– Logan Brock, MS2 –
On the most recent episode of the Penn HealthX podcast, we had the opportunity to speak with BA Sillah, an MD/MBA student who recently graduated from Wharton and the Perelman School of Medicine.
BA has a BA in Human Developmental and Regenerative Biology from Harvard. He researched bio-fabrication while at Harvard, then came directly to medical school after graduation. While at Penn, he worked as a Hospital Management Intern with the King’s Sierra Leone Partnership, an Operational and Investment Fellow at the Excelsior Group, where he evaluated venture investments on the African continent, and as an intern in the Specialty Pharmacy Department at Penn Medicine.
Some takeaways from our discussion:
1. Healthcare on the African continent varies widely by country
BA highlighted for us the disparities in healthcare between different nations in Africa, as each country uses a different strategy to guide the structure of its healthcare system. Some countries (Egypt, Tunisia, South Africa) have healthcare systems rivaling that of the United States, while others have fledgling systems that are still in early stages of development. As a result, the continent provides a myriad of examples of the various ways to set up a healthcare system, which will provide interesting insights about what types of healthcare systems can and cannot work effectively.
Another interesting challenge for healthcare in Africa is the changing socioeconomic landscape of the continent as countries develop and a growing middle class emerges. In the face of this change, healthcare systems are forced to decide whether to tailor their systems to serve the emerging middle class, who can generally afford to pay some of the cost of their healthcare, or whether to focus on providing care at low/no cost to the poorest citizens. As one example, Ghana provides National Health Insurance that covers all of its citizens – however, a private insurance market exists for the middle class who want to pay more for additional benefits not provided by the national plan.
2. Economically viable companies are more sustainable than charity care
Currently, charity care makes up an appreciable proportion of the medical care available on the African continent, particularly in less-developed nations. While charity care is provided with good intentions, it has unintended consequences. The provision of care by volunteers who only stay for a couple weeks leads to serious gaps in the continuity of care and a lack of long-term follow-up. Additionally, the myriad organizations that travel to provide charity care often do not share records – thus, it might be challenging or impossible for a patient to locate their own medical records. Conversely, investments in economically viable enterprises allows for the development of more sustainable healthcare delivery. If a company is of sufficient quality to attract venture investment and can provide a return on the invested capital, it indicates that the business model is sustainable. Instead of relying on providers to continue to donate time and money, these organizations will continue to exist for as long as they continue to generate a profit. Thus, venture investments in healthcare in the African continent help to ensure that a healthcare ecosystem develops that can sustain itself, instead of relying on transient volunteer care.
3. Investing in Africa requires wearing many hats
During BA’s internship at Excelsior, he saw firsthand the challenges facing healthcare companies on the African continent. As an example, he spoke with us about his work on a pharmacy company that was looking to expand into another African nation. He found that the initiative was fraught with challenges ranging from a complicated supply chain to a plethora of counterfeit medicine. He had to look beyond the company itself and work for increased regulation of pharmaceutical manufacturing to ensure the authenticity of medicines. In another project, he found that to help a diagnostic company succeed, they had to go beyond marketing and go directly to hospitals and medical schools to educate physicians on the use of ultrasound. As a result, the work BA performed to ensure the success of investments had positive benefits on the entire healthcare system.
We really enjoyed sitting down with BA to hear about his experience learning about and investing in the healthcare industry on the African continent. He showed us the ways that venture investments could lead to an independent and self-sustaining healthcare system and create unexpected positive benefits for the healthcare system. We’re excited to see what he does next!
– Logan is a second-year medical student at the Perelman School of Medicine. He is the co-VP of curriculum for Penn Health-X, an occasional co-host of the Penn HealthX podcast, and a contributor to the Penn HealthX blog. You can contact him at firstname.lastname@example.org –