This chapter illustrates how sex work leaders – who have experienced more than a decade of transformation around Human Immuno-Deficiency Virus (HIV) initiatives – employ a form of ‘critical nostalgia’ as a way to construct a history of the present that expresses opposition to reigning forms of health governance. A transnational consortium of business managers, health scientists, programme planners, and non-governmental organisations orchestrated the implementation of the Avahan programme in six of India’s so-called high prevalence states between 2003 and 2010. Across the discussions, participants repeatedly made reference to numbers, targets, sizes, proportions, and percentages to index the changing political positionality of sex workers in the HIV response over time. Some participants contrasted the rigidity of the governmental system to Avahan’s ‘flexibility’, a notion that can be traced to the legacy of Avahan and the re-assertion of its business model in promoting cultures of innovation.