IDH is a leading consumer healthcare company in the Middle East and Africa with operations in Egypt, Jordan, Nigeria, Sudan, and Saudi Arabia.
Egypt is the company’s primary market, contributing 82.7% of total revenues in 2023 followed by Jordan at 14.7%, Nigeria at 2.3%, and Sudan at 0.3%.
Egypt
The Egyptian Diagnostics Industry (EDI) can be broadly divided into public and private sector infrastructure, with the latter including both labs attached to private hospitals and independent standalone labs (chains and single labs). According to the Boston Consulting Group (BCG), IDH is the largest fully-integrated private sector diagnostics service provider, with more than 50% share by revenue of the private chain market in Egypt.
IDH is in a strong competitive position in the EDI, having created formidable barriers to entry with its over 40-year track record and 544 branch network as at year-end 2023. This has been achieved by:
Long-established brands with trusted reputations that have engendered strong patient loyalty.
Strong relationships with key stakeholders including physicians, patients and hospitals
A scalable, asset-light business model that enables expansion in fragmented markets
International accreditations notably the coveted CAP certification of the Mega Lab
Jordan
Jordan has one of the most modern health care infrastructures in the Middle East. Whilst medical services remain highly concentrated in Amman, c. 70% of Jordanians have medical insurance. Notably, medical laboratories must abide by the price list that was issued by the Jordanian Ministry of Health in 2008, which has not since changed. Consequently, Biolab’s strategy is to expand its range of check-up packages offered, thereby increasing the number of tests per patient.
Unlike Al Borg and Al Mokhtabar in Egypt, Biolab does not operate a Hub, Spoke and Spike business model. Whilst Biolab’s 23 central labs perform many of the +1,000 pathology tests offered, four that are considered specialty labs perform particular types of tests including, but not limited to, haematology, endocrinology, immunochemistry, parasitology, oncology, transfusion medicine, molecular genetics and antenatal diagnostics and gene sequencing. Furthermore, Biolab does not share purchasing, supply and logistics, IT, marketing or sales functions with its Egyptian parent company.
Sudan
IDH operates under two brand names in Sudan, Ultralab and Al Mokhtabar Sudan. Al Borg acquired a majority interest in Ultralabs in 2011, whilst Al Mokhtabar Sudan had been established in 2010 prior to the Group’s acquisition of Al Mokhtabar in Egypt. While Al Mokhtabar Sudan operates independently, Ultralab shares purchasing, supply and logistics, and IT functions with the Company’s Egyptian operations. At 2023 year end, there were 18 branch labs in Sudan.
Despite a significant easing of tensions in 2022, a violent conflict erupted in April 2023 between two rival groups; the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF). The conflict is currently ongoing and has resulted in the death of more than 13,000 people, injury of an additional 33,000, and the displacement of 10.7 million as of January 2024. IDH’s two brand names in Sudan have been dramatically affected, with 17 of the Company’s 18 branches in the country closed starting April 2023. The Company currently operates one remaining facility and continues to monitor the situation to safeguard its people and operations in the country
as possible.
Nigeria
The strategic rationale for making Nigeria the fourth country on our regional platform is compelling. Nigeria’s diagnostic services market is very large, highly fragmented and underpenetrated, offering significant opportunities for growth and economies of scale. As importantly, it shares many similarities with Egypt’s market in the 1980s and 1990s in terms of structure, pace of development, and the emerging disease profile of patients. IDH has expanded its geographic platform to four countries with an investment in Nigeria’s promising healthcare industry. The Group closed on a transaction in February 2018 in which it formed a joint venture with Man Capital LLC (“Man Capital”), the London-based investment arm of the Mansour Group, called Dynasty Holding Group (“Dynasty”), which is 51% owned and controlled by IDH. In turn, Dynasty partnered with the International Finance Corporation (“IFC”) to invest in Eagle Eye Echo-Scan Limited (“Echo-Scan”), a leading medical diagnostics business based in Nigeria.
Dynasty and the IFC have committed to invest significant capital in Echo-Scan over the next four years. Dynasty has acquired a majority stake in Echo-Scan and assumed management control of the company, whilst both Dynasty and the IFC will invest US$ 25 million to expand EchoScan’s diagnostics network, service offerings, and quality standards. In building the Echo-Scan brand, Dynasty aims to equate the name with quality and safety, embodying the same core values that have earned the Al Borg and Al Mokhtabar brands strong loyalty in Egypt over the years.
Saudi Arabia
Saudi Arabia marks IDH’s newest geography, with its official inauguration in January 2024. The venture comes following a strategic partnership between IDH, its Jordanian Subsidiary, Biolab, and Izhoor Medical, a company owned by Fawaz Alhokair. The new venture aims to create a full-fledged pathology diagnostic services provider in one of the region’s fastest-growing markets characterized by robust macroeconomic fundamentals and an increasingly health-conscious population. The venture will launch two initial branches in the Kingdom’s capital city, Riyadh.