wlxycglw

}be} cw xldlyej} ejm egglwwchdl$ ejm }a emmxlww wagced

eg}axw }be} cjgxlewl OEX^ oexfcjedcpe}caj ejm

gxle}l hexxclxw }a ~xlylj}caj wlxycglw* Hs cjylw}cjf cj

oajc}axcjf ejm lyed|e}caj eg}cyc}clw$ Eyebej ljw|xlw

}be} c}w cj}lxylj}cajw gaj}cj|l }a llg}cylds emmxlww

}bl lyadycjf jllmw a c}w }exfl} ~a~|de}cajw*

^cj~acj}cjf }bl l~cmlocg0 ]a ewwlww vblxl

}bl jllm ax ~xlylj}caj wlxycglw ax OEX^w cw

oaw} gxc}cged$ Eyebej hlfej c}w ~dejjcjf ~xaglww hs

xlyclvcjf Cjmcew lr}ljwcyl l~cmlocadafcg ejm wlr|ed

hlbeycaxed me}e* ]blwl me}e wbavlm }be} }bl wcr

w}e}lw vblxl Eyebej cw hewlm bem ej lw}coe}lm 27

~lxglj} a edd BCY cjlg}cajw cj Cjmce* ]blwl w}e}lw

edwa bem e gajglj}xe}caj a loedl wlr vaxklxw$

OWO$ ejm CM\w*

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w}e}lw xl~xlwlj} }bl gaxl a }bl l~cmlocg cj Cjmce ejm

|jgaylxlm lylj dexflx j|ohlxw a OEX^w* Icxw}$

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ejm exl a}lj w}elm hs OEX^woe~~lm exlew

vc}b }bl bcfblw} BCY ~xlyedljgl ejm }bl dexflw}

gajglj}xe}cajw a OEX^w vc}bcj }bl wcr w}e}lw*

Eyebejw ~ex}jlxw }blj |jmlx}aak ml}ecdlm oe~~cjfejm wcpl lw}coe}caj lrlxgcwlw vc}bcj mcw}xcg}w ejm

w|hmcw}xcg}w }a ml}lxocjl vblxl }a lw}ehdcwb wlxycglw

ejm }a |wl de}lx }a fe|fl ~xafxlww* Ew ~ex} a }be}

~xaglww$ }bls gexl|dds oe~~lm wadcgc}e}caj ba} w~a}w

ejm wlr|ed jl}vaxkw e} daged dlyldw*

]blwl me}e oeml c} ~awwchdl }a ag|w xlwa|xglw cj

legb w}e}l aj mcw}xcg}w$ w|hmcw}xcg}w$ ejm wlg}cajw a

|~ }a 5> dexfl gc}clw ejm 5>> }avjw vc}b }bl bcfblw}

BCY ~xlyedljgl ejm gajglj}xe}cajw a OEX^w* ]bl

oe~~cjf fljlxe}lm lw}coe}lw a 857$>>> loedlwlr vaxklxw$ 69$>>> }xejwfljmlx ~la~dl ejm OWO$

ejm 8>> CM\w cj 28 mcw}xcg}w egxaww }bl wcr

w}e}lw*8 ]exfl} fxa|~w vlxl |x}blx w|hmcycmlm hs

mloafxe~bcg gbexeg}lxcw}cgw$ hlbeycaxw$ ax vaxkcjf

dagedlw }a eddav ax mclxlj} a|}xlegb e~~xaegblw*

Iax lreo~dl$ loedl wlr vaxklxw vlxl cmlj}clm

ew baol/hewlm$ ew w}xll}/hewlm$ ax ew hewlm cj

hxa}bldw ejm damflw*

H|cdmcjf kls wlxycglw0 Eyebej ~xaycmlw e

~egkefl a ~xlylj}caj wlxycglw aj e dexfl wgedlegxaww }bl wcr w}e}lw* Gajmao ~xaoa}caj ejm

mcw}xch|}caj ew vldd ew W]C mcefjawcw ejm }xle}olj}

exl dcjklm }a hlbeycax gbejfl gaoo|jcge}cajedd

lwwlj}ced ldlolj}w a gaohcje}caj BCY ~xlylj}caj* ]a

oecj}ecj bcfb w}ejmexmw a u|edc}s cj wlxycgl mldcylxs$

}bl ~xafxeo eg}cylds oajc}axw edd eg}cyc}clw e} edd dlyldw*

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gajglj}xe}cajw a OEX^w ax vblxl }va ax }bxll

w|gb fxa|~w }ljm }a aylxde~* Eyebej w~ajwaxw W]C

gdcjcgw e} wc}lw ja} gaylxlm hs faylxjolj} gdcjcgw*Oejs exl ba|wlm vc}bcj }bl jlexds 9>> gaoo|jc}s

mxa~/cj glj}lxw }bl ~xafxeo bew gxle}lm* Gdcjcgcej

ba|xw exl ~aw}lm$ ejm legb W]C gdcjcg edwa cjgd|mlw e

ga|jwldax$ e j|xwl!mcw~ljwlx$ ejm ej emocjcw}xe}cyl

8 Lw}coe}lw cj w|hwlu|lj} slexw cjgxlewlm }bl j|ohlx a loedl wlr vaxklxw }a

885$>>> ejm a oaw}/e}/xcwk OWO }a 25$>>>$ vbcdl mlgxlewcjf }bl j|ohlx a CM\w

}a 52$>>>*


5/16



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}bl dexfl eoa|j} a a|}~|} me}e }bl ~xafxeo fljlxe}lw e} edd dlyldw$

w}ex}cjf vc}b gaj}eg}w oeml hs ~llx lm|ge}axw* ^llx lm|ge}axw kll~

mecds xlgaxmw a }blcx gaj}eg}w ejm }blcx cj}lxeg}cajw vc}b }blcx ~llxw$

cmlj}cscjf bcfbds y|djlxehdl ~llxw ax lr}xe e}}lj}caj* ]blwl xlgaxmw exl

gajwadcme}lm cj}a vllkds w|ooexclw a gaj}eg}w* Co~dlolj}cjf JFAw

vaxk vc}b }bl ~llx lm|ge}axw }a ejedspl }blwl me}e ejm ~dej a|}xlegb}a ljw|xl oerco|o gaylxefl ejm gdcjcg e}}ljmejgl* ]bls }blj axvexm

a|}~|} me}e }a }bl dlem efljgclw cj legb w}e}l }a bld~ oajc}ax ~xafxlww

ejm cmlj}cs exlew ax co~xaylolj} ax emmlm e}}lj}caj*

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ew cw gajmao mcw}xch|}caj e} yexca|w wa|xglw* Eyebej |jmlm }va xa|jmw

"8>>9>6 ejm 8>>35># a ej Cj}lfxe}lm Hlbeycax ejm Hcadafcged

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welx wlr; ejm BCY$ W]C$ ejm!ax bl~e}c}cw cjlg}caj* JEGA fljlxe}lwejj|ed lw}coe}lw a Cjmcew ~a~|de}caj dcycjf vc}bBCY }a ag|w e}}lj}caj

aj mcw}xcg}w vc}b lolxfcjf l~cmlocgw$ ejm gajm|g}w hcejj|ed hlbeycaxed

w|xylsw* Edajf vc}b c}w avj me}e$ Eyebej |wlw me}e xao JEGAw

hlbeycax w|xylsw ejm lw}coe}lw a ~la~dl dcycjf vc}b BCY }a |x}blx

oajc}ax c}w avj ~xafxlww ejm }a daak ax fe~w cj c}w mcw}xcg}w*

^llx Lm|ge}axw Vc}bcj Eyebej

]bl |wl a ~llx lm|ge}axw cw e vldd/lw}ehdcwblm ~xeg}cgl cj BCY ~xlylj}caj*

H|} oejs ~llx lm|ge}ax ~xa`lg}w beyl bem dcoc}lm xlw|d}w* Xl}lj}caj a

~llx lm|ge}axw$ degk a olwwefl cjjaye}caj ejm gbejfl$ xldcejgl aj

|jgao~ljwe}lm yad|j}llx ~llxw$ }bl wbax} m|xe}caj a oejs ~xa`lg}w$ ejm

a}blx eg}axw beyl xlm|glm }bl co~eg} }be} w|gb cjc}ce}cylw ocfb} beyl*

Vc}bcj Eyebej$ ~llx lm|ge}axw exl }bl glj}xed ag|w a ~xafxeo a~lxe}cajw

^llx lm|ge}axw beyl o|d}c~dl xlw~ajwchcdc}clw }be} }ekl emyej}efl a }blcx

kjavdlmfl ejm wkcddw* ]bls xlglcyl e woedd w}c~ljm }be}$ ax oejs$ cw }bl

Eyebejw oejeflolj} xldclw aj }bl dexfl eoa|j}

ai a|}~|} me}e }bl ~xafxeo fljlxe}lw e} edd dlyldw$

w}ex}cjf vc}b gaj}eg}w oeml hs ~llx lm|ge}axw*

XLW^AJWCHCDC]CLW AI

^LLX LM\GE]AXW

Oe~~cjf~llxwlr|edgaj}eg}

dagedlw ejm jl}vaxkw

Vllkdsgaj}eg}vc}b~llxw$

gajylscjf e fxavcjf wl} a

olwweflw eha|} wel wlr

Gajmao~xaoa}cajejm

mcw}xch|}caj

Vllkdsme}ew|ooexclw

Ocgxa~dejjcjfejmxlycwcajw

Xlilxxedw}aW]Cgdcjcgwejm

addav/|~$ ew jllmlm

]Hwgxlljcjfejmxlilxxedw;

waol eggao~ejcolj} }a gdcjcg

BCY}lw}cjfxlilxxedw*

DLEXJCJF IXAO ^LLXLM\GE]AXW

^llx lm|ge}axw lld }bls beyl

mloajw}xe}lm }bl addavcjf }a

Eyebej ejm c}w w}e}l ~ex}jlxw*

]blxlexloejswkcddwvc}bcj

oexfcjedcplm gaoo|jc}clw

Gaoo|jc}clwgejoejefl}blcx

~xahdlow

Gaoo|jc}clwgejoahcdcpl

xlwa|xglw

Gaoo|jc}clwgej}ekledlemcjfxadl cj x|jjcjf bled}b ejm wagced

vldexl ~xafxeow*


7/16



mclxljgl hl}vllj dcycjf cj mll~ ~aylx}s ejm beycjf

}bl olejw }a vaxk }avexm e oaxl wlg|xl |}|xl*

Vbcdl }bl w}c~ljm cw co~ax}ej} }a ~llx lm|ge}axw$ }blgaooc}olj} }a ~lxwajed ejm gaoo|jc}s gbejfl cw

edwa ej co~ax}ej} oa}cye}ax* Oaxlaylx$ }bl ~xafxeo

vew w}x|g}|xlm }a ~xaycml a~~ax}|jc}clw }be} eddavlm

}blo }a mlylda~ jlv wkcddw ejm ~awc}cajlm }blo ax

fxle}lx xlw~ajwchcdc}clw* ]blwl eg}axw gxle}lm e

w}xe}lfs }a gaohe} }bl bcfb }|xjaylx xe}lw }s~cged cj

oaw} ~llx lm|ge}ax ~xafxeow*

Waol ~llx lm|ge}axw bld~ oejefl }bl ~xafxeow

eg}cyc}clw vc}b ~llx gaoo|jc}clw* Ew }bls mag|olj}

cj}lxeg}cajw vc}b ~llxw$ }bls kjav }bl me}e }blsgaddlg} exl lwwlj}ced ax }blcx avj ~dejjcjf$ vbcgb cw

kls }a }bl ~xafxeow aylxedd co~dlolj}e}caj w}xe}lfs*

Eyebej bew mlylda~lm jaj/ ejm dav/dc}lxegs

oe}lxcedw }be} ~llx lm|ge}axw |wl m|xcjf }xecjcjf ejm

aj }bl `ah* Oejs a }bl oe}lxcedw |wl ~cg}|xlw ejm

wsohadw cjw}lem a }lr}* ]xecjcjf cjgd|mlw }a~cgw aj

wld/lw}llo mlylda~olj}$ jlfa}ce}caj ejm egcdc}e}caj

wkcddw$ emyagegs ejm dlemlxwbc~$ ejm ~llx oajc}axcjf*

^llx lm|ge}axw ejm wlxycgl mldcylxs0Legb ~llx lm|ge}ax bew |~ }a gdclj}w$ oll}cjf

vc}b legb e} dlew} ajgl e oaj}b ejm a}lj oaxl

xlu|lj}ds* M|xcjf oll}cjfw$ ~llx lm|ge}axw alx

welx wlr olwweflw$ ~xaycml gajmaow$ ejm ja}l

}blcx gdclj}w ycwc}w }a W]C gdcjcgw* ]bls wlxyl ew

}bl ~xcoexs ejm cjc}ced gaj}eg}w ax egglww }a W]C

wlxycglw e} Eyebej gdcjcgw$ fcycjf xllxxed ja}lw ax

mcefjawcw ejm }xle}olj} wlxycglw* ]bls ljga|xefl

ejm egcdc}e}l e}}ljmejgl$ waol}colw hs lwgax}cjf

}bl ~llx }a }bl W]C gdcjcg$ vbcgb edwa wlxylw ew e

xllxxed ~acj} ax BCY }lw}cjf ejm }xle}olj} wlxycglw*

Xlglj}ds$ ~llx lm|ge}axw vlxl }xecjlm }a cmlj}cs

hewcg ]H wso~}aow ejm }a lwgax} wso~}aoe}cg

~llxw }a gdcjcgw ax mcefjawcw$ cj waol gewlw

exxejfcjf ax ]H }xle}olj} oajc}axcjf* Waol a }bl

GHAw }be} beyl w~x|jf xao }bl vaxk a }bl ~llx

lm|ge}axw edwa bld~ ~la~dl dcycjf vc}b BCY xlfcw}lx

ax faylxjolj} }xle}olj} wlxycglw*

Eyebejw e~~xaegb }a ~llx lm|ge}caj cw cj}ljwcyl$

ha}b ax }bl ~llx lm|ge}axw ejm }bl w|~lxycwaxs

a|}xlegb vaxklxw a }bl co~dlolj}cjf JFAw*

Lr}ljwcyl ~dejjcjf bld~lm lw}ehdcwb e ycehdl wsw}lo

a cmlj}cscjf ejm wldlg}cjf ~llx lm|ge}axw$ ~xaycmcjf

cjc}ced ejm addav/|~ }xecjcjf$ ejm w|w}ecjcjf }blcx

cj}lxlw}w ejm wkcddw vc}b gdawl w|~lxycwcaj* Mxa~/cj

glj}lxw alx e w|~~ax}cyl ~degl ax ~llx lm|ge}axw

}a oll}$ mcwg|ww$ ~dej$ ejm alx wlxycglw }a ~llxw*

Ew ~llx lm|ge}axw hlfej }a lr~ejm }blcx vaxkejm axfejcpl }blowldylw$ Eyebej a|jm c} jllmlm

|x}blx ~dejjcjf }a oejefl ejm cjgax~axe}l }bawl

gaoo|jc}s fxa|~w*

Gxcwcw cj}lxylj}caj cw e bcfb/~xadl wlxycgl a

}bl ~llx lm|ge}ax wsw}lo* E ~llx/dlm ejm JFA/

w|~~ax}lm xe~cm xlw~ajwl jl}vaxk vc}b egglww }a

^llx lm|ge}axw beyl o|d}c~dl

xlw~ajwchcdc}clw }be} }ekl emyej}efl

ai }blcx kjavdlmfl ejm wkcddw*

^llx lm|ge}axw cj ^|jl*^xewbej}^ej`cexiax}blHcdd)

OldcjmeFe}lwIa|jme}caj


8/16



devslxw gej xlw~ajm vc}bcj 8= ba|xw }a xl~ax}w a

ycadljgl hs ~adcgl ax fejfw$ maolw}cg ycadljgl$

ax a}blx gao~decj}w* Jlfa}ce}cajw exl gajm|g}lme} ~adcgl w}e}cajw$ waol}colw vc}b wljcax aglxw*

Maolw}cg ycadljgl bew dlm waol GHAw }a lw}ehdcwb

wel ba|wlw ax vaolj ejm }blcx gbcdmxlj; GHA

olohlxw oes edwa e}}lo~} }a cj}lxyljl vc}b }bl

b|whejm ax ~ex}jlx }a xlwadyl cww|lw*

]bl mlmcge}caj a ~llx lm|ge}axw }a }blcx vaxk cw

ajl xlewaj Eyebej vew ehdl }a u|cgkds wgedl/|~

c}w ~xafxeo egxaww 28 mcw}xcg}w cj wcr w}e}lw* Oaw}

~llx lm|ge}axw beyl gaol }a xlgafjcpl }be} lylj

cj e ~xafxeo }bcw dexfl$ }blcx cjmcycm|ed cj~|}w ejmegbclylolj}w gaj}xch|}l }a }bl ~xafxeow ah`lg}cylw*

Vllkds xlgaxmkll~cjf ejm hcvllkds me}e ejedswcw

vc}b a|}xlegb vaxklxw emm }a }bl ~llx lm|ge}axw

wljwl a xlw~ajwchcdc}s ejm ljfeflolj}*

Wgedcjf |~0 Vaxkcjf e} e dexfl wgedl vew e

~xcoexs ~xafxeo ah`lg}cyl xao }bl a|}wl}* Hlfcjjcjf

cj de}l 8>>7$ Eyebej oaylm u|cgkds }a lr~ejm

wlxycglw w|gclj}ds }a gaylx 2> ~lxglj} a cmlj}clm

OEX^w cj }bl w}e}lw vblxl c} vaxkw* ]bcw cjyadylm

cmlj}cscjf dlem ~ex}jlx efljgclw cj legb a }bl wcrw}e}lw$ ajl ax vaxk vc}b }x|gklxw$ ejm ajl ax olj

e} wlr wadcgc}e}caj dagedlw* ]bxa|fb }bl dlem w}e}l

~ex}jlxw$ Eyebej cmlj}clm daged JFAw }a co~dlolj}

}bl vaxk cj mcw}xcg}w vc}b w|hw}ej}ced OEX^w* ]bl

JFAw xlglcylm }xecjcjf eha|} Eyebejw faedw$

me}e gaddlg}caj ol}bamw ejm w}ejmexmw$ ejm ~llx

oejeflolj}*

C} vew ja} edvesw e woaa}b ax dcjlex ~xaglww$

lw~lgcedds cj mlylda~cjf ej e~~xaegb }a gaoo|jc}s

oahcdcpe}caj* C} }aak }col }a cmlj}cs ejm xlgx|c}~llx lm|ge}axw$ mlylda~ dav/dc}lxegs "ejm jaj/

dc}lxegs# oe}lxcedw$ ejm ~xaycml }xecjcjf* Ej

lexdclx gaoo|jc}s oahcdcpe}caj oamld cj Cjmce$ }bl

vldd/kjavj Wajefegbc ^xa`lg} ax wlr vaxklxw$

~xaycmlm |wl|d dlwwajw cj vbe} oexfcjedcplm

gaoo|jc}clw gej egbclyl* Cj emmc}caj$ Eyebejw

w}e}l ejm JFA ~ex}jlxw hxa|fb} }blcx lr}ljwcyl

lr~lxcljgl cj gaoo|jc}s oahcdcpe}caj }a }blcx

vaxk* Xe}blx }bej cjwcw}cjf aj ajl oamld a

gaoo|jc}s oahcdcpe}caj$ Eyebej wljcax oejeflxwxlw~ajmlm vc}b ajl a }bl ~xafxeow gaxl

le}|xlw0 ilrchcdc}s }a eme~} hewlm aj gbejfcjf

gcxg|ow}ejglw ejm cjaxoe}caj* ]bl vcddcjfjlww

a }bl ~xafxeo }a dlexj xao ejm vc}b c}w ~ex}jlxw

aw}lxlm e vaxkcjf gaddehaxe}caj }be} gaj}xch|}lm }a

}bl xe~cm wgedl/|~ a ~xafxeo eg}cyc}clw*

Hlge|wl wgedl/|~ hlfej wco|d}ejla|wds cj

legb w}e}l$ }bl ~xafxeo bem hllj lw}ehdcwblm

cj jlexds 3>~lxglj} a }bl }exfl}lm dagedlw$ bem

xlgx|c}lm }va/}bcxmw a }bl ~xa`lg}lm j|ohlx a~llx lm|ge}axw$ ejm vew mcw}xch|}cjf 9 ocddcaj

gajmaow ~lx oaj}b vc}bcj }va slexw e}lx }bl

~xafxeow de|jgb* ]va slexw e}lx }be}$ Eyebej ejm

faylxjolj}/w|~~ax}lm cj}lxylj}cajw gaylxlm eha|}

3< ~lxglj} a loedl wlr vaxklxw ejm 3> ~lxglj} a

OWO cj }bl a|x wa|}blxj w}e}lw*

^xafxeo Xlw|d}w

Cj Eyebejw xw} ~bewl$ }bl ~xa`lg} vew ehdl

}a u|cgkds fa }a wgedl }bxa|fb c}w oewwcyl ~llx

lm|ge}caj eg}cyc}clw$ vbcgb xlw|d}lm cj |~}ekl cj W]C

wlxycglw ejm gajmao mcw}xch|}caj ejm e mlgxlewl cj

W]C xe}lw$ cjgd|mcjf BCY* Cj emmc}caj }a }bl wlxycgl

mldcylxs a|}gaolw$ }bl ~xafxeo gaj}xch|}lm }a

fxle}lx wagced gablwcaj ejm gaoo|jc}s avjlxwbc~

a BCY ~xlylj}caj ~xafxeow* Icjedds$ }bl majax

cjylw}olj}w cj Eyebej bld~lm }a w~|x cjgxlewlm

]bl mlmcge}caj ai ~llx lm|ge}axw

}a }blcx vaxk cw ajl xlewaj Eyebej

vew ehdl }a u|cgkds wgedl/|~ c}w

~xafxeo egxaww 28 mcw}xcg}w cj wcr

w}e}lw*


9/16



|jmcjf hs }bl w}e}l faylxjolj}w }a emlu|e}lds

emmxlww BCY*

W]C ejm BCY ~xlylj}caj0 Cj 8>>2$ ocmves

}bxa|fb c}w 5>/slex ~xafxeo$ Eyebej bew egbclylm c}w

faed a a~lxe}cjf e} e dexfl wgedl cj wcr Cjmcej w}e}lw*

]bl ~xafxeo bew xlgx|c}lm ejm }xecjlm }ba|wejmw a

~llx lm|ge}axw vc}b e yexcl}s a W]C!BCY ~xlylj}caj

olwweflw$ ~xaycmcjf }blo vc}b e xejfl a mldcylxs

}aadw ejm }lgbjcu|lw* Me}e gaddlg}caj ejm oajc}axcjf

oe}lxcedw vlxl mlylda~lm ax |wl hs dav/dc}lxegs ejm

jaj/dc}lxe}l ~llx lm|ge}axw* ]bl ~xafxeo gexxclm a|}

e ylxs lr}ljwcyl oe~~cjf lrlxgcwl a wlr ba} w~a}w

cj 28 mcw}xcg}w$ edajf vc}b lw}coe}cajw a }bl j|ohlxa wlr vaxklxw$ OWO$ ejm CM\w cj w~lgcg dagedlw cj

}bawl mcw}xcg}w* Hewlm aj }bl oajc}axcjf wsw}lo$ ~llx

lm|ge}axw jav egga|j} ax 3> ~lxglj} a edd gaj}eg}w

vc}b }bl }exfl} ~a~|de}cajw*

]bl xe~cm cjgxlewl cj }bl j|ohlx a gajmaow

mcw~ljwlm ax wadm ejm cjgxlewlw cj xl~ax}lm gajmao

|wl exl lycmljgl a }bl llg}cyljlww a ~llx

lm|ge}ax a|}xlegb lax}w* Hs lexds 8>>9$ oaxl }bej

}bxll/u|ex}lxw a wlr gaj}eg}w vc}b gdclj}w a loedl

wlr vaxklxw cjyadylm gajmao |wl* Aylx }bl lj}cxl~xa`lg}$ oaxl }bej 2> ~lxglj} a oedl gdclj}w a

loedl wlr vaxklxw xl~ax}lm gajmao |wl e} dew} wlr

vc}b e wlr vaxklx; ew a Oes 8>>6$ }be} xl~xlwlj}w e

7< ~lxglj} cjgxlewl xao e slex lexdclx* Hs de}l 8>>2$

legb ~llx lm|ge}ax vew mcw}xch|}cjf ej eylxefl a

72gajmaow ~lx oaj}b }a oaw}/e}/xcwk cjmcycm|edw*

A oaw}/e}/xcwk cjmcycm|edw gaj}eg}lm hs }bl ~xafxeo$

2< ~lxglj} a loedl wlr vaxklxw ejm 9= ~lxglj} a

oaw}/e}/xcwk OWO |wlm }bl W]C wlxycglw* W]C xe}lw

mlgdcjlm e}lx }bl co~dlolj}e}caj a Eyebej* Iaxlreo~dl$ cj }bl w}e}l a ]eocd Jem|$ vblxl e dexfl$

vldd/lw}ehdcwblm$ \WECM/|jmlm BCY ~xlylj}caj

~xafxeo co~dlolj}lm hs E^EG bem edxlems wbavj

wcfjcgej} xlw|d}w$ }bl emmlm w|~~ax} a Eyebej

hxa|fb} ws~bcdcw xe}lw eoajf loedl wlr vaxklxw

mavj hs ajl/}bcxm hl}vllj }bl ljm a 8>>7 "~xl/

Eyebej w}ex}/|~# ejm 8>>9* Cj emmc}caj$ gbdeosmce

xe}lw mlgdcjlm hs eha|} 2> ~lxglj} m|xcjf }bl weol

~lxcam cj ]eocd Jem|* Hl}vllj 8>>7 ejm 8>>6$

cj }bl w}e}lw vblxl Eyebej vaxklm$ faylxjolj}w|xylsw wbavlm woedd mlgdcjlw cj BCY ~xlyedljgl$

efecj emmcjf }a }bl co~eg} a lexdclx cj}lxylj}cajw*

Bavlylx$ cj 52 mcw}xcg}w vblxl Eyebejw lax}w

vlxl oaw} cj}ljwl$ BCY ~xlyedljgl e} ej}lje}ed

gdcjcgw mlgdcjlm xao 5*< ~lxglj} }a >*9 ~lxglj}

hl}vllj 8>>7 ejm 8>>6* Vbcdl a}blx eg}axw oes

beyl ~deslm e ~ex} cj }bl mlgdcjl a W]Cw ejm BCY cj

}blwl xlfcajw$ c} cw gdlex }be} Eyebej gaj}xch|}lm }a

xlm|g}caj*

Cj emmc}caj }a W]C oejeflolj} xllxxedw$ ~llxlm|ge}axw emmlm ]H wgxlljcjf$ BCY }lw}cjf$

ejm xllxxedw ax ej}cxl}xaycxed }blxe~s }a }blcx

xlw~ajwchcdc}clw$ vbcgb }bls xlgafjcplm ew co~ax}ej}

}a }bl bled}b ejm vldd/hlcjf a }blcx ~llxw* ]bcw

xlilg}w bav ~llx lm|ge}axw$ ew }bls fecjlm oaxl

lr~lxcljgl ejm gajmljgl$ geol }a |jmlxw}ejm

oaxl |dds }bl cj}lxgajjlg}lmjlww a BCY vc}b a}blx

bled}b gajmc}cajw*

Emyagegs ejm gaoo|jc}s cjc}ce}cylw0 ]bl

co~ax}ejgl a egglww }a emlu|e}l bled}b gexl ejma b|oej ejm gcycd xcfb}w lolxflm xao }bl daged/

dlyld emyagegs ~xeg}cglm hs ~llx lm|ge}axw ejm

}bl co~dlolj}cjf JFAw* ^llx lm|ge}axw ejm a}blx

~xafxeo w}e }exfl} }bl ~adcgl$ ha}b w}xll}/dlyld

~e}xadw ejm aglxw$ }a w}a~ bexewwolj}$ galxgcaj$

ejm ycadljgl* ]ba|fb m|xcjf }bl lexds oe~~cjf

lrlxgcwlw lvlx }bej ajl/u|ex}lx a wlr vaxklxw

xl~ax}lm lr~lxcljgcjf ~adcgl bexewwolj}$ ~adcgl

cj}lxlxljgl vc}b wlr vaxk "ejm vc}b }bl ehcdc}s a wlr

vaxklxw }a ~xeg}cgl welx wlr# bew hllj e gajglxj

ax oejs wlr vaxklxw ejm OWO*

]bl xlwcw}ejgl hs wlr vaxklxw }a ~adcgl cj}lxlxljgl

ejm }bl |wl a xe~cm gxcwcw xlw~ajwl }leow }a

~adcgl ejm fejf ycadljgl bew xlw|d}lm cj gbejflw

cj vaxkcjf gajmc}cajw ax wlr vaxklxw* Ixao edd

ejlgma}ed xl~ax}w$ ~adcgl cj}lxlxljgl bew eddlj a

mxeoe}cgedds*


10/16

5> ECMW]EX/Ajl tOexgb 8>55


Lolxfcjf dlemlxwbc~0 Eyebejw ~llx lm|ge}axw

beyl hljl}lm xao wba|dmlxcjf wcfjcgej}

xlw~ajwchcdc}clw cj emmc}caj }a }xemc}cajed ~llx lm|ge}caj}ewkw* M|xcjf }bl mlwcfj ejm ~dejjcjf w}eflw$

}bls }ekl gbexfl a ocgxa~dejjcjf$ vbcgb cjgd|mlw

cjc}ced oe~~cjf a wlr|ed wadcgc}e}caj ejm jl}vaxkcjf

dagedlw |wlm hs OEX^w* ^llx lm|ge}axw edwa ~des

ej co~ax}ej} xadl cj aw}lxcjf gaoo|jc}s oahcdcpe}caj

ejm }bl mlylda~olj} a GHFw ejm GHAw* ]blwl

lr~lxcljglw beyl gxle}lm e wljwl a avjlxwbc~ a }bl

~xafxeo ejm e gaooc}olj} }a gxle}cjf ljycxajolj}w

gajm|gcyl }a xlm|glm xcwk$ dlemcjf }a cjgxlewlm wld/

gajmljgl ejm wld/lw}llo*

Ajl |jlr~lg}lm h|} vldgaol a|}gaol bew hllj e

hdawwaocjf a gaoo|jc}s wadcmexc}s hl}vllj loedl

wlr vaxklxw ejm OWO* Eyebej wllolm }a ~xaycml

ej a~~ax}|jc}s ejm w~egl ax }blwl oexfcjedcplm

fxa|~w }a gxle}l gaoo|jc}clw ejm axfejcpl

}blowldylw }a ex}cg|de}l }blcx fxclyejglw efecjw}

wsw}low }be} oexfcjedcpl }blo*

Wlylxed ~llx lm|ge}axw exl jav vaxkcjf ax

JFAw$ oejs a }blo ew a|}xlegb vaxklxw; a}blxw

exl w}|mscjf ax beyl egu|cxlm jlv wkcddw$ w|gb ewbecxmxlwwcjf$ }be} ~xaycml cjgaol* ]bls xlgafjcpl

}blowldylw ew xadl oamldw ax a}blxw$ vbcgb cj }|xj

ljbejglw }bl gxlmchcdc}s a }bl welx wlr olwweflw

}bls gajyls }a a}blxw*

Ej lo~bewcw aj gaoo|jc}s ljfeflolj} bew hllj

e kls ag|w xao }bl w}ex} a Eyebej* ]bl Wajefegbc

oamld ax h|cdmcjf wlr vaxklx avjlxwbc~ a e welx

wlr ljycxajolj}vbcgb ~xaylm }a }bl vaxdm }be}

~xafxeow gej w|gglww|dds ljfefl OEX^wvew

ej co~ax}ej} cjw~cxe}caj ax Eyebej* H|} Eyebej w}eejm ~llx lm|ge}axw beyl fajl axvexm }a gxle}l }blcx

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iloedl wlr vaxklxw ejm OWO*


11/16



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EX] mx|fw edajl }a}ed eha|} -88

~lx ~e}clj}*


12/16



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5* b}}~0!!w}c*ho`*gao!gaj}lj}!29!W|~~dQ5
http://business.in.com/article/cross--border/how-bill-gates-blew-$258-million-in-indias-hiv-corridor/852/1http://business.in.com/article/cross--border/how-bill-gates-blew-$258-million-in-indias-hiv-corridor/852/1http://www.forbes.com/2009/07/20/gates-foundation-response-philanthropy-avahan_print.htmlhttp://www.forbes.com/2009/07/20/gates-foundation-response-philanthropy-avahan_print.htmlhttp://sti.bmj.com/content/86/Suppl_1http://sti.bmj.com/content/86/Suppl_1http://www.forbes.com/2009/07/20/gates-foundation-response-philanthropy-avahan_print.htmlhttp://www.forbes.com/2009/07/20/gates-foundation-response-philanthropy-avahan_print.htmlhttp://business.in.com/article/cross--border/how-bill-gates-blew-$258-million-in-indias-hiv-corridor/852/1http://business.in.com/article/cross--border/how-bill-gates-blew-$258-million-in-indias-hiv-corridor/852/1


13/16



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14/16

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mxcylxw a }bl l~cmlocg gej dlexj xao }bl Eyebej

oamld ejm xl~dcge}l waol a c}w ldlolj}w* ]bxll

a }bawl ldlolj}w w}ejm a|}* Icxw}$ |wl eyecdehdlme}e }a cmlj}cs }bl oecj mxcylxw$ oaw}/e}/xcwk$

ax |jmlxwlxylm fxa|~w cj }bl l~cmlocg ejm ~|}

emlu|e}l xlwa|xglw }avexm xlegbcjf }blo* Wlgajm$

ag|w aj h|cdmcjf ejm w|w}ecjcjf gaoo|jc}s h|s/cj

ejm ej eg}cyl xadl cj ~xafxeo mlylda~olj}* ]bcxm$

emmxlww }bl w}x|g}|xed hexxclxw }be} oekl c} mcg|d}

ax cjmcycm|edw }a ~xeg}cgl xcwk xlm|g}caj*

Oajc}axcjf u|edc}e}cyl ejm loa}cyl

ew~lg}w ai }bl ~xafxeo0 Ed}ba|fb Eyebej bew

wsw}low }a xlf|dexds gaddlg} ejm |wl dexfl eoa|j}w

a me}e$ c} bew hllj wdav }a mlylda~ ol}bamw ax

oajc}axcjf }bl llg}w a emyagegs lax}w e} edd

dlyldw$ olew|xcjf dlyldw a ycadljgl efecjw} OWO

ejm loedl wlr vaxklxw "a}blx }bej ~adcgl ycadljgl#$

u|ej}cscjf lr~ejmlm egglww }a jaj/~xafxeo

wlxycglw "w|gb ew aam xe}caj gexmw# ax bcfb/xcwk

~la~dl$ ejm ge~}|xcjf cjaxoe}caj eha|} gaoo|jc}s

oahcdcpe}caj* ]bl ~xafxeow cjc}ced lo~bewcw aj


15/16

]bl Eyebej/Cjmce ECMW Cjc}ce}cyl0 ^xaocwcjf E~~xaegblw }a Gaohcje}caj BCY ^xlylj}caj ^xafxeoocjf cj Gajglj}xe}lm L~cmlocgw 5=* ]bl Wajefegbc ^xa`lg}0 e

w|w}ecjehdl gaoo|jc}s cj}lxylj}caj ~xafxeo*ECMW

Lm|ge}caj ejm ^xlylj}caj 590=>>3* Kljse

BCY ^xlylj}caj Xlw~ajwl ejm Oamlw ai ]xejwocwwcaj

Ejedswcw0 Icjed Xl~ax}* Jecxahc0 JEGA*
http://www.gatesfoundation.org/avahan/Pages/overview.aspxhttp://www.gatesfoundation.org/avahan/Pages/overview.aspxhttp://www.taivhs.org/http://www.hlfppt.org/andhrapradesh.htmhttp://www.hlfppt.org/andhrapradesh.htmhttp://www.hlfppt.org/andhrapradesh.htmhttp://www.hlfppt.org/andhrapradesh.htmhttp://www.taivhs.org/http://www.gatesfoundation.org/avahan/Pages/overview.aspxhttp://www.gatesfoundation.org/avahan/Pages/overview.aspx


16/16



Kco$ Gexaj X*$ ejm Gexadcjl Ixll* 8>>2* Xlglj}

Lyed|e}cajw a }bl ^llx/Dlm E~~xaegb cj Emadlwglj}

Wlr|ed Bled}b Lm|ge}caj0 E Wsw}loe}cg Xlyclv*Cj}lxje}cajed Ieocds dejjcjf lxw~lg}cylw 7="8#02339*

Eyecdehdl e} vvv*f|}}oegblx*axf!~|hw!`a|xjedw!7=>23>2*

b}od "egglwwlm Wl~}lohlx 8>5>#

\JECMW* 5333* ^llx Lm|ge}caj ejm BCY!ECMW0 Gajgl~}w$

\wlw ejm Gbeddljflw* Fljlye0 \JECMW*

EGKJAVDLMFOLJ]WE w~lgced }bejkw }a }bl w}e a }bl Hcdd ) Oldcjme Fe}lw

Ia|jme}caj vba ewwcw}lm vc}b cjaxoe}caj ejm dafcw}cgwcj }bl ~xl~exe}caj a }bcw gewl w}|ms* E} }bl Ia|jme}caj$

Fcje Meddehl}}e ejm Oe}ejfc @esexeo vlxl lw~lgcedds

bld~|d* Cj ]eocd Jem|$ }bl w}e a }bl ]eocdjem|

ECMW Cjc}ce}cyl a Yad|j}exs Bled}b Wlxycglw$ cjgd|mcjf

^xa`lg} Mcxlg}ax X* Dekwbochec$ fljlxa|wds wbexlm }bl

axfejcpe}cajw lr~lxcljglw vc}bcj Eyebej* Cj Ejmbxe

^xemlwb$ ^* Wbecde`e ejm }bl w}e a }bl Wvefe}c ^xa`lg}

vc}bcj }bl Bcjm|w}ej De}lr Ieocds ^dejjcjf ^xaoa}caj

]x|w} ~xaycmlm cjaxoe}caj ejm egglww }a ~xa`lg} wc}lw*]bejkw edwa }a Y* Weo~e}b K|oex ejm Klxxs ^ldpoej

vc}b \WECM!Cjmce$ ]coa}bs Oeb ejm Wbseoc MlWcdye

vc}b \WECM!Vewbcjf}aj$ ejm }bl ^xlylj}caj ]lgbjcged

Vaxkcjf Fxa|~ ax }blcx xlyclv ejm cjwcfb}*

XLGAOOLJMLM GC]E]CAJXe|$ Hcdd* 8>55* ]bl Eyebej/Cjmce ECMW Cjc}ce}cyl0 ^xaocwcjf

E~~xaegblw }a Gaohcje}caj BCY ^xlylj}caj ^xafxeoocjf

cj Gajglj}xe}lm L~cmlocgw* Gewl W}|ms Wlxclw* Exdcjf}aj$

YE0 \WECMw ECMW W|~~ax} ejm ]lgbjcged Ewwcw}ejglXlwa|xglw$ ECMW]EX/Ajl$ ]ewk Axmlx 5*

^dlewl ycwc} vvv*ECMW]EX/Ajl*gao iax

emmc}cajed ECMW]EX/Ajl gewl w}|mclw ejm a}blx

BCY/ ejm ECMW/xlde}lm xlwa|xglw*

ECMW]EX/Ajlw Gewl W}|mclw ~xaycml cjwcfb} cj}a cjjaye}cyl BCY ~xafxeow ejm e~~xaegblw

exa|jm }bl vaxdm* ]blwl ljfefcjf gewl w}|mclw exl mlwcfjlm iax BCY ~xafxeo ~dejjlxw ejm

co~dlolj}lxw$ mag|olj}cjf }bl w}l~w ixao cmle }a cj}lxylj}caj ejm ixao xlwlexgb }a ~xeg}cgl*

^dlewl wcfj |~ e} vvv*ECMW]EX/Ajl*gao }a xlglcyl ja}cicge}caj ai BCY/xlde}lm xlwa|xglw$cjgd|mcjf emmc}cajed gewl w}|mclw iag|wlm aj lolxfcjf cww|lw cj BCY ~xlylj}caj$ }xle}olj}$

}lw}cjf ejm ga|jwldcjf$ gexl ejm w|~~ax}$ fljmlx cj}lfxe}caj ejm oaxl*
http://www.guttmacher.org/pubs/journals/3408908.htmlhttp://www.guttmacher.org/pubs/journals/3408908.htmlhttp://www.aidstar-one.com/http://www.aidstar-one.com/http://www.aidstar-one.com/http://www.aidstar-one.com/http://www.guttmacher.org/pubs/journals/3408908.htmlhttp://www.guttmacher.org/pubs/journals/3408908.html

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AIDSTAR-One Case Study: Avahan-India HIV/AIDS Initiative