The target audience is impact investment stakeholders with an interest in Sub-Saharan Africa, private sector development as well as good health and well-being. The problem addressed is that Sub-Saharan African faces a disproportionate spend on healthcare to the burden of disease. The private sector delivers quality healthcare and medicines in the region but growth is challenged by a lack of funding. Funding private sector health represents a lucrative investment opportunity, as well as lucrative social return on investment. This presents an opportunity to blend public and private stakeholder capital to crowd-in investment through risk mitigation in the capital structure.

1. 0 African access to healthcare and medicines impact investment fund
African access to healthcare and medicines impact investment
fund
December 2015
An innovative purpose-driven blended capital investment vehicle delivering socio-economic
development impact by increasing availability of affordable, good quality healthcare and
medicines in Southern Africa through loans to sustainable enterprises operating at critical
points of the health value chain
©

2. 1 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
AFRICA: The growth story is real and the private sector is
participating
Source: Ernst & Young

3. 2 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
PROBLEM: Sub-Saharan African faces a disproportionate
spend on healthcare to the burden of disease
11%
24%
1%
Sub-Saharan Africa
Rest of World
World’s
Population
World’s
Disease
Burden
World’s
Healthcare
Spending
2.2x more
disease
10x less
resources
Burden 1: Sub-Saharan Africa has
2.2 times more disease per capita
than the rest of the world combined
Burden 2: Healthcare spending in
Sub-Saharan Africa is 10 times less
per capita than the rest of the world
leading to tremendous healthcare
challenges
Source: IFC

4. 3 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
OPPORTUNITY: The private sector delivers quality healthcare
and medicines but growth is constrained by lack of funding
Private, for-profit healthcare providers already
serve a large portion of the population…
4445
53
64
48
61
67
51
EthiopiaNigeria Uganda Kenya
Source: IFC
Population (%) receiving care from private, for-
profit providers of modern medicine
Highest Income Quintile
Lowest Income Quintile
…but are currently limited by a
severe lack of funds
Market surveys indicate lack of financing is
impeding the growth of heath care providers
• A market research study of private providers in Zambia
in 2007 found that almost 90% of respondents had not
applied for a business loan in the last three years.
• In Nigeria only 15% of surveyed physicians and patent
medical vendors and 10% of nurses/midwives have
applied for business loans in the past three years.
• A study in Ethiopia identified financing as one of the top
two constraints in the development of the private health
sector.
Situation is unlikely to change due to
established barriers to entry
• In many countries, financial institutions don’t
lend to the health sector in a significant way.
• High risk, public good, lack of market
information, collateral, poor quality applications.
• In some countries the regulatory environment
restricts lending.

5. 4 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
OPPORTUNITY: Funding private sector healthcare and
medicines represents a lucrative investment opportunity
Numerous investment opportunities
have been identified
Source: Promoting Sustainability of Health Markets: Financing Private Health Providers in Africa – Shops presentation;
IFC; IMS Health Market Prognosis;
• The IFC estimates the SSA private investment
opportunity between $11-20 billon
• IMS Health has identified $3.6 billion of
investment opportunities in SSA’s 10 largest
cities alone
There is a market opportunity for impact investors to fund the
development of the SSA healthcare and medicines sectors
The African healthcare industry
is growing at a tremendous rate
Morocco
$1.2B
6%
Nigeria
$1.8B
13%
S. Africa
$3.7B
8%
Botswana
$56m
12%
Kenya
$659m
17%
Egypt
$3.0m
14%
Country
2011 Sales
’11-’16 CAGR
Algeria
$2.8B
9%

6. 5 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
ENTERPRISE REQUIREMENTS: Capital and technical
assistance are vital throughout the business cycle
Proof of Concept Incubation Growth Stage
Scaled
businesses
Commercial
Blended
Social Grants / CSI
Impact Investment /
Blended Capital
Impact Investment /
Blended Capital
Private Equity /
Commercial
Finance
IPO / Commercial
Finance
Grants / CSI
Angel Funding /
Venture Funding
Impact Investment /
Blended Capital
Grants / CSI
Impact Investment /
Blended Capital
Grants / CSI
Technical Assistance
Self Funding /
Angel Funding
Unique asset class dynamics demands bespoke
capital allocation and technical assistance design
Capital
Source: Ubuntu Capital & Advisory

7. 6 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
An impact investment
advisory & technical
assistance facility for
financial intermediaries
developing investment
products with
development impact1
objectives in sub-
Saharan Africa. The
project is to be grant
funded but financial
intermediaries need to
demonstrate meaningful
financial commitment to
the product
development process.
SOLUTION: Catalyse impact investment products by
‘subsidising’ components of the development process
Impact Hypothesis
Development & Testing
Investment
Products
Financial
Intermediaries
Investors
Impact
Capital $
Product Development &
Structuring
Market Assessment &
Development
Impact Investment
Advisory & Technical
Assistance Facility
Private Sector
Enterprises
ESG & Impact Management
Strategy & Process Design
Technical Assistance Strategy
& Programme Design
Fundraising & Promotion
Governance & Oversight
Investment Support
& Capacity Building
Project
1. Development impact = the potential for an investment to result in positive social; economic and/or
environmental impact

8. 7 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
SOLUTION: Provide loans to enterprises to increase access
to healthcare and medicines in Sub-Saharan Africa
Fund
Investor
A
Fund
Investor
B
Fund
Investor
C
Africa
access to
healthcare
& medicines
fund
Fund Investors PPP Fund Management JV Beneficiaries & Co-investors
Board of
Directors
Advisory
Panel
Investment
Manager
Impact M&E
Manager
Capital Invested
Principal &
Interest
Increase Access
Market
Intelligence
Market
Development
Manufacturing
Distribution
Procurement
Diagnostics
Rational Use
Capital Loaned
Principal &
Interest
Tech Assistance
Increase Access
Technical Assistance Fund
CreditGuarantee

9. 8 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
OBJECTIVE: Catalyse investment into the health private
sector to achieve socio-economic development impact
• Socio-Economic Development Objectives
– Increase access to healthcare and medicine:
 To deliver measurable social and development impact by increasing access to
affordable, good quality healthcare and medicines in Sub-Saharan Africa…
– Local economic growth:
 …through the growth and development of sustainable private sector enterprises
operating at critical points along the health and medicines value chain,…
– Pro-Poor:
 …targeting investments that benefit the base-of-the pyramid.
• Financial Objectives
– Market related investor return:
 Target a net portfolio return of 4-6% per annum.

10. 9 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
STRUCTURE: Funding structure crowds in private financing
through 1st loss and credit guarantee risk mitigation tools
Investment Class
• The capital of the Fund consists of:
• 1 non-redeemable ordinary share
which will be held by the promoter
of the Fund;
• Class A Shares providing for 1st
loss capital
• A limited recourse secured
debenture programme providing
for senior debt participation
1. SME – Small to medium enterprises;
2. MFI – Micro finance institution and non-banking financial institutions
3. Public Private Partnerships
Legal Structure
• The investment company is a Mauritius
domiciled open ended private company
with limited liability
• The company holds a Category 1
Global Business Licence issued by the
Mauritian Financial Services
Commission
Investors Investors
Equity Debentures
SME’s1 MFI’s2
Board of Directors
Credit Guarantee
Loans
Investment Manager
African access to healthcare and
medicines fund
PPP’s3
Investor Portfolio
Committee

11. 10 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
BLENDED CAPITAL STRUCTURE: balance reaching the
poorest populations with ensuring acceptable risk levels
SHAREHOLDER CLASS A SHARES DEBENTURE
RISKS
1st Loss1 Tranche Yes No
FINANCIAL RETURN
1st Distribution (capped at 4%) 2nd preferential distribution 1st preferential distribution
2nd Distribution
Equal distribution based on
investment holdings and
remaining income
Equal distribution based on
investment holdings and
remaining income
Notes:
Loss refers to any losses incurred on an underlying investment that stems from a default or non-performing debt instrument that the
Fund holds in its portfolio. This does NOT apply to any expenses incurred by the Fund in its on-going operational business or under-
performance stemming from exchange rate fluctuations etc.

12. 11 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
INVESTMENT THEMES: Two core corporate investment
themes have been identified
–Companies looking to scale their operations: Start-up
companies that have successfully used grant or venture capital
funds to develop and prove their operating model and now want
to grow into new locations.
–Companies struggling with high cost of debt: A number of
established companies have a disproportionally high cost debt
given their low risk profile. By accessing lower cost debt the
companies will be able to pass savings onto their customers
(either the local public sector, aid agencies or directly to local
consumers) or expand their operations.

13. 12 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
25
100
180
140
145
160
6050
200
80
50
220
60
45201510 55
40
120
20
0
403530
Nigeria
Madagascar
Kenya
Ghana
Zambia
Malawi
Botswana
Ease of doing
business ranking
Tanzania
Lesotho
Population living on
less than $2 per day
(Millions)
Ethiopia
Rwanda
Uganda
Zimbabwe
South Africa
Congo, Dem. Rep.
Mozambique
Namibia
INVESTMENT UNIVERSE: balance reaching the poorest
populations with ensuring acceptable risk levels
Requires grant or
equity funding
Suitable for
debt funding
Note: Doing business rankings adjusted to reflect advantages AMIIF will enjoy through links to ministries of health etc.
Source: World Bank; doingbusiness.org, Internal Analysis
Poor vs. Least Developed
It is important to note the difference between
poor beneficiaries and LDC's. Middle income
countries still have many poor people and
from a population size perspective actually
offer relatively large poor populations where
investments can have dramatic social impact

14. 13 African access to healthcare and medicines impact investment fundAfrican access to healthcare and medicines impact investment fund
TECHNICAL ASSISTANCE: Human capacity development and
business development support services alongside capital
Healthcare
Fund
Financial
Intermediary
Donors Investors
Investment $
Monitoring and
Evaluation
Healthcare Investment Companies
Business
Development Support
Human Capacity
Building
Technical
Assistance
Investment $Grant $
*Including AMSCO

15. 14 African access to healthcare and medicines impact investment fund
IMPACT SUMMARY: Fund Activities and objectives aligned
with the Sustainable Development Goals