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As a student at the Graduate School of the University of Washington in the USA, what first struck the then 28-year-old Antony Natif was the quality of healthcare in the developed world.
Back home in Uganda, his countrymen and women were suffering under the yoke of limited access to life-saving drugs.
“More than 40% of counterfeit medicine seizures are on the African continent and by some estimates, at least 30% of medicines sold in this part of the world are either falsified or substandard and that’s not to talk about ability or inability, that is, of our people to afford good quality medicines,” Natif recalls.
And it is not difficult to understand why Natif was preoccupied with improving access to healthcare for the majority of Ugandans. He himself, had grown through a bare-minimum childhood.
He was raised in Seeta, Mukono District, on the outskirts of the Greater Kampala Metropolitan Area, by his father, Abner Natif, a retired teacher and his grandmother. He is the last born in a family of about 25 children. He never got to meet his mother. His grandmother served a dual role.
“She guided most of my decisions,” Natif recently told The Observer newspaper in an interview.
He attended Seeta Church of Uganda Primary School and then went to Namilyango College, one of the best schools in the country for both ordinary and advanced levels. He then went on to Makerere University on government sponsorship, to pursue a Bachelor of Pharmacy.
As young child, Natif had a knack for doing business, that was accelerated when his Cambridge-trained teacher and Schools Inspector dad retired, putting the family’s scarce resources under further pressure. With encouragement from the grandmother, a young Natif started a side hustle of fetching water for the neighbours. He also took on a job as a cashier for a local video hall, locally known as Kibanda. By the time he joined Namilyango College, he had saved up to about UGX100,000 (USD27 today) with his grandmother, acting as his savings box.
This helped him shop a few things to make his start in high school a little more comfortable.
As a bright student in class, Natif studied on scholarships placed aside for bright children at the School.
“I had no option but to be the best in class, or I would be sent away from school for lack of fees. My grandmother advised me to join Namilyango College. In hindsight, she knew that I would study for free. I scored four aggregates at P.7, nine at S.4, and 24 points at S.6. I later proceeded to Makerere on government scholarships.” Natif narrated to The Observer newspaper.
“For most of us, education remains the only reasonable gateway into an almost equal world with children born out of affluence. Without Namilyango, I wouldn’t have had this opportunity. I have a lifetime commitment to paying it forward,” he added.
Natif, in fact recently committed to donate half a billion shillings towards the Namilyango College Endowment Fund, that among others, seeks to help more financially constrained children complete their education.
“As a beneficiary of the generosity of Namilyango College, it was my role to pay it forward. The first gift was UGX100 million. The other UGX400 million was given in honour of my grandmother and will be paid over 12 years. This is to challenge my 12-year-old daughter, Ruby, to always pay acts of kindness forward,” Natif said in The Observer interview.
A pharmapreneur is born
At Makerere, he would later chance to meet with Professor Ogwang Engeu of the anti-Covid-19 drug, Covidex fame. On learning that Natif was pursuing pharmacy, Prof. Ogwang who had just opened up his Genesis Pharmacy in Kyebando, a Kampala suburb, offered him his first job.
He later joined Vine Pharmacy, owned by Pastor Grace Munyirwa.
Natif confesses he picked up significant pharmapreneurship knowledge from Pastor Munyirwa.
“Munyirwa taught me everything that I know about retail pharmacy. He took a bet on me and allowed me to flourish as a young man. It was from him that I learned that it works to empower young people. We eventually became friends. That is how I learned how to raise capital,” Natif recalls.
“He allowed me to own pharmacies under Vine⏤ one in Ntinda and another in Kabalagala. Grace visited me in the United States in 2012. He offered me a deal to buy out my interests in those two pharmacies, which I took. That’s what sparked the start of Guardian,” Natif told The Observer.
He subsequently landed a job at the Uganda Cancer Institute, a government-owned health facility as an oncology pharmacist between 2007 to 2011. While at the Uganda Cancer Institute, he would meet with Corey Casper, a world-renowned researcher on cancer. Corey was helping the Cancer Institute trained doctors, through a collaboration between the University of Washington and the Fred Hutchinson Cancer Research Center, also in the US.
This is how he landed an opportunity to go to the University of Washington, where he specialised in HIV-associated cancer.
“It is at this university where I learned how to think and question things without fear of reprisal,” Natif says.
Upon completion of his degree, he briefly worked at the Seattle Cancer Care Alliance before deciding to return home.
Lucky enough, back in November 2012, while still at graduate school in Washington State, he had incorporated Guardian Health Limited, a company whose vision was to transform the quality of healthcare in Uganda by ensuring access to high-quality, yet affordable medicines, for the commonest ailments, eating up Ugandans.
Using his savings of USD50,000 he opened his first Guardian Pharmacy store in Kabalagala.
“ I could have remained in an air-conditioned office and pumped out research papers highlighting the problem like lots of folks in my position would. I chose instead to roll my sleeves and do something about it; get my hands dirty, if you will.,” he later told CEO East Africa Magazine in a November 2022 interview.
“I had a keen interest in public health and wanted to make tangible improvements in the lives of people back home on the African continent,” he said, adding: “I believed and I still believe that well harnessed private enterprise can play a pivotal role in addressing these seemingly intractable societal problems.”
Guardian Health was started with a mission to provide quality pharmaceutical care aimed at improving the health, well-being and quality of life of Uganda. The company’s vision is about becoming Uganda’s neighbourhood pharmacy of choice. This is all built on the values of professionalism, integrity and dedication.
But as it is, a powerful vision and mission are not enough to run a successful business. Capital is equally important to fuel the ambition, as Natif would later learn, the hard way. The hunger and vision to change things got him into a faster-than-he-could-manage expansion, an expansion that in his own words, was not well thought through.
“As a growing company, it is very easy to lose sight of your bottom line and instead put more emphasis on the volume of sales. The amount of money you’re putting in the bank blinds you and you start thinking that all that money is your money. And then you pick that money and use it for expansion, that’s what we did,” Natif told Digest Africa, in a January 2018 interview.
Digest Africa is a Ugandan data analytics company, that provides an exhaustive database of African startups by sector, stage, country etc with their funding history.
“When you’re in a single founder company, you get tempted to think “I make all the decisions, I have all the freedom.” But, you can not have freedom when you have all the worries of all supplier debt. You have the worry of, “I need to make the payroll, how do I make the payroll and then still expand?” Natif further told Digest Africa.
“So, you know those challenges. You never sleep. There was a time I used to sleep for only 3 hours. Because you’re constantly worried about your people’s next paycheck. You mortgage everything you have to make sure your dream comes to fruition,” he added.
So into expansion, he was that initial attempts by another Private Equity Fund to invest in his Guardian Pharmacy were rebuffed.
“In 2015 we were doing very well, the fund came in and we signed a letter of intent and didn’t bother following up. Then 2016 we get on an expansion drive and things started going south then we are like oh, we need this investor. I hadn’t paid much attention to private equity, quite frankly. But then that first encounter with our partners got me curious. So I read about it a bit. The need for money, I didn’t think it was there. And that’s partly because I never paid attention to my bottom line. I was paying more attention to what we were putting in the bank,” he recalls.
“Back then; our expansion wasn’t informed by clear financial analysis as it is these days with my partners onboard. You start thinking, if I am turning over x billion shillings, why would I need someone to give me more money? I already have enough money. So, I suppose part of my refusal wasn’t the loss of control per se but it was largely down to not properly having systems in place to help inform our decisions to expand.
He also says that the fear of the unknown also contributed to his initial snubbing of private equity.
“You don’t know what’s going to happen. And, you just don’t take it up. Which is a really stupid decision that I made. But at least, I can live to smile about it. Other people don’t. Their companies don’t survive that expansion,” Natif says in the Digest Africa interview.
He also talks about the fear of losing control that initially gripped him.
“You see, now, that control question is what stops a lot of people from considering say private equity or getting partners on board. Because they’re so obsessed with staying in control. But, what point is it for you to have all of something so small as opposed to having a bit of something huge? Something that’s going to reach millions of people. Which would you choose?”
“Control is overrated, help is what you need. Then you grow together,” he adds.
Ascending to the top in 6 years with Ascent Africa
After running out of cash flow, he was forced to go back and knock on the door of Ascent Africa, and after six months of due diligence, he secured an investment from them.
Ascent Africa is an East Africa focuses independent Private Equity Fund. It is running the Ascent Rift Valley Fund, a USD80m private equity fund and the Ascent Rift Valley Fund II, a USD120m private equity fund.
Ascent Africa, in 2017 acquired a controlling stake in Guardian Health. Following the majority stake, Ascent Africa also infused both working capital, creating better cashflows, a wider product portfolio, better systems, a larger footprint and a bigger working force. As of March 2023, Guardian Pharmacy had expanded from 5 stores to 19 stores in 6 districts, with a workforce of nearly 1 million people. It also became the country’s largest retail pharmacy chain.
Neither Natif, nor Ascent Africa will say how much they invested in Guardian Health, but Natif is grateful that they came on board.
“This company has benefited from appreciating the importance of having proper, functional systems in place. Most single-founder companies find it difficult to evolve into a well-run corporate entity. There are always teething pains and I feel we’ve worked a lot to move the company from just being a subsistence entity running on the whims of the founder to a corporate entity with aspirations for the best corporate governance in its class,” he confessed to CEO East Africa Magazine in the November 2022 interview.
According to Cedric Ssendiwala, the Guardian Health General Manager, the coming of Ascent Africa allowed the company to have better cashflows, better budgeting and managing costs.
“This means we are able to keep our suppliers happy and maintain good relationships with them such that even when unforeseen events like COVID-19 disrupted a lot of businesses and supply chains, we were able to stay afloat and rebound back quickly,” Ssendiwala told CEO East Africa in an earlier interview.
“The core nature of our business is that we supply products to cater for our client’s needs so in the past we found ourselves with a bloated products portfolio and some items would not sell hence putting a strain on our financials however with support from Ascent, we have been able to access analysts and this help to have a better understanding of our portfolio and reduce it down to be more efficient in catering to our customer’s needs in a more reliable manner. This has actually improved customer satisfaction as they can always be sure they will almost always find their product needs available,” he added.
“With the capital input from Ascent, we have been able to expand our supplier base especially overseas. This has helped us reduce reliance on local suppliers for some products and also helped us to increase access to quality medicines and other wellness products at the best prices in the country,” Ssendiwala explains.
Guardian was also able to attract and retain great people.
Private equity firm, Alta Semper, through its MYDAWA investee firm, buys 100% of Guardian Health
With the financial and governance inputs by Ascent Africa, Guardian not only became profitable, almost overnight, but it also became a sort of ‘beautiful bride’ for the next private equity suitor. Valued at about USD10 million at the end of 2022, it was just a matter of time. After all, it was about time Ascent Africa exited and cashed in on its investments⏤ the nature of private equity investments anyway.
This week, MYDAWA, a Kenyan-based Alta Semper investee e-health company announced that it had bought 100% of Guardian Health at an undisclosed amount, which our sources say could be “a little below USD10 million”.
MYDAWA acquired both the stake held by Ascent Africa as well as that held by Anthony Natif, the Co-Founder and Chief Executive Officer until last week.
MYDAWA was in 2016 founded by Neil O’leary, the billionaire Chairman and CEO of Ion Equity a private equity firm that invests in energy, agroforestry, multimedia, healthcare, and hospitality sectors on the continent and Tony Wood, an ex-Wananchi Group and Alcatel-Lucent health technology, e-commerce and strategy business leader.
MYDAWA is Kenya’s first fully licensed e-pharmacy, providing patients and consumers with convenient access to affordable and genuine prescriptions and over-the-counter medicines as well as health and wellness products along with a wide selection of personal care products. In 2019, AAIC, a Japanese-backed African healthcare fund, invested USD3 million into MYDAWA, acquiring some stake in the business.
Alta Semper Capital, a healthcare leading Private Equity firm recently acquired a majority stake in MYDAWA and infused USD20 million into the business. We do understand that the MYDAWA e-healthcare business has not been performing to expectations, necessitating the acquisition of a healthier Guardian Health to create a well-balanced cross-border bricks-and-clicks healthcare portfolio.
I want to take off time, travel, recharge my batteries then come back to build
In an emailed comment, Anthony Natif, the Guardian founder and now ex-CEO, said he was glad they had found the right partners to continue his mission of easing access to medicine for Ugandans.
“When I went to pharmacy school at Makerere University and later to The Department of Global Health at the University of Washington, my goal was always to build something that would address the problem of access to medicine but also address the issue of counterfeit medicines in sub-Saharan Africa,” he said. “By starting and successfully growing Guardian Health into a pharmacy chain that reaches millions of people, I think our partners and I have done our part in showing that business can be a force for good. It can be a force for public health good,” he added.
Natif said he leaves Guardian with “a lot of gratitude to my partners, Ascent Africa who took a chance on us even when convention said they shouldn’t”.
“I’m glad to say we’ve returned their investment with significant upside. I especially would like to thank our staff over the years who have laid it all on the line to ensure our clients get the best pharmaceutical care possible. I believe they’ll continue doing their best to grow a dream we started more than 10 years ago. They and our clients are the real MVPs,” Natif reiterated.
“I’m excited for the future of the company under the stewardship of young people like Cedric Ssendiwala that I’ve painstakingly mentored and supported to become the future leaders of the healthcare industry. It’s gratifying to see them take the reigns with confidence. I have every intention to support them to overwhelming success. I believe MYDAWA shares a lot of the values that pushed us to start this company and I’m confident they’ll take the company to even greater heights,” Natif further said.
“I leave with a lot of gratitude to my partners, Ascent Africa who took a chance on us even when convention said they shouldn’t. I’m glad to say we’ve returned their investment with significant upside,” Natif told CEO East Africa.
He is also very grateful to the company’s staff who he says “over the years have laid it all on the line to ensure our clients get the best pharmaceutical care possible.”
“ I believe they’ll continue doing their best to grow a dream we started more than 10 years ago. They and our clients are the real MVPs.”
Natif is also excited about the significance of the transaction to the infant startup ecosystem in Uganda.
“This exit isn’t just for us, it’s also for the Ugandan and East African ecosystem. We’ve been laughed at for a while as a region without successful exits. Of course, that’s a false narrative that moments like these and the ones to come after will most certainly refute.”
On where he is going next, Natif says he wants to “take off time, travel, recharge my batteries then come back to build.”
On what lessons he has learned from the entire experience of building Guardian Health that he would like to share with fellow entrepreneurs, Natif says: “Being a founder is a very lonely, emotionally debilitating experience and oftentimes, only you will know this. It’s okay. It’s the price. But find ways to let off this pain and frustration. Find a balance. It’s for the good of your mental health. Be unapologetic about protecting your emotional space.”
“Founders need to recognize the importance of putting their aspirations below the dreams and vision of the company. The collective is more important than you, the individual. Choosing to hold onto a small dream because it gives you the illusion of power might not be the best way you serve your company and its objectives,” he told CEO East Africa, in an earlier interview.
He says that “choosing who to partner with shouldn’t just be down to who is cutting the cheque.”
“That partnership will most likely live or die by other intangibles that have very little to do with money. I’d encourage founders to think about this before they jump in bed with anyone flashing a chequebook. Do your own due diligence as they do theirs. It’ll save you numerous headaches. The importance of finding alignment at the get-go can’t be over-emphasised,” he concludes.