We face a unique opportunity in growth markets today, a by-product of the profound demographic shifts occurring at the confluence of a growing middle class, urbanization, ongoing challenges in battling infectious diseases and the rise in non-communicable diseases. These shifts are driving the need for substantial investment in infrastructure and innovation to enable the delivery of quality healthcare that is both accessible and affordable.  The difficulties in combating Ebola tragically illustrated the urgent need for a collective strengthening of fragmented and strained health systems. The often resource-constrained public sector – the traditional provider of healthcare to poor communities in most growth markets – faces a herculean task in attempting to address these challenges.

We believe that in order to create genuine and long-term impact in lower- and middle-income population segments, there must be a paradigm shift. The organized private sector, including investment fund managers such as Abraaj, Big Pharma, and diversified technology companies must work together with governments, foundations and NGOs, supporting one another in a “new compact,” one that leverages their complementary strengths to deliver truly cost-effective healthcare systems. This can only be meaningfully achieved by a comprehensive realignment of all constituents’ priorities with the broader government health strategy, a focus on the priority needs of under-served population segments, and an ability to contribute to overall system capacity, capability, and quality.

Changing Health Care Delivery Models

Factors commonly hindering advances in healthcare delivery across growth markets include a lack of financial protection from the catastrophic health expenses forcing people into poverty, and inadequate health system reform. In order to meet some of these challenges head on, Abraaj will establish affordable high-quality health systems for low- and middle-income groups predominantly in sub-Saharan Africa and South Asia. Our focus will be in creating city-based multispecialty “hub-and-spoke” healthcare ecosystems and super-specialty networks that provide a coordinated set of healthcare facilities and capabilities. We believe that in order to achieve sustained impact at scale, it will be critical to implement an innovative approach to diagnostics, clinical delivery and therapy, clinical and workforce training, logistics, and operational knowledge. Innovation and best-in-class practice in these fields provide the potential to address capital efficiency and the availability of medical expertise.

Social Franchise Networks

One of the exciting ways we are trying to link clinical care for the poor to our health care ecosystems is by strategically partnering with NGOs to enhance their social franchise networks. Social franchises are networks of qualified, private sector healthcare providers linked through agreements to provide socially beneficial health services under common franchise brands. The providers retain complete ownership and autonomy over their outlets, and continue to charge reasonable fees for their services. The overall aim of social franchises is to ensure health impact, quality, cost-effectiveness, equity, increased use and sustainability. Applying commercial principles and discipline can be advantageous for achieving public health goals.

Partnering with NGOs and their franchisees allows us to innovatively help the end-consumer in a number of ways, including:

  • Using our global platform and strategic partnerships to help with procurement;
  • Reducing diagnostic and treatment costs;
  • Promoting the use of low cost medical devices that simultaneously encourage quality and economies of scale;
  • Providing access to a wider range of laboratory and imaging diagnostic services within our ecosystems;
  • Offering low-cost access to mHealth and IT systems to boost operational efficiency and documentation;
  • Lowering medication costs through our partnerships with Big Pharma and major distributors;
  • Providing access to a wider range of training opportunities for providers through our learning and development programs; and importantly,
  • Creating a viable high-quality local referral facility as an alternative for cases that can’t be managed in primary care and where the patient seeks trustworthy, affordable private care outside of the public sector.

An Ambitious Vision

Expanding trained community healthcare worker programs within appropriately supervised learning environments and in parallel to the social franchise model benefits can also help strengthen the number of options available to deliver responsible care cost-effectively in low-resource, low-income communities.

Our approach envisages a close partnership with governments, ensuring that opportunities for clinical skill development can be shared across the platform for doctors, nurses, managers and allied health providers, stimulating long-term value creation through capacity building and training. It is our hope that these ecosystems provide a sustainable platform for skills and career progression useable within any public, private or non-governmental organization. Embedding and empowering health workers with the right tools and support will significantly improve patient health outcomes. In order to achieve this, we will invest in scalable and sustainable healthcare services models that provide measurable improvements.

There remains much work to be done but working collaboratively, proactively and in partnership with the wide cross-section of stakeholders augurs well for the successful delivery of this highly ambitious vision.

Prof. Bobby Prasad is Global Chief Medical Officer for Abraaj and is based in the Group’s London office. He is a Specialist in Gastroenterology and has been in clinical practice for over 20 years, having worked in senior roles in the UK and US including on faculty at Yale. He is a Fellow of the Royal College of Physicians of London and the American College of Physicians.