Book excerpt: When Ashok Alexander left a high-profile corporate job to head Avahan, the Bill & Melinda Gates Foundation's programme to stem the growth of the HIV epidemic in India, he was plunged into an India far removed from the comfort zones he had lived and worked in all his life. It was a grinding place where women sold themselves for fifty rupees and fourteen-year-olds injected drugs. It was the shadow world of transgenders and of young gay men in a country that still criminalized same-sex love. It was the strange world of truckers, lonely journeymen along forgotten highways. Above all, it was a place where valiant battles for a barely decent life were being fought every day. During the ten years Alexander built Avahan, it grew to become one of the largest and most successful HIV prevention programmes in the world, credited with averting over 6. 5 lakh new infections.