He was drawn into the Indian freedom struggle influenced by Karnad Sadashiva Rao in 1925, when he was a student in Mangalore.
Other positions he held in this period include the presidency of the Mangalore Port and Dock Workers' Union, chairmanship of the District Board Public Health Committee, board member of the Mangalore Port Trust and presidency of the South Canara branch of the Indian Medical Association.
[1] Alva contested the Panemangalore constituency with an Indian National Congress ticket in the 1957 Mysore State Legislative Assembly election and won.
[1] In 1970, Alva was elected to Rajya Sabha, the upper house of the Parliament of India, and served a full-term of six years until 1976.
[8] Alva took part in the JP movement and was jailed during the Emergency after his tenure as a parliamentarian.
[1] In 1979, he replaced Philipose Koshy in a one-man commission that was appointed to inquire into the alleged medical negligence of Jayaprakash Narayan by the doctors of Postgraduate Institute of Medical Education and Research in Chandigarh, while he was in their charge during the Emergency.
Their eldest son, Mohandev, served as a corporator in the Bruhat Bengaluru Mahanagara Palike; Jayaprakash worked as a doctor; and the youngest, Jeevaraj, who also studied medicine, pursued a career in politics, and served as a cabinet minister in the government of Karnataka.