The distribution of fake and expired drugs is a problem in sub-Saharan Africa. According to the United Nations Office on Drugs and Crime, counterfeit antimalarial drugs could be responsible for up to the annual 270,000 additional deaths in the region. More than 30 per cent of medicines sold are substandard or falsified medical products.
In Africa, street pharmacies play a vital role in helping people access drugs. However, there are two types; the licensed and the unlicensed. The unlicensed pharmacies belong to regular business people, but both serve as a bridge between giant pharmaceuticals and communities. Many Africans who cannot afford to pay hospital bills or buy doctor-prescribed drugs from hospitals or licensed pharmacies patronise unlicensed street pharmacies.
On the other hand, pharmacy graduates who dream of owning drug stores cannot raise capital. While job insecurity increases, their earning power plunges, making it hard to save seed capital. Therefore, pharmacists in the region migrate to other countries to work.
Field Intelligence (FI) is working to change this narrative with Shelf Life. The Pharmtech startup makes the pharmaceutical supply chain radically simple, affordable, and effective. Through Shelf Life, FI creates jobs for pharmacists, ensures the availability of drugs, reduces costs, and empowers pharmacies to grow by improving access to authentic medicines.
Below is an insightful interview with Peter Bunor, Global Growth Lead at Field Intelligence Inc. and Co-founder of Shelf Life:
Walk us through some of your earliest fun memories, academic background and what informed the birthing of Shelf Life.
I was a very curious child growing up. I incessantly asked questions about everything and spent a lot of time reading all sorts of books-including those I was told not to. I would typically badger my father with questions about manufacturing. And when he could not give answers, he would ask people in his network if anyone could take some time for a super inquisitive kid. That led me to spend some time with people who owned some manufacturing businesses and touring factory floors, on sets for advert shoots.
I had a brief and quite successful career as a child actor. That perhaps goes to show the breadth of my interests.
Following on from a science background in secondary school, I switched to the arts and pursued a BSc in Public Administration at the tertiary level. That gave me public policy roles in the public sector.
The birth of Shelf Life was simply a couple of things coming together at a great time. Some of the work we were doing in the public sector- like helping supply chains become more resilient and efficient- helped us to identify gaps in the private pharma space we could fill.
What are Field Intelligence’s notable milestones? Mention your key partnerships and the impact they’ve had on your startup?
We work with governments, NGOs, and private sector players to deliver positive health outcomes. Presently, we have enabled 300 million pharmaceutical interventions and work with over 35,000 points of care.
Last year, a huge milestone for us was expanding our Shelf Life service to 11 new cities across Kenya and Nigeria. Another milestone for us is the enlistment of my co-founders (Michael Moreland and Justin Lorenzon) and me to Endeavour Entrepreneurs in the first quarter of 2022.
Field Intelligence has done well in the markets it operates. Were there times you questioned your decision to start this? What were your major challenges?
I think it is impossible to start a business and scale it as we have without challenges. One of our lowest moments at Field would be when the COVID-19 pandemic hit. Before then, most of our sales motions were heavily outbound. The global lockdowns compelled us to halt some investments, forcing us into a compressed timeframe to rethink, re-train and redeploy our teams.
We work on some of the most critical problems of our time to build products and services that deliver access to life-saving medications in frontier and emerging markets – where it is hardest fought and has the highest impact. That comes with many challenges like infrastructure constraints, deals, foreign exchange issues, etc.
There are also pressure points that spur us on rather than defeat us. Factors like high expectations from our investors and employees, expectations from the businesses we serve and internal pressure. They put us in check to make the business succeed.
Your digital product, Shelf Life, operates a Pay-as-you-Sell package. What are the costs and criteria for a subscription? How do you generate revenue to secure investor interests?
We operate a zero upfront-cost model. Hence, all licensed and accredited pharmacies, drug stores, hospitals, telehealth providers and insurers can join our network.
Amongst others, our primary revenue generation channels are via margins on the product sales and subscription fees our clients pay. We also ensure that the margin we make on product sales does not lead to the cost of the drugs becoming higher for the end-user.
In most African societies, the idea of a pharmacist is a street pharmacy sales representative, a myth which informs young people’s disposition toward the profession. How can that narrative be corrected?
Ultimately, people need to see pharmacy businesses and their owners as innovative. This is what makes it appealing to the next generation, and this is one of the things we hope to help achieve with Shelf Life. When young people see more pharmacists thriving, that could change. I think we need to make the practice more appealing. We also need to project role models in the sector who are thriving and doing very well.
More so, pharmacy students need to know that there are opportunities to make a proper living once they graduate. Shelf Life makes it easy for them to set up their businesses and take control of their economic futures.
Most sub-Saharan African societies are littered with unlicensed street pharmacies. These pose an increasing risk of fake drug distribution. There is no denying the critical role of these informal players in the healthcare sector as 7 out of 10 Africans would rather visit these stores or patronise hawkers (due to lack of health insurance and cost) than visit a hospital. Are there plans to harness or include these unlicensed street pharmacy operators in Shelf Life to guarantee safer drug distribution?
Street pharmacies serve as a bridge between most urban-situated big pharma companies and rural communities. They are the first point of contact for millions of people, providing access to healthcare for those without health insurance. These pharmacies have built a relationship within their communities which sometimes benefits individual needs that would not necessarily be the case with some of the larger outlets.
However, including street hawkers in the formal chain is a job for the regulators. We are a regulated entity playing in a highly regulated space and we only work with properly licensed and regulated vendors. If the regulators, in their wisdom, decide to license these unlicensed vendors, we will work with them to ensure availability. But if not, we cannot.
Field Intelligence’s 2021 report revealed a deficit in pharmacy professionals in some African countries. In Nigeria, where tertiary institutions churn out hundreds of thousands of graduates annually but with poor representation of pharmacists, what strategic steps do you think the government can take to correct this problem?
An analysis of the pharmacy workforce in Nigeria by BioMed Central revealed that there were 21,892 registered pharmacists, with only 59 per cent in active professional practice. Over the five years studied, there was an increase in the number of pharmacists. However, the overall density remained significantly low. This is not good enough. There have to be incentives such as scholarships and other bursaries that make the study of pharmacy attractive to young people.
Also, there has to be an active private sector willingness to invest in domestic drug manufacturing plants. We do realise that most of the few students who graduate tend to travel outside the continent in search of better opportunities and working conditions. This problem could be curbed if central governments across the continent make funds available for research work in drug development and clinical pharmacy.
Some developed countries create separate institutions for pharmacy education and research. Whereas in most sub-Saharan countries, the study is a path of the larger university system. Do you see African governments adopting separate education frameworks for pharmacy education anytime soon?
Most developing countries go with what works best for their systems. Presently, several African educational systems are yet to develop specialised schools like in Western countries. However, it would be beneficial to the student, government and the pharmaceutical industry on the continent to have such institutions as it adds value to the ecosystem. If the shortage in manpower persists, I will not be surprised to see special government interventions.
Do you think policymakers understand the urgency in the sector? If not, what can be done to make them understand?
We have done a substantial amount of work with governments and can affirm they do see and feel the needs in the system. We see an increased use of new and private labs to quickly onboard new capacity in the sector. We also see them leverage private sector investments to solve pressing public problems. However, there’s still more to be done in terms of regulatory and policy-making interventions to boost development in the sector.
Through Shelf Life, your startup has helped to provide jobs for pharmacists and has contributed to reducing the exodus of pharmacists in your markets. Are there incentives Shelf Life is offering these professionals to make them stay back and serve the continent?
We do not provide any incentives other than solving the problems that made it difficult for them to thrive. We tackled the problems of the supply chain, range of products supplied and financing at the community level. We have ensured that these professionals can access a wide range of pharma products without committing a huge pool of capital. This way, they can make reasonable profits and improve their lives.
As previously mentioned, our platform enables better cash flow, drastically reduces stockouts, eliminating waste and makes it possible for pharmacists to scale. With over 1,000 pharmacies served by Shelf Life to date, Field currently has the largest pharmacy network on the continent. I’d say there’s an assurance of a decent disposable income and a path to a better future once young pharmacists join Shelf Life.
Since launching in 2015, Field Intelligence has raised investor funding and recorded $1.3 billion worth of product orders. Does this mean that your business is profitable enough to list on the stock exchange of any of your markets?
Our business has seen some growth since we began operation. Revenue grew about six times between 2020 and 2021, showing that things are moving in the right direction.
In terms of listing on the stock market, we think that we still have some work to do before we get to the point of considering that. Our current focus is on deepening our presence in existing markets and exploring prospective markets to harness.