Up to $30 billion investment needed for health sector

According to a recent study, $25–$30 billion in new investment will be needed in health-care assets, including hospitals, clinics, and distribution warehouses over the coming 10 years to meet the growing health care demands of Sub-Saharan Africa. The study is “The Business of Health in Africa: Partnering with the Private Sector to Improve People’s Lives”, prepared by the International Finance Corporation (www.ifc.org) with consultancy McKinsey & Co www.mckinsey.com.
It notes that health care in most of sub-Saharan Africa remains the worst in the world. The region has 11% of the world’s population, yet bears 24% of the global disease burden and commands less than 1% of global health expenditure. Increased attention from outside donors has resulted in some remarkable initiatives, funneling billions of dollars to help combat HIV/AIDS, tuberculosis (TB), and malaria the worst health scourges of the region. In spite of billions of dollars of international aid, an astonishing 50% of Sub-Saharan Africa’s total health expenditure is financed by out-of-pocket payments from its largely impoverished population. Because of economic growth, the study estimates the market for health care will more than double by 2016, reaching $35 billion.
Most of the sub-Saharan Africa lacks the infrastructure and facilities to provide and deliver minimal levels of health services and products. It also faces a severe shortage of trained medical personnel, with just 3% of the world’s health workers deployed there.
The IFC report highlights the critical role of the private sector in meeting the need for more and higher-quality health care and identifies policy changes that governments and international donors can make to enable the private sector to take on an ever more meaningful role in closing Africa’s health care gap. About 50% of health-care provision already comes from for-profit companies, non-profit organizations and social enterprises, along with insurers, providers, and manufacturers. Their role is growing.
The expected improvement in Africa’s macroeconomic climate over the next decade will expand the health care gap, as higher incomes will create new demand. The biggest individual investment opportunities will be in building and improving the sector’s physical assets. Around 550,000–650,000 additional hospital beds will need to be added to the existing base. An additional 90,000 physicians, about 500,000 nurses, and 300,000 community health workers will be required over and above the numbers that will graduate from existing medical colleges and training institutions. Demand for better distribution and retail systems and for pharmaceutical and medical supply production facilities will also be strong.
An estimated $25–$30 billion in new investments will be needed to meet demand between now and 2016—of which $11–$20 billion is likely to come from the private sector. A broad range of investment opportunities exist across all components of the health care industry in the region (as described in detail in the annexes to this report). These opportunities can deliver compelling financial returns and have an enormous potential development impact.
Health care provision accounts for roughly half the investment opportunity, with the remainder split across distribution and retail, pharmaceutical and medical product manufacturing, insurance, and medical education. These investments will fund capacity expansion, new businesses, and renovation of existing assets. About half of these investments are expected to be made by for-profit entities, the remaining portion of private sector investment being equally spread between social enterprises and nongovernmental organizations (NGOs).
The vast majority of the investment opportunities in the near term will be in the SME sector. Only a quarter of the opportunities are expected to have a project size larger than $3 million. This report also highlights the availability of investment opportunities in social enterprises that, while delivering lower financial returns, can have a tremendous role in the positive development of Sub-Saharan Africa.

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