Symposium 4Social entrepreneurship & eye care

Role of Social Entrepreneurship in Eye Care: Up-scaling and Sustainability

Professor Kovin NaidooGlobal Programs Director

WHO, 2010

• “As the world grapples with the combined challenges of economic slowdown; the increasing globalisation of the economic system and of diseases; and growing demands for chronic care, the need for universal health coverage (and a strategy for financing it) has never been greater”

• Despite best intentions, governments still grapple with:− Where and how do they find the financial resources?− How can they protect people from the financial consequences of

ill health?− How can they make optimum use of resources?

GLOBAL POVERTY STATISTICS

Almost half the world (over three billion people) live on less than $2.50 a day.

Disability and Poverty

• 82% of the 600 million people with disabilities worldwide live below the poverty line (Khanna, Raman &

Rao, 2007)

• 64% of those with disabilities were not in poverty prior to the onset of their disability (Gooding, 2006)

• Households affected by disability:− 3x more likely to enter poverty within one year of

onset− Lower probability of leaving poverty → increased

costs and reduced earningsDisability Poverty

PARADIGM SHIFT

Public sector

Social enterprise

Private sector

Reaching the 7 billion

For Profit

Social Enterprise

Not for Profit

Social enterprise

Socially minded

Revenue generated= +

Social enterprise is not:• Traditional fundraising

• Grant money

• Gifts/donations

• A “quick fix” in a time of a crisis

• For everyone

Social enterprise is:• Creating sustainable

revenue streams

• Engaging market forces

• Devise new ways to leverage existing assets

• Decreasing dependence on the external funding

• Utilisation of business methods

Eye health and income generation

• Can conflict with universal health coverage

• Can be controversial− e.g. sale of reading glasses

Social enterprise strategy

• Experience in URE

• Not all activities to conducive to income generation− Health systems integration

• Human Resource Development

Mission Centric SE

• Most eyecare NGOs will have a mission centric social enterprise

• Primary purpose to advance the social mission

• Social programs and business activities have a significant effect on each other

Risks of establishing/converting to a social enterprise

• Erosion of core values

• Investor dictated agenda

• Governance challenges

Should your organisation undertake SE or undertake other earned income activities?

Is your organisation risk averse?

Does your organisation have the organisational capacity to start and run an enterprise

Will a separate business provide the best opportunity to meet your goal

Y

N

N

N

Y

Y

Earned income activities Social enterprise

Initiating a social enterprise

• Expand what you already do− Commercialise something

your organisation already does, e.g. creating a fee for a service model within an existing program

− Develop a new aspect of something your organisation already does

• e.g. expanding services to a new population

• Start something new− Create a new

commercial product or service

− Or do something totally new

Attracting investment

Find the perfect match• Research• Don’t try to fit a square peg in a round hole

Lead with people Not the enterprise• Whose lives will you change• How will their lives be transformed

Measure impact• Be clear on social impact and how you measure it• Set and measure clear financial goals

How can we source start-up funding?

• Conventional modes of funding− Donor/government− CSI− Crowd sourcing/Online platforms− Local governments− Business Angles− Philanthropy− Foundations− Social Investors

Cautions

• Distraction from your mission

• Donor cannabilisation

• Inadequate resources

• Diversion of resources

• Cultural difference creates tension between NGO and enterprise staff

• Cause of financial losses

• Conflicting stances among board

• Risk of failure - reputation and morale

• Depoliticising of social problems

• “Let governments off-the-hook”

Opportunities for social enterprise in eye health

Social franchising, e.g. Vision Centres

Micro entrepreneurship, e.g. Vision Entrepreneurs

Cross subsidisation, e.g. product diversification

Technology, e.g. screening or surgical tools

Public-private partnerships, e.g. with government

Networks, e.g. partnering with private optometrists

Co-operatives, e.g. for bulk purchasing

The dilemma!

• Some eye health activities often sit squarely in the public domain while others are best served in a commercial format

• Many social entrepreneurs have successfully built Hybrid organisational structures

• Non-profit with entirely owned business subsidiaries

Licensing

Basic & Applied

Research

Collaborative

Research &

Product Develop

ment

Public Health

Commercialisation

Ophthalmic Research

Institute Vision and Eye Health

VisionMyopia

and Presbyopia

NGOUncorrecte

d refractive

error

Licenced 2 technologie

s fromVision CRC

to ATI

ATI Developing breakthrou

gh solutions

and surgical products

ATAComXISO

Certified Culture

The Brien Holden Vision Institute

Not for profit Commercialization - For profit

Get the correct message across: Sustainability is more than just financial

Vivian Greene