▪ How Can IFC support the Health Care Sector?
(products, value added)
▪ IFC’s Experience in the Healthcare Sector
▪ How can IFC work with the Health Care
Sector?
▪ Examples of Projects
2
Agenda
IFC is a Member of the World Bank Group
3
IBRD International Bank
for Reconstruction
and Development
IDA International
Development
Association
MIGA Multilateral
Investment and
Guarantee Agency
To promote
institutional, legal and
regulatory reform
Governments of
poorest countries with
per capita income of
less than $1,025
Technical assistance
Interest Free Loans
Policy Advice
To reduce political
investment risk
Foreign investors in
member countries
Political Risk Insurance
Est. 1945 Est. 1960
IFC International
Finance Corporation
To promote private
sector development
Private companies in
member countries
Equity/Quasi-Equity
Long-term Loans
Risk Management
Advisory Services
Est. 1956 Est. 1988
To promote
institutional, legal and
regulatory reform
Governments of member
countries with per
capita income between
$1,025 and $6,055.
Technical assistance
Loans
Policy Advice
Role:
Clients:
Products:
Shared Mission: To Promote Economic Development and Reduce Poverty
U.S
.$ b
illio
ns
Total committed IFC financing: US$20.4 billion
Ne
t In
co
me
(U
.S.
$ b
illio
ns)
Ne
t W
ort
h (
U.S
. $ b
illio
ns)
IFC’s Net Income and Net Worth
IFC – Over $100 Billion Invested in EM Since 1956
IFC FY13 Highlights
S&P, Moody’s AAA
Portfolio $65 billion
# of companies >2,00
# of countries 103
Sub-Saharan
Africa 15%
East Asia and
Pacific 14%
South
Asia
11% Europe and
Central Asia
21%
Latin
America
and the
Caribbean
21%
Middle East
and North
Africa 10%
Global
7%
Investments by Region
FY12
4
IFC Investment
Services IFC Advisory Services
IFC Asset
Management
Company (AMC)
Loans
Equity
Short term Finance
Syndications/Mobilization
Securitized finance
Client risk management
services
Treasury services
Liquidity management
Access to finance
Corporate advice
Environmental and social
sustainability
Infrastructure
Investment Climate
Launched in 2009, invests
third-party capital
alongside IFC
Permits outside investors
to benefit from IFC’s
expertise
The African, Latin
American and Caribbean
Fund co-invests with IFC in
Africa, Latin America, and
the Caribbean
Approximately US$4.2
billion under management
IFC Three Businesses Lines
5
Senior Debt
& Equivalents
Equity
Mezzanine /
Quasi Equity
Senior Debt (corporate finance, project finance)
Fixed/floating rates, in US$ or local currency
Commercial rates, repayment tailored to project/company needs
Long maturities: 8-12 years, appropriate grace periods
Range of security packages suited to project/country
Mobilization of funds from other lenders and investors, through
cofinancings, syndications, parallel lending.
Subordinated loans
Income participating loans
Convertibles
Other hybrid instruments
Corporate and JV
Typically 5-20% shareholding
Long-term investor, typically 6-8 year holding period
Not just financial investor, adding to shareholder value
Independent board member appointed by IFC provides Value added to the Company
Financial Products – From Equity to Debt
6
Global Industry
Expertise IFC’s Global Healthcare Team investment expertise and experience in emerging
markets with in-house health specialists adds value to its clients
Long-term
Competitive
Financing
IFC is a one-stop-shop for financing (equity, debt, structured finance, etc.) depending
on the Project
Longer investment horizon and less cyclical than most financial investors
Country Risk
Mitigation Reduced Political risk through Government Relations, Neutral broker Role, Preferred
Creditor Status
Withholding Tax Benefit
Regional
Knowledge Global and local presence in more than 100 countries with increase focus on local
presence.
Environmental &
Social Risk
Management
Advice on Environmental and Social Best Practices
Local Consultation and Disclosure
Corporate Governance
Capital
Mobilization IFC can mobilize funding: debt from commercial banks and other DFIs (syndications),
equity from investors (AMC), etc.
How IFC Differs From Other Partners
7
Agenda
8
▪How Can IFC support the Health Care Sector?
(products, value added)
▪IFC’s Experience in the Healthcare Sector
▪How can IFC work with the Health Care Sector?
▪Examples of Projects
IFC in Healthcare - Over US$2 billion Invested in Health
in Emerging Markets
Largest multilateral investor in the private health sector in Emerging Markets
Diversified portfolio across health services and life sciences
Large base of experience
In-house specialists
Support for public-private collaboration and investments
Successful long-term partnerships
Ability to work closely with World Bank on regulatory and business environment
Shareholders in over 35 health sector companies worldwide
Sector Highlights (to June 2013)*
Health Commitments US$2.75 billion
Health Services Commitments US$1.8 billion
Life Sciences Commitments US$643 million
# of companies 57
# of countries 38
9
IFC in Healthcare – US$2.75 billion invested in 38
countries around the world
10
Total Healthcare Commitments to June 2013* (US$ million)
Active portfolio: US$442.70
million (29% of health
portfolio)
IFC works with clients in
pharmaceuticals, biotech,
vaccines, medical technology,
pharmacy/distribution, and
personal care/cosmetics
Active Portfolio: US$1,089.69
million (71% of health
portfolio) investments
IFC works with a variety of
clients, including hospitals,
diagnostic chains, and HMOs
17.2 million patients treated
annually in health services
Health
Services
Life Sciences
* Does not include $15m in global transactions
349.7407.7 389.9 368.3
341.7
154.4
167.0
152.0
69.6
178.8
148.3
10.8
0
100
200
300
400
500
600
MENA Latin America Europe andCentral Asia
South Asia East Asia Sub-SaharanAfrica
Life Sciences Health Services
Agenda
11
▪How Can IFC support the Health Care Sector?
(products, value added)
▪IFC’s Experience in the Healthcare Sector
▪How can IFC work with the Health Care Sector?
▪ Examples of Projects
PROVIDERS
Hospitals/
Clinics
Outpatient
Physicians
Laboratories
Diagnostic
Centers
FINANCIAL
INTERMEDIARIES
HMOs
Insurance
SUPPORT SERVICE
PROVIDERS
Technology
Services
CROs
Healthcare
Logistics
Providers
DISTRIBUTION
CHANNELS
Distributors
Wholesalers
Pharmacies
SUPPLIERS OF
PROVIDERS
Medical Devices
Medical
Equipment
Drugs (Finished
formulations,
vaccines, etc)
Other Healthcare
supplies
IFC works closely with a wide range of parties to provide
financing solutions across the health industry.
Investment Possibilities Across Health Services
and Life Sciences
12
IFC works with a developed network of over 200 client and partner
financial institutions to provide health-related solutions.
Supplier
Finance
Pharma
Medical
Equipment
Consumables
Reach smaller
producers in
emerging
markets
Distributor
Finance
Medical
Equipment
Bring machinery
and technology
to emerging
markets
Risk-Sharing/
Credit Facilities
Health SMEs
Climate Change
Encourage
banks to cover
new sectors
Encourage
trade flows
Medical
Equipment
Pharma
Consumables
Trade Finance
IFC Healthcare – Wholesaling Initiatives
13
• IFC is a patient investor
that partners with young
companies to develop new
markets
• IFC brings expertise,
access to finance and
access to its unrivaled
network
• IFC’s involvement sends a
strong signal of support
and boosts credibility
• IFC assists clients through
transformations to reach
the next level in:
• Scale
• Corporate governance
• Regional expansion
• Internal processes and
social & environmental
and insurance standards
• IFC works with industry
leaders to provide support
in:
• Consolidating regional
networks
• Exploring expansion
opportunities further
afield
• Realizing successful
fundraising in
international financial
markets
Growth &
Transformation Early Development
Com
pany
Develo
pm
ent
IFC
reso
urc
es
IFC Investment at different stages of a Company’s
Development:
Mature Market
Leadership
14
Growth and transformation Early development
Mature market leadership
• Acibadem first became an IFC client with only 2-3 hospitals.
• Its eventual growth and successful sale to Abraaj was aided by IFC’s
presence A leading private healthcare
provider in Istanbul, Turkey
• IFC became the first outside investor in this family owned business and
has provided guidance on corporate governance.
• IFC’s long-term debt and equity package and strategic knowledge share is
supporting the company’s regional acquisition plan A leading pharmaceutical
manufacturer in Colombia
• IFC supported Alkaloid through an Advisory Project associated with its
investment to become the first in the region to achieve EU GMP
• Alkaloid has been able to leverage its EU GMP certification to become a
leading export focused producer in the region. Leading regional Balkan generic
producer and distributor
Growth &
Transformation Early Development Mature Market
Leadership
IFC Investment at different stages of a Company’s
Development:
15
Growth and transformation Early development
Mature market leadership
One of the largest private
healthcare providers in India
• IFC purchased equity of US$11m and preferred shares of US$56m
• IFC advised MHI on operational best practices that would improve the
company’s ability to become one of India’s leading health care providers
• IFC’s investment demonstrated support for Life’s emerging markets
expansion strategy
• IFC supports Life’s expansion into new markets through financing as well
as knowledge of emerging markets
The second largest private
healthcare group in South Africa
• IFC has been a long-term partner of Hikma in debt and equity since 1987
• The Company credits IFC with helping it to grow from a small Jordanian
generics company to expanding its presence across MENA, US and
Europe, achieving US FDA approvals and listing on the LSE in 2005
Leading prescription-only generics
company in MENA
• IFC assisted a medium-sized company to transform itself from a bulk
drug into an integrated company with R&D and formulation capacity.
• Today the company has a diverse portfolio leveraging cost advantages
from its diverse portfolio. Vertically integrated Indian
producer
Growth &
Transformation Early Development
Mature Market
Leadership
IFC Investment at different stages of a Company’s
Development:
16
How Can IFC work with Public Private Schemes?
• IFC’s counter part is always a Private Company or
Investment Vehicle
• The Private Company provides products, services or
solutions to the Public sector in the form of a public-
private partnership (APP, PPS, “Servicios Subrogados”,
etc)
• IFC can finance the Company or an SPV
In the case of an SPV, a waterfall mechanism is
pre-agreed, in which debt service is done after WK
needs are financed.
Project’s assets and agreements are placed in the
SPV until full repayment.
How can IFC work with Public Private Schemes?
SPV IFC
Financing
Debt Service
LT Contract
for WK,
Infrastructure,
etc.
Products Services Solutions
Service
Agreement
PUBLIC INTITUTION
COMPANY
Agenda
19
▪How Can IFC support the Health Care Sector?
(products, value added)
▪IFC’s Experience in the Healthcare Sector
▪How can IFC work with the Sector in general
and with public-private schemes?
▪ Examples of Projects
Representative Transactions in Health Services
20
Equity Debt and Equity Equity/Quasi-Equity Quasi-Equity Investment and
Advisory
US$4m Equity
2007
US$12m Senior Debt
US$29m Senior Debt
US$2m Quasi-Equity
2000, 2008
US$20m Equity
US$15m Senior Debt
US$10m Senior Debt
2008
US$10m Senior Debt
US$1m Quasi-Equity
2008
US$8m Senior Debt
Advisory
2008
US$8m Senior Debt
Advisory
2006
US$50m Senior Debt and
Equity
2013
US$4m Equity
2013
UST – Univ. of Science
and Technology Asian Hospital
Dar Al Fouad Hospital
Magrabi Hospitals AAR Healthcare Concord Aier
Hospital Metropolitano
US$93m Equity
2010
Life Healthcare
Sub-Saharan
Africa
Egypt
US$15m Equity
US$15m Debt
2012
MNT
Turkey
Saudi Arabia /
MENA
US$37m Senior Debt
US$55m Equity and
Quasi-Equity
2007, 2009
Saudi German Hospital Grp
MENA
East Africa
Philippines
China
Nicaragua
Yemen
China
US$45m Equity
US$55m Debt
2013
Fortis
India
US$40m Senior Debt
US$10m Quasi-Equity
2013
Alliar
Brazil
US$48m Equity
2012
IHH Healthcare
Asia
US$10m Debt
Green Building Advisory
2013
Hospitaria
Mexico
Debt Debt Debt and Equity Equity/Quasi-Equity Investment and
Advisory
US$20m Debt
2007
US$4.5m Equity
2005
US$8m Debt
2005
US$33.7m Debt and Equity
2009
US$88.3m Debt
2006, 2012
US$35m Quasi-equity
2000
US$45m Debt and Equity
2007
US$50m Debt
US$80m B-Loan
2012
Weigao
Fosun Pharma
Abolmed Orchid
Hikal
Tecnoquimicas
Bharat Biotech
Pliva Alkaloid
US$25m Equity and Debt
US$1m Cleaner
Production Loan
2007, 2009, 2011
US$7m Debt and Equity
Advisory
2007
Bio-Extracts EPZ
Hikma
US$164.3m Debt and Equity
Advisory
1987, 1989, 1993, 1994,
2003, 2011
US$9m Quasi-Equity
Advisory
1999
US$30m Quasi-equity
2001
Bosnalijek
US$14m Debt and Equity
1999 , 2005
US$3.5m Debt
2006
Biocon Group
Belcorp
Granules
Representative Transactions in Life Sciences
21
China
China
Russia
Latin
America
India
Ukraine
Colombia Croatia Macedonia
India India MENA
Bosnia-Herzegovina India Kenya