The Fred Hollows Foundation, in conjunction with partners, will become the first investors in a new social enterprise designed to provide funding for eye care centres throughout South East Asia.
Alina Vision is a collaboration between the Fred Hollows Foundation, social entrepreneurs David Green and Ben Midberry, and Japanese pharmaceutical company ROHTO. Alina Vision “will deliver high-quality, accessible and sustainable eye care for people of all income levels, actively reaching out to those excluded from mainstream healthcare systems, particularly low-income people and women,” and the first Alina Vision eye care centre is set to open in Vietnam this year. Further centres are planned for a range of other countries including India, Indonesia and China.
“We’ve been examining options for a little while to tap into the impact investing market, and leverage the donations we receive to bring in investors,” said Kirsten Armstrong, director of knowledge and innovation at The Fred Hollows Foundation. “One of the key challenges has been building the right sort of, dare I say it, product that will meet a social need as well as attract the impact investors. That’s been an underlying approach we’ve been exploring. We know that the social enterprise model can work – there are good examples out there. A classic one is Aravind Hospital in India, where they have the social enterprise model right. It’s an efficient, strong hospital that cross-subsidizes by charging wealthier patients a higher fee.”
The Fred Hollows Foundation said it expects that nine Alina Vision surgery centres will be opened in the next three years, laying the foundation for scaled growth in the second phase of expansion, which will see up to 10 new surgery centres opened annually.
“The Fred Hollows Foundation is providing grant money to launch each new surgery centre,” Armstrong said. “We focus on the soft costs – doing the original business planning, training new staff, equipping the facility with the right machines that go bing, getting the business model right, and the clinical protocols. What we’ll do is bring in the investors to support the hard start up costs – building refurbishment, and so on. For us, we looked at what we could achieve with the grant funding alone, as if we were to grant-fund the whole hospital. We could do seven times as many hospitals if we could use the grant money as an investment.”
Japanese pharmaceutical company ROHTO, is the first private sector investor in the social enterprise. ROHTO has been distributing over-the-counter eye drops for more than 100 years and its range of products is distributed in more than 110 countries. The company recently broadened its focus to include cosmetics, food and agriculture, as well as sustainable systems that have a positive impact on society.
The Vietnam eye centre is seen as a pilot, but all centres will be led by “outstanding local medical professionals and will treat the main causes of preventable or treatable blindness, in particular cataract,” the Fred Hollows Foundation said. Cataract is the leading cause of avoidable blindness worldwide, affecting more than 25% of those who are blind or vision impaired.
For Alina Vision co-founders David Green and Ben Midberry, the organisation has been built using the lessons learned from the experience of microfinance organisations and is designed to blend philanthropy to address barriers to growth and private capital to fund scale.”
“What my co-founder and I decided is that we wanted to seek out a professional, socially motivated organisation that has been in caring for a long time,” said Midberry, who is managing director of Alina Vision. “The Fred Hollows Foundation is that. We have a great fit by having a non-profit as our major shareholder, and there is ownership and ownership and governance to make sure that everyone knows this is a kosher use of funding to social ends and a long term dedication to the project.”
Alina Vision is set up as a holding company in Singapore and will have operating companies managing the eye centres in each country of operation.
“This is a hybrid engine designed to go out to philanthropic organisations and get funding,” Midberry said. “We will work through the regulatory barriers, the training of the initial cadre of medical professionals, and we will achieve high quality through deep training, significant process and procedure, and charging the tiered pricing, with the lowest price being zero.”
Alina Vision has a ten-year commitment to growing the projects, which will result in full-service eye hospitals for community members across socio-economic classes. Midberry noted that services will include cataract operations, provision of glasses, and treatment of glaucoma, diabetic retinopathy and macular degeneration as well as paediatric and critical eye health services.
“Our thesis is that by removing the barriers to replication and by proving out the sustainable strategic advantage, we can achieve the same return expectations that other healthcare private equity investments do,” Midberry said. “And we think we can do it with more regularity. This is a subspecialty of healthcare where capital investment that is relatively modest. Our set up costs are $1-3 million if we’re buying or leasing a facility.”