"Health care is not a risk. It is a predictable event that every family will face."

What makes COVA different from traditional health insurance for families in Africa?

In 2014, I was treating a six-month-old boy whose parents worked on a sugarcane plantation. He came to me one morning with a high fever, and when I listened to his chest, I diagnosed pneumonia. His mother looked at me with hope, and I was confident we could save him. I prescribed an antibiotic — but it wasn’t available at the public dispensary. By the time his parents found a pharmacy that had it, it was four in the afternoon, and the bill came to $40, which they didn’t have. The father left the mother at the hospital with the baby and went back to the village, going door to door to raise the money. The community managed to raise the $40, but by the time he got back to the hospital that evening, the baby — Clifford — was gone.

That story tells us something profound: when money is missing in health care, health care stops. The promise of insurance through employers or families is one that nine out of ten families in Africa simply cannot afford. Health care isn’t a risk — it’s a predictable event every family will face — and the insurance model has proven unsustainable for families like Clifford’s.

I vowed from that day to build something to solve that problem. What we’ve built is a health wallet inside WhatsApp, where an employer, community members, or even your bank can extend you credit. That credit unlocks up to four times its value in benefits — enough to consult a doctor, get a diagnosis, run labs, and get medication, all at a lower price than retail. If Clifford’s parents had had that cover, they could have simply sent a text that morning, gotten a prescription for $28 instead of $40, and had friends contribute to the wallet within minutes. The medication could have reached their home in time, and that baby would have been saved.

Insurance is fundamentally a model where you pay against risk — a hope that when you pay, you won’t need to use it. That structure creates barriers by design: age limits, provider network restrictions, exclusions on family planning, on vitamins, on routine occupational checks. It doesn’t serve the common person. What we’ve built instead lets an African family use WhatsApp as a gateway to their employer, their bank, or their own network to access credit at the point of care, and get discounts, through nothing more than a few text messages. Our vision is to offer the fastest access to credit the moment someone has a medical bill.

What is the biggest challenge in making quality health care affordable across Africa?

The challenge is straightforward: health care requires a diagnosis, a supplier for medication, and money changing hands, and unlike most other sectors, these are typically handled by three or more different people. Coordinating care across multiple stakeholders is inherently expensive, so the real question is how you make something inherently expensive, affordable.

Today, the market has adapted to that complexity by having people shop by exclusion. About a third simply go straight to the pharmacy and self-medicate. Others decide it’s too complicated and stay home. And some hope to eventually find a job with a health plan that covers it. Those are the real options available to most people in the African market.

What we’ve done with COVA is integrate the full supply chain — doctor, pharmacy, lab, and diagnostics — into a single bouquet of benefits, so a patient can address all four without separate transactions. That makes the process less overwhelming and more efficient, which is what allows us to lower costs and deliver up to four times more value than paying out of pocket or through a traditional insurance plan priced at retail rates.

What surprised you most while building a healthcare model around savings and medical credit?

What surprised me most is that we assume walking into a facility means you have access to care. You don’t — you only have access to care when you can pay. I didn’t fully register that for years, until I saw a well-dressed patient come in to buy his hypertension medication, get a $65 bill, and tell the pharmacist he’d be back in two days.

The fact that we still treat healthcare financing as something arranged in advance by third parties, entirely disconnected from the moment someone is standing at the hospital counter, is a death trap hidden in plain sight. Every day, people delay care or avoid the hospital altogether because they know they won’t be able to pay — women, men, single mothers, fathers, people with simple, treatable conditions. Even employers are opting out, saying they can’t afford insurance for their staff.

What's the best advice you ever ignored and now wish you hadn't?

Going back to Clifford’s case — I didn’t really listen to the family. We assume, from our own vantage point, that credit is easy for everyone to access in that kind of circumstance, so I felt comfortable prescribing and letting the family go, without understanding what they were actually dealing with.

The lesson I should have learned much faster is that speed of access to credit is the defining factor in health care. That’s why, when consulting a patient now, we make a point of understanding whether they can pay and figuring out how to solve that in the moment, rather than offering free care, which never works and never scales, or letting people ration care, which usually ends up costing them more. That’s the belief this company is built on for the long haul.

What would you like COVA to achieve over the next few years?

Our goal centers on one objective: getting banks involved in financing healthcare credit for their customers. In every economy, including African economies, banks are the largest financial players, and if they take part in financing care, it would meaningfully address the healthcare shortage across the continent.

We’re focused on partnerships that let banks extend $50 or $100 in credit to their members, kept as a healthcare benefit inside COVA. A healthy customer isn’t a risk, it’s an opportunity, because if a bank doesn’t extend that credit, the customer will get it elsewhere, and by the time they do, it may be too late, and the relationship, and the money, goes elsewhere too.

Because we operate on WhatsApp, anyone in Africa can already reach one of our doctors; the only limit is medication delivery in areas where we don’t yet have distribution. But with as little as $10 or $15 in credit, roughly a day’s wage for many people, someone can access a doctor. That’s the world we’re building toward: a market where healthcare credit sits at the center of the patient encounter, so if you can’t afford your antibiotic, your bank steps in and you repay it in installments over time.

Latest From The Executive Insight

  • Wellness

    The first week of the holiday goes well. You sleep ten hours a night, read a novel for the first time in a year, and start to feel like yourself. Then, somewhere around the Sunday before you fly home, the dread comes back. Two weeks […]

    9 min read
  • Editorial

    Most advice on how to manage stress at work treats stress as a personal failing: breathe better, sleep more, download an app. Those help at the edges. They leave untouched the thing that makes work stressful for most people, which is having a lot asked […]

    8 min read
  • Business

    Most people asking how to become a consultant already have the hard part: years of doing something well inside a company. What they lack is a way to sell it. Consulting is a business built on a narrow promise, and the people who struggle usually […]

    8 min read
  • Lifestyle

    Is an online MBA worth it? For a working professional who wants the knowledge and the credential without giving up a salary, it can be one of the better deals in higher education. For someone who wants to change careers, it is often the weaker […]

    8 min read
  • Education

    AI consulting for small businesses has become a crowded market in about two years. Agencies that built websites now sell AI audits. Freelancers who learned prompting last spring sell implementation packages. Most owners who get a pitch have no way to judge it, because they […]

    8 min read
  • Wealth

    Will AI replace financial advisors? For the part of the job most clients think they are paying for, the portfolio, it largely has. Software has been picking funds, rebalancing and harvesting tax losses for over a decade, for a fraction of what an advisor charges. […]

    8 min read
  • Mindset

    You sit down to do the one piece of work that matters today, and forty minutes later you have answered six messages, read two articles and started nothing. Learning how to stay focused at work is less about willpower than about design. Attention breaks because […]

    8 min read
  • Wellness

    Most advice on balance starts with values and ends with a vague promise to spend more time with family. The practical version is smaller and more useful. The time management techniques for work life balance that actually last are the ones that decide where work […]

    8 min read
  • Business

    A full-time chief financial officer is out of reach for most small businesses. A fractional one is not, and that is why the question of fractional CFO cost comes up at a particular stage: revenue is growing, cash feels tighter than it should, and the […]

    7 min read
  • Lifestyle

    Most people who want to read more assume the problem is time. Usually it is something smaller: no fixed place in the day for reading, and a habit of finishing books they stopped enjoying fifty pages in. If you want to know how to read […]

    7 min read