Salem, India -- A young mother of two sprang from the floor in this Tamil Nadu city where HIV and other STD infection rates are declining. She wanted to make sure that this representative of the Gates Foundation understood how important the Tamil Nadu AIDS Initiative (TAI) is for her and the targeted 6,000 others who are soldiers in the battle to stop infections while also improving their own lives.

TAI is part of the Avahan initiative, a public-private partnership in six Indian states to prevent AIDS throughout southern India, including along trucking routes that historically have seen high concentrations of infections.

The initiative offers monthly prevention services to more than 35,000 poor female sex workers and 15,000 high-risk men who have sex with men as well as transgendered people across 13 districts in the state. After nearly eight years of encouraging progress, and an investment of $338 million, the program is transitioning to the state governments to carry forward the prevention agenda.

Understandably, the transition to full government ownership is a time of both uncertainty and excitement for our grantee partners and for the communities we support.

Dr. Lakshmi Bai (umbrella), project director for TAI, surrounded by clinic workers in Salem.

The young woman I met gave testimony to the TAI program’s impact in her life. When she mentioned her two young children, tears came to her eyes as she imagined their faces and their vulnerable future.

But even as she showed her anxiety, another young mother—the president of the local women’s group—leaned forward from her place seated on the floor in front of donors and local NGOs.

She spoke with a confidence and forcefulness that I would not want to face if I were an elected leader of that state. She spoke about how poor women in this community simply need a caring and helping hand to protect their health and encourage their already industrious spirit to improve their lives economically.

As the nation and the world closely watch various state elections in India, all eyes are on young, first-time voters like the women I met in Tamil Nadu. They are great in number, but will they use their collective voice to help ensure social and economic progress? If ever there was a time for these women to gain the attention of their state governments, and gain support for programs like AIDS prevention, it is now.

Recently Bill Gates wrote on Impatient Optimists about why the foundation invests in India.

Even as the foundation transitions its investment in Avahan to local governments, it is investing in new global health and global development initiatives in the Indian states of Uttar Pradesh and Bihar.

The purpose of my visit to this country was to better understand how our new commitment to strengthening grantee partnerships is gaining momentum in a very strategic geography. Ultimately, the relationships we build with grantees like TAI are critical to accomplishing the kind of impact we all desire.

“The quality of our relationship determines the velocity of our work together,” one grantee partner told me.

The Population Council, World Health Partners, Global Health Strategies, IFPRI, the BBC, CARE, Project Concern International in India, Public Health Foundation of India, Urban Health Initiative, and many more grantee partners are on the frontlines of our mission to improve the health and productivity of women like those I met.

During a week of intensive conversations about how our foundation can better partner with their organizations, we learned a great deal about the importance of setting clear expectations, communicating clearly and consistently, and asking (and using) feedback.

Collaboration and partnership are critical to our work in India—where deep, challenging, and age-old poverty persists—alongside a new evidence-based approach to solving what was once seen as hopeless problems.

Join the #gateschat conversation on Twitter and learn about how the foundation partners with grantees around the world. If you’re a grantee, can you share a best practice in building a productive relationship with a donor?