An interesting recent piece from Forbes India puts the boot in to the Gates Foundation’s $283 million prevention programme for HIV/AIDs on the subcontinent, Avahan. It says that the programme hasn’t worked and is being scaled back. It claims that money has been wasted on travel costs and expensive salaries for its ex-McKinsey staff. It accuses the programme of insensitivity (for instance, relying too much on English to be able to engage properly with NGOs and people they are trying to reach, like women in prostitution).
What to make of all this?
For the past year NPC has been working on the ground in a pilot project in Delhi so has learned one or two lessons about the Indian NGO sector. We’ve not had much direct contact with the Gates Foundation because we’ve been looking at a different set of issues. But some of the points the article makes do sound like common mistakes make by funders overseas. For instance:
- creating a Rolls Royce programme won’t work if your expectation is that government will ultimately take over.
- starting in many different geographies at the same time is creating a rod for your own back – better to pilot, and then scale.
- cultural sensitivity does matter. There’s a nice example in the article of Avahan introducing sleek mobile vans to bring health clinics directly to brothels, but the vehicles were so expensive looking they put the women off. The workers thought they must be from government or the police.
So far so good. But what is most telling about the piece is not the strength of its criticisms of the Gates Foundation’s activities. Rather it is the underlying suspicion of the kinds of approach the Foundation uses: analytical, well-resourced, bringing in skills from outside the NGO sector.
In India, but not uniquely there, NPC has identified at least two major structural problems affecting NGOs.
The first is a deep-rooted belief that NGOs should be run on a shoe-string. The second is that most NGOs don’t measure their impact in meaningful ways. Unfortunately both of these problems undermine the effectiveness of Indian social organisations. Unable to pay decent wages, organisations struggle to retain staff (this was probably the number one challenge NPC heard about talking to charities on the ground). Failing to understand their impact, they can’t say what they are and aren’t achieving.
I don’t know the rights and wrongs of the Avahan programme. But I do know that the kind of approach pioneered by the Gates Foundation has brought a welcome rigour to the activities of the NGOs it supports. One notable irony is that the article uses Gates’ own evaluations to criticise its programmes. But this transparency is precisely the organisation’s best defence: in general, funders and NGOs in India don’t measure and don’t publish this kind of data. For that at least, Foundations like Gates deserve our gratitude.
