Rebel advises on landmark healthcare PPP in Uzbekistan

09 February 2021 3 min. read

The government of Uzbekistan and NephroPlus are set to deliver affordable kidney care and dialysis across the country via a new public-private partnership agreement. Rebel was among the advisors for the landmark deal. 

Aiming to make dialysis more accessible, the government sought to supplement its own resources with private sector scale and expertise. A first-of-its-kind digital bidding process drew three proposals from global dialysis companies. NephroPlus – India’s largest dialysis and kidney care company – was chosen for the attractiveness and financial viability of its bid.

The resultant public-private partnership (PPP) will deliver dialysis to more than 1,000 patients across Tashkent, Karakalpakistan and Khorezm, at no personal cost. Notable among the offerings is the country’s first peritoneal dialysis capabilities, which allow treatment at a patient’s own home. The upshot is widespread rural access to kidney care without travel costs.

Uzbekistan selects Nephroplus in landmark public-private partnership

The mammoth deal saw involvement from several experts. Technical and financial advice for the transaction came from Rebel – a Netherlands-based finance and investment consulting firm specialised in PPPs. Rebel owner Rolf Dauskardt described the deal as a “landmark transaction.”

“Closing a healthcare PPP transaction in the middle of a worldwide pandemic was extra rewarding. The international bidding process was highly competitive, with lots of interest from international bidders. Importantly, the PPP is designed as such that it rewards good outcomes for the patients.”

Advising the Uzbekistan Ministry of Finance and Ministry of Health on the deal was the International Finance Corporation (IFC) – a member of the World Bank Group and the largest global development institution specialised in the private sector. IFC brought to the table its knowledge of global best practices in high quality affordable healthcare.

In specific terms, IFC used a framework of international standards to upgrade the government’s patient selection and referral system for dialysis – making it more transparent and better aligned with clinical and socio-economic factors.

Lastly, legal advice on the transaction came from global law firm Pinsent Masons and Tashkent-based legal services firm Kosta Legal. The former is a global outfit of more than 2,000 employees with multi-sectoral expertise, while the latter is a local operation specialised in helping foreign investors set up in Uzbekistan.

Together, this consortium of advisors has helped clinch the government-NephroPlus deal – Uzbekistan’s second PPP ever and the first in healthcare. IFC Director for Europe and Central Asia Wiebke Schloemer praised the government’s proactive approach to improving healthcare, particularly amid an unprecedented healthcare crisis. “This project will not just improve the quality of patients’ lives, it will save lives.”

Economic reform agenda

Healthcare is just one of the areas where Uzbekistan is charging ahead. A vibrant economic development agenda has seen global consulting firms such as Boston Consulting GroupMcKinsey & Company and the Big Four all called in for support in recent years – mainly focused on drawing foreign investments via tax and industry reform.

And the private sector is heavily involved in this transformation. The first PPP in the country was a renewable energy agreement signed last year to boost solar power production – a reform supported by the governments of Austria, Germany, Hungary and Switzerland.