private sector

case study 2
Public-private
Partnership for Health

INDIA
DISEASE COMPONENT

HIV AND AIDS

INDIA
DISEASE COMPONENT

HIV AND AIDS

BACKGROUND
Infrastructure Leasing & Financial Services Limited (IL&FS)
is an Indian financial institution with a strategic focus on
the infrastructure sector. Health was identified as a social
infrastructure worthy of suitable intervention by the private
sector. As one of the many visions of the company is
partnering progress, IL&FS ETS was incorporated as a social
infrastructure initiative in 1997.
IL&FS ETS helps companies identify and implement corporate
social responsibility projects while also building their internal
capacity. The company felt it had the capability to partner
with the government for large, complex, long-term and widely
spread projects/schemes and looked for projects where there
were multiple stakeholders, tough targets and exceptional
operational challenges. HIV and AIDS and malaria were
identified as focus areas of intervention within the health sector.

WORKING WITH THE

GLOBAL FUND
LEAD ORGANIZATION INVOLVED:

GRANT DETAILS
ROUND 21
Scaling up of Integrated Counseling and Testing, PPTCT and
Referral to Care, Support and Treatment Services for People
Living with HIV in India.

Program Description
IF&FS Education and Technology Services (ETS) is one of
several Principal Recipients implementing this grant, along
with the National AIDS Control Organization (NACO). IL&FS ETS
provides services in support of Objective 2 of the grant, namely
Expand Access to Prevention from Mother-to-Child Treatment
(PMTCT) services to an estimated 80 percent of HIV-positive
pregnant women.

Grant AMOUNT US$ 11,023,189

1. Because of its performance, this grant was extended at the end of

its initial five-year period through a mechanism known as the Rolling
Continuation Channel.
p2 . Private Sector Case Study 2 . Public-Private Partnership for Health

In 2008, the Ministry of Health and Family Welfare invited IL&FS

ETS to make a presentation on its work and capability before
the Country Coordinating Mechanism for India.
The interaction with the Country Coordinating Mechanism was
challenging, as some members of the group seemed to take
exception to the idea of involving a private sector company
in the fight against HIV and AIDS. Medical fraternity and
government representatives, however, made a case that merit
should prevail.
With the approval of the Country Coordinating Mechanism,
IL&FS ETS first became a sub-recipient of NACO, the Principal
Recipient of the grant, for a pilot project entitled the Link
Workers Scheme. This project is being piloted in 30 districts and
aims to develop a cadre of dedicated health workers who would
spread knowledge and awareness about HIV and AIDS. The Link
Workers Scheme in North Goa, which is managed by IL&FS ETS,
has regularly been achieving the targets set by NACO.
IL&FS ETS was also selected through a competitive bidding
process to work on a smart card (computer chip) project on
behalf of NACO. Under this project, treatment data is recorded
on the smart card, allowing patients to receive care at any
center which is equipped with the necessary card reader.
This enables people living with HIV/AIDS to be mobile and yet
still have access to the same quality of treatment and care
at antiretroviral therapy centers in seven states across the
country. IL&FS ETS is the program manager for this project.

WHY BECOME A
PRINCIPAL RECIPIENT?
Having served on grant implementation as a sub-recipient,
IL&FS ETS felt that the full advantages of a public-private
partnership model could be displayed only with the extra
flexibility and responsibility that comes with becoming a
Principal Recipient.
When the PMTCT program implemented by NACO was extended
through the Rolling Continuation Channel, IL&FS ETS felt that
this would be the appropriate opportunity to apply in one
project the lessons learned in several previous experiences,
including the Link Workers Scheme and smart card projects.
After rigorous scrutiny, the Country Coordinating Mechanism
accepted IL&FS ETS application to become a Principal Recipient
along with NACO for the new period of grant implementation.
The proposal was approved by the Global Fund in 2009 and
grant negotiations were successfully concluded in June 2010.

PROPOSAL
DEVELOPMENT PROCESS

LESSONS LEARNED
For a public-private partnership model to work, it is
essential to negotiate a middle ground between the private
and public partners to ensure the progress of the project.
Putting in place a uniform procedure for different
geographic regions also helps greatly in standardizing
administrative tasks.

OTHER BENEFITS
Several departments within the government have started
discussing the possibilities for health-related projects that
are IT intensive. IL&FS ETS has also been talking to other
multilateral agencies and donors in order to expand the
existing program and add new dimensions.
In addition, the project has generated a lot of goodwill
from the local communities and the nongovernmental
organizations due to the development of their management
capability and the introduction of uniform procedures.
The program uses the Greater Involvement of People Living
with HIV/AIDS (GIPA) principles and has led to womens
empowerment and community mobilization.

IL&FS ETS worked quite closely with NACO from the very
beginning, starting with development of the proposal. This gave
IL&FS ETS an in-depth understanding of the existing PMTCT
program. Since NACO has the overall responsibility of reducing
the AIDS pandemic in India, it was very important that IL&FS
ETS activities align with those of NACO. The proposal was
developed entirely in-house by core health teams within both
IL&FS ETS and NACO, working together.

PRELIMINARY RESULTS
(AS OF MARCH 2011)

As a result, the PMTCT program has been able to report the

following results:
1. A dedicated mobile phone-based technology for real-time
reporting by outreach workers has been developed. This is
a single window for reporting to the donor and stakeholders.
Pilot testing has been done and the Phase 1 rollout began
in July 2011.
2. Over 180 sub-recipients (nongovernmental organizations)
have been appointed across 23 states covering over 220
districts, including some districts where the prevalence is not
high, but where the antenatal care case load is heavy.
3. After nine months of implementation, the program has
increased the enrollment of pregnant women for testing and
also the case management of HIV-positive pregnant women
in the field. A unified reporting system has also been put in
place throughout the country.

Private Sector Case Study 2 . Public-Private Partnership for Health . p3

Please note that the above illustration shows only a partial list of our valuable private sector partners.

The Global Fund to Fight AIDS, Tuberculosis and Malaria

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