symposium 4 social entrepreneurship & eye care role of social entrepreneurship in eye care:...
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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
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