News Archives - Health Finance Coalition

Financing the Belém Plan: A Discussion at the 2025 Global Conference on Climate and Health

During the 2025 Global Conference on Climate and Health – hosted by the Government of Brazil, the World Health Organization, and the Pan American Health Organization in Brasília, Brazil – global leaders convened to accelerate action at the intersection of climate change and public health. A central outcome of the conference was to gather concrete inputs for the Belém Health Action Plan, a forward-looking framework designed to build climate-resilient health systems, particularly in countries most vulnerable to climate shocks. The plan outlines urgent priorities – from greening health infrastructure to expanding early warning systems – while calling for new investments to make health systems more adaptive, equitable, and sustainable.

In support of this agenda, a high-level panel titled “Financing the Belém Health Action Plan: Achieving Climate-Health Resilience through Blended Capital Solutions” featured various experts – including Tamer Rabie (World Bank), Seonmi Choi (The Global Fund), and Dr. Adi Utarini (Universitas Gadjah Mada). Facilitated by Alex Honjiyo, Director of The Health Finance Coalition, the panel explored how blended finance – an approach that combines public, private, and philanthropic capital – can unlock the resources needed to bring the plan to life.

Here is what we heard:

The Stakes Are Rising – And Aid Is Shrinking

As climate threats mount and global budgets tighten, traditional aid alone cannot meet the moment. This is why the Belém Health Action Plan calls for continuous, country-led financing – and why blended finance has emerged as a powerful tool to close the gap.

“Around the world, we are witnessing the real impacts of climate change on public health and facing the sobering reality that traditional aid is shrinking just when we need these resources to grow,” said Alex Honjiyo, Director of the Health Finance Coalition.

Blended Finance Works Best When Aligned to Risk and Stage

Not all money does the same job. Catalytic grants are crucial for early-stage R&D, piloting innovations, and de-risking investments. Concessional loans can help scale proven models. Domestic resources ensure long-term sustainability. Matching capital to risk is essential.

“We are really seeing at the Global Fund the importance of how we can best leverage catalytic grant financing to really help mobilize and unlock much larger scales of funding… to meet the ever-increasing health finance gap,” said Seonmi Choi, Global Fund Senior Advisor for Climate and Environment.

Break Down Silos Between Climate and Health Funds

Climate and health funding streams are often fragmented. A common investment framework can unlock cross-sector solutions and joint investments that neither side could deliver alone.

“We need to be cognizant that this is not just the health funds, but also the climate funds… and that we need to be able to work across them… ensuring they cater for more increased sources of financing,” said Tamer Rabie, World Bank Global Program Lead for Climate and Health, Health, Nutrition & Population. “Together with the Global Fund, the Green Climate Fund, the Rockefeller Foundation, the World Bank and IFC, we’ve been working on trying to set up a common investment framework… to operate across institutional cycles and create concrete co-financing opportunities.”

Government Leadership Makes or Breaks Co-Financing

Ministries of Health and Finance must co-lead from the outset to align investments with national plans and ensure long-term success. Without domestic buy-in, co-financing strategies often stall.

“Access to finance is an ongoing discourse that must happen between line ministries and ministries of finance. Ministries of Health need to make the case for why they need the resources, and how these resources are going to bring about the impacts that they see coming through reforms”, said Tamer Rabie, World Bank Global Program Lead for Climate and Health, Health, Nutrition & Population.

Philanthropy Unlocks Larger Investment

Grants work best when they close early-stage gaps—like product development or regulatory approvals—and catalyze larger contributions from governments, multilaterals, and the private sector.

“What we’re hoping with the climate-health catalytic fund is not to create a parallel mechanism or standalone funding mechanism, but actually really enable and trigger deep change,” said Seonmi Choi, Global Fund Senior Advisor for Climate and Environment

Local Context Must Drive Solutions

From slow-onset droughts to sudden disasters, climate-health impacts vary dramatically by place. Effective investment begins with listening—to communities, frontline health workers, and national programs.

“We really need to unpack and demystify climate and health solutions in specific local contexts,” said Seonmi Choi, Global Fund Senior Advisor for Climate and Environment. “Nobody really made a real clear link between HIV and climate change… [but] Cyclone Freddy… has had long-lasting, devastating impacts on the whole cascade of HIV services… especially for young women and adolescent girls.”

Don’t Forget the Private Sector

Private capital can accelerate innovation—but it requires de-risking tools like guarantees and concessional first-loss funding. Public actors must make the investment case.

“It’s really important that we do not lose sight of the role of the private sector … and we ensure that we’re de-risking private investments in climate and health … we can bring in, for example, guarantees to reduce risks on private investments and push them more towards innovation,” said Tamer Rabie, World Bank Global Program Lead for Climate and Health, Health, Nutrition & Population.

Case Study: Indonesia’s Bold Path: How Local Leadership and Long-Term Investment Are Powering a Climate-Resilient Health Breakthrough

Dr. Adi Utarini, Professor of Public Health, Faculty of Medicine, Universitas Gadjah Mada, in opening remarks ahead of the panel discussion, showcased Indonesia’s Wolbachia success as an example of a community-based model aligning capital to tackle climate-driven health threats.

Dr. Utarani shared how researchers, over the past decade, have tested and refined the Wolbachia method to stop the spread of dengue fever – transforming a Yogyakarta-based study into one of the world’s most promising tools against climate-sensitive diseases. While Utarini said the journey has not been without challenges, she credits the risk-tolerant, venture philanthropy approach of partners like the Tahija Foundation for providing Indonesia the space to innovate, fail forward and try again.

Now, with plans to scale Wolbachia nationally to protect over 100 million people, Utarani stressed that grant funding remains essential – not just to enable innovation, but to crowd in broader investment from governments, development banks, and private partners.

“To build climate-resilience, we must align capital to risk across the full cycle of innovation – from discovery, to delivery, to scale,” said Dr. Adi Utarini, Professor of Public Health, Faculty of Medicine, Universitas Gadjah Mada. “This is what we are working toward in Indonesia: a country-led, community-based financing model that can be adapted and applied across region and diseases impacted by climate change.”

The Bottom Line

To scale climate-health solutions, we must stop thinking in silos—whether by sector, funding stream, or institution. From global donors to grassroots organizers, the path forward lies in blending resources, sharing risks, and building systems that last.

The Belém Health Action Plan offers a historic opportunity. But turning ambition into impact will require financing models that are flexible, inclusive, and relentlessly focused on results.

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News / Stories / Uncategorized - 07/31/2025

The Anatomy of a Deal: Be Girl & GCC | Investing in Menstrual Health for Girls

The Health Finance Coalition (HFC) recently worked with Be Girl, an innovative social enterprise changing the way menstrual health is addressed in Africa, to secure a new $500,000 investment from Grand Challenges Canada (“GCC”). Together, Be Girl’s CEO & Founder, Diana Sierra, GCC’s Equity Investments Lead, Brishan Rowjee, and HFC’s Swathi Rao discuss the step-by-step process of the deal’s transaction construction to expand access to Be Girl’s innovative products across Africa.

What health challenge do you aim to solve and how does Be Girl address it?

SIERRA: The health challenge Be Girl aims to address is menstrual health inequality, which encompasses both a lack of access to affordable, high-quality menstrual products and inadequate menstrual health education. These barriers often lead to girls missing school, feeling ashamed of their bodies, or facing long-term health risks. Be Girl addresses this by designing and distributing reusable, dignified menstrual products and by developing educational tools that help girls understand their bodies and make informed choices about their health. We believe that when girls have both the tools and the knowledge, they gain the confidence and opportunity to thrive.

Why was Be Girl interested in seeking more capital?

SIERRA: Be Girl is seeking more capital to scale what we already know works: high-quality menstrual products paired with impactful education. As a social enterprise, we maintain low margins to ensure affordability, but this limits our ability to invest heavily in growth. After testing and learning from a direct-to-consumer model in Mozambique, we pivoted to a business-to-business approach (partnering with governments, UN agencies, and NGOs), which has proven far more sustainable and impactful. To date, we’ve distributed over a million products and reached over 530,000 youth with menstrual health education. But we know that’s not enough. Our goal is to reach 1.2 million youth by 2030, and to do that, we need to scale faster and more efficiently. With additional capital, we can make that leap, transforming education delivery and reaching the next generation with tools that promote dignity, equity, and menstrual health literacy worldwide.

Could you walk us through the transaction construction support you received from HFC?

SIERRA: The Health Finance Coalition played a pivotal role in helping Be Girl become investment-ready to unlock new financing from GCC. While we had a strong track record in product design and implementation, we needed support to present our financials, growth model, and impact metrics in a way that would resonate with investors. HFC provided hands-on coaching in areas such as refining our financial projections, preparing investor materials, and stress-testing our business model. Just as importantly, they brought sector expertise, helping us articulate our value proposition within the broader health and gender equity landscape. This wasn’t just technical assistance: it was transformative. We were one of three companies selected to receive this support, and it positioned us to successfully close the transaction with GCC and prepare for long-term, scalable growth.

What did you learn through the process?

SIERRA: One of the most important lessons we took from this process was the critical role that financial sustainability plays as a business begins to scale. As a founder with a background in industrial design, I had deep expertise in product development and user needs, but less exposure to the financial frameworks needed for investor confidence and long-term growth. Through the Health Finance Coalition’s support, we gained a deeper understanding of our business from an investor’s perspective, asking and answering questions such as: What should our margins look like? What’s our true cost of goods sold? What does our growth model look like at scale? That insight was transformational. HFC’s support wasn’t generic; it was precise and high impact, more like a tailored consultancy than a typical incubator. We didn’t just leave with a pitch deck; we walked away with a stronger, more financially resilient business model. We also recognized the importance of generating more evidence to strengthen the case for investing in menstrual health. With partners like GCC, who are committed to long-term impact, we’re building momentum. But it’s clear that attracting more investors to this space will require continued proof of impact and commercial viability, and we’re now better equipped to deliver both.

What attracted GCC to Be Girl?

ROWJEE: GCC has been a long-standing partner to Be Girl, supporting their mission since 2018 with early grants aimed at launching and expanding operations in Mozambique. This partnership reflects our broader commitment to advancing menstrual health and backing innovative solutions in the sector. Since our initial investment, Be Girl has made impressive strides, scaling its impact well beyond Mozambique with initiatives in Angola, Ghana, and Egypt. Its impact profile remained strong, with over 1 million menstrual products sold, more than 530,000 youth educated, and five impact studies conducted by the time we considered a reinvestment in late 2024. In May 2025, GCC provided a new catalytic equity investment of $450,000, along with an additional $50,000 in technical assistance funding. This capital will support strategic hires across the organization, accelerate advancements on their online education platform, and launch a Zimbabwe pilot. We’re proud of the progress Be Girl has made and excited to continue our journey together, deepening our partnership to help scale their impact and reach even more communities across Africa.

What factors was GCC looking at to consider an investment with Be Girl?

ROWJEE: We begin every investment conversation with impact. Our lens is always: how many lives will this opportunity reach and improve, and which communities will it serve? Be Girl stands out as a menstrual health innovator that is deeply aligned with our strategy, values, and long-standing commitment to improving women’s health. As mentioned, Be Girl has a strong impact profile with significant lives reached and improved. From a business model perspective, Be Girl’s strength lies in its ability to deliver across the entire value chain by shaping national curricula in collaboration with governments, deploying multilingual educational platforms, and ensuring product access in underserved communities. We’ve also been impressed by their ability to pair innovation with adaptability, successfully shifting from a direct-to-consumer approach to a more scalable business-to-business model. Their leadership was another key strength. With a resilient CEO and a strong team supported by strategic governance and mission alignment, Be Girl has built the capacity needed to grow responsibly and sustainably. As they enter this next chapter, they do so with solid fundamentals, diversified revenue streams, and a healthy growth pipeline.

What will GCC be monitoring or looking for moving forward?

ROWJEE: At GCC, we define success by the real-world impact our investments deliver. We’ll be looking closely at how many products are reaching the hands of those who need them, which communities are being served, and how effectively education is being delivered, particularly in schools. It’s not just about reach, but relevance and equity. Together with Be Girl, we co-develop a clear impact plan and continue to track progress year over year. The goal is to ensure that every dollar we invest contributes to meaningful, measurable change in people’s lives.

What was the role of HFC?

RAO: The project initially began with Be Girl aiming to expand into the MENA and West Africa regions but needing extra capital. We started by doing market research to assess the areas where they wanted to grow and look at the feasibility. From there, HFC worked with Be Girl to refine and enhance their investment pitch deck, highlighting the economic and sector dynamics featuring the countries where they aimed to expand. HFC also helped put together the financial plan. But as the project progressed, HFC recognized there were shifts in the competitive landscape, so instead of prioritizing geographic location, HFC helped Be Girl shift its focus to retaining its existing market share and deepening penetration in its current markets. But that shift also required not only operational adjustments but a reassessment of the financial implications. HFC worked with Be Girl to design a new financial strategy and help to attract investor interest. As a result, HFC was able to help Be Girl demonstrate its ability to adapt to market conditions while maintaining a compelling growth narrative, which strengthened its investment appeal to GCC. Today, we are thrilled that Be Girl has successfully secured a new, substantial investment from Grand Challenges Canada to expand access to their innovative products across Africa. This investment from GCC allows Be Girl to enter a new phase of growth – one that will expand access to Be Girl’s innovative products and life-changing education programs across multiple countries in Africa. As Be Girl puts it, their work is about more than just products – it’s about giving girls power, voice and opportunity. We are proud that with continued support from mission-aligned partners like GCC, Be Girl is well on its way to achieving that vision—one girl, one classroom, one country at a time. 

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News / Stories / Uncategorized - 07/25/2025

Transform Health Fund Calls for Financing Applications from African Healthcare Companies

May 9, 2025 (NAIRBOI) – The Transform Health Fund (“The Fund” or “THF”) is calling for Applications from African healthcare companies seeking investment.

The Transform Health Fund, an initiative of Health Finance Coalition and AfricInvest, is a $111 million debt/mezzanine fund, dedicated to creating access to quality, affordable healthcare products and services and building resilience in Africa’s healthcare ecosystem.

By scaling proven innovations and sustainable business models, the Fund aims to address critical healthcare challenges, improve access to affordable and quality healthcare, and ensure essential supplies for middle to low-income populations across the continent.

Opportunity

THF provides customized financing to organizations working on scalable, high-impact solutions in the healthcare sector. With a focus on debt and mezzanine investments, the Fund targets companies delivering measurable social outcomes and long-term financial sustainability. THF invites healthcare companies with presence in the Southern African Development Community (SADC) region to submit applications to apply for investment. The Fund seeks to partner with entities that are implementing solutions to create access to quality, affordable healthcare products and services. Applicants with sustainable and scalable models that align with THF’s objectives are encouraged to apply. The Fund’s investment criteria are as follows:

Investment Structures – Debt and mezzanine capital
Ticket size – USD 2M – USD 15M
Currency – USD-denominated
Tenor – Up to 7 years, to be determined based on company’s cash flow needs
Grace Periods – Up to 2 – 3 years, dependent on company’s cash flow needs
Collateral – flexible, including ringfenced cash flows / contract financing, sponsor share pledge, etc.

THF is able to move quickly and support companies in developing strategy and investment materials. This includes practical support in areas such as strategy development, financial planning, and building networks. It also provides technical assistance to strengthen organizational capacity and support sustainable growth.

Focus Areas

THF is committed to addressing systemic challenges in healthcare through investments. Specific areas of interest within THF’s strategic pillars include, but are not limited to:

Supply Chain Transformation: Business models in scope include: manufacturers of pharmaceuticals and/or medical devices, distributors of medical products, logistics / transport / cold chain companies that operate in the health sector, health insurance / health financing, etc. This can include models that improve infrastructure, logistics, and distribution systems to strengthen healthcare delivery; enhance last-mile supply chain capacity for underserved regions or implement robust financing models and data-driven approaches to ensure supply chain efficiency.
Innovative Care Delivery: Business models in scope include: hospitals, clinics, labs, imaging centers, etc. Products and solutions should create access to quality, affordable health service delivery and management models, including primary care, with a focus on scalability, efficiency, and measurable health outcomes. Initiatives should scale proven approaches to delivering healthcare services. Efforts should demonstrate clear improvements in patient outcomes, operational efficiency, and cost-effectiveness in reaching underserved populations.
Digital Innovation: Business models in scope include telemedicine, HMIS/EMRs, inventory management systems, etc., Companies that leverage digital platforms and innovations to transform healthcare delivery by improving access, scalability, and efficiency. Additionally, companies that offer digital innovations like telemedicine to extend healthcare access to remote and underserved communities, breaking down geographical barriers and reducing the cost of care.

All applications will be reviewed on a rolling basis. Interested healthcare companies can review eligibility requirements and apply for an investment through the Transform Health Fund’s application online portal. For inquiries, contact hfcinfo@healthfinancecoalition.org.

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News / Stories - 05/09/2025

Unlocking Growth: Navigating the Capital-Raising Journey for African Healthcare Businesses

Access to financing is pivotal for business growth, yet it remains a significant challenge for many in Africa. The International Finance Corporation (IFC) estimates that the finance gap for formal MSMEs in developing countries is approximately $5.2 trillion, representing nineteen percent of these countries’ combined GDP. Even more striking, over fifty percent of African businesses fail to secure their intended capital on the first attempt, often due to a lack of investor readiness and misaligned expectations.

Capital raising fuels innovation and expansion. Whether its equity financing, where ownership for investment is traded, or debt financing, which provides funds repayable with interest, each path offers distinct opportunities and challenges.

The capital-raising landscape is evolving rapidly, driven by technological advances and regulatory shifts. Digital platforms now connect businesses to investors with ease, democratizing access to funding like never before. Simultaneously, new laws are unlocking innovative financing pathways, creating an environment ripe with possibilities.

Navigating this dynamic space demands a strategic approach. Below, we explore the essential steps to prepare businesses for a capital raise, strategies for effective fundraising, and practical solutions to navigate transaction complexities.

Preparing Your Business for a Capital Raise

Assess Your Financial Health: Assessment of financials is a crucial step in preparing for a capital raise. Dive deep into key financial metrics such as revenue growth, profitability, and cash flow, benchmark your performance against industry standards, and undertake historic trend analysis. Such evaluations provide a clearer picture of your business’s strengths and weaknesses, helping identify areas to improve before approaching investors. A strong financial foundation is critical to gaining investor confidence and demonstrating readiness for growth.

Have a Compelling Growth Strategy Backed by Financial Projections: Investors seek businesses with a clear vision and a path to success. Develop a well-defined growth strategy that outlines how your business plans to scale and achieve profitability. Support this strategy with detailed financial projections that reflect realistic revenue and profit targets. Growth strategies should further be backed by a deep understanding of the state of the markets, business operations as well as potential challenges.

Understand Your Business Needs: Capital raising isn’t a one-size-fits-all process; it must align with the specific needs of your business. Determine the best type of financing, from grants, debt, convertibles, equity financing, or other financing mechanisms. Additionally, take a cash flow approach to calculate the exact amount of capital needed. Raising too little can leave you underfunded, while raising too much could dilute ownership or add unnecessary complexity.

Strategies for Effective Capital Raising

Be Well-Prepared with Transaction Documents: Your transaction documents are the backbone of a successful capital raise. Ensure your pitch deck is compelling and articulates your value proposition, market position, and growth potential. Complement this with a well-organized data room containing financial, operational, and legal documents to expedite investor due diligence. Professional, comprehensive documentation reflects preparedness and builds investor trust.

Build Strong Investor Relationships: Investors place significant weight on the capabilities of the management team, sometimes just as much as, or even more than, the business evaluation itself. Capital raising is as much about relationships as it is about funding. Engage with potential investors early, building trust and rapport over time. Strong relationships not only improve your chances of securing funding but also pave the way for long-term partnerships. Demonstrating an understanding of investors’ goals and aligning your pitch with their priorities can set you apart in a competitive landscape.

Understand Investor Priorities: Each investor has unique priorities, whether they focus on returns, sustainability, impact. or industry-specific growth. Take the time to research what matters most to your target investors. Align your messaging with their expectations and show how your business meets their goals.

Practical Solutions for Navigating Transaction Complexities

Conduct an In-Depth Valuation Assessment: A thorough valuation assessment is essential for setting realistic expectations. Establishing your business’s worth accurately will not only guide negotiations but also help avoid overvaluation, which can deter potential backers.

Use Scenario Modeling to Guide Negotiations: Scenario modeling is a powerful tool for navigating negotiations. By simulating different outcomes, you can anticipate challenges and better understand the implications of various deal structures.

Seek External Support to Structure Deals: Navigating the complexities of structuring capital-raising transactions can be overwhelming. Engaging external advisors or consultants with expertise in deal structuring can ease the process. These professionals bring valuable insights, handle regulatory requirements, and provide strategic guidance.

Ensure Compliance with Legal and Regulatory Requirements: The capital-raising process involves extensive legal and regulatory requirements that vary by jurisdiction. Work closely with legal advisors to ensure compliance, avoid delays, and minimize risks. Staying ahead of regulatory changes can also position your business as a credible and reliable investment opportunity.

Develop a Contingency Plan: Unforeseen challenges can arise during capital raising, from economic shifts to investor withdrawals. Having a robust contingency plan ensures you’re prepared to adapt quickly and maintain momentum. This plan could include alternative funding options, backup investors, or flexibility in your deal terms.

Focus on Clear and Transparent Communication: Open, honest, and transparent communication is vital throughout the capital-raising process. Regular updates and clear messaging can help build trust and keep all stakeholders aligned. Investors value clarity and are more likely to engage when they feel well-informed about your business’s progress and challenges.

News / Stories - 01/13/2025

Key Takeaways from the AMMTEC Conference: Advancing Pharmaceutical Manufacturing in Africa

The Health Finance Coalition recently had the privilege of participating in the African Medicines Manufacturing Trade Exhibition and Conference (AMMTEC) held 20 – 22 November in Dar es Salaam. The conference brought together stakeholders from across the pharmaceutical manufacturing ecosystem, including manufacturers, global funders, government representatives, and other key players, offering a unique platform to exchange insights, address challenges, and explore opportunities shaping the future of pharmaceutical production on the continent.

Key takeaways include:

Collaboration as a Catalyst for Progress
From the outset, the conference was rich with engaging discussions and inspiring moments, reinforcing the critical role collaboration plays in progressing Africa’s pharmaceutical manufacturing sector. Attendees underscored the need for unified efforts among industry players, policymakers, and funders to overcome systemic barriers, such as financing gaps, regulatory hurdles and market competition, as well as unlock the sector’s full potential.
Flexible Financing Models for Growth
Pharmaceutical manufacturers on the continent face diverse needs, and rigid financing structures often hinder growth. The conversations at AMMTEC emphasized the value of flexible financing models tailored to the realities of these businesses. Whether through blended finance, patient capital, or innovative debt structures, attendees stressed that creating adaptable financial solutions is vital to supporting manufacturers’ expansion, innovation, and resilience.
Balancing Quality and Streamlined Regulation
While maintaining high-quality standards is non-negotiable for pharmaceutical manufacturers, the conference highlighted how burdensome regulatory processes can stifle growth. Stakeholders called for a more streamlined regulatory framework that supports compliance without imposing unnecessary hurdles, a balance that is crucial for enabling manufacturers to scale production while maintaining the quality required for global competitiveness.
Financial Sustainability Beyond WHO Prequalification
Although achieving WHO prequalification (PQ) is a critical milestone for many manufacturers, financial sustainability cannot end there. Discussions underscored the importance of robust financial planning and modelling to ensure long-term viability. Attendees also stressed how manufacturers must go beyond compliance and focus on creating sustainable profit margins to compete effectively with international suppliers. It was also emphasized that financial planning and a deep understanding of target markets and the interplay between costs, pricing and profitability are crucial.

The AMMTEC conference reaffirmed the urgency of addressing these interconnected challenges and opportunities. By embracing collaboration, innovative financing, streamlined regulation, and financial sustainability, the sector can rise to meet its full potential.

At the Health Finance Coalition (HFC), we are inspired by the insights and partnerships forged during the conference. We remain dedicated to providing solutions that not only enhance access to medicines but also strengthen the financial health and strategic direction of the sector.

To learn more about the work of the Health Finance Coalition, visit healthfinancecoalition.org.

News - 12/05/2024

Investing In Our Future: A Conversation with Cees Rustenhoven, Healthy Entrepreneurs’ Chief Financial Officer

In an interview with the Health Finance Coalition, Cees Rustenhoven, Chief Financial Officer with Healthy Entrepreneurs, discusses the critical role of innovative financing for scaling healthcare solutions.

How and why did Healthy Entrepreneurs start?

RUSTENHOVEN: The founder of Healthy Entrepreneurs, Joost Van Engen, first worked for a wholesale company that distributes medicines and health products in Africa and other developing countries throughout the world. In that time, he realized that if Coca-Cola can get its products just about anywhere Africa, why couldn’t you deliver medications or healthcare products more effectively. So, Engen started thinking about a kind of network or franchise, or even small kiosks, that could sell medicines and various products in more rural or desolate areas of Africa.

He pitched the idea as a business case for the company he was with, but they weren’t interested. So, he thought …what if I quit and start my own company? It was a bold idea but that’s how it started over a decade ago. First, we did a few assignments for a small NGO in the Netherlands. Then we got grants from the Ministry of Foreign Affairs to serve a company in Africa.

And it was in that early start that I joined Healthy Entrepreneurs, because they were wanting to bring onboard someone who could manage the financials. So, we continued that journey, scaling up the company, particularly these last couple of years. Now, we are active in seven different countries.

As a business model, what has been Healthy Entrepreneurs’ evolution? What have you learned through the process?

RUSTENHOVEN: We have improved quite a lot. But the changes we’ve made weren’t something that just happened in a day. But over the years, we have evolved and now do things completely differently from when we first started. For one, we came to appreciate that it’s really community health workers who are the heart of any community and are trained and already registered by local governments. They’ve become the basis for our business. We recruit, train and make them community health entrepreneurs. We do that in close collaboration with local health authorities. We essentially sell our products to community health entrepreneurs, and they, in turn, sell the products to the end customer.

For us, it’s not about sales, as much as it’s about engagement, because we know that these entrepreneurs need to be engaged with the community for this to work. It’s not just about asking someone if they are ready to place an order. It’s more. You need to sit next to them, listen to them, coach them, and support them in doing their own business. If we do that, then the sales increase automatically. So that model now determines the people we are recruiting for this type of engagement.

Healthy Entrepreneurs has also used an outcome-style convertible note model? Can you explain more?

RUSTENHOVEN: That’s been an important step in the process. In 2020, we had our first financing round, and our initial investors were willing to invest more than half a million dollars into Healthy Entrepreneurs. Then, we negotiated the interest percentage and how much it would increase year over year. But it’s a loan that’s not part of your equity. Therefore, we also agreed to a certain profit sharing. So, at the end, if we are reaching a certain EBITDA level, meaning “earnings before interest, taxes, depreciation, amortization”, they would get a certain, part of the profit.

On the other hand, if we reached specific impact targets, then that resulted in a lower profit sharing.

So, that model served as a stimulus for us to reach social impact because there’s also a financial benefit for the company.

At the same time, we only want to have investors on board who are interested in the social impact and not only there for financial benefit.

Not many companies are making these types of agreements but it’s truly a win-win model. The loan, profit sharing and the social impact all come in together to achieve more healthcare solutions.

What would you say about the role of innovative or blended financing structures on scaling healthcare solutions?

RUSTENHOVEN: If you look at our business case, we are dealing with community health entrepreneurs who are living in desolate and rural areas of Africa. People there often earn just $1 or $2 a day. So, most orders being made by our community health entrepreneurs are often relatively low.

So, our business case is not the strongest commercial business case. We’re focused on the social business case. But still, there is a business case. Between the combination of public funding and commercial funding, it becomes a more sustainable business case than all the NGOs actively dealing with community health workers.

A couple of months ago, I was in Uganda, and I spoke to someone from an NGO that focuses on community healthcare. And they said, our Healthy Entrepreneurs model has essentially never-ending projects since our model is based on community health workers or entrepreneurs who remain in communities and can making a living from their business. Of course, not all our entrepreneurs reach that level of success, because some are higher performers than others. But still, there are quite a number of entrepreneurs who can make a living from their business and have a sustainable business model opening doors in the most rural areas of sub-Saharan Africa.

So, for us, that combination really makes this model extremely powerful, and opens up opportunities to scale healthcare using this network of community health entrepreneurs.

We can also finance innovations and new approaches, which is something we’ve done for communicable diseases, NCDs. We set up a closed supply chain to pick up orders from chronic patients through our call centers. We now have doctors on the payroll who can write prescriptions, and we can distribute medicines with a simple barcode scanned by a smartphone. We make sure each community health entrepreneur has a smartphone, where he or she can place online orders, and ensures the correct order is distributed to the appropriate patient.

That happens through public funding. But when we scale up, we need working capital. We then add in some commercial funding into our company so that we can continue to scale our business model.

What other innovative healthcare solutions are in the pipeline?

RUSTENHOVEN: We know the smartphone is increasingly being used also to register housing data of people living in the most desolate places. For example, the Electronic Community Health Information System (eCHIS) is digitizing community health information registered on household level. It’s expected that these information systems will play a critical role in measuring the performance of healthcare delivery and generating the necessary data for program monitoring, planning and evaluation. And it’s that kind of system that community health workers will then use to register every single household in each desolated village in Africa.

We are also seeing an increase in health apps with counselling services, videos and different tools for measuring vitals. Ultimately, what we would like to see, is a central database for all this information. Because, when we know the demands or the health needs of customers, then we can, in turn, provide the necessary products and services.

For those who haven’t considered innovative financing structures, what would you say?

RUSTENHOVEN: We thought that we were only making the margin, on the sale of products. But through the sale of our products, we are also making an impact.

Now, when an NGO comes to us and wants to try out a health intervention, we already have a network for scaling up. So, this network has a certain value. It’s not just about selling products and earning margin. It’s more about this network of community health entrepreneurs which can be used for health interventions.

For example, we distributed a product that is an injectable contraception. In Africa, if a woman gives birth four or five times, many times the sixth can be fatal. In order to prevent that, they get this injection and are protected for several months. So, we have partnered with an NGO that now pays us to distribute this injection and train our community health entrepreneurs to give this kind of an injection to women. That’s a good example of how we can use this network to scale a healthcare solution and achieve more social impact.

It is still quite cheap to distribute, but now we’re seeing more governments getting involved and wanting to use this type of network.

But this all stems from a combination of public and private funding – combining commercial funding for the working capital and public funding for startup and innovations. This way, you get a combination, which makes it more powerful and sustainable. The result is a larger network that is maintained and supported by community health entrepreneurs in the most remote areas of Africa.

After more than a decade of doing this work, I think we’ve developed a very stable business model with community entrepreneurs who will be with us for decades to come.

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News / Uncategorized - 11/25/2024

Investing In Our Future: A Conversation with Noorin Mawani, Co-lead of the Transform Health Fund

In an interview with the Health Finance Coalition, Noorin Mawani, co-lead of the pan-African recently- closed Transform Health Fund (THF), discusses the fund’s innovative blended-finance structure, which aims to bolster healthcare systems in Africa by scaling proven and innovative healthcare models. Earlier this month, AfricInvest and The Health Finance Coalition (HFC) announced the Transform Health Fund exceeded its initial target in its final close, raising $111 million, through commercial, public, and private donor investments.

What makes the Transform Health Fund unique?

MAWANI: What makes the THF unique is its investment strategy that focuses on reaching low to middle income patient populations in Africa which today lack accessible and affordable healthcare

Too often, healthcare investments target companies serving middle- to high-income patients. That’s been for a few reasons: First, investors with high target returns tend to focus on patient populations with a dependable ability to pay. Unfortunately, in many African countries, less than 10% of the population has private health insurance. And while public healthcare systems dominate, many people rely on out-of-pocket payments for medical expenses, and yet to not have the means to cover them. The second reason healthcare investors target companies with higher income patients is geographical. These companies are typically located in large cities and so they are better known.

THF’s focus on low-income patient populations is made possible by a blended capital structure at the Fund level, that allows us to focus on companies expecting moderate returns.

Can you describe how blended financing is used?

MAWANI: With blended financing, different types of capital (with different return requirements) are combined into one fund structure. In more traditional funds, there is just one type of share class for all investors who all receive the same terms.

By combining investors with different risk and return expectations, it is possible to “grow the pie,” or catalyze investors who may not have otherwise had the risk appetite to invest, and providing the opportunity for Africa to see a greater share of international capital flows.

Where does the Transform Health Fund fit into the health financing ecosystem?

MAWANI: The health financing ecosystem is extremely wide, spanning donors who give philanthropic grants to larger institutional players like UNICEF, the US government, PMI Healthcare and many others.

I think about the providers of finance on a continuum of returns. On one extreme, there are those who do not expect even the return of their principal, providing grants and donations. Many are motivated by the belief that the provision of adequate healthcare is a basic human right, and grant financing is sometimes required to help ensure this

In the middle, there are those interested in supporting health in emerging markets given their development impact agenda, who still require a rate of return, but perhaps not a fully market adjusted rate of return. Think of a development finance institution – e.g., BII or IFC. They use limited taxpayer money to drive development in the least developed nations across the world but require a return to sustain their ability to invest.

Moving across the spectrum, the financing available becomes increasingly commercial in nature. Market returns are expected and while impact is an important outcome, it is not necessarily the primary intention of the investment.

This continuum is a necessary feature of the healthcare finance ecosystem. There are some parts of the market, some subsectors, some geographies, where pure commercial investments are unavailable, and philanthropic capital has a critical role to play.

In my view, there is a place for all types of capital – across geographies and across different subsectors. However, it is critical that the right capital is being used for the right kinds of projects. Commercial money should not be used for something that should have been funded by grants, potentially leaving commercial investors disappointed. At the same time, using grant or donor money for a commercial investment is not an efficient use of precious grant dollars.

That’s the challenge for us all making sure we’re matching our capital and the requirements of our capital to the type of risk and expected return of the projects.

What does it mean to be impact focused? And where do you see the most healthcare impact?

MAWANI: For me, being impact focused is basically identifying the kind of impact you’re trying to achieve, and then aligning your internal processes, your fund governance, and your incentives to achieve that objective.

For example, we consider ourselves impactful, because we’ve stated what our impact policy is, and we have a way to govern that. We have an investment committee process that considers impact votes on whether a project is sufficiently impactful.

We also have incentives tied to impact. For our investors and for ourselves, it is not enough to just deliver financial returns and so it is only fair that our incentives are ties to impact.

What challenges exist for scaling healthcare innovations in Africa and deploying capital?

MAWANI: One of the challenges we face, like other sectors in Africa, is the ability to pay. To increase access to healthcare services, either the services must become more affordable or the patient’s ability to pay must improve.

The challenge in Africa is that both of those are difficult. It’s hard to bring down the cost of healthcare, especially since he primary input into the cost of healthcare is labor. There are just not enough trained medical staff on the continent. And even those trained in the medical profession on the continent are tempted to leave for other markets where there’s more financial opportunity.

The other big challenge is the cost of drugs and pharma. Africa doesn’t manufacture adequate supplies of pharmaceutical products for its population and while there are efforts to encourage local production, many barriers still exist: The cost of energy is high, financing isn’t always available, and prices of products from other emerging markets are extremely competitive.

On the other hand, helping to improve a patient’s ability to pay is typically driven by two things: First, increasing income, a variable that it not in the control of healthcare investors. Secondly, increasing the availability of health insurance. While improvements in this regard are underway in some markets, it is a long road, and often requires government intervention and regulatory support.

Despite these important challenges, they are part of what makes African healthcare investing so exciting and such a big opportunity.

That’s where the innovation comes from, particularly companies targeting decreases in the customer cost of care.

With this final close, would it be fair to say you’re optimistic?

MAWANI: Definitely. I think we’re very optimistic because of achieving this final close of THF for an amount surpassing our target. As you can see, the is a great deal of interest and drive from investors to finance companies providing innovative solutions to some of Africa’s most pressing healthcare challenges.

And from the investments we’ve made so far, we’ve found incredible opportunities to solve for affordability. Still, this is by no means an easy sector. But we’ve found really strong entrepreneurs who are finding ways to drive innovation.

Finally, we are inspired by our investors, because at the end of the day, we’re a conduit for their money. It’s still their money and they’re still taking the risk.

So, our optimism is driven by both investors, as well as the hard work being done by the entrepreneurs themselves. While we are pleased with the success of the Transform Health Fund, investors and entrepreneurs are really the ones that are going to solve Africa’s healthcare problem.

Financing is just one piece of the puzzle that we try to unlock for them.

Q: Can you talk about Health Finance Coalition’s Transaction construction role in the fund? How does HFC’s support enhance THF’s investment process?

MAWANI: The Health Finance Coalition (HFC) plays a crucial role in structuring transactions that drive the development and execution of investment opportunities, strengthening THF’s pipeline, value proposition to companies, impact, and overall fund performance. HFC provides healthcare companies with strategic, financial, impact, and transaction structuring support, offering customized solutions that enhance their readiness to attract investment from partners like THF.

A recent example of this work is HFC’s collaboration with THF’s investee – Lapaire, an optical retailer operating across Africa. HFC assisted Lapaire in assessing strategic, high-impact opportunities designed to generate sustainable financial and social outcomes. By aligning management on the optimal strategic growth path, HFC helped Lapaire maximize impact while safeguarding THF’s investment value.

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News / Stories / Uncategorized - 10/21/2024

Transform Health Fund Surpasses $100 Million Target Final Close to Improve Access to Quality Healthcare in Africa

NAIROBI, October 3, 2024 – AfricInvest and The Health Finance Coalition (HFC) today announced the final close of the pan-African Transform Health Fund (THF), an innovative blended-finance fund that aims to bolster healthcare systems in Africa by scaling proven and innovative healthcare models across the continent.

Under the management of AfricInvest, a leading pan-African investment platform active across private equity, venture capital and private debt, in collaboration with the Health Finance Coalition, a group of leading global health funders, the Transform Health Fund exceeded its initial target, raising $111 million, through commercial, public, and private donor investments.

Notable fund investors include Royal Philips, the International Finance Corporation (IFC), Swedfund, the U.S. International Development Finance Corporation (DFC), Proparco, Merck & Co., Inc., known as MSD outside of the United States and Canada, FSD Africa Investments, Grand Challenges Canada (with funding from Global Affairs Canada), ImpactAssets Inc., the Global Health Investment Corporation (GHIC), Ceniarth (the family office of Diane Isenberg), UBS Optimus Foundation, Skoll Foundation, Chemonics International, Anesvad Foundation, Netri Foundation, U.S. Agency for International Development (USAID).

The successful closing allows THF to expand its investment into locally led health supply chains, care delivery, and digital solutions in Africa, providing debt and mezzanine financing to scale proven high-impact health enterprises serving vulnerable communities while offering risk-adjusted returns to investors.

The Transform Health Fund has already committed $20m in financing to:

Africa Healthcare Network (AHN), the largest dialysis chain across Sub-Saharan Africa, delivering high-quality, life-saving dialysis and preventative care treatment at affordable cost.
Lapaire Glasses, a network of more than 60 optical shops, providing affordable and accessible eye care products and services across six countries in West and East Africa.
Insta Products, a producer of ready-to-use therapeutic food for millions of malnourished children and mothers across sub-Saharan Africa, supplying its accredited products through international NGOs.

The Transform Health Fund, publicly highlighted in December 2022 at the U.S.-Africa Leaders’ Summit in Washington, D.C., was established to address Africa’s massive health financing and capacity gaps. While Sub-Saharan Africa is home to 14 percent of the global population and 20 percent of the global disease burden, just 1.6 percent of annual impact investments target the healthcare sector in Africa.

“Financing companies in Africa’s health sector through innovative financing models such as the Transform Health Fund is critical to address Africa’s health financing and capacity gaps,” said Ziad Oueslati, Founding Partner, AfricInvest. “By teaming up with private sector leaders, the Transform Health Fund has become a proven model for scaling locally led healthcare solutions across the continent.”

“The Transform Health Fund demonstrates that health enterprises serving the most vulnerable communities are in fact investible,” said Martin Edlund, CEO, Malaria No More and Executive Director of the Health Finance Coalition. “The context of static donor funding for health and unsustainable debt for African countries makes private investment in high-impact healthcare more important than ever.”

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For more information on the THF, please contact Noorin Mawani at noorin.mawani@africinvest.com. For interview requests, please contact Mindy Mizell at mindy.mizell@malarianomore.org.

About AfricInvest:

AfricInvest is a leading pan-African investment platform active in multiple alternative asset classes including private equity, venture capital, private credit, and listed equities. Over the past quarter century, the firm has raised more than $2bn to finance more than 200 companies at various development stages, delivering value and impact for its investors, portfolio companies, and the communities they serve. The 100-person-strong team of investment experts in more than ten offices across three continents has a proven track record of providing attractive risk-adjusted returns while spurring productivity growth, creating jobs, and ultimately improving African lives through inclusive and sustainable development. Learn more at: www.africinvest.com

About the Health Finance Coalition:

The Health Finance Coalition (HFC) was launched by a group of leading philanthropies, investors, donors, technical partners convened by WHO Ambassador for Global Strategy and Health Financing Ray Chambers and hosted by Malaria No More. The HFC seeks to attract an unprecedented level of private-sector investment to impact millions of lives and accelerate progress to ensure healthy lives and promote well-being for all, a UN Sustainable Development Goal 3. The coalition uses public and philanthropic funding to encourage private-sector capital investment in transformative healthcare impact. Learn more at: healthfinancecoalition.org

News - 10/03/2024

HFC & CHAI Announce Partnership to Scale-up Wolbachia Interventions to Prevent Dengue

The Health Finance Coalition (HFC), a subsidiary of Malaria No More, and the Clinton Health Access Initiative Inc. (CHAI), today announced a new partnership and initiative to scale up Wolbachia bacteria interventions to prevent dengue and aedes-borne diseases, with a generous award of £6.1M from Wellcome.

News - 10/01/2024

Ready for Investment, Ready for Scale: HFC’s approach to supporting African manufacturers

To scale manufacturing locally, African manufacturers must receive support to better understand the realities of the markets in which they operate, strengthen business planning, and understand the connection between market structures, competition, and regulatory requirements with their revenues. Without such “investment-readiness” support, manufacturers will be unprepared and unsuccessful in accessing catalytic growth financing from DFIs and other impact investors.

News - 09/18/2024

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