Read the Conversation

EF: What were some of the key lessons and experiences from the past two years to leverage for the future?

IB: Having an opportunity to change the way we engage with patients was an absolute highlight and a silver lining for us during COVID. During the pandemic, our focus shifted from doctor to patient-centric. Becoming patient-centric showed us how capable patient capacity is with the right focus, support, access, and information. Many patients showed awareness and self-care capabilities. This level of self-awareness will dominate the future of healthcare on a global level, both physically and mentally.
Self-care should become our primary point of engagement with healthcare consumers. The process of change brought self-care and patient centricity to the forefront.

This occurred in two steps. The development of telemedicine brought about the first change making it a key solution. The most impactful deployments of telehealth have resulted from a shift from business to consumer to business to business. Company-to-consumer telemedicine comes with several challenges. In business-to-business telemedicine, clinicians engage with other clinicians so that the patient can better engage with the system at a primary care interface. Embracing community health workers like nurses, pharmacists, and physicians to be the first point of access for patients with support from centralised specialists through telemedicine will create greater effective access for the patient.

Telemedicine is not only about healthcare delivery; it is about providing support, empowering patients, and healthcare workers, developing skill sets for remote practitioners and educating the population. Telemedicine creates better efficient utilization of the industry’s secondary and tertiary capacity.

The second change is the utilization of diagnostics. When the pandemic began, we funded educational programs and initiatives to teach doctors about the differences between antibody, antigen, and molecular tests and deployed a significant range and volume of equipment to pints of care. Now, people can take tests at clinics, pharmacies, and even at home. Physicians can make faster decisions with a quicker diagnosis and help more patients. Telemedicine and patient-facing diagnostics can drive universal access. We can maximize efficiency if we change our primary engagement point from doctors to patients and include technology to expedite diagnosis. We can change the cost and scale with which we engage with patients. As we advance, we must use the lessons we have learned to improve ourselves and the healthcare system.  

EF: Can you elaborate on the role of the private sector in developing access?

IB: Expanding the private sector to create an affordable, high-quality, accessible system is fundamental to the growth and strengthening of every country’s healthcare system. Historically donors were big, governments were growing, out-of-pocket was small, and insurance was minuscule. Covid was the continent’s tipping point for fund generation. Last year most of the total health expenditure was self-funded.

Third-party reimbursement models are becoming more common. Many clinics and hospitals need funding to provide quality and accessible care for the community at affordable prices. The volume of patients at clinics is incredibly high.  

Unjani Clinics was launched in 2010, and now we have 110 clinics serving more than 60,000 self-funded patients monthly. The mid-term goal is to develop these clinics into networks that convert their funding source into prepaid third-party reimbursement models.  As an industry and a continent, we need to find ways to fund small to mid-sized enterprises that make a difference. The investments should deliver care and healthcare commodities. The funds should be managed transparently and demonstrate the impact they make. We are not looking for opportunities for the greatest financial return but for the market where the conditions are for investments to achieve the greatest impact on care.

EF: What are the four key points you look for in investments?

IB: The first key factor we look at is need and demand. The market dynamics and the market's sustainability are crucial factors. Many companies grow from singularly focused enterprises to investment-ready, scale-ready businesses. Therefore, we look at the company's capacity to meet market needs. The second key factor is to identify an African-owned enterprise that could receive the investment and fulfil the requirement. The third intervention is to find ways to develop and synergize the business skills required to create a more efficient player in the market. The fourth is taking the product through new channels and into new markets to grow the business. This, in aggregate, is venture development.  

EF: Can you elaborate on the necessity of healthcare investment and philanthropic efforts?

IB: Smart investment is all about thinking about the future, but not at the expense of the present moment. Blending different financial instruments can create maximum impact. When used individually, the agents work; however, so much can be leveraged by combining the various financial tools.  

The integrity of providing adequate care here and now is the focal point. However, ensuring future patient readiness and keeping momentum in the change is important. Creating a significant impact with the investment money and leveraging it in the market is more meaningful. I use all the knowledge and experience I have acquired throughout the years to drive a futuristic vision but not at the expense of the present moment. A healthy society is equal to a healthy economy.

Often, our biggest challenge is changing the government’s view of healthcare as an expense rather than a driver of economic growth. We need governments to invest in healthcare. There is a clear linkage between healthcare expenditure and GDP growth. It is a position we are encouraging governments to adopt.  

EF: Can you elaborate on the role of healthcare in developing the economy?

IB: In our brand, the ‘d’ in development is a capital D. Development is fundamental to and a representation of the basis of health. One of our key focuses is the healthcare outcomes of children in Africa. Our mission is to get at least one parent into a meaningful job for a healthier family and healthier children. Through this initiative, we are contributing toward dynamic economic growth. Creating better health creates economic development and develops people's self-sufficiency. SMEs provide 80% of the continent's jobs. Therefore, the more we grow the SMEs, the more jobs are created. We need more businesses to create a sustainable and more credible economic platform.  

EF: What is your perspective on a national or continental level of self-sufficiency?

IB: Local manufacturing is the number one item on today's African Union heads of state meeting agenda. Before the pandemic, starting the conversation on local manufacturing was impossible. People and leaders now realize its strategic priority. The most important thing to note is that this is a long-term investment. It is a 10-to-15-year investment cycle. The main aim should be to manufacture essential commodities and basic medicines that cover the continent's needs. We need to focus on fixing the key elements.

EF: What advice would you give to potential investors regarding putting a stake in the South African healthcare system?

IB: The healthcare industry in South Africa has been through three momentous events in the last 20 years. The first was the deregulation of retail pharmacy. The second was the single exit price, and the third was the regulation of dispensing fees. The common running theme in all these events is the industry's superb growth after each event – in patient access and financial benefits for all role players. I am confident that it will be the same with National Health Insurance.
The biggest challenge we are facing is investment fear. The vision for the long-term future over the short-term vision is at the centre of healthcare discourse. Investors should strongly consider long-term prosperity over short-term gains. Sure, the UK’s NHS is an imperfect model. But it works – supporting patient health, social wellness and economic growth. Most of the challenges we face are long-term challenges. Therefore, there should be long-term solutions provided.

EF: What would you like to celebrate at the end of the year?

IB: I would like to celebrate the launch of H4D’s integrated finance funding model for small to medium enterprises for capital development that incentivizes the right market dynamics and the right market resilience. If you do what you love, you do not have to work a day in your life.

July 2022
South Africa