International remittances shape the livelihoods of people in many sub-Saharan African countries. The Gambia receives over $500M in remittances annually, reaching 15.6 percent of GDP in 2019.
With 1 out of every $4 sent in remittances going to healthcare, finding solutions that allow the diaspora to invest directly in the healthcare of their loved ones would reduce the amount paid in fees — financial intermediaries charge about $11 for every $100 sent to Gambia. Increase access to healthcare — only 4% of Gambians have health benefits and access to preventative medicine. And reduce the amount lost to medical tourism.
Starting with The Gambia, InnovaRx Global Health is on a mission to transform healthcare delivery in sub-Saharan Africa, pioneered by Ismail Badjie, a former pharmacy manager at Walgreens. In that role, he oversaw $1 million in inventory and generated $60 million annually.
In 2018, together with his co-founder Gerard Mengang, PharmD, Ismail left Walgreens to build a vertically integrated healthcare services company. InnovaRx scope includes brick and mortar stores, an e-commerce business, a global telemedicine platform, electronic health record (EHR) integration support, and a mobile clinical unit.
I spoke with Ismail Badjie, PharmD, CEO & co-founder of InnovaRx, about InnovaRx's impact on healthcare in Gambia, the role technology plays in their business model, and tips for diasporan entrepreneurs considering tapping into Africa’s tech ecosystem.
The journey to building InnovaRx: Traveling to 4 different countries.
It took us six years to get our first franchise opened because we wanted to first understand where healthcare was going. To get a global perspective, we traveled to India, Dubai, Germany, and China.
India’s the largest manufacturer of generic medications to the US but, on the flip side, the largest supplier of substandard medications to Africa. We traveled to India to understand the disparity in the supply chain between the US and Africa.
At the time, my dad was the Gambian ambassador to India, which made it more accessible. We built relationships with the specialty hospitals that were often manned and run by healthcare professionals trained at the top universities in the US. They built a robust ecosystem, and medical tourism alone was a billion-dollar industry. We wanted to see how we could leverage that model in Africa.
Dubai was embracing technology across all parts of healthcare, their e-commerce industry, logistic & delivery systems, pharmacies, and how they use data was progressive. We knew Africa was ripe for this level of innovation in healthcare and that if we implemented these technologies, it would put us 5–10 years ahead of everybody else in Africa.
Germany, as well as here in the US, had the latest point of care devices. These devices were the size of a cell phone and could tell you your cholesterol level in 90 seconds.
Every country we visited showed us what was possible, helping us ignore the current state of healthcare in Africa. Had we not, we would have created a substandard version of InnovaRx. Most companies create an African version of their business for the continent. We decided to do something different. We took a global idea and were intentional about Africa being the first people to receive it.
Now we’re delivering healthcare better than the US. Medications are cheaper at our facility here than they are in the US.
InnovaRx Business Model: Being vertically integrated
In addition to our travels, two statistics also helped shape our business model. Only 4% of Gambians have health benefits and access to preventative medicine, and last year 600 million dollars came into the country from people in the diaspora through remittances.
Our model allows the diaspora to purchase healthcare plans for their loved ones back home, and it’s cheaper than a plane ticket. You can purchase an annual subscription for $750, and it gives your loved one access to four prescription medications a month at no additional cost with free delivery, access to doctors, virtually or in person. The days of traveling to America or another country to get quality health insurance are over because we provide the same services.
To avoid being dependent on the existing ecosystem to work correctly, we decided to vertically integrate. We realized that even if we had the best pharmacy in the Gambia, if labs, health records, or logistics had issues, we wouldn’t have the impact on the healthcare ecosystem we desired.
We locked down distribution deals from companies in the US that provide prescription medications, over-the-counter medications, supplements, vitamins. We have an electronic health record system that we license out, do lab testing, and offer telemedicine.
What impact is InnovaRx having on healthcare in Gambia?
We’ve changed the landscape of healthcare delivery in Gambia forever. We’ve caused so much tension in the market because we established a new way of delivering care. If you are at your office and experience a headache or a toothache, you can go on our website and order ibuprofen or a pain relief gel. Within 30 minutes, it’s there. Or, if your mother lives in a village two hours away, you can order the blood pressure medication and get it delivered to her on the same day.
We’ve raised the standard. We’re showing people this is how it’s supposed to be done. A lot of players in the market have gotten away with not investing in innovation and technology. If you asked for medication, they would give it to you in a Ziploc bag or a piece of paper. The substandard healthcare that many companies offer to Gambians is why we could have so much impact on the country in a short amount of time.
In 18 months, we’ve become a household name when it comes to healthcare. Now Gambians who used to travel to Senegal for a simple test come to our facility and get their results within 60 minutes.
How is InnovaRx leveraging technology?
We own a cloud-based electronic health records system — Agastha EMR, which allows for data sharing across patients, families, and nurses. We also license Agastha out to other hospitals, clinics, and labs that want to digitalize. We’re currently transitioning the country’s only maternal and child hospital from manual records to digital records.
Point of care testing:
We have a Tech-enabled clinical operation where we utilize point-of-care testing. We have the technology to get a blood sample and test your hemoglobin or white blood cell count in a couple of seconds to see if you have an infection. We also invested heavily in portable technology that we could take to somebody’s grandmother’s bedside.
We have an E-commerce platform and brick & mortar facility for the distribution of retail healthcare products. Our logistics department, called Wellness on Wheels (W.O.W) allows us to deliver to our patients.
What were some of the challenges you’ve faced building InnovaRx?
When you start a company in Africa, you become a human development company because there’s a huge talent gap. You can’t put out a job posting and get qualified individuals. We’ve had to put significant resources into building our team up to operate at a high level.
Many companies are unwilling to invest what’s required to get their team performing at a global standard. Instead, they provide minimal innovation and ingenuity. It’s why people rather go into the commodities business because there’s little human development. Our goal is to continue building talent density by disrupting the pay scale locally to attract and retain high performers.
We spend a significant amount of money on backup generators, backups to the generator, and a backup Internet system because our solutions are cloud-based, and data is expensive in Gambia. It cost us about a quarter of a million dollars to get our facility up and running, including our startup inventory cost.
We source everything from the US, and while that means we can trust the quality of the product, it also means we’re paying a lot in shipping costs and are subject to delays. At times, during the pandemic, we had to use air freight to ensure we received our supply on time.
Being the first, you pay a tax for clearing the ground. But despite all these challenges, the value proposition is so strong that the business is self-sustaining. So as our supply chain improves, the talent pool improves, and our infrastructure costs come down, the company will become more and more valuable. But for now, it’s the cost of doing business in Africa.
Challenges with getting investment.
In the beginning, it was difficult because nobody had done what we are doing, which meant there was nothing investors could compare us to. Also, many found it difficult to understand why it was important for us to be vertically integrated. Unfamiliar with the African landscape, it looked like we were doing too much. They felt our model was too complicated and too risky of a proposition, especially at an idea stage.
Now that we have traction, it’s an easier sell because the business is performing well, and we’re only scratching the surface of what we can do. To date, we’ve raised most of our funds from young African professionals in the US, looking for places to invest that also relate to the pain point our solution addresses. We also raised funds from Startup Health, which gave us a stamp of approval and made the conversation easier.
But it’s still a tough sell. I think we'll be more valuable once we have InnovaRx Accra, InnovaRx Freetown, and InnovaRx Bissau. Then, we’ll be in a position where we can raise our Series A round.
How do you see InnovaRx evolving over the next 3-5 years?
Expansion! Gambia was always a pilot country, and so far, business is going well. Our performance last year exceeded my business plan. The beauty of our model is that we figured out logistics, so there’s no rush to open a second or third location here in Gambia because we can reach the entire country with our current location.
The next phase is expansion across west Africa. We want to replicate this exact model in places like Freetown and Accra. Being vertically integrated puts us at an advantage because any part of the company can be an entry point to a market, and then once we settle down, we can see what other opportunities there are to add value.
Tips to other entrepreneurs in the diaspora considering tapping into Africa’s tech ecosystem?
In the next 20 or 30 years, the wealthiest people in the world will come out of Africa. The population growth coupled with the opportunity for innovation is setting up Africa for the perfect storm. If you pay attention, every country is running here to plant seeds. It’s either you be one of the people who makes the sacrifice now to get in on the ground level or come back in 50 years and realize that non-Africans own everything.
We in the Diaspora have to decide because if we don’t make the necessary sacrifices now, somebody will own Africa, and it may not be us. I walked away from 160k in the US because I’m betting that in 10 or 20 years, InnovRx will change the trajectory of my family. My kids won’t have to go to a university in America, struggle to get a degree with six-figure earning potential and play the game of building generational wealth by somebody else’s rules. Instead, I’m building generational wealth here in Africa.
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