We are excited to create Antara. We aspire to bring the knowhow of scaling up to add to strengthening the government and therefore try to fill in an important gap.


How has Antara fared in India? What are the challenges that you face?

We are ahead of where we had thought we would be in terms of programs, organization and sponsorship.
Our flagship program is in Rajasthan where we have a partnership, ‘Akshada’ with the state government and the Tata Trusts to have impact on the state’s maternal and child health. We signed an MOU in the presence of Chief Minister Vasundhara Raje and Ratan Tata and the kind of support we have received from the government has been outsanding. We have a built a vibrant team of 21 so far that brings together people fropm the private sector and public health. We are guided by four exceptional Sponsors: Arjun Malhotra, Shiv Nadar, Cyrus Poonawalla, and Bill Gates.

Challenges are inherent with any venture with ambition and vision. We have taken up a big task of helping the state to transform its maternal and child health indicators and this involves understanding many things from behaviours, training, data gaps, and social norms. Given the scale and diversity of what we are doing, much of it is experience combined with imagination.

What is your focus area and how is it different from your role at Bill and Melinda Gates Foundation?

The major difference is that at the Bill and Melinda Gates Foundation, I was giving away a lot of money, and now I am looking to raise much smaller amounts of money! More seriously, the basic change is that the Foundation, was a grant making organization while we are an implementing NGO and it is a different experience. We were very close to the implementation at the Foundation also, but now we are actually doing it. I believe that the closer you are to the front line workers, the deeper the learning.

Despite several Government schemes and corporate initiatives, why is the standard of maternal and child healthcare in India dismal?

On paper, the scale and reach of our existing public heath platform is good and some of the programs that govern public health are really far sighted The impact is insufficient in many states for several reasons.

Scaling up delivery of known solutions is the biggest challenge. One of the biggest impediments are the social norms that get in the way. Certain social norms prevent a mother from breastfeeding her child till some male figure gives her permission to do it. Sometimes she is unable to do it as she has to get back to work as a labourer. It’s difficult for the government to deal with such issues. It goes beyond having a structure of public health and budgets.

We are excited to create Antara. We aspire to bring the knowhow of scaling up to add to strengthening the government and therefore try to fill in an important gap.

How is Antara different from other players in the maternal and neonatal health space?

There are few outside-government entities today that try to focus on delivery with scale and sustainability. Most organisations are trying to find newer and better solutions for many issues in maternal and child care. We have a slightly different perspective on this. We believe that solutions exist, but scaling them up using business principles is the key.

What are some of the most critical issues that require attention when we think about healthcare for the underprivileged?

I feel that the most critical issue is the empowerment of women. Issues like anaemia, safe birth or women getting married at an early age can be addressed only if the woman herself is empowered and can access her basic health rights. Empowerment cannot be addressed overnight, although there are several places where it’s been done: SEVA and AVAHAN are examples
Another important area that is critical is the usage of data by frontline workers.

India Inc has pledged over 1000 Cr to the Swachch Bharat campaign and companies like Bharti are taking responsibilities for sanitation and healthcare requirements of districts/towns. Do you think this is a sustainable idea or something else needs to be done?

I think it’s a good start. I believe that if the mind-set changes and if people across start understanding the importance of sanitation through well laid out existing and new programs it could be the beginning of a revolution.
Ultimately, if communities take on the challenge of sanitation and if corporates start taking ownerships, then it is sustainable by definition. Community mobilization is very important in most large scale campaigns. Government partnership is almost always essential

We still have a long way to go reach acceptable levels of healthcare and sanitation in India. What are the industry and the government doing for this?

There are already well laid out structures and programmes. In public health, the rubber hits the road at the state level and the work we are doing in Rajasthan gives me a huge amount of optimism. Some states are beginning to understand the importance of public and neonatal health and that this is a fundamental issue to be driven by the leader of the state The Southern states are way ahead of the northern states in terms of their acceptability and understanding of these problems.

In Rajasthan for example, the Chief Minister is deeply committed to the cause and I think it is a very positive sign because health is not necessarily popular or an easy thing to manage. We believe that if we do this well in Rajasthan, many other states will view this as a beacon of good work.

What is the fundamental reason why Southern States are way ahead in areas like Public Health and Education?

I think there are two reasons. The first is the high rate of social issue awareness and literacy levels. Since women’s literacy is high, it leads to better awareness and empowerment towards health and education.

What was your driver to move from Mckinsey to the Social and Development Sector?

The biggest was the opportunity for huge impact. It gave me the opportunity to create a programme called AVAHAN. Through AVAHAN I had the opportunity to contribute in stemming the growth of HIV in India. I found it both exciting and meaningful to lead a program that has been credited with averting over 600,000 fatal infections.

I feel that it’s a pity that people don’t discover careers in public health in India. Public Health in India is still considered the realm of doctors and medicine. However in the west it’s multi-disciplinary. Leaders from the business world can contribute so much because of their managerial skills. The trickle of quality talent in Public Health bothers me as many private sector managers and graduating students are unable to see the opportunity for larger contribution and a life shaping experience.

Since the time of your movement to the Social Space, what is the one thing you are most proud of?

I am really very proud of AVAHAN as it made a major contribution in stemming the growth of HIV in India. At a personal level, it gave a new layer of meaning to my life.

AVAHAN has become a part of the government functioning and the front line continues to follow the norms and systems we laid out.

Do you think that India Inc’s current focus on CSR is primarily a marketing stunt triggered by the government’s directive that companies need to invest a part of their profit in CSR?

There will always be companies who look at CSR from the wrong kind of marketing perspective. But I am optimistic and I know of companies who are looking at CSR strategically and are willing to take it to the next level. But obviously a lot needs to be done as the notion of thinking strategically has really not happened in philanthropy or CSR. Fundamental questions like “What is your goal? ”What areas should you focus on? “How do you scale? And how do you sustain? “ are often not asked. This would never happen in a business the same companies run!

What does a typical day look like for you?

My days are typically not the same and involve a lot of travel. I spend 3-4 days in the field.. This is probably the most complex undertaking I have taken in my career and I feel very good about the team we are building.

When you recruit people for your team what are some of the things that you look for in an individual?

Some things are common and fundamental like analytical skills, good communication etc.
I put more emphasis on an individual’s attributes and his innate nature.I put a premium on passion, creativity, and drive. Self-awareness and humility are key and these are not easy to put into a resume.

I recruited for over 15 years with Mckinsey but this human quality dimension is more emphatic here.

Finally on an informal note, what do you do when you are not at work?

I am into many things and one of them is chess. I have played chess at a competitive level and I continue to play it every day. I am an avid painter, working primarily in oils and charcoal, doing portraits and landscapes from my field travels. I love doing new things, and the joy of learning.

While recruiting, I often ask the candidates that apart from work what do they do in life and I often get a blank look because people are not prepared for that question. I believe that unless there is a passion outside work people can get burnt out easily. Work can’t be everything, and when work becomes everything then there is no life.

Mr. Ashok AlexanderMr. Ashok Alexander led the Bill & Melinda Gates Foundation’ India office from its inception in 2003, until 2012. He created Avahan, the Gates Foundation’s flagship India AIDS prevention program. Avahan became the largest private prevention program ever undertaken in HIV/AIDS. It worked with groups most at risk to HIV – primarily commercial sex work workers. The Lancet, in 2013, credited Avahan with preventing over 600,000 HIV infections.

Ashok is now engaged in creating Antara, a non-profit dedicated to health delivery at scale. Akshada, is the foundation’s flagship program in Rajasthan in partnership with the Tata Trusts and the state government. Chief Minister Vasundhara Raje and Trusts’ Chairman Ratan Tata take direct interest in this seminal program, which addresses the challenges of maternal and child health, including malnutrition
Ashok came to the Gates Foundation with 24 years of experience in the private sector working in Hong Kong, the United States and in India. Prior to joining the foundation, he was a Director with McKinsey and Company and head of the consulting firm’s New Delhi office. He joined McKinsey in 1986 in New York and was part of a small group of McKinsey consultants who moved to India to establish its highly successful India practice.

Ashok is a graduate of St Stephens College in New Delhi and has a post-graduate degree from the Delhi School of Economics, and an MBA from the Indian Institute of Management in Ahmedabad. Married with two sons, his passions are painting with oils and charcoal, translating Urdu poetry, and chess in which he has been a US Master. He is a founding board member of the Public Health Foundation of India. He has also served on the board of CARE India, and has been a founding trustee of the America-India Foundation.

EA research