When doing the right thing might harm the very people your work aims to help, how do you proceed? James Robertson ’99, former CEO of the India HIV/AIDS Alliance, describes just such a dilemma and how his insistence on doing the right thing produced both blowback and new opportunities to advance his mission.
I believe that when you perceive a problem in the world, you have to address it. That means, very often, the times we live in define what we do as leaders. My time presented the opportunity to respond to the AIDS epidemic. I was 16 when it began; I’m 53 now. It has arced over my life and has defined who I am as a gay man because it affected my community so deeply.
From 2010 to 2016, I served as the chief executive of India HIV/AIDS Alliance. When I started, our organization served about 100,000 people in six states. During my tenure, we grew to become the largest nonprofit organization working on HIV in India with 1.4 million clients in 32 states and territories.
One of our most important programs, called Vihaan, was designed in coordination with the Indian government to be the care and support component of the national HIV program. While we worked closely with the government, the program was separate from the government and implemented by civil society at every level.
It was a dynamic model that brought together the public sector at national and state level; civil society, which included Alliance India and other organizations such as the National Coalition of People Living with HIV and its community networks; and our donor, which was the Global Fund, a Geneva-based multilateral financing organization supported by the governments of more than 60 countries around the world and a key part of the global HIV response.
Everything was in place for us to take over that care and support piece of the national program, an essential complement to the country’s treatment services, also supported by the Global Fund. All we needed was a largely pro forma signature from a senior Indian government official to release our grant from the donor. There was delay after delay.
The program that we were attempting to implement was consequential. It provided treatment adherence support, counseling, nutrition assistance, legal services, and linkages to other social welfare programs. It improved the lives and well-being of people living with HIV across India. It was extremely frustrating to be so close to providing that help, yet we simply couldn’t get the signature.
The Indian government has good people in it, but it is also plagued by corruption. I don’t know this for sure, but I suspect that our problem was part of a larger delaying strategy designed to create an opportunity for self-enrichment or, at the very least, to gain leverage to improve the government’s grant terms with the donor. I found this baffling as the delay in starting our program had consequences on the health of hundreds of thousands of people.
We needed to maintain our relationship with the government, yet we had to find a way through this without being party to corruption, especially at the expense of our beneficiaries. We needed to be and be seen as an organization with integrity that wasn’t going to be pushed around by the government and that would stand up for the communities at the heart of our work.
It was rough. What I wanted was to get the signature and start the project, but as a manager sometimes you run into situations in which doing the right thing may force you to face a different set of challenges than you expect or want to deal with.
The ethical route can be quite difficult, but I think you have to be willing to face the consequences of doing the right thing.
I had a great team in India. The solution we came to was the result of our team’s mission-driven ethos and the support of our partners. Because we already had an existing relationship with the donor, we cajoled and convinced them to give us the initial tranche of funding to start implementation without the government signatory.
The blowback from the Indian government was considerable—a whirlwind of unhappiness. It damaged our relationship with a powerful senior official. While that official wasn’t the most important person for our work, taking a path that would weaken our relationship with a partner as important as the Indian government was a difficult tradeoff.
In seeking a solution, I certainly thought about what was the right thing to do, a solution that would let me sleep at night and that would let our organization operate the way we believed we should. I was looking for an option that, within our values, might get us some of what we needed because that was certainly better than nothing.
I wasn’t necessarily thinking about the upsides of choosing an ethical path; however, those proved to be quite rich. Knowing you have done the right thing and haven’t suborned corruption—that’s valuable. Keeping your integrity is an obvious upside. However, something we didn’t expect was its impact on our relationship with the communities of people living with HIV—quickly, it became exceptionally strong. We were seen as an organization that would act in their interests and be a reliable advocate for these communities, which are often disempowered, poor, and overwhelmed trying to make sure the government does what it needs to do.
We gained credibility because we’d shown that we were willing to stand up to a challenge. We used that credibility to develop capacity for the longer term. We used it to build life-saving care and support institutions at the local level, and through this success, we rebuilt our relationship with the national government too.
Standing up for ideals and values creates consequences; some choices may be difficult, but they don’t exist in vacuums. When you think about how the available options and their consequences intersect and interact with each other, I think you come up with better solutions. It became clear how important the choices we made were to the communities we served; however hard, I would do it the same way again.