Anthony Natif is a special kind of guy in all ways. If you met him on the street, you wouldn’t tell he is the brain behind the ever-expanding Guardian Health brand of pharmacies- I am sure there is one in your Kampala neighbourhood and if you have travelled, you have seen a couple of them spring up in a number of out-of-Kampala towns; Jinja, Mbarara, Gulu, …. to be exact.
But behind the bespectacled eyes and often dreaded hair, is an oncology pharmacist, with a passion and a dream to transform Uganda’s health care.
Oncology Pharmacists are a special kind of pharmacists, specialized in Cancer Treatment. Anthony got his pharmacy degree at Makerere University as well as a Master’s Degree in Public Health (Leadership, Policy& Management) from the University of Washington, among other trainings. He received his training at the Fred Hutchinson Cancer Research Center in Seattle, Washington where he also did a fellowship in HIV associated malignancies. He then briefly worked at the Seattle Cancer Care Alliance before deciding to return home, to Uganda to take up a not-necessarily glamorous job at Uganda’s Cancer Institute as the Head of Cancer Pharmacy services as well as Head of Finance and Administration.
During his brief stint at the Uganda Cancer Institute, he is one of the brains that kickstarted the pharmacy as well as the private patients service at the Institute. He also co-wrote the essential drugs list for cancer for Uganda and his efforts at the institute saw the growth of their medicine budget from just about UGX50m a year, in his words, not enough to buy medicines for a week, to more than USD2 million in just 18 months.
Even with the changes at the Cancer Institute, Anthony did not feel he was quite in charge to make the changes he wanted to make in Uganda’s healthcare system.
Lucky enough, back in November 2012, while a still at graduate school in Washington State, the USA he had started 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 his countrymen and countrywomen.
“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. I was disturbed by statistics that showed that almost 300,000 malaria deaths in Sub-Saharan Africa could be prevented if only we stopped the sale of counterfeit drugs,” Anthony recalls.
“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. 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 reiterates, 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’s mission was and is to provide quality pharmaceutical care aimed at improving health, well-being and quality of life and our vision is to become Uganda’s neighbourhood pharmacy of choice,” he says, adding: “And we want to do this with professionalism, integrity and dedication, as our values.”
“Our core objective is to improve our client’s well-being and quality of life by improving access to quality affordable health care and health care products,” Anthony firmly says.
But not long after, the same problems that bedevil most African private enterprises, especially indigenously owned businesses, would catch up with him.
See, he had started Guardian Health with just USD50,000 and one store in the Muyenga-Kabalagala Area. The passion and vision Anthony had for Guardian Health, saw him embark on an expansionist drive across the city- which sooner than later stretched the thin capital.
“In 2015, we were doing very good in terms of turnover. And we were making good money. Well, at least we thought we were. So, we felt that from that money we could easily finance our growth. 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,” Anthony told Digest Africa, in a 2018 interview.
With stretched capital, comes a lot of challenges- but according to Anthony, the biggest founder’s challenge is seeing one’s passion and vision whittle away. But he could see his vision go just like that, he had to seek a solution and expensive local borrowing wasn’t one of them, he had had enough of that already.
He remembered that in 2015, Ascent Capital an private equity firm had approached him seeking to make an equity investment into the business but he hadn’t quite taken them seriously.
“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,” he recalls in the Digest Africa interview.
Ascent is a for-Africa private equity fund manager that focuses on equity investments into ambitious and scalable small and medium-sized enterprises (SMEs) in majorly Eastern African countries of Ethiopia, Kenya, Uganda, Tanzania and Rwanda.
Ascending to new heights with Ascent
Anthony won’t say how much Ascent has invested in the business but said the investment was significant enough to give Ascent the majority stake, but more importantly, it was just in time.
With the investment, in 2017, Guardian Health’s future, vision and mission, according to Ssendiwala Cedric David, the Guardian Health General Manager, got a new lease of life.
Cedric is a licensed pharmacist who started his career at Guardian Health in October 2017 as a Pharmacist in Kisementi Branch while also working as an Intern Pharmacist at Mulago National Referral hospital. In January 2018 Cedric was promoted to a Branch Manager at the Kisementi Branch. Shortly after, in November of that year, he became the Regional Manager/ Business Development Manager. He then went on to become a General Manager in March 2020, at the onset of the Covid-19 pandemic.
“Before the Ascent investment we did not have proper controls or systems to watch over the business and that led to the aggressive expansion that was not well planned however now with a fully functional board and management team, we have been able to systematically plan and grow our footprint to now 6 districts and 18 stores (from 8 stores at the end of 2017) which is the largest in the country of any pharmacy chain,” says Cedric.
He also says that the company now has healthy cashflows which have allowed the business to achieve a lot in time.
TRIBUTE | Miriam Ekirapa Musaali: A Testament of Faith, Courage, and Enduring Strength Against Cancer“Financially, we have also been able to maintain good cashflows by proper budgeting and managing spending. 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,” he adds.
“With the capital input from Ascent, we have also 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 which is in line with our mission,” Cedric says further.
Building a Covid-19 proof business
Cedric who took the reins of the company, just 10 days before the onset of the Covid-19 pandemic, says that having Ascent Capital as a partner, helped the business survive the Covid-19 pandemic and emerge even stronger.
“Those were rough times. Lockdowns across the world impacted the global supply chains from raw materials production to freight and shipping. This meant that many of the essential medicines were placed on export bans by western governments and even those that were available became expensive to ship across the world which reduced access to healthcare as prices also went up,” he recalls.
“Lockdowns affected people movement and therefore this meant that with our brick & mortar shops we would be unable to reach our clients. This meant our revenues were impacted significantly in the first few months which made us rethink our strategy as with every challenge arises an opportunity and a need to innovate. This made us think, “how can we reach our clients despite the lockdowns?’
But with solid capital, the business was able to launch a tele-pharmacy service and an online business department.
“This is supported by our in-house delivery service while also bringing the pharmacy closer especially over-the-counter products onto popular services like Jumia and Glovo as well as having our own online store. Think of it as a bricks & clicks business model,” explains Cedric.
He says the company has also developed a playbook to guide the business on the actions to take during the epidemic and any other similar occurrences in the future.
“Top management took significant pay cuts while we made sure our people on the front-line did not have to take on this extra burden in the already scary covid times. I am proud to say that we did not lose lay off any staff despite the financial hit we experienced. Also, since we had great relationships with our suppliers, we were able to renegotiate some terms to ensure we all stayed afloat despite the challenges and this helped us to remain reliable even in the tough times and this has helped us capture a larger segment of the market,” Cedric says.
On the whole, he says, the company has emerged out of the Covid-19 pandemic, both wiser and stronger, thanks to the strong governance systems and a capital base that came with the Ascent Capital investment.
“On an impact level by the end of 2022, we would have served close to 1 million Ugandans across the 6 districts we are in and expanding. We have grown to have a work force of more than 200 while also providing internship/training opportunities to many pharmacy students from different institutions across all our branches in the different districts,” he adds.
From USD50,000 to a USD10 million business and unstoppable
Like Cedric, Anthony is now confident of Guardian Health’s future and more important he is now firm, more than ever that his vision of contributing to his country’s healthcare system is firmly back on track and there are more hands on the job to have it fast-tracked.
“It’s gratifying to see that a business I started with USD50,000 has grown to serve millions of people and is the only retail pharmacy chain in Uganda that can rightfully claim to have a national footprint,” he says, adding: “Listening to feedback from our clients and stakeholders all over the country makes me proud of the excellent job that the team has done. I know, of course, we aren’t where we really want to be, but we are well on our way, and nothing can stop us from reaching every nook and cranny of this region with our services.”
Anthony also says, there is now a well-motivated young team to continue the dream.
“We have a young team that has grown into their roles and have bought into the bigger vision of the company. We are all about access to good quality, cost-effective pharmaceutical services. We believe that people are recognizing us as their neighbourhood pharmacy of choice; partners in health, if you will, and that’s such a beautiful thing to witness,” he reiterates.
Cedric, probably one of the youngest leaders in the Pharmacy business is bullish about Guardian Health’s future prospects.
“We are looking at an even a bigger footprint across the country to be in at least 15 districts and 30 stores in the next 3 years. We are aiming to expand our online business offering and want to be the leading tele-pharmacy service provider in the country,” he says.
Anthony is also very bullish about Guardian Health’s medium to long term potential.
“I’m happy that we are at a point when the company will be able to grow beyond its founder. That’s the holy grail; to dream up something, start it, nurture it and then let it fly. Guardian is going to fly and continue impacting people’s lives long after we are all gone. That’s major!” he says.
“I want to see a time when we branch out into the larger East African region and a time when this company is listed on the stock exchange. I want to see our people own a part of a company that’s providing solutions to their daily healthcare challenges. They’ve built us to what we are today, it will please me to no end to see them tap into the rewards of their support,” he re-affirms.
