Open Africa Founder: Emilian Popa, Ilara Health
Providing life-saving diagnostics, one community at a time
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Hi friends 👋🏻,
Welcome to another essay on Open Africa.
Please permit me to rant a bit.
If you play FIFA, you’d probably be familiar with the different difficulty levels.
Beginner.
Amateur.
Semi-Pro.
Professional.
World Class.
Legendary.
Ultimate
If studying for an Engineering exam is on the Amateur level and getting a job is Professional then starting a business in Africa is Ultimate.
It’s tough. It’s truly tough.
Startups go through hurdles like low capital, absence of infrastructure, strict government policies (CBN et al, we see you) and so on. But despite all these, African startups are going strong!
The African Tech Ecosystem was on a massive tear in 2021⚡. Records were set, matched and broken multiple times.
More unicorns were minted in 2021 than in the prior years combined. A whole five - Chipper cash, Flutterwave, Wave, OPay and Andela.
We raised a record $4.65 billion in disclosed funding.
More businesses were funded- 564 up 42% from 2020.
The record for the largest single round was broken on more than 5 occasions with Flutterwave, TradeDepot, Gro Intelligence, Chipper Cash and Yoco all taking shots.
African tech seems to finally be having a coming of age moment.
But how can we build upon these successes to reach higher heights?
I wanted to speak about Oo’s and Jason’s “fight” the other week, but thankfully they came to a quick resolution. We don’t need such distractions but more unity.
mPharma’s CEO, Gregory Rockson gives us a guide on a proper way to do this.
While there’s great media on new fundraising and product launches, there’s less focus on “how” businesses are working. In the words of fan favourite, Emeka Ajene of Afridigest, we need:
…reliable sensemaking analysis that puts events & trends in the proper context and is actionable…for a variety of decision-makers.
So, this is my call to founders, investors and operators.
We need greater participation. Just as APIs give businesses superpowers of scale and speed, your insights on strategy, execution, hiring, business models etc propel more businesses to make fewer mistakes and reach success much faster.
Today’s article is a step towards stimulating more collaboration within the ecosystem. More participation means more innovation which leads to more ideas being turned into businesses.
Maybe one day, this knowledge would inspire great products built out of college dormitories and labs thus reducing the time from ideation to exit.
And we all know we want more of that😉.
P.S: I have some exploratory ideas on this. If you want to discuss more, you can send me an email or a DM.
End of Rant
TL;DR on Emilian and Ilara Health
Disclaimer: This is not a sponsored post and there was no commercial interaction between Open Africa and Ilara Health.
If you only have a few minutes to spare, here's what you should know about Emilian and Ilara Health.
Ilara Health is a healthcare startup bringing essential diagnostics and digital healthcare tools to Sub-Saharan Africa. Based in Nairobi, Kenya, they bring diagnostics to low-income communities where they are inaccessible.
70% of medical decisions require some form of diagnostics, like a simple blood test. More than 500 million people in Africa struggle to access or afford it. Seeing this, Emilian’s passion for the detection and early prevention of illnesses push him to start Ilara Health.
In their early days, they were building a product that had no market. Overcoming the pushback was difficult and so they had to train medical professionals to see the need for diagnostics services.
But, in under 3 years, they’re in 43 counties, partnered with 800+ facilities that work with >100,000 patients each month. They got their earliest clinics through government databases, “Chancing” and lab referrals.
P.S: If you’re thinking of how to manage sleep and live better, Emilian advises that you should consider buying the $300 Oura Ring. (Still, I don’t think I’d be getting this anytime soon😅).
Let’s get to it.
Hello Emilian! What's your background, and what is Ilara Health about?
I’m Emilian Popa and I’m the CEO and co-founder of Ilara Health. Ilara Health is a Nairobi-based healthcare startup bringing essential diagnostics and digital healthcare tools to Sub-Saharan Africa. We bring diagnostics to locations where these basic tools are inaccessible.
What motivated you to get started with Ilara Health?
I’ve spent the last 11 years building companies and investing in Africa. Before Ilara Health I was at DiGAME, the VC firm I grew for 4 years. As a biohacker, I have always been passionate about health, prevention, early detection and longevity. I went part-time at Ilara Health spending 6 months ideating health tech models before structuring what is now the Ilara model.
I went full time in 2019.
In early 2019, I met Dr Boniface. He runs a small clinic in Kawangware, just outside of Nairobi. He’s trained as a clinical officer who consults and dispenses medicines, tablet by tablet, to patients in his low-income community.
I asked him what he would need to do his job better and this was his reply:
I would need a small lab. For example, If a patient needs a blood test, I can’t do it because I can’t afford the equipment. So, I send them to a lab. Because of the high transport costs, the patient often does not come back.
That was an aha moment for me!
Since meeting Dr Boniface, I’ve visited more than 500 health clinics and community pharmacies, and the summary is the same; there is low quality and access to life-saving diagnostics.
70% of medical decisions require some form of diagnostics, like a simple blood test. And there are more than 500 million people in Africa today who struggle to access or afford it. Seeing this, I became even more motivated to support these communities with better clinical and laboratory services.
What went into building the initial product?
In the early days, we wanted to learn from healthcare providers directly, so we conducted a pilot with 5 healthcare providers; facility owners, managers and clinical staff. We learned that they wanted better, smarter diagnostics for their patients, but lacked the financing and tech skills required.
One of the biggest challenges we encountered and continues even today is our geography.
In Kenya, the healthcare ecosystem, particularly the primary healthcare ecosystem is fragmented. This means that there are over 15,000 small, primary healthcare facilities. With small clinics spread across large areas, there aren’t enough patients visiting each facility to make diagnostic devices economically viable.
Then there’s the issue of expertise.
These facilities are run by nurses and clinical officers, not doctors who have core clinical expertise. For this reason, only basic tests are recommended, because there is a belief that there is no need for anything more complex. Take Vitamin D for example (a vitamin that regulates the processes of the body), no one tests for it because it is not properly understood.
Due to these reasons, we can’t do anything complex and so we were limited to working with the basics.
In our pilot, we placed devices in 5 clinics to monitor their use. We saw early traction that informed us that something could be built. But we wanted to make the device affordable and also go above the basics.
Facilities told us they need more than just diagnostics. They also needed medications, improved facilities and access to finance.
So, we built a platform that acts like an EMR (electronic medical record), but also records patient payments and manages clinic expenses. The clinics use Ilara Health to build their reputation. But many facilities are too small to be able to make money. We work with those facilities where the person who runs it, whether they’re a nurse or a clinical officer, is also an eager entrepreneur that wants to be trained to run a better and bigger business.
What was the journey to attract and grow the first 1000 clinics?
In under three years, we went from 5 clinics in 2019 to about 800 clinics equipped and using our devices. With an increasing number of patients and tests administered, we raised our $735k seed round in 2019.
Our approach is both top-down and bottom-up.
We combine the databases provided by the government with google maps to get a clear profile and location of clinics. Our sales teams do what is called Chancing. They take an area in the outskirts of Nairobi, go street by street, door to door to register new clinics.
In addition to these, we grew our menu of tests to meet the different needs of clinics. We considered lab referrals.
Is there a lab? What tests do they do? What can they get paid for? Who can provide us with access to more clinics? The lab referrals were a success. We were able to reach more clinics and introduce new devices. These devices check and diagnose cholesterol levels, haemoglobin A1c (the key diabetes marker), blood sugar, weight etc. We even added a portable ultrasound device for Antenatal Care (ANC).
Where a device didn’t meet the need, we built centralised labs with a Hub and Spokes model. We are always identifying new disease areas. Take eye care, for example, so many taxi drivers in Nairobi can’t see well, but no one considers ophthalmology.
One tactic that didn’t work was working with some organisations that federalise healthcare facilities. We didn’t see traction there.
What's your business model, and how have you grown your revenue?
We began with providing access to life-saving diagnostics to primary care facilities through smart financing and forming a network. We then layer mHealth tools on top, the same devices used for diagnostic and patient care described previously. Finally, we integrate these solutions into our digital platform.
We measure our success by the number of providers and primary care facilities in our network. We are currently active in close to 800 facilities in Kenya. These primary care facilities are the gateway to millions of patients across sub-Saharan Africa.
We were bootstrapped for the first 6 months. Now, we have raised close to $6m in our Series A and seed funding rounds and participated in accelerators including the Making More Health Accelerator led by Ashoka and Boehringer Ingelheim, MIT Solve, and Google Accelerator for Startups.
What are your goals for the future?
I’m proud of our growth in the number of facilities we are present in, and the number of people we have tested. In under 3 years, we have entered 43 counties, partnered with about 800 facilities leading to a direct pathway to 100,000 patients each month.
We are also looking at new markets across East and Southern Africa.
Our goal is to push this model but also finance more needs of medical facilities with diagnostic devices. This will help them grow and eventually standardise the services and care they provide. We’re looking to fund more facilities that can be transformed into better and bigger clinics.
Building a business is hard, building one in Africa is a lot harder. What was your most 'if I perish, I perish' moment that turned out to be worth it? What were the stakes for you?
It was finding the product-market fit for diagnostics.
I was essentially building a business for which there was no market, and we stalled at around 15 facilities. Recently, I read a book that shared a story of Indomie’s expansion into Nigeria. No noodle market existed. Today, they are a household name, showing there is always a way. For Ilara Health, we had to train medical professionals to see the need for diagnostics services to create the market.
How did you motivate yourself and your team to avoid failure when things were tough? Do you ever think about giving up, and how do you push through that feeling?
Personally, Ilara Health is a very deep passion. It's always been my goal in life to pursue detection and early prevention of illness. So I am highly motivated to push through. Failure is unacceptable. Still, when hurdles come, you can always pivot and find a solution. For the team, we are all motivated by the same goals. We see a huge need, and we never give up.
Have you found anything particularly helpful or advantageous?
Humanity awakened when Covid struck.
People realised they needed to pay closer attention to their health. Looking at metabolic diseases like diabetes and sickle cell anaemia, it was mostly people with these conditions that died of covid first. We have to consider how we can get stronger, and increase our immunity.
There will be other pandemics in the future which makes the need for better healthcare even stronger.
I am inspired by the leaps in innovation we are seeing in health tech. The world is moving really fast.
We are surfing a wave of exponential growth of miniature/comfortable diagnostics. Health tech is almost becoming a part of people’s lives whether it’s in their homes, on their bodies or even in their bodies. In 5 years, we could be at home, put our fingers in a machine and do our blood tests. Take the Oura Ring, for example, which can measure your sleep and heart rate.
We look at these trends, take the advanced version and find a way to bring it to the market in a cheaper way.
For fun
Measuring my sleep has been one of the biggest “aha moments”.
Less than two years ago one of our investors said
If you want me to invest, I will give you an Oura Ring to understand your sleep, physical and mental health.
Since then, I have been able to monitor my sleep quality. It may drop or rise significantly depending on when I eat, if I have a glass of wine or even if I look at my phone before sleep. All these help me understand their impact on my physical and mental health.
Today, I use this information to improve my performance and happiness.
One African founder you’d love to have dinner with: Definitely Sim Shagaya. Even though I’ve had multiple dinners with him, he remains a great friend as I’m always learning from him.
Where can we go to learn more?
website: www.ilarahealth.com
Personal website: www.emilianpopa.com, https://emilianpopa.com/my-six-daily-practices-for-a-healthy-life/
Twitter: @emilianpopa
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Thanks for reading and see you soon.
Kamso.