African healthtech has a familiar problem: plenty of pilots, plenty of grant funding, but far too few companies that can stand on their own commercially. i3 — the value creation network run out of Salient Advisory and backed by the Gates Foundation — was built to attack that gap directly, tying grant funding to commercial partnerships and brokering deals between innovators and some of the biggest names in health.
Somto Chloe Keluo-Udeke is a pharmacist by training, with a master’s in public health and nearly a decade in the sector. As a Senior Consultant at Salient Advisory, she works on i3 — a network born out of Salient’s own research into healthtech across the continent. That research-driven vantage point means she has watched, up close, the difference between a pilot that impresses donors and a business that can pay its own bills. She brings both the clinical eye of a pharmacist and the systems view of a public health researcher to the question of why so many promising healthtech companies stall — and what it takes to move them from grant dependency to commercial traction.
In this conversation with Launch Base Africa’s Charles Rapulu Udoh, she takes us inside how i3 actually works, and the hard questions about profitability, regulation and what happens when the grant funding ends. This is a candid, clear-eyed look at what it will take to move African healthtech from impact metrics to investable businesses.
Launch Base Africa: Thank you for joining this conversation, Somto.
Somto: Thanks for having me.
Launch Base Africa: At Salient and i3, with most capital still grant-based, what is the defining failure mode when a founder has a working pilot but no paying customer — and what should they fix first?
Somto: At i3, one of our key criteria for selecting innovators is that they already have some level of revenue coming in. We accept companies that have some form of paying customers. The way health is paid for on the continent is interesting, because there are different models. Sometimes it’s government — which can be trickier. Sometimes it’s donors, and that’s where the grant question comes in. And there are direct-to-consumer payments as well. So the big thing will always be defining your customer segments for health, because health is one of those places where we see a lot of business to government models as well, beyond B2B or B2C. It completely depends on the model.
Launch Base Africa: Then there’s this “missing middle.” Research shows commercialization is hard for clinicians or engineers who lack sales backgrounds. How much of i3’s work is commercial education — teaching founders how to sell to ministries, insurers, and distributors — versus simply making introductions? Can that be taught, or is it a founder-selection problem?
Somto: Across the founders and innovators we support, we see different kinds of backgrounds. Some are clinicians; some come from the technical side. What we’ve done is build an offering we call bespoke deal facilitation — and it is working very well.
For each company accepted into the i3 cohort, we sit down with them — alongside i3’s sponsors and a steering committee made up of leaders from our sponsors but also leaders in health across the world — to figure out what they’re trying to do strategically over the next three to five years. In defining that, we decide how i3 can support them. That support looks different from innovator to innovator, from founder to founder, depending on their needs.
We also have relationship managers for each of these companies. We sit down with them every month, sometimes more than once a month, helping them think through the kinds of partnerships they want to close. Take an online pharmacy running a bricks-and-clicks model — physical stores plus an online component — that says they want more partnerships with big pharmaceutical companies. We make introductions. But beyond that, we sit down in meetings with the pharma company so we can help the founders translate — all the way down to structuring what a partnership could look like and what a contract could look like. This support looks different on a case-by-case basis, depending on the company.
Launch Base Africa: i3 reaches about 6.8 million patients, but reach is not sustainability. How many companies in the cohort are profitable or on a clear path to profitability, and is there tension between the impact metrics donors want and the commercial metrics that would make these companies investable?
Somto: Profitability is an interesting dynamic for healthtech companies. If you look at which companies are actually profitable, it’s harder. It is harder to get to profitability for healthtech companies. But at i3, when we think about partnerships for innovators, we’re not thinking about sustainability in terms of grant funding.
i3 provides four offerings. The first is funding: we give them some grant funding. The amount is up to $220,000 per company. In the past we used to give $50,000 per company; there were 60 companies that received $50,000 each. Right now we have a cohort of seven companies, and each is getting up to $220,000. But then we usually tie that grant funding to partnerships. We ask: what are the blockers, and then tie them to partnerships.
If a company comes to us and says, “I want to form a partnership with banks,” we look for banking partnerships. Let me give a real scenario. One of the companies in the cohort is Dawa Mkononi, based in Tanzania. They offer inventory finance and inventory management to pharmacies and hospitals in Tanzania. They wanted to close working capital partnerships with traditional banks so they could stop lending off their own balance sheet — which means they can extend credit to even more pharmacies, hospitals and clinics. What did they need to get there? They needed an in-house credit facility, they needed to upgrade their tech, and they needed strong credit analyst capacity in-house. Funding that, as well as following up and connecting them to experts, has led to them signing at least two partnerships with traditional banks since they started. That’s what that funding does across all the innovators. There are a bunch of stories like this, where we tie the funding to what could potentially unlock partnerships. It’s not just grants — it’s commercial partnerships. We are very big on wanting commercial partnerships that are self-sustaining.
Launch Base Africa: With about 760 introductions leading to 160+ partnerships, pilots and MoUs valued at $19m+ — what does i3 actually do when a founder wants a bank or pharma partner: who makes the first call, frames the proposition and manages follow-up, and where do introductions most often fail? Where have you seen the highest value, and is i3 sub-Saharan only or Africa-wide?
Somto: We have a current cohort of seven companies, and in the last two years since we’ve been running this current phase of i3, we’ve made about 700 introductions. This year alone, we’re at over 400 introductions.
With this phase of seven companies, we understand where they’re trying to go strategically. There’s a push and pull. Companies sometimes tell us, “These are my targets — my targets are banks.” Then we reach out to the i3 network. You have a list of all the i3 sponsors, which beyond the Gates Foundation includes pharmaceutical companies like MSD, Sanofi, and Boehringer Ingelheim, alongside private foundations like Endless Health and the Kühne Foundation — one of the biggest supply chain foundations in the world. Executives from all of these organizations sit on our steering committee, alongside select individuals. We’re constantly facilitating meetings between the steering committee and the innovators, or talking to them every month. Sometimes innovators say, “I want this.” But other times, sponsors say, “I think you should be talking to this person, because the intelligence I have suggests they could potentially work with an innovator like you.”
We make those introductions — whether by email or through the events we host every year — and what comes next depends on each company, each founder, and their specific needs. For example, there’s a company that raised debt funding from a pharmaceutical partner: we made the initial introduction between the innovator and the pharma company providing the low-cost debt, but then the innovator needed additional support gathering documents, building their data room, and modeling impact in a way the pharmaceutical company would understand. Those are the exact kinds of expertise i3 provides until the partnership is closed. Fundamentally, it depends on the nature of each partnership.
Regarding highest value, I can’t make a blanket statement. When you look at the four partnerships from our last Access to Markets event, one was with a commercial bank, one with a foundation and a research company, one with a traditional big pharmaceutical company, and one with a regulator. We’re seeing all sorts of partnerships across all sorts of segments, including signed government partnerships.
Overall, i3 is Africa-wide — not just sub-Saharan Africa. We currently have 63 companies that have benefited from the program so far, coming from over 20 countries across the continent. We had specific targets initially: one was to reach francophone countries, because francophone regions are often underserved. We are also intentionally focusing on women-led businesses. We’ve seen strong activity from North Africa — with quite a few companies from Egypt — as well as West Africa with Nigeria, East Africa with Kenya, and Southern Africa with South Africa.
Launch Base Africa: Sproxil–PCN/NEPP shows regulation as a partner, but for most startups regulators are gatekeepers, customers and competitors. How do you advise founders to navigate that? And across Africa, pharmacy associations often fight innovators — have you faced major confrontation with a regulator or association?
Somto: At Salient Advisory we’ve done some work on regulation. I’d like to highlight some interesting examples we’re starting to see out of Africa of regulators working with innovators — setting the pace and standard for how healthtech companies can work with regulators, but also making sure there’s an enabling policy environment for innovation.
We’ve seen that in Nigeria. In 2026, Nigeria — through NEPP, the National Electronic Pharmacy Platform — learned from Ghana, which also had its e-pharmacy platform, and supported the revision of the 2021 rules to what we now have in 2026, where they recognise pharmacy aggregators. The national electronic platform encourages innovation. I am particular about the Ghanaian example. The Pharmacy Council there has built an e-pharmacy platform for Ghana. They worked with a healthtech company called RX Health to make that happen.
In Rwanda, the regulator for medical supply — Rwanda Medical Supply Ltd (RMS )— built a data warehouse and tools with an innovator called Field Intelligence, which works in Rwanda, Kenya and Nigeria. RMS led that partnership and brought on innovators.
Across these countries — Nigeria with Sproxil, Ghana with RX Health, Rwanda with RMS — once they start to work with one, they start to work with many others. It signals to the entire ecosystem that the regulator can be worked with, and we see much more shared understanding and openness to innovation because one partnership has worked. Getting there can sometimes be difficult. With Sproxil, one of the supports we provided as part of our bespoke deal facilitation was a government relations expert — somebody who had been in the sector for decades and could broker relationships between PCN and Sproxil.
About confrontation with pharmacy associations: not that we have seen. Some of the examples I mentioned are countries where we’ve seen a lot of openness — Ghana, Nigeria. It takes advocacy. It takes years of building relationships and shared understanding. A lot of African regulators are receptive to innovation — not just receptive, but supportive of it.
Launch Base Africa: Dawa Mkononi’s 0.3% NPL is extraordinary for unsecured pharmacy lending — is that genuine underwriting innovation, and what does it say about how banks should lend to healthcare?
Somto: We had this conversation with their founder as they’re closing several working capital partnerships. Regarding how banks should lend to the health sector, it’s too early to tell, but I am personally excited to see them doing so. Banks are expanding beyond standard healthcare businesses to include pharmacies, a category they traditionally haven’t known how to underwrite. Now, traditional banks are building out specialized health practices to learn. Access Bank in Nigeria, for instance, has been working to understand the sector and provide fit-for-purpose working capital.
Dawa Mkononi built an in-house credit capability that assigns a credit score to every pharmacy in their network. Initially, they were lending to pharmacies, clinics, and drug shops off their own balance sheet, which forced them to master credit risk before extending that capability to banking partners. The 0.3% NPL you reference stems from their Dawa Kwanza program, a partnership with NMB Bank and Vodacom.
By building strong internal credit capacity — knowing their customers, understanding their risk profiles, and supplying their medicines — they’ve created a model that can scale. That program targets 20,000 pharmacies and clinics across Tanzania. They are currently reaching over 3,000, so as the portfolio scales, that NPL figure will likely normalize.
Launch Base Africa: Are you worried that banks setting up internal health units could disintermediate healthtech companies and startups — an obvious concern for the sector?
Not at all. We’re excited about it. Not worried that banks have started setting up health units.
Launch Base Africa: Your recent Access to Markets (A2M) event produced four deals — MYDAWA pilot, bank credit line, debt financing, etc. Could Meditect and others have closed them without i3?
Somto: The way i3 comes into play is as an enabler, a catalyst that helps speed things up. Through our network, we can make introductions and validate companies, using our goodwill and relationships to lend them credibility.
One of the four partnerships you mentioned, between MYDAWA and a company called Endless Health, came about through an introduction I made via i3. Someone could argue that MYDAWA and Endless Health would eventually have crossed paths anyway, and probably they would have. But did that happen sooner because we said to MYDAWA, “You could potentially be talking to another company, Endless Health, which is also an i3 partner”? That’s the value of the network.
You cannot always quantify the value of an introduction, but there is a clear role for us in accelerating the process, acting as a catalyst, removing barriers and supporting innovators so they can avoid costly mistakes.
Launch Base Africa: You keep emphasising MYDAWA — is it the most replicable model for the next cohort?
Somto: I wouldn’t say that. MYDAWA is in Kenya, and Meditect and Dawa Mkononi are also building interesting businesses. In healthcare, these are all players contributing to a stronger health value chain. MYDAWA, for instance, reaches patients directly, and we need that. Meditect, on the other hand, works with pharmacies to tackle counterfeiting and ensure that medicines circulating in our markets are genuine. These are also the medicines that companies like Dawa Mkononi and Meditect supply to pharmacies such as MYDAWA, which then distribute them to consumers. They each have a distinct role to play, and their contributions are complementary.
Launch Base Africa: Why pharmacy for this cohort— what does the channel offer, what are its structural weaknesses?
Somto: We have this cohort we call the Future of Pharmacy cohort. We know that pharmacies are already an important point of contact for people seeking healthcare. Data from several African countries shows that between 40% and 60% of people’s first contact with the health system is through pharmacies, where they often receive first-line care. Yet these pharmacies largely operate independently, with limited support.
Our thinking is that if we can strengthen the pharmacy model and the wider pharmacist network, we can turn pharmacies into more integrated primary healthcare providers. They are already where people go for first-contact care. The question is how to improve the quality of that care. How do we ensure pharmacies are consistently stocked with essential medicines? How do we introduce diagnostics so that, for instance, someone seeking malaria treatment is tested before being given medication?
We recently conducted a study titled Private Pharmacies as a Delivery Channel for HIV, TB and Malaria Care. It examined the role private pharmacies could play in delivering services in areas where they have traditionally had limited involvement. What we found was that much of the necessary infrastructure already exists. The opportunity, therefore, is to build on it, improve its capabilities and support the innovators developing solutions around it.
Launch Base Africa: What is i3/Salient’s stake in all of these? Are you looking at supply chain and data infrastructure behind these companies?
We actually started with the very first cohorts of i3, which had a stronger supply chain focus. At i3, we want to see the entire ecosystem grow. We’ve been tracking this work at Salient for years now (since around 2020).
Historically, there was a major gap in this ecosystem: healthtech companies were not partnering with large healthcare buyers. Without those partnerships, healthtech companies cannot truly scale, which means impact is left on the table. In healthcare, impact always translates to lives — lives saved and the total number of patients reached. That is what matters most to us at i3 and Salient.
Launch Base Africa: i3 is about commercialisation than exits — but what does success look like in five years: acquisition, merger, profitable standalone, or something else? If most portfolio companies are VC-backed and i3 isn’t positioning them for exit, is that a worry?
Somto: Exits are ultimately what the ecosystem needs to thrive. We want to see more acquisitions, more profitable healthtech companies, and an African healthtech unicorn. Beyond financial milestones, success means seeing healthtech solutions scale nationally and regionally — ensuring the plethora of innovations emerging across the continent are deployed at scale. Ultimately, it comes down to people in communities across Africa being able to access quality care and essential medicines because of these innovations. Those are the ultimate indicators of success.
To be clear, our core focus is simply on how individual companies — and the ecosystem as a whole — can perform better. That progress can manifest as exits, acquisitions, or path-to-profitability. Our work is fundamentally hinged on our belief in these companies, and we have no doubt they have what it takes to get there.
Launch Base Africa: i3 depends on Gates and corporate sponsors. What happens when the grant ends — are you raising more, is funding in the pipeline, and how long can it last? Given USAID’s dismantling and 2025–26 cuts, can i3 outlast funders? And with attention on growth-stage companies, do you know how many early-stage companies still exist?
Somto: While I won’t comment on specific funding in the pipeline, the next direction of i3 is something we are actively planning internally.
As for the longevity of the program, I fully expect i3 to endure. We launched in 2022, and we are now in 2026. In Phase 1, we supported 60 companies over two years — 30 per year — spanning both early- and growth-stage startups. We took those learnings, iterated, and launched Phase 2 with a hyper-focused cohort of seven larger, growth-stage companies. We chose them because they were best positioned to forge strategic partnerships and drive immediate scale — and in Phase 2, we’ve already seen numerous partnerships materialize in a short timeframe.
We plan to apply the insights from Phase 2 to shape what Phase 3, Phase 4, and beyond will look like. There will definitely be announcements regarding the future of i3 coming soon.
To clarify a common question: i3 was not funded by USAID, so we were completely unaffected by those recent budget cuts. As a program, we have never had to pause operations. The current phase is designed to run through 2027. As we approach that mark, we will share details on what comes next.
Can this program outlast its funders? Absolutely. We are continuously designing sustainable models to support innovators long-term.
We equally maintain active communication across the entire i3 network and remain closely connected with our alumni. When we worked with early-stage companies in Phase 1, the goal was to build a robust pipeline. We’re now seeing clear evidence of companies successfully transitioning from early-stage to growth-stage.
A great example is Meditect: they participated in Phase 1 as an early-stage startup receiving $50,000 in support, and today we are supporting them in Phase 2 with $220,000. Many of our early-stage alumni are making headlines and scaling rapidly, which is incredibly rewarding to see.
Launch Base Africa: Does your background as a pharmacist make you more skeptical of tech-only founders or more sympathetic to clinical constraints? Given Salient’s vantage point, what gaps remain in the ecosystem?
Somto: It actually gives me both. Having worked in both hospital and retail pharmacies, I approach healthtech models with deep empathy, but also with the inclination to ask probing questions grounded in hands-on experience. It’s not about skepticism — it’s about having a practical, real-world perspective rather than relying purely on theory to understand what a solution truly requires to succeed in the field.
Regarding ecosystem gaps: innovators are building high-quality solutions, but we need to think about healthcare as an interconnected ecosystem.
Personally, I would love to see true continuity of care. A patient’s data should flow seamlessly as they move across touchpoints — starting at the retail pharmacy when they first experience a headache, progressing to a primary healthcare center, and ultimately reaching a tertiary facility. Beyond data flow, we need to focus on factors that elevate overall quality of care: reliable healthcare infrastructure, consistent supply chains for medicines and hospital equipment, and accessible clinical data. Ultimately, I want to see ecosystem players operate as a cohesive unit with much greater interoperability.
Launch Base Africa: What did moving from IQVIA to Salient teach you about how health systems buy and adopt technology — and about the limits of donor-funded projects and pilots?
Somto: My career path has given me a unique multi-dimensional lens. I started out of pharmacy school at NAFDAC, the regulatory agency. From there, I moved into healthcare consulting focused on primary healthcare system strengthening, followed by IQVIA, where I supported supply chain infrastructure and primary care across several African countries, before ultimately joining Salient.
While that trajectory might seem varied on the surface, it all converges directly into my work today. Having worked inside the regulatory space, I understand what regulators look for and prioritize. Having provided technical assistance directly to public sector entities, I also understand government constraints and resource capacities.
When advising healthtech companies, that experience allows me to offer practical strategy: you have to understand what the government is trying to achieve and plug directly into their agenda. For instance, if a ministry of health has a five-year strategic plan, you need to understand how to embed your technology seamlessly within that framework rather than operating in a vacuum.
Launch Base Africa: For MYDAWA, how do you keep startup momentum while running slow evidence research? And for government MoUs, how do you protect them from leadership changes and slow procurement?
Somto: Companies like MYDAWA — a market leader operating the largest pharmacy chain in Uganda, alongside their strong presence in Kenya — are already doing incredible work. Often, our role isn’t to tell them how to run their business, but to help them translate their operational success into a compelling evidence base that resonates with major healthcare buyers, including governments and global health agencies.
Through their partnership with Endless Health, we address the resource constraint directly. Innovators rarely have the bandwidth or internal headcount to conduct rigorous research while running day-to-day operations. This partnership provides the funding and technical expertise required to evaluate models like chronic care delivery through private pharmacies. The ultimate goal is to produce a validated use case that proves private pharmacy chains can reliably deliver chronic care, unlocking new markets both for MYDAWA and the broader ecosystem.
Regarding government relations: as part of our support, we recently matched Sproxil with a government relations expert. Sproxil has a deep history in Nigeria — pioneering the scratch-code authentication technology with NAFDAC to verify medicine authenticity. Staying relevant and sustaining partnerships across changing political administrations in markets like Nigeria is challenging. By pairing companies with specialized public sector advisors, we help them navigate leadership transitions, embed into long-term policy, and build enduring government partnerships.
Launch Base Africa: With donor and philanthropic capital contracting, what is the biggest factor and your prediction? Can i3 unlock venture capital for African health, and why hasn’t it generated more VC interest?
Somto: We’re seeing donor funding largely contracting, but at i3, we anticipated this years ago. We realized health systems need much more sustainable ways to deliver care, which is why we believe in healthtech innovators who can build a commercially viable investment case for health. Funding cuts are here to stay, and we all have to live with that reality and think more from a commercial perspective: who pays for health, and what does health coverage actually look like?
Also, a lot of these companies are not grant-driven — in fact, very few are. We are seeing companies build strong, real commercial businesses by selling medications at scale, leveraging group purchasing, and selling directly to customers. These are commercially sustainable businesses, and that’s what we want to see. The role of donor funding should be catalytic: it should come in to provide room for risk, room to generate evidence, and space to test new things that are commercially viable, then exit and let the business keep running.
On venture capital: one of the primary needs that always comes up from innovators is capital — specifically working capital. There have been some interesting solutions, such as SihAfya, a working capital fund also backed by the Gates Foundation. Quite a number of working capital solutions are being taken up across the ecosystem, but there’s room for much more, especially lower-cost, locally denominated working capital. Those are the big needs we hear from innovators, and while solutions are definitely in the works, it’s clear that the future isn’t just grants.
