Entrants's Name: Scott Hillstrom

Country: United States

Field: Health Care Delivery

Innovation - idea: I conceived and co-founded a franchise network of (currently) 55 drug shops and health clinics in rural Kenya which today are visited 40,000 times each month-- patients receive high-quality, affordable, and accessible essential drugs and basic health services. I am now taking the lessons we have learned in Kenya and working to promote new iterations of this concept outside of Kenya.

Innovation - why it is pioneering: Thousands upon thousands of people die each year of malaria, diarrhea, and respiratory infections. They suffer and die even though they could be easily cured with the right medicine. My model is pioneering because it intersects two existing resources that have never before intersected: the commercial franchise industry and the public health system...all for the benefit of patients.

Strategy - how it achieves impact: The franchise business model has been used with great success in many unrelated industries: -Fast food (e.g. McDonald's, Subway) -Hotels (e.g. Marriott, Hilton) -Fitness clubs (e.g. Curves) -Hardware (e.g. Ace Hardware) -Technology (e.g. RadioShack) -Car repair (e.g. ServiceMaster) -Tax preparation (e.g. H&R Block) -Etc. The reason the franchise model works for such a variety of businesses is that it is a content-less idea, ready to be applied to whatever goods or services need to be delivered with consistent quality to customers. By delivering essential drugs and basic health care through the franchise model, we solve many of the severe and prevalent problems plaguing public health in developing countries: 1) Quality of drugs 2) Affordability of drugs 3) Geographical access of drugs Franchising aligns the mission of the franchisor, which in this case is humanitarian, with the self-interest of the franchisees. This private sector approach has proven extremely effective.

Strategy - growth plans: I advocate the open sharing of all information that is learned while practicing the humanitarian franchising I am describing. The goal of this sharing is for each successive iteration of the fundamental idea--adapting the franchise business model to distribute essential drugs and basic health services--to get better. In the short term, I am locating and advising talented entrepreneurs in the developing world who want to establish their own franchise networks. Later, I hope that a training institute is established to disseminate learnings in this field. Ultimately, the goal is to spark a movement where 100s of networks reach tens of millions of patients/year. An important part of my strategy to reach this goal is to bridge experts who usually work in different silos: public health experts, entrepreneurs, and franchise industry leaders. This will ensure that the networks that are started are *true* franchise networks and not simply the same old failed health models w/ a new name.

Impact to date: Impact: The HealthStore network I founded in Kenya received over 400,000 patient visits in 2005. 55 Kenyans have jobs owning and operating these outlets. Inspiration: My colleague Greg Starbird and I have been working together for the past 10 months to encourage able and accomplished entrepreneurs in developing countries to launch their own franchise networks. So far, such entrepreneurs in India and Ghana have decided to indeed launch such networks. And we get more requests for assistance every day. Eventually, we hope that there will be hundreds of franchise health networks in the developing world, delivering life-saving medicine and basic health services to tens of millions of people. We hope to achieve this by pushing towards a tipping point, i.e. by catalyzing a movement towards more and more iterations of the fundamental model (which is to use the lessons and strategies and structures of business-format franchising to achieve social ends).

Future impact: Ten years from now, there will be dozens of business format franchise networks in dozens of developing countries. These networks will demonstrate the power of franchising to do three things at once: 1) Control the consistency of the quality of medicines and basic health services to those who desperately need them 2) Scale up rapidly while never reducing quality 3) Achieve economies of scale, where the cost to treat each patient shrinks as the network grows. In Kenya, each of our outlets serves about 5000 patients each year. Imagine dozens of networks, each with anywhere from 50-500 outlets, each outlet serving 5000 patients each year! This will have a dramatic effect on public health in the developing world. Furthermore, we hope that we or others will adapt the model to achieve other public health goals, such as the distribution of potable water, the provision of adequate sanitation, etc.

Sustainability - resource base: The HealthStore network I founded in Kenya works in the following manner: -A Kenyan NGO oversees the network of drug shops and clinics. -Our 55 franchisees own their own businesses, which at the outlet level are profitable and self-sustaining. We train them into our system. In order to continue operating their outlets, they must follow our rules on drug quality, storage, diagnosis, etc. If they break these rules their right to operate their business is revoked. Thus, they self-regulate. -Patients pay for the drugs and services they receive. -We use monetary donations as a subsidy to provide ongoing training, support, and monitoring for these franchisees, and to reach into even poorer regions. -The HealthStore network in Kenya now serves patients at a cost to the network of around 1 dollar per visit. This is *extremely* low relative to any other public health intervention ever conceived. As the network grows this number will shrink even further.

Major challenge for the field: The major challenge for the field is to be humble enough to admit failures in health care delivery and tap innovative sources to remedy these problems. Thousands die daily because they do not get the medicine they need. We need to sit at the feet of those who have ALREADY mastered models for delivering quality goods and services...franchise industry leaders.

Contact Information:

Name: Scott Hillstrom
Country: United States
Website: http://www.healthstore.org