1 September 2023 Africa Healthcare Network (AHN) Expanding access to world class, life saving care at an affordable cost
2 Executive Summary External Developments Tanzania : Govt continues to want to reduce rates, with stronger resolve. They’re cutting # of sessions, pharma pricing, and looking to exit contracts with Harsh/Fresenius, creating major PPP opportunity for AHN Kenya : Continued Fx slide (Jan 124:1 April 132:1 Sept: 146:1), new taxes, and local kit purchases are impacting margins. On positive side, NHIF payment improving and more brownfield opportunities emerging Rwanda : Transplant program has launched (small scale, 9 to-date). Govt. has back-tracked on rate increases recently announced, creating confusion. Rate intervention needed (A50 / USAID support?) Recent “hits” Financing: Local teams navigated cash crunch and limited the distraction over prolonged process Deal signings: Continued progress across all three countries, with our 42 nd center recently signed. Promising opportunities in Zambia ($100/session) Local capabilities: Country teams maturing with broader and deeper talent pools emerging SG&A: Total overhead remains lower than one year ago, despite ~60% YoY volume growth Recent “misses” Project delays: New center openings have lagged (in part but not fully due to funding delays) Volumes: Slow organic growth in Tanzania for Q1-Q2, though promising uptick so far in Q3 Margins: As Bain requires full pre-payment, we’ve used local kits in KE (on credit), adding $4-5/session EBITDA: Impacted by several factors (project delays, TZ growth, local kits, Fx ); some of which is temporary ALMC: Legal process continues, as we seek NHIF sweep and/or asset seizure (next court date 9 th Sept) Overall, our 2023 plan is 2-3 months behind target, with Q3 focus on closing the gap
Current Performance Snapshot 3 # of Clinics Operational + Signed Dec 2022 Aug 2022 Comment Total Volume # of Sessions / Week Unit Margins EBITDA % Overhead Total SG&A (Annualized) EBITDA Run-Rate (Annualized) 31 42 BD is on-track overall, despite some project / signing delays 1,730 2,100 Organic growth largely on-track (puts/takes), with gaps on inorganic XX % 39 % Margin - X.X % vs. plan due to mix effect, Fx impact & local kit usage $ X.Xm $ X.Xm SG&A flat despite top-line volume growth, as we continue to scale up $ X.Xm $ X.Xm As noted, EBITDA uptick 2-3 months behind; focus on closing the gap We’ll do projections together Mike to fill the first two columns in
Current Performance Snapshot 4 # of Clinics Operational + Signed Dec 2022 Aug 2022 Total Volume # of Sessions / Week Unit Margins EBITDA % Overhead Total SG&A (Annualized) EBITDA Run-Rate (Annualized) 31 42 1,730 2,100 XX % 39 % $ X.Xm $ X.Xm $ X.Xm $ X.Xm Dec 2023 50 3,000 XX-YY% $X.X- Y.Ym $X.X- Y.Ym After a tough Q2, we have solid momentum to close out the year We’ll do projections together Mike to fill the first two columns in
5 Q1’21 Q2’21 Q3’21 Q4’21 Q1’22 Q2’22 Q3’22 Q4’22 Q1’23 Q2’23 Q3’23 1 * 3 * 1 * Q4’23 2 2 5 5 Tanzania Rwanda Kenya Zambia Total centers Total hospital signings, by quarter 22 23 25 25 27 28 3 1 32 3 5 3 7 4 2 47+ BD: We continue to sign new centers, in line with expectations Goal remains: ~50 centers by the end 2023, ~75 by 2024, and ~100 by 2025 +10 in last 4Qs +5 in prior 4Qs +10 in next 2Qs * Expected, not yet signed
Volumes: Key levers to boost volumes by December 2023 6 Current
Run-Rate KE: Metropolitian
+ Ladnan 130 KE: Other
brownfields KE: Center
openings 130 KE: Organic 120 TZ: Organic 30 RW: Organic Dec’23
Projection Compared to Dec’22, this would be 73% YoY growth Despite financing delays, we have a good shot to close the year in a strong way Exact deals we win TBD Likely +/- in some areas, but reasonable in aggregate As context, in Dec’22 we did 1,730 sessions 5 new centers plus 2 expansion projects Weekly Volumes (# sessions)