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• Leading Change in Emerging Health Markets

  Jocelyn Ling 7:53 am on May 8, 2013 | 0 comments Permalink | Reply
  Tags: Africa, change (28), collaboration (21), Government (6), health, ifc, worldbank (2)

  About a month and a half ago, I was in Istan­bul attend­ing a global pri­vate health con­fer­ence hosted by the Inter­na­tional Finance Cor­po­ra­tion (IFC) and John Hop­kins Med­i­cine Inter­na­tional. The event brought together global lead­ers in the pri­vate health indus­try to have share ideas, knowl­edge and lessons in the indus­try. Par­tic­i­pants were mainly senior management/CEOs across the health value chain from health ser­vice providers to phar­ma­ceu­ti­cal & med­ical tech­nol­ogy man­u­fac­tur­ers to investors in emerg­ing mar­kets. On top of the con­fer­ence, my team orga­nized a sep­a­rate panel ses­sion for health providers in sub-Saharan Africa.

  

  I just wanted to share some of my notes and key take­aways from the con­fer­ence as I was really struck by the dis­cus­sions of the world’s lead­ing health providers and how it feeds into my work as an investor in emerg­ing mar­kets. Essen­tially, how I should be look­ing at the over­all mar­ket and types of deals I should be focus­ing on. There were two pre­sen­ta­tions in par­tic­u­lar that I would highly rec­om­mend going through, which is Credit Suisse’s Cap­i­tal Mar­kets Per­spec­tive on the health­care ser­vices sec­tor and IFC’s lessons from invest­ing in hospitals.

  • Health is a major dri­ver of GDP growth in OECD coun­tries aver­ag­ing approx­i­mately 7.3% as a per­cent­age of total GDP.
  • There is an upward trend of life sci­ence tools and med­ical equip­ment providers in terms of performance
  • When com­par­ing trad­ing val­u­a­tions (EV/EBITDA), EMEA and RoW com­pa­nies sig­nif­i­cantly out­per­form Amer­i­can com­pa­nies in terms of rev­enue growth, par­tic­u­larly in Acute Care provision
  • Banks are shrink­ing their lend­ing port­fo­lios par­tic­u­larly in SSA
  • M&A activ­ity will con­tinue to increase in a frag­mented mar­ket with pri­vate equity play­ing an impor­tant role in sec­tor consolidation
  • Health­care ser­vices are trend­ing from inpa­tient to out­pa­tient, inva­sive to non-invasive, and from treat­ment to prevention
  • The global finan­cial cri­sis slowed growth rates of com­pa­nies in IFC’s port­fo­lio, but none expe­ri­enced a drop in sales — indi­cat­ing that hos­pi­tal busi­nesses are resilient but not immune to the global finan­cial crisis
  • IFC’s rev­enue pro­jec­tions were rea­son­ably close to actual, on aver­age erring 5% lower than actual (which is impressive!)
  • The health mar­ket in SSA is an SME mar­ket, hence a need for smaller deal sizes, or a con­sol­i­da­tion of deals for increased access to financing

  Over­all, the con­fer­ence left me feel­ing uplifted, but also a great sense of urgency in terms of the work that I am try­ing to do. The con­fer­ence was IFC’s 5th annual health­care con­fer­ence and am already look­ing for­ward to the next one.

   

• Responsibilities of an (Impact) Investor

  Jocelyn Ling 3:02 pm on December 6, 2012 | 0 comments Permalink | Reply
  Tags: Africa, collaboration (21), impact (23), impact investing (12), investing, social finance (9), venture capital

  For the past few months, I have been reflect­ing a lot on my role as an investor. Busi­ness plans and pro­pos­als come across my desk and as I shift through them, it really struck me on how large a respon­si­bil­ity investors play in accel­er­at­ing trends, shap­ing a com­mu­nity or even country’s econ­omy, but yet how lit­tle this respon­si­bil­ity is spo­ken about in the invest­ing cir­cles. We place so much empha­sis on find­ing the right busi­ness, the right man­age­ment team, the right social impact, that some­times we get lost in our own capac­ity to rec­og­nize what really is inno­v­a­tive and what truly deserves to be funded. So, from my expe­ri­ences, here’s what I think an investor’s respon­si­bil­i­ties are on top of the typ­i­cal invest­ment work:

  1) Investors need to live in the future. 

  This is a point I feel very strongly about. If you’re an investor: VC/PE and par­tic­u­larly if you play in the startup and impact invest­ing work, (as Fred Wil­son pointed today in his blog post and what Paul Gra­ham said):  you should live in the future and see what is miss­ing. So well said. I’m cur­rently in an envi­ron­ment (yes, I rec­og­nize that I am in Africa — so feel free to shower stereo­types), where I know investors who are still using yahoo mail, inter­net explorer and Win­dows 2003 (true story!). Not to say that there are any­thing wrong with the prod­ucts, but more so — I think it’s so impor­tant to be keep­ing up with the trends in the world, tech­nol­ogy being one of them. How can you expect to iden­tify an invest­ment that is ‘ground-breaking’ if you’re not even fol­low­ing the newest trends in your sec­tor? Tak­ing this a step fur­ther, if you are fol­low­ing these global trends vs. local trends, it is then our respon­si­bil­ity to seek out entre­pre­neurs who can close this gap and fur­ther ele­vate the devel­op­ing world, or the devel­op­ing world would for­ever be play­ing ‘catch up’.

  2) Don’t be a sheep. 

  This respon­si­bil­ity is par­tic­u­larly impor­tant in the impact invest­ing space. Given that we’re play­ing in a field that is largely uncharted, risk is high and typ­i­cally, most investors are unable to size up a new mar­ket and end up rely­ing on the opin­ions of other investors. aka. I’ll invest if some­one else will too aka. a sheep. Impact investors say that they are risk tol­er­ant, but few trans­late this tol­er­ance into sign­ing along the dot­ted line. A very chicken and egg sit­u­a­tion. Hence, I have to con­stantly push myself to under­stand what is the right bal­ance of being a mar­ket leader but also not be a reck­less investor. Bal­ance is key.

  3) The need to close and dis­burse faster

  There are a lot of delays that occur in [impact] invest­ing. The court­ing of investors and [social] entre­pre­neurs, the dance between find­ing the right termsheet, the issue of mak­ing sure that the social impact actu­ally has an impact, and [insert your tra­di­tional delays in invest­ing here]. This is the norm. This is my chal­lenge to investors: rec­og­nize that the longer the delay, the big­ger the strain on the business/organization. From an entre­pre­neur per­spec­tive, you’re con­stantly watch­ing your ‘run­way’ aka. how much money do I have before I run out, and a delayed clos­ing round and dis­burse­ment is to the [social] entrepreneur’s dis­ad­van­tage as well as to their cus­tomers. If we’re really stand­ing with the poor, then deals need to close quicker with clear and sim­ple terms, as the longer the delay, the more peo­ple are miss­ing out on poten­tially expe­ri­enc­ing the product/service.

  This is by no means sup­posed to be an exhaus­tive list of respon­si­bil­i­ties, but instead ones that I feel are most impor­tant given my expe­ri­ence. As investors, we are in a priv­i­leged posi­tion to start/continue or end trends. I think it’s time that we started think­ing a lit­tle harder about where our respon­si­bil­i­ties lie.

   

• My Week's Discoveries: Healthcare & Design

  Jocelyn Ling 10:47 am on November 20, 2012 | 0 comments Permalink | Reply
  Tags: Africa, BottomOfPyramid (5), design (13), healthcare

  I’ve been spend­ing a lot of time in the health­care world for obvi­ous rea­sons, and have been immers­ing myself with knowl­edge from all angles. One of the more fas­ci­nat­ing angles is the cross sec­tion of health­care and design. Here’s a cou­ple of my favourite findings:

  1) Cut­ting for Stone by Abra­ham Verghese

  It’s been a while since I’ve read a work of fic­tion and I was highly rec­om­mended this book by my Acu­men Fund col­leagues. I fin­ished this book over the week­end and was so cap­tured by the story, out­raged on behalf of the pro­tag­o­nist, delighted by the inten­sity, and over­all over­whelmed at how beau­ti­fully writ­ten this book was. It’s a story that takes place from Ethiopia to New York, about love, med­i­cine and the inter­twin­ing of fate.

  We are all fix­ing what is bro­ken. It is the task of a life­time. We’ll leave much unfin­ished for the next generation

  - Cut­ting for Stone, A. Verghese

  2) Butaro Hos­pi­tal in Rwanda 

  When you look at East Africa’s health­care land­scape, Rwanda stands out as a med­ical suc­cess. Health indi­ca­tors have improved on all counts since the geno­cide, all pri­mar­ily due to the suc­cess of a uni­ver­sal health insur­ance, where the poor­est 25% of Rwan­dans get free med­ical care. One of my favourite things about the Rwan­dan health­care land­scape is a hos­pi­tal, Butaro hos­pi­tal that was designed by MASS Design Group The hos­pi­tal has no hall­ways, so patients can’t gather in close spaces, and the air in the wards are changed more than 12 times per hour to pre­vent patients from being infected by other patients — par­tic­u­larly, with multi-drug-resistant TB.

  Image taken from: Arch­Daily by Iwan Baan

  3) Future of health­care is Social - Fast Company 

  I recently was in Tan­za­nia attend­ing and speak­ing at a mobile health con­fer­ence orga­nized by USAID and the MIn­istry of Health of Tan­za­nia. The theme at hand was the increas­ing tech­nol­ogy and mobile pen­e­tra­tion that is chang­ing the health land­scape in Africa. There are over 500 mhealth projects deployed around the world with the major­ity of projects (over 30%) being in Africa. I really enjoyed this arti­cle by Fast Com­pany on the increas­ing social nature that comes along with the increased tech­nol­ogy pres­ence in health­care. Also worth read­ing is another arti­cle by Fast Com­pany, on 5 steps to design­ing a bet­ter health­care sys­tem.

  4)  Design for trust - UX Magazine 

  Good design isn’t beau­ti­ful. Good design builds trust. As an investor, when I eval­u­ate health­care inter­ven­tions, I look to see how the ser­vice accounts for fac­tors that mat­ter to a person’s dig­nity: they way they are being treated, train­ing of health­care staff and acces­si­bil­ity of infor­ma­tion. This is espe­cially impor­tant when deal­ing with the poor, who are used to being mar­gin­al­ized, and not receiv­ing proper ser­vice. The arti­cle is more web-based trust, but rel­e­vant nev­er­the­less, when think­ing about how you inter­act with a patient. At the end of the day, when receiv­ing med­ical news, every­one wants infor­ma­tion that is “cor­rect, com­plete and unbiased.”

  7) Design­ing Hand­wash­ing — Core77

  An older arti­cle, but a goodie in address­ing one the most fun­da­men­tal issues in health­care: Hand­wash­ing. A great read in explor­ing: Move­ment Design, Mus­cle mem­ory, move­ment scripts and fluidity.

   

• Dambisa Moyo: Why aid is not working and how there is a better way for Africa

  Jocelyn Ling 9:27 pm on October 18, 2010 | 4 comments Permalink | Reply
  Tags: Africa, BottomOfPyramid (5), debate (6), foreign aid (3), Global Voices (4), Government (6), sustainable (5), world (17)

  I am so so unbe­liev­ably stockedex­cit­ed­hap­py­breath­lessi­nan­tic­i­pa­tion for this event. Seriously.

  I read her book, Dead Aid, when it first came out and it opened my eyes to a very dif­fer­ent per­spec­tive of aid, devel­op­ment and the finan­cial world. Her views are a chal­lenge and a strong vision on how to address the global poverty issue. Spread the word (and read the book!)

  
   

• Half the Sky: Turning Oppression into Opportunity for Women Worldwide

  Jocelyn Ling 8:44 pm on October 11, 2010 | 2 comments Permalink | Reply
  Tags: Africa, change (28), education (12), empowerment (13), inspiration (21), peace (4), women (6), world (17)

  Women hold up half the sky — Chi­nese Proverb

  Real­ity is hard. It is a star­tling rev­e­la­tion at times often because we choose to sur­round our­selves with our view and expe­ri­ence of the world. This Thanks­giv­ing, I am reminded of real­ity when I sat down to read Half the Sky by Nicholas Kristof and Sheryl WuDunn. In Half the Sky, Kristof and WuDunn throw an inter­est­ing twist into the con­ven­tional view of plights of women around the world: by telling their sto­ries. From Cam­bo­dia to South Africa. From sex slaves to mater­nal health. By putting a name, emo­tion and pas­sion into the sto­ries. This ten­ta­tive foray into the realm of story-telling melds sur­pris­ing well with what is, essen­tially, a pas­sion­ate call to action against our generation’s most per­va­sive human rights vio­la­tion: the oppres­sion of women and girls worldwide.

  The open­ing of the book fol­lows the story of Srey Rath, a young Cam­bo­dian teenager, who was sold as a sex salve across the bor­ders, end­ing up in Kuala Lumpur, Malaysia where she endured rou­tine bru­tal­ity and con­stant humil­i­a­tion. It was a huge shock to my sys­tem, as Malaysia is some­place I call my home town…  to read in such vivid detail the human rights vio­la­tion done to Srey Rath was stun­ning in every sense.

  These sto­ries of human per­se­ver­ance, injus­tice and ulti­mately hope, just like Srey Rath, are woven into three main issues: sex traf­fick­ing and forced pros­ti­tu­tion; gender-based vio­lence e.g. honor killings and mass rape and mater­nal mor­tail­ity. Sub issues include edu­ca­tion, micro­cre­dit and reli­gion. The sto­ries in the book are shock­ing, but ulti­mately this is the cen­tral truth of the book: Women aren’t the prob­lem but the solu­tion. The plight of girls is no more a tragedy than an opportunity.

  “It appears that more girls have been killed in the last fifty years, pre­cisely because they were girls, than men were killed in all bat­tles of the twen­ti­eth cen­tury. More girls are killed in this rou­tine “gen­der­cide” in any one decade than peo­ple were slaugh­tered in all the geno­cides of the twen­ti­eth century.

  In the nine­teenth cen­tury, the cen­tral moral chal­lenge was slav­ery. In the twen­ti­eth cen­tury, it was the bat­tle against total­i­tar­i­an­ism. We believe that in this cen­tury, the para­mount moral chal­lenge will be the strug­gle for gen­der equal­ity around the world. ”

  Through sto­ries, Kristof and WuDunn demon­strate how the key to eco­nomic progress lies in the fact that as a soci­ety, we need to stop ignor­ing women who hold up half the sky. Unleash­ing this incred­i­ble human poten­tial is not only the right thing to do in terms of our own shared human­ity, but also the best way to tackle poverty. They show how in vastly dif­fer­ent cir­cum­stances, the endurance of the human spirit and how a lit­tle help can go a long way e.g. the sim­ple act of iodiz­ing salt to improve a baby’s IQ.

  I won’t go into the details of the book because my sum­mary will not do these incred­i­ble sto­ries jus­tice. How­ever, on a per­sonal level, this book’s mes­sage has imprinted itself deeply within my beliefs in inter­na­tional devel­op­ment. After all, how many books make such a  state­ment about a mat­ter than con­cerns every­one because of our shared human­ity? The sto­ries of these women show me the resilience and amount of hope they have within them­selves who have every rea­son to give up but con­tinue on. It’s so mov­ing and inspi­ra­tional that I just want to shout it out loud and tell every­one about the issues Kristof and WuDunn have writ­ten about. If there is one thing that this book is about, it is the story of transformation.

  Rat­ing: 10/10

  “If you think edu­ca­tion is expen­sive, try igno­rance.” — Derek Bok