Working on PPP-type of primary care initiatives in Africa we experienced that the investment case for primary health care is challenging due to limitations in the revenue model, high development costs and political risk factors. Primary health care is hard to fund sustainably and at scale as:
- commercial funders consider this sector as too risky,
- impact funders typically have a “vertical” focus (certain disease area, care path, patient segment) and do not fund holistic primary care, and
- projects need a lot of structuring and support to be “investable”.
Universal Health Care in sub-Saharan Africa requires leveraging public, private, and philanthropic sector capacity to create new service delivery and financing models that can strengthen primary health care (PHC) at a system-wide scale.
We would propose to break the impasse and unlock much needed investments into better primary healthcare by applying a “double blended finance’ approach, which we developed together with Total Impact Capital. Double blended financing refers to (1) Investment blending to cushion the investment and early-stage development risk using first loss and development grants and (2) Revenue blending at the project/venture level by strengthening the revenue sources and de-risking instruments to ensure that innovations thrive in the long term and reach everyone, including the poor.
Source: double-blended financing in Health Finance Coalition, 5 Sept 2021
A partnership agreement has been signed with FMO (Dutch Development Bank) to unlock invesmtents into the primary healthcare space.
Together with and lead by Health Finance Coalition and AfricInvest, we are in the process of fundraising for a fund, structuring investable deals and building the deal pipeline. The aim is the establishment of a 100m US$ Primary Healthcare Fund that is able to unlock investments in high impact projects at scale for underserved communities with a focus on the primary healthcare sector.
Next to this we are on different engagement levels with various funders, donors and other relevant stakeholders to develop and align funding approaches on the “revenue side”.
Ultimately, at Philips, our purpose is to improve people’s health and well-being through meaningful innovation. We thus aim to improve 2.5 billion lives per year by 2030, including 400 million in underserved communities.
We believe that each actor has a role to play to mobilize the required financial resources. For example, donors and philanthropists can 1) contribute grants for technical and transaction assistance, and first loss to support testing of innovative projects in real life settings and/or scaling interventions with proven impact, and 2) provide guarantees to de-risk equity and debt instruments. Impact investors can invest according to their risk appetite either in the testing of projects or in the de-risked (sub-national) roll out of proven projects. Governments must work to gradually increase the uptake of national health insurance schemes and increase domestic resource mobilization to sustain the business models. A key challenge is to design an impact investment vehicle that is tailored to the individual risk appetite and return requirements of the broad range of investors we seek to engage in. Furthermore, if the much needed risk capital is not provided by DFIs we need other providers of risk capital such as Corporates or Foundations.
Our advice to our peers is to take time to understand all the elements required to establish a sustainable solution and incentivise all the stakeholders required – there needs to be something in for all of them! Another recommendation is to be open to adapt as you go and to be patient. Finally, let’s join forces to make existing funds more “usable” and to build a strong funnel of (investable) projects that can scale!
See blog double-blended financing in Health Finance Coalition, 5 Sept 2021.
Philips Capital / Philips Foundation – Impact Finance
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