Johannesburg — Losing a friend because of a fake malaria drug and inadequate healthcare services pushed Vivian Nwakah to take on the pharmaceutical industry in Nigeria. In 2017 she founded the company Medsaf - a digital platform to finance and facilitate the distribution of medication. Since then, the company has grown to 40 employees, shifted in the wake of Covid-19 market changes, and is one of the businesses fundraising on the Prosper Africa Virtual Deal Room.
Visit Prosper Africa to access U.S. Government trade and investment support and browse the Virtual Deal Room with curated investment opportunities, including companies like Medsaf.
Sham drugs are the world's most lucrative counterfeit goods. Globally, the trade in counterfeit pharmaceuticals is worth up to U.S.$200 billion (£150 billion) annually, with Africa among the most affected regions, according to industry estimates.
A 2015 American Society of Tropical Medicine and Hygiene study found that 122,000 children under five died due to fake malaria drugs each year, most of them in Africa.
Anti-malarials are the most commonly counterfeited drugs, along with antibiotics and pain relievers, according to Nigeria's National Agency for Food and Drug Administration and Control (Nafdac). The agency's director of investigation and enforcement directorate Kingsley Ejiofor has said that in the past three years, Nafdac seized two trillion naira ($4.8 billion/£3.5 billion/E4.2 billion) worth of counterfeit drugs.
The World Health Organization (WHO) says 42 percent of all fake medicines reported to them between 2013 and 2017 were from Africa . The European region and the Americas accounted for 21 percent each.
To fight the flood of fake pills, Nafdac, in partnership with Nigerian startup companies, has created stickers with unique codes that manufacturers and distributors can attach to boxes and sachets of pills. Consumers can then use apps on their phones to scan the code and confirm the medication's authenticity.
Vivian Nwakah's Medsaf occupies a different niche in the Nigerian health tech startup sphere by addressing supply-chain issues. Her company's innovations fill a gap by linking medicine manufacturers to institutions that provide medications directly to the public. The Medsaf platform ensures that safe and cost-effective drugs get to the hospitals and pharmacies that dispense them.
Medsaf is short for Meds Africa. It was no accident that the company was founded in Nigeria, where 30 to 40 percent of medicines are estimated to be fake or substandard.
"Quality medication is a fundamental human right. It's the Medsaf rallying cry," Nwakah says. She sees her family's ancestral home as a country that combines enormous problems with immense opportunities. She wants to contribute to Nigeria by applying her business expertise to building sustainable enterprises that help solve pressing problems.
" For us here at Medsaf, it's about creating value," she wrote on LinkedIn , offering the example of how hospitals typically purchase drugs. They can buy on credit, she says, but "they end up paying for those medications at inflated prices. Our 'Pay as you go' plan, cuts the overall price but still allows the facility to avoid a large upfront payment, and we receive our money. It's a win-win situation."
Medsaf's soft-launch in 2017, Nwakah says, demonstrated both the value and the feasibility of the enterprise. The company realized an average profit margin of about nine percent with the first seven hospitals and pharmacies that used the platform.
"We help to increase the quality, accessibility and affordability of medication to the end consumer" she says. "We work with suppliers, manufacturers, hospitals, clinics, diagnostics, specialty centers, patients, pharmacies - the entire ecosystem. We roll out technology and data analytics techniques to improve the flow of medication among all stakeholders."
Her aim is to build a pan-African enterprise, taking best practices from other challenging markets. The company plans to begin expanding regionally in the west African region before moving continent-wide. "You can think of us as a one-stop shop for pharmaceutical needs in Africa!" Nwakah says, ambitiously.
Hospitals, pharmacies, patients, other healthcare companies in Nigeria seem to understand how crucial an issue Medsaf works on solving. "We always get applause and gratitude because we really did focus on how to solve one of the hardest problems in having a healthcare company in the African context, which is procurement and distribution and 'last mile'," Nkawah says, referring to the logistical barriers to getting medicines everywhere they are needed, even to rural medicine vendors and clinics.
Across the continent, , the newly formed African Medicines Agency will regulate medical products and work to improve access to good quality, safe and efficacious medical products and health technologies for the African population.'
The World Health Organization, also, is working with the African Union to improve health coverage across Africa. Various country-specific organisations, such as the Safe Medicines Foundation in Nigeria, are part of the campaign for safe medicines.
Vivian Nwakah's early entrepreneurial interests were focused in other directions. She studied Business at the Sorbonne in Paris, France, the Federal University of Rio de Janeiro in Brazil, and the J. Mack Robinson school of Business at Georgia State University in Atlanta Georgia before settling in Nigeria full time.
Her plan was to build a hybrid solar company. Nigeria was once a flourishing industrial and agricultural economy – manufacturing steel, for example, and was one of the world's largest exporters of peanuts. But with the discovery of light, sweet crude oil, that commanded high prices on the global market, those sectors languished. The country's utility grid fell into disrepair, and most Nigerians still lack reliable electricity, despite years of oil exports.
Nwakah saw the potential of a country with vast amounts of sunshine to build renewable energy capacity and to do so profitably. But her friend's death changed her trajectory.
Now she is a med-tech CEO with a team of 40 employees. She says having a great team on the ground has kept Medsaf in business – among them Medsaf co-founder and chief technology officer João Pinheiro, and cybersecurity, warehousing and eCommerce experts. About a quarter of the team are pharmacists and half are healthcare professionals or have been trained in various parts of the healthcare industry.
" I've spent a lot of time creating an environment where people feel free to try things, execute, come up with ideas, make mistakes, learn from the group, and hold each other accountable," she says. "We have meetings sitting in a circle and everyone is equal".
Two years into the spread of Covid-19, no business has been spared from the ruthlessness of the deadly pandemic. Companies have had to learn to adapt or die.
During this difficult time, Medsaf survived by focusing on its core business. Remembering what the company set out to do has been the greatest lesson from running a business while navigating through obstacles.
"During the pandemic there were just hundreds of opportunities that kept getting thrown at us from all places," she says "because now people are taking healthcare much more seriously. For us, [we need] to balance: we have to be able to hold on and ride out this wave, but we still have to grow and meet the demand of the moment", she adds.
" The only thing that kept me going at the lowest moments, while creating Medsaf, was a deep sense of purpose and that I was doing the right thing," she advised other entrepreneurs .
Nwakah believes that "If you can focus on the pain that your customers or your target market might be feeling and come up with innovative solutions to solve those pain points – and you are really focused on how to improve the customer experience – then I feel like you can put in place solutions to solve these problems.
In 2019, Medsaf became the winner of the Seedstars Malaria Challenge, supported by the Bill and Melinda Gates Foundation at the Seedstars Summit.
Prosper Africa 's Deal Room , managed by the U.S. Government initiative to increase trade and investment between African nations and the U.S, where investors, buyers or interested parties are able to register and review curated deals worth between $1-million and $100-million, has been supportive in ways that are critical for a start-up. " [Prosper Africa] has definitely been an amazing amplifier of what Medsaf has been doing," Nwakah says.
"Financial support and human capital are the two areas where we probably need the most support. We are trying to solve a complex issue, and we are trying to build a company that needs to have advanced technology techniques in place in order to really solve the issue [of access to medicines]. But if you look at Africa in general, there are not too many companies that have solved or cracked this in the past, so we do find ourselves as a bit of a trailblazer.
" One lesson I learned is that even though you may need the money, it's important to find people who can invest that really believe in your vision and roadmap."
Nwakah wishes investors knew that, "This is the future". She believes what her company is doing for the pharmaceutical industry is necessary. Though it is a blend of some traditional and some futuristic thinking, she thinks that's what is needed.
"What we are building is the type of technology that's needed to really create value for the average African citizen. We are the future, and investors should be jumping at the opportunity to partner with us now," she concludes.
