The Cure: Revolutionizing the Business of Healthcare in Africa
The Cure is a deep-dive podcast exploring what it takes to revolutionize the business of healthcare in Africa. Hosted by Temitope Coker, each episode features candid conversations with the people shaping the continent’s health systems, including visionary founders, investors, researchers, policymakers, and reformers.
We go beyond surface-level insights to unpack the real-world challenges, innovations, and investment strategies transforming care delivery across Africa. At the same time, we aim to infuse hope into the narrative by spotlighting the momentum and progress already unfolding across the continent.
From financing and infrastructure to research, technology, and policy, The Cure is the place for serious thinkers and doers who care about the future of African health.
The show is powered by TC Health, a platform providing healthcare and pharmaceutical insights in Sub-Saharan Africa.
The Cure: Revolutionizing the Business of Healthcare in Africa
When the System Is Missing, Build It: Scaling Diagnostics by Creating the Infrastructure - Part 1 | A Conversation With Soga Oni
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Soga Oni, CEO and Co-founder of MDaaS Global, joins us to break down what it really takes to scale diagnostics in Africa from infrastructure to access to impact.
Because without strong diagnostic systems, healthcare simply doesn’t work.
Season 2 is about Building the Rails and this is a critical piece.
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#TheCurePodcast #AfricanHealthcare #Diagnostics #HealthSystems #HealthcareAfrica #TCHealth
Hello, healthcare enthusiasts, and welcome back to The Cure. This is the podcast where we're revolutionizing the business of healthcare in Africa, one conversation at a time. I'm your host, Tim Topekoka, and in each episode, I sit down with the people that are reshaping the way that we think about healthcare in Africa and the future of healthcare in Africa, from founders to investors to policymakers and beyond. And our goal is very simple to infuse hope back into the narrative by spotlighting the progress and momentum that's already unfolding across the continent. At the heart of every episode is one key question: What does it take to revolutionize the African healthcare business model? All our insights are powered by TC Health, your trusted source for pharmaceutical and healthcare insights in sub-Saharan Africa. So let's get into it. In season two, we're exploring what it takes to build the rails, the regulation, the financing, the partnerships, the data, the physical infrastructure that turns a promising idea into scalable and reliable care. Today's conversation is the most literal embodiment of that theme we've had this season. Today we're sitting with a founder who has spent the last decade building a layer of African healthcare that almost everyone agrees is essential for any functioning health system. Diagnostics, the labs, the imaging, the tests that produce the information that clinicians use to decide what to do next. Without diagnostics, every adjacent layer of the health system, from if we talk about precision medicine to telemedicine to insurance, it can't function. And it's part it's a part of the health system that has to exist before most of the conversations we have, even on this podcast, um, become possible. And in Nigeria, the gap in diagnostics is pretty substantial. Fewer than 300 radiologists serve a population of over 200 million people. The country has fewer than one CT scan per million people. And the WHO's most recent regional report, so this is for the African continent, says that only about a third of African health facilities have functioning basic diagnostic equipment. And for many molecular tests, the samples still need to be flown out of the continent before a clinician can get a result. My guest today set out to solve this problem with an asset slight model at first. He wanted to import refurbished diagnostic equipment from the US, sell it to Nigerian hospitals, and layer a service on top of that. But the market did not kind of let that model work. Um, hospitals couldn't justify the upfront capital, the payer, the health insurance kind of infrastructure that would have underwritten it wasn't as mature as it needed to be. And the team eventually pivoted to the harder version of the same idea. They built the centers themselves. Choga Oni is the CEO and co-founder of MDAS Global. He completed his master's in system design and management at MIT and co-founded MDAS in January 2016. So this is your 10th year.
SPEAKER_0110th year, yeah.
SPEAKER_00Oh. Um, but you co-founded it alongside Joe McCord and Genevieve Bernard Oni.
SPEAKER_02And Aquayemi Ologo.
SPEAKER_00And Aquayami Ologo. The company was incorporated as a medical equipment importer before pivoting in 2017 to operating physical diagnostic centers directly. And since then, the proliferation has been quite impressive. So today, under the brand Beacon Health Diagnostics, MDAS runs 26 company-owned clinics and 40 affiliate clinics across 15 Nigerian states, plus a center in Douala, Cameroon. Did I pronounce that right?
SPEAKER_03Yeah, Douala, yeah.
SPEAKER_00The company has served over 600,000 patients to date and ran more than 1.2 million diagnostic tests in 2025 alone. The network now receives referrals from over 1,500 clinicians and offers more than 500 tests. And across all rounds, MDAS has raised approximately 6.8 million. Most recently, a $3 million pre-Series A in March 2024, co-led by Arura Capital Management and Newton Partners, and then follow-on from Ventures Platform. Shoga is also an MIT Legatum Center Fellow and was part of the first cohort of Techstars Impact. Shoga and the MDAS team have articulated the company strategy. So Shoga sent me a lot of homework. He sent me some pre-reads that I had to brush myself up on. And they've articulated the company strategy in three parts. So part one is building the physical diagnostics rails for the mass market across Nigeria. Part two is then laying the technology layer on top of that, that turns it into, from infrastructure into a coordinated healthcare network. And then part three is kind of scaling exponentially through partnerships and data with the long-term ambition of becoming the largest integrated health network on the continent. So the conversation today will move through each part in turn. We're going to walk through the pivot from being an importer to an operator, the realities of running a 60-plus clinic network across two countries, the tech, the partnerships that turn MDAS into something closer to infrastructure than a chain of clinics, how an Indigenous operator keeps pace with international diagnostics groups, and just the bigger question of what it actually takes to fund and scale capital-intensive healthcare in Africa today. So, Shoga, welcome to The Cure.
SPEAKER_01Thanks for having me.
SPEAKER_00Really, really glad to have you. Before we dive in, I want to share something exciting. The Cure is partnering with the World Health Expo Lagos, West Africa's leading medical trade event, taking place from the 2nd to 4th of June 2026 at the landmark center in Lagos. WHX brings together over 500 exhibitors, 8,000 healthcare professionals, and 30 world-renowned speakers across diagnostics, medical devices, health infrastructure, digital health, and the list goes on. This year's Hospital Investment and Buyer Leadership Forum is tackling one of the themes we care deeply about on this show. How do we build resilient supply chains? How do we localize manufacturing? And how do we create strategic partnerships that strengthen healthcare delivery across West Africa? So we're going to be live at WHX, bringing you coverage straight from the exhibition floor. We'll be interviewing key speakers, we'll be giving you behind the scenes content and just giving you an experience that you can't get from just a press release. So if you're going to be at WHX Lagos, please come find us and you can well you can register at www.worldhealthexpo.com. Okay. Um before we jump into today's interview or today's episode, as always, we want to take a couple of minutes to set the stage and walk through the signals in the African diagnostics space today. And Shoga, I implore you to chime in, to give me your thoughts, to give me the color that you can only bring from operating in the space on a day-to-day basis. So we'll start with the diagnostics gap. Diagnostics is the part of the health system that produces the information. Like I said, clinicians used to decide what do we do next, what is going on with the patient, what would be the best course of action. And the layer is very thin in Nigeria. There are fewer than 300 radiologists for a population of more than 200 million. The country has fewer than one CT scanner per million people, compared to roughly 40 per million in high-income countries. So that's like a yeah, it's like a 40-fold deficit. Um, the WHO's most recent regional report estimates that only a third of African health facilities have functioning basic diagnostics equipment. And what ends up happening downstream is diagnosis tends to happen late. Um, treatment decisions get made on incomplete information. You have patients waiting for ages because their samples have been shipped to Germany. I've literally had that happen to me before. I am not going to mention any names, but I went to get some tests done and they were like, Yeah, it's gonna take around like five to six weeks for you to get your result. And I was like, why? And they were like, We have to ship your samples to Germany.
SPEAKER_01Not surprised. I think to have a little bit more context to that, I think when you think about the gap and you mention these numbers, when you kind of split the country and say, okay, most of those radiologists, the majority of them will live in Lagos.
SPEAKER_06Right? Yeah.
SPEAKER_01And so when you think about the number of radiologists, say in some states, sometimes you're looking at like one person for three million people. Um so it's even worse when you kind of like look deeper into the numbers, yeah. Because look at the city scan number between Ekoi, lucky face one, and VI, you probably have about 25 city scans there. Wow. But when you see there's some states that in the all of the states, there's literally no city scan. Right. So when you think about the numbers, not just about that headline number. Yeah. When you dig a little bit deeper, it's even worse because the a lot of the capacity tends to be concentrated in bigger cities like Lagos, Abuja, Port Accord, compared to the rest of the country.
SPEAKER_00Yeah. And that ties into, and when we get to it, the the strategy of MDAS in terms of when you think of location, when you think of which populations to serve, MDAS has been quite strategic in trying to identify the populations that aren't as well served with the existing diagnostic infrastructure that we have. So that makes sense when you think about, yeah. It's usually concentrated, if we're just going to be very honest and blunt, where the wealthiest people are. That's where most of the diagnostic infrastructure is concentrated. So it really is kind of a class divide on whether you have access to diagnostics that you desperately need if you have any sort of life-threatening illness. So that's something that I think came through in the homework that you gave me. I was reading through a lot of the way that MDAS thinks, and I can't wait for us to unpack that later on in the episode of how exactly did that strategy and that thinking come about. But we also have the NCD wave that's reshaping the demand for diagnostics. So Nigeria's WHO non-communicable disease or NCD profile attributes about 29% of all deaths to non-communicable diseases like cancer, cardiovascular disease, and diabetes. And the WHO has projected an almost 30% rise in Africa's NCDs over the next decade. And that's faster than the global rate of 17%. So the global rate of NCDs is rising at 17%, Africa's is rising at almost double at 30%. Um, we've also seen recent Nigerian survey data that places our diabetes prevalence at around 12.7%, hypertension at 14%, and obesity at 25%.
SPEAKER_01I think hypertension is probably higher.
unknownReally?
SPEAKER_01Yeah, just from looking at our own data, internet data.
SPEAKER_00Where do you think hypertension is?
SPEAKER_01I think it's gonna be, I think around the bigger cities, um, one we've done, when we look at our numbers, I think it's probably like 20-30% in the bigger cities of the people we screen at at risk of or are already on the way to hypertension. Yeah. And then hypertensive crisis. Yeah. So you're already saying that like, you know, if this person doesn't take care, they're gonna have an apertensive crisis soon. And these are all really young people that we're screening. Yeah. So it's kind of quite worrying.
SPEAKER_00Yeah. Um I was going to ask, what do you what is the profile that you're seeing of people with hypertension? Sounds like it's young people.
SPEAKER_01It's young people, old people, like it's it's really a wide range of people. It's people because we tend to do a lot of previous um un screenings for for folks. And so, and that's where we can see, and that's one of the basic screenings we do, like you know, like just checking people's blood pressures.
SPEAKER_04Yeah, yeah.
SPEAKER_01Um, and so that's something we see that's you know, in bigger cities, the prevalence is much higher than than everywhere else. Like, what do you think it is about big cities that stress uh people are more stressed, people um don't are working themselves to that literally sometimes. Um and so I think and you know there's just a lot of more things to to people don't eat well. I think for the NCD burden that's increasing, I think a big part of this is that we're changing our diet, um, but we're not changing the lifestyle. So we're still eat we're still eating food as if we are farmers um and we're not quite farmers anymore, we're office workers now, you know. Yeah, and so it's it's it's it's some of it, and some of it is just like just people are not just in the know of these things because with NCDs, you feel okay till you don't feel okay.
SPEAKER_04Yeah, yeah.
SPEAKER_01So people don't tend to do a lot of preventive care screenings to or just the regular checkups. So that's one thing that we're trying to change is how do we ensure that our people do more regular checkups so that when you pick up on a sign, you can start working on it. You know, so yeah, very important.
SPEAKER_00It's interesting the diet points, because I saw a few weeks ago on TikTok that somebody was saying the actual portion of rice we should be eating versus what I know I eat as a portion of rice. Like the any Nigerian can attest to rice and stew. Rice and stew and some sort of fried meat, fried chicken, or whatever, the mountain of rice that we eat is a lot versus the size that is actually a portion of rice.
SPEAKER_01I was like, but I'll I will push back to that because I think in Japan, right, people eat a lot of rice too. Yeah, yeah. Right. And you know, they're the healthiest country, they're one of the heatiest countries at least. Um, but I think it's also about like physical activity, the culture of engaging in a lot of physical activity and and you know, creating time to do that, yeah. And having a more balanced diet, not just eating rice, eating other things, balancing your food with some vegetables and everything.
SPEAKER_05Yeah.
SPEAKER_01And so I think the diet is one piece of it, but I think also like the stress levels in bigger cities are definitely higher. Um, people live very sagittary lifestyles. Um so people also need to change that, yeah, you know, yeah with the diet. Yeah.
SPEAKER_00So and Nigeria is also just like hot. Like I was speaking to someone at a large farmer company, and they were talking about how some of the work that they're trying to do some research on is the impact of climate change on health outcomes. And one of the things that they notice is, especially in sub-Saharan Africa, as global temperatures rise and it gets hotter, they're actually seeing a correlation with things like cardiovascular disease.
SPEAKER_03Wow, that's interesting.
SPEAKER_00So when you think about, like you mentioned, people working themselves to death in some cases, when you're out in the sun from morning till sundown, that level of heat stress, you know, dehydration, just the general what heat does to your body can actually affect your heart. It kind of like we hear about heat stroke all the time. Um, like in London or New York, when it's July or August and there's a heat wave, there's all these like public notices about heat stroke, make sure you have water on you, etc. But the temperatures then are like a normal week here in Nigeria.
SPEAKER_03Yeah, that's funny.
SPEAKER_00I know we've adapted, we're used to it, but as the as the east here too. Yeah, right.
SPEAKER_01Um, some people do get eastrochea too. So that's something to note.
SPEAKER_00Yeah. Um but yeah, I think there's there's quite a lot in terms of the rising chronic diseases in in not just Nigeria, but in the region. I think diabetes alone was estimated to cause 40,000 deaths in Nigeria in 2024. And I'm sure that number is rising. Um and so what this creates is a need for diagnostic touch points. Like all these diseases have some level of test that you need to kind of diagnose the condition that's happening. Um, but one thing I wanted to point to, because we always want to point to hope and things that are encouraging, is that policymakers are starting to take the financing side of chronic disease more seriously. And particularly in Kenya, the Social Health Authority expanded its cancer care package from about 550,000 shillings to 800,000 shillings, effective the 1st of December 2025. And this was part of a presidential directive with a publicly stated plan to raise that cover again to 1 million shillings within three years. That's the equivalent of over $7,000. Obviously, $7,000 in this context is a lot, but when you think of the cost of treating some of these conditions, especially when they get quite severe, it's much more than that.
SPEAKER_01Yes.
SPEAKER_00So this is the kind of policy that if we see this kind of proliferating across the region, could turn the rising NCD burden into a financial demand signal that diagnostic networks have been waiting for. Like not just we're seeing chronic disease rise, but we're actually seeing serious policy attached to meeting that demand and making sure that there is kind of an affordability to it and patients have access to care. Um, we'll touch on that later because I would love to understand from your perspective, your touch points at all with the public sector and what any moonshot aspirations are on the public sector side. Um, but speaking about the public sector, there's also a genuine movement from that side from MedServe. So MedSuv is the wholly owned healthcare arm of the Nigerian sovereign investment authority. It has its healthcare expansion program that it flagged off in August of 2024 to establish 23 additional diagnostic centers, three oncology centers, seven, I'm gonna mess this up, catheterization labs across cat labs across Nigeria. I don't know why I typed the whole name, but um seven cat labs across Nigeria, six geopolitical zones. Um, in February 2026, the IFC, the International Finance Corporation, and NSIA signed a Naira-denominated financing deal to fund this expansion. And so the oncology facilities are expected to serve more than 2,000 patients on an annual basis. And the diagnostic centers are projected to reach over 350,000 Nigerians a year. This is an example of sovereign and DFI capital being deployed to infrastructure at scale, and that's exactly the part of the system that MDAS has been building from the private side. So very interesting to see kind of all these things kind of coalesce. Um, and then we just want to talk about the growing um market, the growing diagnostics market in Nigeria. So Nigeria, and you would know more of these stats, so please feel free to kind of push back. But Nigeria's clinical lab services market was valued at roughly 500 million in 2020 and is projected to reach over 650 million by this year, according to some recent intelligence reports. Within that market, the gap, the biggest gap in demand is mass market and structural. So, according to this industry data, uh roughly 70% of African health clinics lack the equipment to perform basic diagnostic tests. Even within the organized diagnostics market, as of 2016, the top four chains in Nigeria owned less than like 2% of total volume. Um, and some of the analysis that you sent, some of the homework that you sent indicated that it's your initial target geography sits on top of a $2 billion unserved diagnostics market serving more than 250 million West Africans that have limited or no access to high-quality, affordable diagnostic care.
SPEAKER_01So had a little bit more context to that number. When a lot of the research people do on trying to figure out the size of the diagnostic market, it's always trying to evaluate current demand, right? There's a lot of non-consumption going on. Um so when you think about the the non-consumed, non-consumed market, yeah, yeah. That you could, it's probably around two billion.
SPEAKER_05Yeah.
SPEAKER_01And and part of it is that when you don't have diagnostics in a location, it's not that people will stop getting care. What happens is doctors treat according to clinical science. Right? So the gap might be there, yeah, not being served, but people would do half is better than none, right? Yeah, yeah. And so the quality of that. Healthcare will be much poorer, but it will still happen. And sometimes the outcome for individual patients will be much, much worse. And so that's what we see is that even though the market at 500 million, it's kind of small for Nigeria when you think about it. A single player in Egypt, for example, does over a hundred million in revenue. So when you think about Egypt is 90 million people, Nigeria is 240, 230, 240 million people. So that number is much, much smaller. There's a lot of non-consumption. And when you look at the non-consuming number, it's probably a higher number. It's around 2 billion, 3 billion market.
SPEAKER_00I I would love you to give a practical example of that clinicians, when they don't have access to diagnostic data, treat by clinical science.
SPEAKER_01When I was growing up, there was not all diagnostics was available in the town.
SPEAKER_08Yeah.
SPEAKER_01There's probably only a couple of extra machines. And so if you came in, for example, let's even use a lab procedure and you needed to do like a viral load for something that you know nobody could do, nobody had it, and the doctor knows you cannot afford it. Yeah. They will just treat you right there, right there with something old. Here's an antibiotic, here's some antiviral.
SPEAKER_05Yeah.
SPEAKER_01We think this is what you have, and you might have to have something totally different. Or or another example is what tends to happen when people have fever in Lagos, right? The first thing you do is you're going to take anti-malaria. Yeah, malaria. Everything is malaria. And it might not be malaria, right? Yeah. But you could have done the test, confirmed. And oftentimes it's not malaria, it might be something else. And that's why, you know, oftentimes oftentimes someone will go to a new place, we pretty much have to, if it's a place where maybe we're the first diagnostic operations there, a lot of it will be first trying to educate the doctors around like, hey, this is available now. There's a lot more tests you could be doing now that you weren't doing before.
SPEAKER_05Yeah.
SPEAKER_01And once you when you also think about it, even in places where diagnostics used, you know, there's some diagnostic capacity, there might be new type of testing coming out that will be better than the old good standard. Yeah. So for a classic example is say we there test for typhoid, where the most of the world has moved on from using weed out tests to do typhoid. We have to be the one educating the doctors in those places because historically that's what they used.
SPEAKER_04Yeah.
SPEAKER_01But now, you know, we we have to educate them that, hey, you should probably be doing this tool MCS instead of weather. So what we do sometimes is if you request for the weather, we package it with the gold standard so that you can the doctors can start thinking about things differently. So it's important. Yeah.
SPEAKER_00And how do the doctors respond when you educate them? Like, hey, there's a better test available, or hey, there is testing now available. Do you do you find that they change clinical practice quickly or it's more of a slow burn?
SPEAKER_01More of a slow burn. I think and rightly so. I think that's um in ethcare, things move a lot more slow, yeah, slower. Because some of these things that people have been doing, even though it might not be optimal, has worked for them for a long time. And they've kind of like learned to uh to they've gotten used to that risk.
SPEAKER_04Yeah. Right. Yeah.
SPEAKER_01So now you're telling them that, hey, there's a new way of doing this, that's you know, they have to like start thinking about the new risk, like is it lower, is it higher, whatever? So things are a lot more slower.
SPEAKER_03Yeah.
SPEAKER_01But eventually people will change if you know all of the signs point to the right ends. So yeah, but it's one of the you know, the unspoken work you have to do, you know, when you are in this sort of field.
SPEAKER_00Yeah, yeah. That is a very useful, like on the ground tidbit. And when you mentioned about malaria, like, you know, people just assume when you have a fever as malaria. I was at a conference in November of last year, quality Society of Quality for Healthcare conference. And Professor Obami, the health commissioner for Lagos, mentioned that he his team actually did an empirical study to really understand what exactly is the prevalence of this malaria that we say everybody has. And I have to go back and check my notes. But he mentioned that the majority of the cases wasn't actually malaria. So while we think any fever that comes up, you just assume, oh, I have a fever, I must be coming down with malaria. Their data actually found that that is actually, by and large, not always the case. But we skip that step of is this malaria? And we just go straight to the pharmacist and we're like, I need anti-malaria.
SPEAKER_01And then if it doesn't work, the the tricky thing about this is that there's probably around 50% of the time where you do it and you it works because you actually have malaria. Yeah, yeah. And then that colors your uh your thinking about it. Yeah. So that the next time you have something like this and you go and take anti-malaria and doesn't work, um, or you're getting worse, then you don't know what's going on, and then you rush to the clinic, and at that time you might be a much worse thing you're dealing with. Yeah. Meanwhile, if you've just gone to a proper clinic originally, yeah, gotten tested, confirmed your diagnosis, you will be in a much better place. Yeah. So it's kind of like the those are the kind of eth seeking behaviors we still need to work on to change for our people. Yeah.
SPEAKER_00So and I view diagnostics as the data engine of the entire healthcare industry. Like it it tells us the disease profile of an entire country if you have consolidated diagnostics data. So I wonder with this, just this one anecdote of malaria, how much are we missing? Like, what is it? If it's not malaria, what are the things that are driving fever that we just don't have insight on because we just assume it's not, we just assume it's malaria and we just treat anyway. And I think there is a case to be made for the diagnosis. I mean, I'm I'm not this is not profound. I'm not the first to make this case. I'm sure you have made this case and you have in the prereads that you sent me, that data from the diagnostics industry has so much potential to inform literally everything else in the healthcare space.
SPEAKER_01I think diagnostics is one of the bedrocks of modern medicine. I think um 70% of the time you're sick, you will probably your doctor will say, Hey, you need to go get tested. And even if you're really sick and the doctors just start streeting you, you also like, what's going on? You should send me somewhere, right? Yeah. And so so that's one of the reasons why we focused on on diagnostics. When we started the business, like you mentioned, we were just doing medical equipment generally.
SPEAKER_05Yeah.
SPEAKER_01But once we uh were in the process of pivoting, um, one of the reasons why we pivoted to diagnostics was that that subsector was so important, yet um not a lot of people worked in it. Because obviously, obvious reasons CapEx is CapEx Heavy, yeah. Um, and then a lot of like you know, bigger companies were there. So and then it's infrastructure is just so tough to build.
SPEAKER_05Yeah.
SPEAKER_01So not many people get into it. Yeah. Um, so so it's yeah, so that's part of why we focus on that subsector is so important for modern medicine.
SPEAKER_04Yeah.
SPEAKER_01And and in every other country, the um the sector tends to have significant scale and um have what like one big player, but in Nigeria, it's so fragmented. And so we saw the opportunity to consolidate the space to integrate some of the fragmentation we saw in the marketplace.
SPEAKER_00Yeah, yeah. And yeah, those are the exact things that we're going to kind of touch on. I also wanted to touch on when we think about the fragmentation. I think one of the defining features of the organized diagnostics market over the past decade has been this kind of influx of international capital or acquisitions. Um, so for example, in 2017, CINLAB, Europe's largest lab operator, acquired a majority stake in Pathcare Nigeria, then one of the country's largest private labs. They had like six labs, 21 collection points, ETC. Um, in 2019, France-based Seba Healthcare and Lancet group of labs established Subalancet Africa, this joint venture that then took over Klina Lancet. So now we have Clina Lancet, um, which is now officially known as Surba Lancet Nigeria. Um, and so that brings the Lancet side, which is Indigenous African operations, the Surba side, which is your kind of European. Um, so we have all of these kind of large chains um or large players in the diagnostics market that have brought in this influx of international um capital.
SPEAKER_02And I I find that very interesting, and that's something that we're going to mention, mention IDH acquiring um Ecolab.
SPEAKER_00Oh, yes, Ecolab owned by Integrated Diagnostics Holdings. That's a Egypt headquartered company. Yes. So there's a lot of international players in the space. And my view of MDAS and Beacon Health is it's it's quite indigenous um in the way it operates, in the way it thinks about where to expand, in the way it thinks about the demand gaps that it wants to plug. So that interplay I find very interesting, and we'll we'll get into that. Um but I also wanted to touch, lastly, before we jump in, on an article I wrote recently where I spotlighted um MDAS. So on TC Health, which is the parent company of the cure, I wrote a piece called Oil Pipeline, Cell Towers and Bottling Lines, what af what healthcare can learn from Africa's capital giants. And the argument in I made in that article is not a necessarily new one, is that healthcare in Africa, especially in Nigeria, meets all the standard criteria for a capital-intensive industry, even when you think health tech, because you can't scale health tech with no infrastructure. So large investments in physical assets relative to your labor, high fixed costs, long payback periods, high barriers to entry, like all of those encompass healthcare in Africa, especially in Nigeria. And we use MDAS as the like real-world example for high barriers to entry in terms of the original equipment importation thesis that you kind of launched with ran into that wall the moment it met an infrastructure deficits market. Um and now you then had to pivot to actually building that infrastructure yourself. So I think there's a lot that we can learn about how we've scaled oil, how we've scaled telecoms, how we've scaled um FCMB, like the food and beverage industry. We're able to get a bottle of coke to the most remote village in the country. Why can't we get insulin? Why can't we get, you know, anything else pretty much for healthcare? So some of the lessons that can be learned from those big capital giants that are capital intensive, if we were to just reframe and just say, okay, healthcare is part of these giants in terms of capital intensity. I'm curious your thoughts around that. And as you were kind of transitioning from, you know, asset light to let's build brick and mortar ourselves.
SPEAKER_01Yeah, so I can I think that, you know, there's obviously a lot of overlaps. I think what is slightly different in in when you look at the telecoms industry is that you know there was NITEL before the big guys came in, and NightL was not doing well what we're doing well. But I think once the big empty insular started coming in and people saw the potential, I think the flip was almost like overnight, right? Yeah, yeah. Um, but the it wasn't it was something that happened over a period of time and then all at once.
SPEAKER_08Yes.
SPEAKER_01I think with healthcare, probably the same thing might happen, but there's still like there's still very foundational things we need to fix in the healthcare sector. I think and I think until we fix those things, um, we don't see that transformation. Um, I think number one, for earthcare, people expect some parts of healthcare to be free. I think we've been socialized that way. Yeah. Um, and so um the kind of big investments we need to transform the industry won't happen except they say payer. Um you know, not maybe not today, maybe tomorrow.
SPEAKER_07Yeah, yeah.
SPEAKER_01That a proper payer for all of the services that that infrastructure generates. And on and so I feel like that's a really big question. And right now, the government is definitely not the payer. Yeah. The HMOs, half of them, most of them are not prof are not fully profitable.
SPEAKER_08Yeah.
SPEAKER_01Um, so they also cannot be the payer of those. And then the people too are we live in a poor country.
SPEAKER_08Yeah.
SPEAKER_01So individuals also cannot be the payers for for that. And so that's the fundamental problem. That until we solve that problem, it could be that the way to solve that problem is that Nigeria just becomes a very prosperous country and everybody has a lot of money. And then we just say, okay, the pay is just the patients. Yeah. And then we'll build infrastructure to to serve them. Yeah. Uh, and then everybody's happy. But yeah.
SPEAKER_00That's a very idealistic picture. Yeah. Yeah. But that's a very good, that's a very interesting framing. It's like who whoever solves for that payer problem, I think, unlocks a lot for everything else in the healthcare space.
SPEAKER_01And that's what we're trying to do. Um, we're trying to build infrastructure for what people can afford today.
SPEAKER_00Yeah.
SPEAKER_01But it's also like um it's it's hard.
SPEAKER_00Yeah. Yeah. But yeah, those were some of the context settings. So hopefully everyone listening up until this point has a good enough grasp of what the diagnostics market looks like for us to keep this conversation very stimulating. Um, the core question that anchors all our discussions on the cure is what does revolutionizing the African healthcare business model look like? And specifically for today, we're going to be asking you what that revolution looks like for diagnostics, um, physical healthcare infrastructure, and everything else that once you build infrastructure has to build on top of that. Um, but before we get into that wider question, I want to start with you. Um, I would love for you to walk us through how you came to build MDAS. What was the path from where you started to where you are today? Like, take us back to that class at MIT where they asked you to build a company that will serve a billion patients or a billion people, um, and how the idea of MDAS kind of crystallized in that moment.
SPEAKER_01Yeah, so thanks for having me. It's great to be here. Um, so for me, I always wanted to be an entrepreneur, um, you know, and my journey at the time I was in the US, I was working a tech job. I was a software engineer at the time. And I was working for a company that was at least 50,000 people. And I just knew that um I wanted to live a life that was more impactful, more impactful.
SPEAKER_05Yeah.
SPEAKER_01That I didn't want to be a claw cog in a big whale. I just wanted to so and that journey led me back to to MIT because I felt like at the time tech wasn't as big in Nigeria um as it was, as it is now. Yeah. So I felt like you know, going to MIT would give me a lot of the skills that I needed to move back to Nigeria. I think I was living in Boston, it was extremely cold. And so I really wanted to come back.
SPEAKER_00Yeah, that's a motivating factor for sure.
SPEAKER_01So so I I started MIT, um did this class, and the challenge, the primary challenge of the class was um, can you set up something that impacts a billion lives? And it doesn't have to be a billion lives today, but you could you should be able to see a way to do that. And for me, everybody in my family um works in healthcare, right? My dad's a medical doctor, my brother is a medical doctor, my sister is a nurse, my older sister is a social worker, and their and their spouses, by the way. So we all work in healthcare. So even though I was an engineer, um, I I I just felt naturally drawn to solving a problem that I knew that my dad had, which was around equipment. How do you get access to good equipment? My dad owns a 30, 40 bed hospital in Ikara Coco, Undo State where I grew up. And he I knew that he had issues with getting good equipment for his hospital. So I was I felt like there's a lot of doctors like my dad, um you know, that if I could build something for them, then that was like gonna be I will be able to impact as many people as possible. Yeah, given that not only am I impacting the doctors, but also their patients. Yeah, right.
SPEAKER_05Yeah.
SPEAKER_01And so and that's what we set out to do. Um, and at the end of the class, uh the finals for the class was applying to a bunch of competitions and things like the MIT 100K and the rest. Unfortunately, we didn't win the MIT 100K, we didn't even go anywhere with that. But we won, um, we were part of we were chosen for this accelerator based in in um South Africa that was led by Fred Swaneka at the time. Um and Fred Swaneka is still one of my investors to today because of that. Um, and because we got into that accelerator, that gave me the confidence to say, you know what, I don't know these guys from anywhere. They gave me $20,000 to to do this accelerator and try to start this business, then I must I cannot take their money and run away. I must actually do this, I must actually do what they told me to do. So um at the time I was still I was still finishing up my my studies. So I actually wrote my thesis at MIT on how do you bring capital equipment to Africa and you know did a lot of research around it. Yeah. Um came to Nigeria, visited some of the big infrastructure businesses um for um tractor businesses in Nigeria and how they were doing it, so I had enough insights. And the name of the business is MDAS, it stands for medical devices as a service because one of the key insights then is that you know we wanted to take that um hard asset and made it make it into a service for folks.
SPEAKER_04Yeah.
SPEAKER_01So instead of just buying equipment, you would say, let me lease it or rent it. So you had the option to buy if you can afford it. You also had the option to lease, do a lease or or to rent the equipment. And so my first set of um doctors who are my mostly my dad's friends, to be honest, um they bought a bunch of equipment from us, like x-ray machines, digitizers, patient monitors, feature monitors. We both bought a brought a bunch of equipment in and sold it to them. They wanted direct sales, yeah. But not everybody could pay up front, so we had to do payment plan.
SPEAKER_05Yeah.
SPEAKER_01And and for some of those payment plans took two years to pay. And then we after the initial set of customers we had, we've really struggled to get more equipment out, even though we had a lot of equipment in the warehouse. What we quickly realized was that the economics, um, the unit economics to make this equipment work in these hospitals oftentimes don't exist. And doctors will want an x-ray, not because they have enough patients to justify the cost of the x-ray, but because you know, they were going to be the only hospital and their that had the x-ray and their friend did not have the x-ray. Right? Yeah, so so like you know, it was not a totally financial decision to to go for a certain machine or whatnot. And so, and that's when we realized that we needed to to to change was that the fundamental economic model for those equipment to exist in those places don't exist. And a key example of that is say an extra machine costs say 30 million naira today, and a doctor wants it, right? And he only sees two extra patients a day or three extra patients a day. A lot of doctors will still buy it if they have the money. Sometimes the money is coming from a different maybe the side projects they're doing, and you know, and they will buy it and just do it, and the machine will be in their in their just in their office or in their hospital getting underutilized.
SPEAKER_05Yeah.
SPEAKER_01So we saw a lot of that happening, and that we knew and that prevented us from being able to get the equipment out. And then we also realized that there was still a need because in Lagos, where a lot of our Lease and rental businesses were a lot of folks in Lagos loved that because pretty much, you know, you took care of all of the equipment for them and they just pay you a flat fee every month and whatnot. So the hospitals that we wanted to serve are like, you know, hospitals like my dad, but the hospitals we ended up serving were the hospitals in Ekoyi and you know the creme de la creme places where we were just pretty much dashing them money by doing that model with them because we just took a lot of their risk away from them. And there were never really enough of them to build a business at scale. Yeah. And because that scale has been something that we knew that if we couldn't build a business that could achieve significant scale, that it was a big no-no. Um so when we realized that we couldn't do that with our model, we had to change something.
SPEAKER_00Yeah, yeah. A lot of these points that you raise, I I'm going to like break down and just dissect one by one. But I want to I want to kind of follow up on a few things. The first one, your you you mentioned your dad has run a hospital in um Nigeria for more than three decades.
SPEAKER_01Yeah, for 40 years now.
SPEAKER_00Yeah, okay, four decades. What did watching him practice teach you about everything that informed not just the original idea for MDAS, but how you've evolved today? Like that experience of watching your dad run a hospital. Um yeah, what did it teach you that didn't become obvious until you kind of decided to go with my?
SPEAKER_01I was born in my dad's hospital, grew up literally in an hospital with certain, you know. When I was born, I think my dad's our apartment was upstairs, the hospital was downstairs. So it was one of those types of hospitals, right? Um, so so I think just being around that environment, just you see, my dad works really, really hard. Um, and you know, and just being there seeing how you know it doesn't matter, you know, what mood people are, he tries to make them have a better day by just meeting himself. And that's something that we internalize um in our business now where it doesn't really matter that you know when people who doing diagnostics are not coming there because they're having the it's well day.
SPEAKER_04Yeah, yeah, yeah.
SPEAKER_01Right? So when people come to our facilities, we want to make sure that we make that day better. So that's something we've internalized.
SPEAKER_03Yeah.
SPEAKER_01And that's something my dad did time and time again. And also the work ethics of being a doctor. I think Nigerian doctors are one of the most hardworking um professions, at least growing up, he was just it would work himself. We had to beg him to retire. Um and so so it's just it shows that if you want to build something of notes, you need to work for it, not in a schemen, you know. So so yeah.
SPEAKER_00Yeah. Um, and then just going through your three co-founders who all bring different perspectives. Some have worked on the ground as well in Nigeria, some have worked in Uganda, Malawi, in Ghana. What did each of you bring that the others didn't? So, how does this mix of four co-founders make MDAS possible? And how has it shaped the way MDAS looks like today?
SPEAKER_01Yeah, that's a great question. I think my co-founders, I have a large founding team, four of us, right? And and people sometimes people are like, wow, that's so big. Like, you know, like you know, this is such a huge team for for what you're doing. But what people don't realize is that we run four different businesses in one. When you think about it, four or five even. So we have the we still run the import exports, but that's how we still import a lot of our own equipment and supply. So even though we pivoted from that business, we still run it. Yeah. Um, you know, we run clinics, we run the operations that build clinics, we have a logistics firm and we do tech. Right? So it's and but what having this unique set of people have done for us is that we can contort ourselves to any the team to to run each of them. So, and with different combinations. So Okwa and I, we're both engineers, we we still do on the equipment side.
SPEAKER_05Yeah.
SPEAKER_01Um, and then on in terms of like operations, people operations, you know, Genevieve and I will work on that side. In terms of tech, it's Joe and I that work on that together. Uh so we can really change the Lego to say, okay, this people, you do this part, I do this part, and also because you know, this has been the long journey, and this will be this is probably gonna be a 20-year journey for us. Yeah, right. It also means that we are also like going through life at the same time. So we are having kids, getting married. Joe was my best man, I was upper best man, um you know, in in all of that, you know, so we're also having kids now. Yeah, it means that we can all fill in the gap for like so I recently I had my second child and thank you. And you know, my my wife, Genevieve, who is also my partner, was away for for maternity for six months, yeah, for five months or thereabout. And, you know, and we were able to fill in the gap while she was away and and whatnot. So that's kind of like having that team does. And then we are also like really great. I think that what we do is really hard. And I think we are the best team doing that in Nigeria, and I'm not even trying to brag about that in terms in terms of being able to do the work at a really high level, yeah, given how hard it is. I think my my team is the best at doing what we do.
SPEAKER_00Yeah, I love that. I've I've you know, you usually see like one co-founder or a two-co-founder team, and it's usually like one CEO and one CTO who's more on the tech side. But I like this idea of a well-stacked founder team that can like it's almost like modulate based on the needs of the business, yeah. And on the personal side, can kind of hold down the fort while you know somebody's going with doing with the ups and downs that come with life.
SPEAKER_01And that that that that's really and it also helps us have stay in power, right? Where we don't get burnt out.
SPEAKER_03Yeah.
SPEAKER_01If someone wants to take a step back because like they are like they are like tired, you know, we can say that's fine. Yeah, you know, go take a break while we we do this. Yeah, um, and and so the it's giving us this. Um I think that's one of our superpowers is the team, is the funding team. And uh it doesn't matter what problem we need to solve, we can always solve it. Also because running it now, the business is roughly around 400 people, yeah. Um, right, and so we've gone to be from being a team of four people, four co-founders, to a team of 20 people, to a team of 50 people, to a team of 200 people, now to a team of four uh to 400. Yeah. And we've been able to evolve because we can always, you know, do that. Yeah.
SPEAKER_00So and one more personal question before we go into the technical questions of everything MDAS. Um, you co-founded MDAS with your four co um three co-founders. Genevieve is also your partner. What is it like building a company alongside your partner? Like, how have the two of you divided the work? Divided like what you put in place at home, what you put in place at work, like how do you show up to work, and then how do you show up at home? Like, I'm I'm very curious to know what that is like.
SPEAKER_01Um, I think that to be fair, I I don't think it will work for everybody, but I think um there's nobody else I would rather do this with than her. Um, I think we it's obviously hard to say, oh, work doesn't blend into life, life doesn't blend into work. So that's that's unrealistic. And that does happen, but we we we've been rocks for each other um at different times for both their own life and and for the work life.
SPEAKER_08So yeah.
SPEAKER_01So I think it's not obviously I meet a lot of people, and when they find out that I I work with my wife, they'll be like, oh yeah, I will never do that. And but for me, you know, to hire someone um it would have been impossible for us at the time to hire someone with the technical know-how that she does have, right? Uh I always make a joke that you know, if you can hire them, just marry them. Or do both. Yeah, uh, so so so but but you know, she does the work at um a really, really high level. So she's been away for for maternity, and she recently got back, and even the step change in our production when she came back was like great to see. Yeah, yeah, yeah. And I was like, Yeah, thank God you're back. Yeah, so that we can yeah, do this, we can keep doing this together. So yeah, um, I'm just extremely lucky that I get to do life and work with you know my best friend and the person I love the most. So yeah.
SPEAKER_00I love that. Oh, it's making me all mushy. Um, but okay, now let's pivot into the pivot. So the pivot from importer to builder, where as we mentioned, MDAS started out in 2020 to import the um equipment, but pivoted to building those centers. Um, I think it's in a 2020 2022 piece that you wrote, because I like to when when my guests write, I like to read what they write because it gives me kind of a peep into what you're thinking. In the 2022 piece you wrote, um, and I'm gonna quote you here, you said when we informed different health experts that we were pivoting from a medical equipment supplier to a diagnostic service provider, the feedback we got wasn't very positive. Building diagnostic centers is too capital intensive, you don't have enough experience, you won't be able to get VC investment for brick and mortar retail healthcare. Take us inside that decision to pivot. What you've already told us what you saw in the kind of importing equipment business model that led you to the m, you know, the point where you were like, okay, we might need to change our strategy here. But that moment where you moved to let's make the decision to build our own centers, like that specific decision, like what was the gap between seeing it wasn't working and actually committing? What were you doing in that period? What was it like to make that decision? Where did you start? How did you move past the negative feedback? Like, just I would love to understand that exact moment, the pivot itself.
SPEAKER_01Yeah, so typically it's a series of moments, right? Of things that happened that we obviously 2017 was one of our toughest years. Um, because you know, when you as an entrepreneur, when you come out of the gates, you know, you're just running on vibes.
SPEAKER_03Yeah.
SPEAKER_01And and you know, we had customers, which was mostly my dad's friends, we served them, everybody was happy. But then the next set of customers was very difficult to find um because the products we had at the time did not fit. Yeah, there was no solutions market fit for us, pretty much. Um, and and so it was we were, you know, we I think in 2017 our revenue was from maybe something like $2,000 throughout that year. After doing $100,000 the year before. So it was a very humbling experience. Yeah, yeah. Um, and one of the things we quickly realized was like, you know what, we need to whatever, if we wanted to keep doing this business, we need to have a thesis about what we're going to do. And and and really understand what is driving um the what's actually driving the the decisions of people, of the doctors and whatnot. And once we realize that, oh, they don't have the money, the doctors oftentimes don't have the money. Oftentimes, you know, they owe folks a lot of money um because the customer base is also poor, you know, unfortunately. Um, it meant that our initial model was wrong for what we're doing. We just knew it. And so what we decided to do is go from first principles. Like, um at the time when we started, we wanted to do like, like you said, asset lights where we rented equipment. It was the leasing equipment that we really wanted to do.
SPEAKER_05Yeah.
SPEAKER_01You know, we sold because people said, hey, I would rather just buy it.
SPEAKER_05Yeah.
SPEAKER_01But the listing equipment was what we felt like. If every hospital was just able to list equipment instead of buy equipment, then everybody has the equipment they they needed. But when you had all of the you know, interest fees and and everything, it didn't work for the doctors and they were very vocal about that. So when that didn't work, we're like, okay, is the problem, is it that the problem doesn't exist or that there was there's no patient that needed the services? We actually saw a lot of people come to us to requ to ask for quotes for our equipment steady, but they were not just buying because they didn't have the money.
SPEAKER_04Yeah, yeah, yeah.
SPEAKER_01Right? So we decided to say, you know what? Let's go to one of the places where we've been seeing a lot of demand for people coming to price and take it deep into the diagnostic market. Um, at the time we'd looked at all of the equipment people were interested in in out of all of the equipment we we were bringing in, and we saw that it was the diagnostic equipment that was in the most demand. So we wanted to investigate that sector. Like, okay, everybody that was coming to price equipment was coming to price X-ray machines, ultrasound machines, um, rather than you know, patient monitors and you know, other sort of medical equipment. Yeah, so that helped us focus on that subsector. And then we now went to we called up one of the people who have been coming every three months to price equipment to say, hey, um, the guy was based in Ibada. And we said, Hey, can we come to Ibada and just take a look at the diagnostic centers around because the guy wanted to do a diagnostic center in Ibada. So we said, Hey, can we come to Ibadan and just um take a look at the diagnostic sector um sector in Ebada? And when we did that, what we saw was was so jarring to us that we felt like we could surely do better than this.
SPEAKER_00What did you see?
SPEAKER_01It was just um we saw that you know when we went to I still remember going to one of the diagnostic centers and just nobody just attended to me. I went to make a room to a in an inquiry and then sat down and nobody came back to me to to and the environment did not look nice, it wasn't like great, but patients were there, yeah. Um and the front dex officers they just felt as if they were doing you a favor, you know. So it was obvious. I'm like, I could surely do better than this. Yeah, if yeah, I have the equipment, um, which we did.
SPEAKER_00Which you had, yeah. You had the equipment.
SPEAKER_01We had the equipment at the time. I had the equipment, so I could surely do better than this. And so when the our first location was actually in partnership with the guy, and then that was your like six-month pilot that broke even in six months. Yes, yes, in about yeah. So it was, but then we realized the first day we opened the center, the guy did not show up, and we're looking for him, and we thought he got kidnapped, and they said, Oh, he went to pray on the mountain for this for the for the new business for the first week, so it didn't show up. And then that's when we knew that that partnership wasn't gonna work out. Yes, and obviously the partnership did not work out, and he had to exit the business, and we we just took over it.
SPEAKER_00Yeah.
SPEAKER_01So that's that's what informed it was a combination of us just realizing that the our thesis, you know, when you were in in the US, you know, writing thesis and you know, and when you're on the ground, it's two different things. What we saw on the ground did not measure up to was so different than you know what we we the our aphothes in the US. So we needed to change that thesis, and we did change it.
SPEAKER_00Yeah. And talk to me about the feedback that you got from health experts at the time. You mentioned it was overwhelmingly negative, but you still have some investors, like you mentioned, that are still with you until today. So was there a single conversation, a mentor, an investor that gave you the I don't want to say permission, but like kind of motivated you, like you're you you can do this, and here I will back you up in doing this.
SPEAKER_01So um, I think by and large, most of the people in the ethcare space just felt like we were going on a fool's errand, to be uh to be candid. Yeah. Right. Um, because when they we were just student team, like right, we just barely out of school trying to do this. And then a lot of people that did the work uh like you know, had money from the big foundations to set up something, and then when the money ran out, they kind of like went went ahead and did something else. And people just felt that infrastructure work should be government work, like that's you know, it's Capex in. And I think that's to be fair, they're right. Um but for me, I have a quote I tell my team is that the job determines the job. If the job is infrastructure, then that's what we would do.
SPEAKER_03Yeah, right.
SPEAKER_01It's not like and you can't shortcut it. That's why, you know, when I see folks from the digital earth space trying to move mountains, but then they rely on that infrastructure. I'm like, you cannot, you don't even control your own destiny. Yeah, right. So you cannot, you know, it's gonna be always gonna be tough for you. Right? So for us, from first principles, we asked ourselves what the people want the most is uh access to good quality care close to home. Yeah, right, close to home that is affordable, that is um you know, quality, and that you know, that they feel sand. That's what people just from a basic first person point of view. So doing anything less than that, that won't have them hit those notes, wouldn't have worked regardless.
SPEAKER_04Yeah, yeah.
SPEAKER_01And so when people told us no, um, we just said, you know what, we would um we would just keep going. We were lucky enough to get a few. We won, we did the thing where younger entrepreneurs do where we won a lot of grants from this competition and that competition and this competition and that competition. And we got a grant from this foundation that actually Genevieve used to work with, and that was the funding that we used to do the first location.
SPEAKER_04Okay.
SPEAKER_01And when the numbers came out by month three or month four, we were seeing 400 patients a month.
SPEAKER_03Wow.
SPEAKER_01Right? So that was like really great signal. We were in our old business, we spent two years and we had five clients. And in this new business, in like three months, we had 400 people coming to our location. Yeah. Because we were in the Badon. So, and it was in Ring Road, the Badon. In fact, which it's that location now is our smallest location. Um, unfortunately, because we could have taken the old building, but we didn't know we were going to be successful. So we edged our bed. We took only the ground floor.
SPEAKER_04Yeah.
SPEAKER_01So we've had to open more locations in the badon now because that location is way too small for what we needed. Uh and because we number one, customer service and all of these things, we put our customers, our patients first.
SPEAKER_04Yeah.
SPEAKER_01And so a lot of these things now are the foundational principle with which we we run the business, we have really great ambient centers, and then we do really amazing turnaround times, and we also make sure that we're always, you know, the doctors trust us, we give great results, and they trust us because of that. Yeah. And we're always like working with them with diagnosis, right? So before you know it, we kind of like just um took off in terms of, and in fact, after we did our center, all of the centers around us that looked very shitty at the time I was going, everybody went to kit up their centers after that. Um, right? Because we took so much of their own kind of away. Yeah. And so everybody went to kind of like you know, redid their center pretty much because of us at the time. So impact. So, but once we got that, what took uh we got the numbers. One thing is that we started applying for like textures, yeah. And we were able to get into textures, and then Colli now, who is also a great friend right now, um, of VP Ventures Platform, invested in us also about the same time.
SPEAKER_04Yeah, yeah.
SPEAKER_01And that gave us like now that validation. That we needed to say, okay, maybe we're we maybe we're on to something here. This is just one location. Maybe we can do a second location, maybe maybe we can do third location.
SPEAKER_00Yeah.
SPEAKER_01And so that's that's how that happened.
SPEAKER_00So I'm curious when you then, after the pivot and you saw the results from your first center, and you went out to Techstars, you went out to Colino, what did your pitch deck look like at that point? Because the story of your company was 2016, we did really great. We started this company 2017, then we pivoted, and then we had this really successful center in Ibado, and now we want to do more. What was in that pitch deck and what did investors lock into? Like when they locked in, what was that?
SPEAKER_01Well, I should have sent to that pitch deck. Yeah, I would love to love to see that. Yeah. So so this funny enough, I looked at our old pitch deck um recently, and the thesis of that pitch deck and our current pitch deck is still the same pretty much. It's still like earthcare infrastructure for the masses. Yeah. Um and at the time, um, we we we said it was the thesis was that you know there's a lot of um historically diagnostics was built uh or earthcare in Africa generally is really built around treating infectious diseases. But now you have this double burden of diseases with NCDs coming through.
SPEAKER_07Yeah.
SPEAKER_01And NCDs require capital-intensive diagnostics to do, yeah. And someone has to do it. And so um, this is not a substory about oh, poor Africans, is that this is a massive market opportunity to build the infrastructure to help you know support ethcare systems across Africa with diagnostics.
SPEAKER_04Yeah.
SPEAKER_01And and so that that's the thesis that you know when I listen, I listen to my Texas Pitch Deck Um Um demo day, yeah, and it's still exactly how we pitch the business today, yeah. Um, is that there's a massive opportunity to you know make sure that its systems across Africa have access to great diagnostics.
SPEAKER_05Yeah.
SPEAKER_01And in, you know, that's still true today. That was true back then. And right now, what's different is now, before I was saying that aspire to Paspire. In the future, you see this now you can say, Here are my numbers over the past 10 years. See for yourself. I'm not, I wasn't, you know, at that time you need to have a little bit of faith.
SPEAKER_00Yeah.
SPEAKER_01But right now, you don't really need to have faith anymore. You can just see the numbers. Yeah, yeah.
SPEAKER_00You can say it wasn't a bluff.
SPEAKER_01Yeah, I wasn't well. I think the people, it is, I don't know. People when we people are cynical, rightly so, because you know, there's a lot of challenges out there. When we tell people stuff about like we really want to build, like when I told teams, um investors that, oh, I actually want to build like no 20 locations like in the next three years, two to three years, we were like, oh, it's not possible. It's just like now we have 25 locations, right? It's possible. It's just about solving what what are the barriers you have, you know, which is like you know, operational capacity to build those centers. Um, two is that does the market for those centers exist? Very important. Yeah. And the answer is a yes to the market question. And for the operational capacity, if we don't have it today, it's something we can develop. Yeah. And that's what we've developed over the past, you know. So so when we did the first location, I think we waited to 2019 to do our second location.
SPEAKER_03Okay.
SPEAKER_01So we took all of the lessons we learned in the first one because in the first location, we employed um a lot of people who'd worked in diagnostics before. So you had to deal with a lot of people's bad behavior to kind of like cost correct. Cause correct. But in the look in the second location, we decided that everybody there could, you know, is someone that's not really worked in a typical diagnostic center before. So that we can teach them our own playbook.
SPEAKER_00Which is all MDAS way.
SPEAKER_01Yeah. And so we've kind of like iterated on that now. So right now we have a proper playbook for our centers, how we set them up, how we operate them, and and how we do everything. So so yeah.
SPEAKER_00Interesting. And when we think about the scaling of that brick and moss, so we've we've talked through your first center. We're still in part one of your kind of company thesis. Um by 2018 or 2018, you had done one center. By 2019, you had done your second center. By 2022, you had 15. Right. And then today you have 25, 26 company-owned centers, 40 affiliate clinics um across 15 states. You also have a center in Cameroon, so you've expanded to another country. Um and a footprint of that scale requires quite a lot of operational discipline, and especially in an environment that doesn't make any of this easy. So I'm curious, what does it actually take to keep this network running every day across so many cities and so many states? Like walk us through the operational reality of MDAS, Beacon Health on a day-to-day basis?
SPEAKER_01Yeah, so so that's a great question. Um, obviously, managing all of that is a lot of work, but this is where technology can help. You know, I think that you know when people think about the role of tech in educare, a lot of people want you to build tech that you can sell to people or customers can pay for. Um, I think oftentimes in edcare, what I've seen mostly is that tech can help you optimize, um, help you run things better, yeah, faster, you know, in a more organized way. Um, but you might not be able to nobody wants to pay for your tech.
SPEAKER_05Yeah.
SPEAKER_01Like, because we build a lot of the tech we build that runs our our our centers. Um and we do build a lot of tech. I'm a software engineer by training. Um, we don't sell it to anybody, we just use it for our operations, right? We don't sell it to anybody. So, for example, our patients have a a platform they can go to to check their results and track everything there. Our HMO partners have a portal they can go to to track everybody they're sending to our facilities.
SPEAKER_05Yeah.
SPEAKER_01Uh our centers have technology that runs it, that forces them to work in a specific way. Yeah. And our results, if you see a result from beacon out from, say, Lagos, and see a result from beacon out from offer, it looks exactly the same. And if you go to a Lagos facility or an offer facility, they look also pretty much the same. They tend to have the same equipment. Uh, you know, it's like really standardization and then using tech to enforce workflow so that your patients go there, this is what they do. They go here, this is what they do, then they go here, this is what they do, and then they they wait a little bit and then they get the results on their on their phones, or they come back to pick up a physical copy of the results, whatever their preferences, it we cannot the tech forces people to do that way. So I think what has helped us is the ability to use tech to standardize and and run in a specific way. Yeah. If you take someone who has worked in our center in, say, Lagos and put them in a different center, they would just keep going. Like they're not doing anything different. And oftentimes, even we when we do a new location, we like to like seed one of our old folks from an existing center in a new facility to kind of like ensure that we maintain that continuity. Yeah, yeah. But it's not just about the tech, also, you it's it's also about system the operational processes and how you run your organization. Um, so you know, that's also very important, you know, and so we're lucky enough that we've been able to do that. And obviously, it's not there will be time where we fall short, but like, you know, overall, we've been um we've been great at that. Yeah. I always tell my team this to encourage them. I tell them that anybody can do, you know, 500 patients in a month. And you you can use paper for that, but right now we do between 15 to 20,000 patients a month. And so not many people in Nigeria, even the big shot folks, yeah, can really undo 20,000 patients a month and there won't be any issues with it. And that's what my team does routinely every you know, month in, month out. So it's quite impressive.
SPEAKER_00Yeah, and another aspect about your operational um the way that you run your operations is this five-tier location framework that you use to classify different markets, which I found very interesting in my homework when I was reading off on it. You have your tier one metropolitan cities, which ties into what you had mentioned even in the beginning, where you see that you tend to see a lot of diagnostic infrastructure concentrate around wealthy urban areas. So you have your tier one metropolitan cities like Lagos, Abuja, Kano, Potakot, all the way down to tier five, where it's more rural communities. And the strategy that MDAS takes anchors to your tier two. So your tier two is like your state capitals or your major commercial hubs like Ibado, Lorne, Oshogo, and that is where you anchor your strategy because the idea for MDAS is this kind of mass market, like where does the demand sit? Especially, and I love that you brought that up, the unconsumed demand, and how do we get there? And a lot of the times it is in these tier two cities first. Um, walk us through how that tiering framework actually came about. Like how did you how did you develop it? How did you, what went into the sinking behind the framework and how does it actually play out in practice? Because I see that in that query that you had sent me, there's there's a way that you you go through a very structured process before you think about expanding into a new location based on this framework. So I'd love you to just bring us along into that thinking process.
SPEAKER_01Yeah, so so the I know I always tell tell folks that I know I'm mad, but there's a method to my madness. Yeah, there's a method, yeah. There's a method to it, right? I think we started in a tier two location and and we saw the we saw how quickly we were able to get to market fit because we were solving a particular problem for the community. In the end, anytime we put a diagnostic center in a place, we're solving a problem for that systems. We're truly like a edge systems innovation.
SPEAKER_08Yeah.
SPEAKER_01Right? Because in the end, um uh most of our patients will still come from doctors.
SPEAKER_05Yeah.
SPEAKER_01Doctors that should have, if they had the money, would have bought their own equipment. But because they don't have the money, um, they don't have equipment. So we we are we are pretty much their centralized diagnostic departments for all of the small, medium-sized hospitals across that community.
SPEAKER_04Yeah.
SPEAKER_01So one of the things we want to ensure at the beginning when we did this is like where is the demand? It was easy to say Lagos, that's where all of the people were. But in Lagos, number one, I didn't grow up in Lagos, I grew up in a small town in those states, right? So at the time I was not really passionate about doing another urban, you know, just my soul was not. Another thing in Lagos, yeah. So, so but doing it in Madden saying that trajectory that we had kind of made me a lot more curious about like where else in the country can we go to and have similar trajectory, yeah, but it's not Lagos. So our second location was in Ilraine, right? And our trajectory in Learning was even faster than in Badang.
SPEAKER_04Yeah.
SPEAKER_01Right? And so we started understanding to say, okay, what what what are the things why are we successful?
SPEAKER_05Yeah.
SPEAKER_01Not just saying, oh, we're successful, great. It's like why? And we saw we saw that we're solving a particular problem for the people, for the earth system. And so at that point, we now became where else can we go to? Right. So the next one after that was was Offar.
SPEAKER_03Yeah.
SPEAKER_01Sorry, was Oshubo. That was the third one. And Oshubo was interesting because we had a totally different, we were not in a major part of the town at all, right? So it took us a little bit of time to ramp up there, and then COVID hit, right? And so, but one thing we quickly started realizing is now what two things are important. The city we go to are important, and the locations within the cities are also important. Yeah, that's one thing we learned there. So at some point, and then we eventually came back to did one center in Lagos, and then we realized that Lagos was actually difficult, it was competitive because Lagos is a HMO and corporate market. Yeah. Um, and obviously the big guys are kind of like there's a huge, it's very competitive with Sinlav, Sebalancet competing, Africa Global, Mikhail, and the rest competing for the same person of the pie. So we we we realize that you know what? It's good to be in Lagos and all, but the biggest place where we can have the most impact, and impact is something that is important to us. Yeah, it's gonna be in you know, places where we can be the painkillers instead of the multivitamins.
SPEAKER_07I like that.
SPEAKER_01So we want to become so our goal internally when we go to new places that we want to become an utility in those places where without us, you know, um, you know, like with us they've been there, we just they just need us because we're so ingrained into their healthcare system. Yeah. And the big test for this came during COVID, where you know, at some point people were home and people were worried at the time that you know we're gonna lose our customer base and whatnot. But the business actually grew. Like even without COVID revenues, we didn't really do a lot of the COVID molecular lab. We did our molecular lab after the fact.
SPEAKER_08Yeah.
SPEAKER_01But we so we didn't book a lot of like molecular lab revenue, but our main business grew a lot during that period, which because we were the places that was the most reliable to get diagnosis being done in these communities.
SPEAKER_05Yeah.
SPEAKER_01So then um, after a few centers, we tried said, no, where else can we go to? Can we try a different, a smaller town to see if the model still works? So we tried Offa. Offa, I don't know if you've been to Offa recently. Um it's a big commercial town, historical town, uh, but it's very it's very dusty. But there's a lot of people there in a lot of universities now there, uh stations there now. And we were the first diagnostic center in Offar.
SPEAKER_05Ever.
SPEAKER_01Yeah. And the way the business took off there was amazing. So we're like, wow, the business works in a in like the state captain, but it's working in an even smaller town. So that expands our uh our total addressable market. And so, you know, we obviously did more centers. The tier two are still key to our, you know, because we're trying to expand on distribution. We can talk about distribution later.
SPEAKER_04Yeah.
SPEAKER_01Um, but if last year we decided to test even smaller than offer. So we test our most remote co-location, Share, in in um two hours away from Elari. Um, it's um, I've never been there, probably will never go there. Um, it's really remote. Yeah. Um it's heart of the beating parts, right?
SPEAKER_05Yeah.
SPEAKER_01And the model also still works there. Um so now we realize that it's just it's a massive market.
SPEAKER_04Yeah.
SPEAKER_01The market for diagnostics in Nigeria is massive.
SPEAKER_04Yeah.
SPEAKER_01But the problem is gonna be how do you scale like this infrastructure to as many places as possible? One key caveat in those places is that the revenue potential we which we also look look at in those places might be slightly lower than than the revenue potential in like a tier two or tier one location.
SPEAKER_07Yeah.
SPEAKER_01But you're gonna get profitable much, much quicker in those places because um, you know, the need is so great that and so everybody that is in Latin that used to travel two hours before will stop traveling. So in Offa, for example, one of the reasons why we did Offa at the time was that every week we're seeing between 15 to 20 people come to our facility from Offa in Illori, which is about 90 minutes away, right? And we're like, oh, if we're seeing 20 people coming to us, that means all the diagnosis centers in Illinois are also seeing like 10 to 15 people come to them, also. Yeah, right. So that lets us know that there's enough people in offer to justify you know having a diagnostic center in offer. Yeah, now we see maybe 40 to 50 people per day in those in offer. So so that's that's how that model um came into being. And then this year we said, okay, let's formalize the requirements because now we actually want to expand across the country. Yeah. Um, we at scale will probably have at least 100 facilities across the board. So we wanted to actually just put it down so that as we think about new locations, it won't be about like, oh, we don't want to do this now. As long as you're on our list, we if and we can find a property there, we'll just do it. And we have the money, we'll just do it. We don't think about because some centers will take nine months to break even, some centers will take two years. Yeah, but now we're more we're we we're more open to doing all kinds of centers, just knowing that the distribution is to go. Yeah. Um, so so yeah.
SPEAKER_00Our conversation with Sugar Oni was so rich and insightful that we had to split it up into two parts. We are discussing everything in the diagnostic space in Nigeria and what it takes to really build the rails in this industry. So come back for part two where we continue this really insightful conversation. See you in the next episode. Bye.
