The Future of VC/PE Investment in Health Care in India Matt Eliot IFC Health & Education, South Asia CII 2 nd Evolving Healthcare Investment Landscape Conference Kolkata 21 June 2014

Access * Quality * Affordability Indian Health Sector Attractive to Investors Current Snapshot  Fragmented market, consolidation not happening  High competition in major metros; under-served geographies present opportunity, but with big challenges Sector Trends  Many in market, but few big deals closing  Smaller deals are getting done; most activity crores  IPOs not happening  Secondary opportunities as early round investors try to find exit Limited Deal Flow Over Past 24 Months  High growth, with plenty of room for more  Huge untapped potential  Rise of corporate care providers  Counter-cyclical - safe harbor  Timing mismatch

Access * Quality * Affordability Deal Flow CY up to USD 12 mm equivalent - 3 -

- 4 - Health Needs to be High on Government’s Agenda Source: World Bank Data Bank Source: WHO, via World Bank Data Bank

Access * Quality * Affordability GOVERNMENT HEALTH SYSTEMS The Questions That Will Help Determine What Comes Next  More health sector-specific funds  Does consolidation come?  Can single specialty chains achieve scale at good margins? eye, dental, birthing/M&C, oncology, dialysis  Do nascent models gain traction? primary care clinics, day surgery, medtech  Can shortages in health workforce be addressed? HEALTH SECTOR DYNAMICS  Stronger Economy, Opening of Infra Projects?  Does SEBI easing jumpstart the overall IPO market?  Will RBI ease the reins on ECB restrictions, boosting the debt market?  Does private health insurance gain ground? MACRO  Shift from Provider to Payer?  Better environment for PPPs?  GSHIS: Broader? Deeper? Commercially viable rates?

What It All Boils Down To VALUATION RETURNS EXIT