JA: I’m with Emilian Popa. I’d like to welcome Emil. Emil, are you there?

EP: Yes, thanks, Jerry. Can you hear me?

JA: Yeah, we can hear you just…

EP: Awesome, great.

JA: Loud and clear. So thank you so much for coming on. We appreciate it. It is much later over there now.

EP: Yeah, Nairobi time.

JA: Those in the audience that don’t know who you are, we’d love to hear a little bit about your background. If you give everyone about a 60 second intro about what you’re doing right now with Ilara Health.

EP: Sure, sure. So I’m a healthcare entrepreneur. I’m obsessed about prevention and early detection and about healthy living and improving the health of millions of people through prevention and early detection. At Ilara Health, we’re building a technology enabled primary care network of clinics in Africa, where we power existing clinician entrepreneurs running small primary care facilities. We upgrade them with technology, assets and learnings to be able to turn them into better clinicians and eventually bring them under one single umbrella of quality of care, which is Ilara Health.

JA: No, wonderful. Thanks so much. And we heard earlier around about the different diagnostic devices that Dr. Baby was using, also from the UN. But he didn’t really go into much about what the market looks like in Africa at the minute. We’d love to hear about what that market sort of looks like at the minute. And also, like what the primary care and access also looks like in Africa at the minute, this being an equity or health equity symposium.

EP: Absolutely. So I just I usually use an example. So let’s imagine, Jerry, that you step out of your apartment block, wherever you live in the US. And then instead of finding maybe one medical practice in your neighborhood, you’re going to find 100 of them every single other 20, 30 meters and maybe another 100 pharmacies in your one mile area. But none of those small medical practices have a doctor, but have usually a nurse practitioner who’s unfortunately very basically trained. And therefore, the access to care is not a problem. And that’s a big controversial topic what we say in Africa, there is no access to care. Actually, there’s way too much for the quality of care is the massive issue. All the small clinics have 5 to 10 patients a day because there are so many that don’t have access to financing. They can’t go to a bank and get money to increase the size of the clinic, to bring medical devices. They don’t have access to training. They don’t have systems. They don’t have enough patients. And the result of this is that the quality of care is horrendous. Care is completely out of pocket at primary care level. Patients pay $7 to $8 every time they step into one of those clinics. Consultations are usually free. The rest is actually finishing, setting medication inside a clinic. A Kenyan spent about $70 per year in the whole care ecosystem, half of which is medication, compared to an American spending probably in the $10,000, similar insurance, or a European spending $3,000 to $5,000. So what can you do with $70? It’s very little, but that’s how the market looks like. So fragmentation is the biggest issue of those markets, and all the problems come from the fragmentation.

JA: Really wonderful stats that you can give to us. Definitely stats that I wasn’t aware of, living in America, and obviously having grown up in the UK as well. It’s really great to be able to understand sort of what the market access sort of looks like in Africa at the minute. In terms of primary care and access in Africa, we’d love to hear a little bit more detail maybe around that before sort of starting to talk about what’s being done right now to sort of help increase health equity in Africa at the minute.

EP: Yeah, so sure. Look, I mean, most of the primary care, if you look at, I mean, there’s a public system, which has hospitals and small care centers, mostly in the countryside. They don’t really cover the kind of the big cities and the most massive outskirts of the African cities, which extend over 30, 40, 50 miles. Most of the primary care, targeting the mid to low-income individuals, is actually private, run by nurses, entrepreneurs because those nurses do not have jobs in the public sector, in the formal economy. Only 20% of Kenyans are employed. Therefore, if you come out of a nursing school of any kind of med or pre-med school, you don’t have a job. What do you do? You go and build a small clinic. You call it hospital, and then you expect to get patients. That’s how the kind of the primary care is run. All those things are independent. Very, very little consolidation. Again, out of pocket completely. Geoffrey was talking earlier about value-based care. We’re not even in the very basic sick care, without even thinking of value-based care or preventative care or anything else. The basics are not there. And then again, most of those clinicians make money through selling 70%. They make all about $2,000 to $3,000 per month in revenue, sell mostly medication, like 70%, 80% of the value of the consultation is actually medication. There’s a bit of diagnostics that have any kind of rapid test. They have no diagnostic devices whatsoever, and the rest is actually very, very basic procedures.

JA: Yeah, no I mean look, it’s – you’ve highlighted that it’s such a massive issue that it’s not going to be fixed overnight of course in such a large continent of the world, but in terms of the areas that you were talking about and of course most importantly what you’re doing at Ilara Health at the minute. How do you see or what do you think can be done to sort of change what’s going on with health equity in these different areas and how that can be increased? And of course really focusing on what you’re doing with Ilara right now.

EP: So we’re really trying to say if you’re one of the lucky 2%, 3% of upper income Kenyans or even countries around, then you have access to proper care. There’s hospitals, there’s private clinics, there’s everything. The question that – the problem that we’re trying to solve is how can we bring the same level of quality but to the 97% of the people for the price those people can pay which is probably one-tenth of whatever a high income individual can pay. And the good news is this is possible. It’s not easy, but it’s possible. It’s possible through technology. Technology is not everything. So what we’re building here is a mixed of tech, both systems and the hardware but apply to existing infrastructure. So when there is no infrastructure, one can build the best AI powered symptom checkers and the best portable ultrasound and the best cholesterol analyzers which test – cost per test is super small but you need some kind of physical infrastructure where you can replace those assets. You need some kind of individual clinicians trained to be able to deliver care. So what we’re building here is really we go to the existing broken infra and we upgrade this infrastructure both in terms of physical walls embellishing this infrastructure placing the right portable diagnostic devices most of them are tech powered, AI powered or anyone’s tech powered places to build our own or EMI electronic medical records with different symptom checkers and we try to use whatever is out there in terms of technology, AI or not AI, and upgrade these very basically trained clinicians and this very basic infrastructure to get it to the right level of quality by keeping the prices low.

JA: No, that’s really, really wonderful. And all of – it’s great to be able to highlight all these different things in terms of what needs to be done in each specific area but of course it’s going to be – it’s going to take time, I think is – I think would be the other element that we would want to probably add to that as well. But Emilian thank you so much for coming on again, really appreciate you taking the time to come and talk to the audience about the important work that you’re doing at Ilara Health and letting us know about what the current market and access looks like in Africa. If you do want to get in contact and find out more about Ilara Health, Emilian’s information is going to be in the chat. So please do connect with him, find out more about the important work that he’s doing in Africa with Ilara Health. And Ilara, thanks so much for being on today.

EP: Thank you very much, Jerry. Bye-bye