How would an Impact Investment Portfolio look like if it was focused on Health instead of on Medicine?
Sustainable Development Goal №3: Good health and well being. “No amount of medicine, vaccines and biotech will cure a sick society with a sickening environment, but if we have a healthy society and a thriving environment we can surely afford to give medicine to those who truly need it.” — Bernardo Toro in the Ethics of Care .
What does human life really need in order to achieve the outcome of health?
We can look at health from the perspective of problem solving where we list an inmense amount of diseases and try to solve for each; OR we can look at it from another perspective: the one of the highest health potential for all, (not just caring for the people that are already sick). How can we break degenerative health, vicious cycles and not only restore health but create it’s own regenerative virtous cycles?
The World Health Organization (WHO) defines holistic health as:
viewing man in his totality within a wide ecological spectrum, and … emphasizing the view that ill health or disease is brought about by an imbalance, or disequilibrium, of man in his total ecological system and not only by the causative agent and pathogenic evolution.1(p13).
This important perspective is echoed in the organization’s 1946 preamble, wherein health is defined as a state of complete physical, mental, and social well-being rather than merely the absence of disease or infirmity.
Maybe there is a way to invest in balance and well-being instead of solving for disease. As Ravi Shankar once said: “Health is not the mere absence of disease, it is the dynamic expression of life.”
According to the Maslow’s hierarchy of needs our first needs are physiological: air, water, food, sleep. After those physiological needs are covered the next levels are safety, love/belonging, esteem, and self actualization. How can our impact portfolios facilitate this optimal potential for health instead of problem solving for diseases? Curing cancer is certainly a heroic and much needed feat but what if we could avoid getting cancer all together? isn’t avoiding all this human suffering possibly worthy of impact investment dollars? Curing v.s. preventing that is the question. What investment thesis could facilitate the optimal conditions for life such as clean, air, fresh water, healthy food, walkable cities, and healthy spaces in general?
Economic Benefits of Preventing Disease
The preservation of health is easier and cheaper than the cure of the disease. “Prevention can reduce the significant economic burden of disease in addition to improving the length and quality of people’s lives. Treatment, lost productivity, and health care costs are significant burdens to the economy, families, and businesses. Prevention policies and programs often are cost-effective, reduce health care costs, and improve productivity.” — According to the National Prevention Strategy.
What are we breathing?
When 3 out of 5 of the top causes of death worldwide according to the World Health Organization include respiratory and pulmorary diseases and the biggest killer of all cancers is lung cancer, we have to ask ourselves:
What are we breathing? how can we improve air quality for all?
There is a lot to be done in cities ranging from urban reforestation to protecting workers from toxins in the workplaces and factories. The World Health Organization says that, in 2012, air pollution contributed to 6.7% of all deaths around the world. (It also enters the food system and contributes to climate change.) Here are 5 ways to improve air quality in our cities.
We not only need to takle the contaminants in open spaces, but also in our homes and workplaces: “The average household contains about 62 toxic chemicals, say environmental experts. We’re exposed to them routinely — from the phthalates in synthetic fragrances to the noxious fumes in oven cleaners. Ingredients in common household products have been linked to asthma, cancer, reproductive disorders, hormone disruption and neurotoxicity.” says Jessie Sholl in 8 Hiden Toxins in our Cleaning and Household products and perfumes.
Instead of focusing in finding a cure for lung cancer, lets invest in cleaning the air we breathe. Opportunities for investments in clean air could range from alternatives to tobacco, clean cookstoves, natural cleaning products that are available not just to the elite but widely to all segments of the population, environmental impact bonds for urban reforestation, urban tech like City Tree, cleaner forms of transportation like public transport and bicycles, healthier perfume products free of hazardous chemicals, air filters, and so many other possibilities for a cleaner air.
What are we drinking and eating?
We are what we eat. The investment opportunities for clean water access and healthy food have been widely explored in impact investment before. In recent years the trendier cities have certain areas where healthy food and even so-called super foods are readily available and convenient for the public elite, how can we make this healthy meals affordable and accesible conviniently to all segments of the population? There are some cities that have a headstart with community gardens such as Todmorden in the UK and Detroit in the United States.
But in most cities in the emerging world (and even in the smallest towns) healthy foods are still a market opportunity that has yet to materialize, while sugar and highly processed foods are taking over the streets increasingly by the minute. There is certainly a lack of uprocessed food, unsweetened food, or food free from harmful chemicals available to the public. Opportunities for investment in healthy water and food could range from green infraestructure for urban and rural water management, rainwater harvesting, community gardens, healthy food products, unsweetened beverages, companies that serve healthy school lunches or workplace lunches, healthy restaurants and tougher regulations or public policy around food ingredients labeling and transparency on health consequences of certain unhealthy foods.
What are we feeling/ thus how are we sleeping?
As Peter Senge once said: “ Our interdependence is growing but our consciousness of that interdependence is diminishing”. Mind and body are not separate, what affect one affects the other. How well we sleep is very tightly connected to our feelings of safety, love/belonging, esteem, and self actualization. Disruptors of sleep can come from external factors but also from feelings within us like anger, guilt, anxiety and most of all stress. How can we invest in feeling better and safer, loved, and at the same time tackle creative endeavors that can drive self actualization?
Meditation, excercise, group activities and art all have a very positive correlation to mental and physical health outcomes in multiple studies. Here is a deeper and dedicated organization tracking the Connection Between Art, Healing, and Public Health: A Review of Current Literature.
Chronic diseases are a worldwide burden, with cardiovascular disease being the leading cause of death during the past century and the incidence of diabetes continuing to increase, now affecting more than 20 million Americans. These diseases are associated with psychosocial difficulties such as depression and chronic stress, contributing to negative cardiovascular outcomes. Engagement with creative activities has the potential to contribute toward reducing stress and depression and can serve as a vehicle for alleviating the burden of chronic disease.
Opportunities for investments in balancing our feelings could include excercising, mindfulness, and dancing companies, art companies, musical therapy, among many other possibilities. In our work at SVX Mexico we’ve been fortunate enough to encounter Mexican startups that alleviate depression and other mental health issues through diverse media. One is Happinss a virtual reality consciousness therapy company and Impulsarte a music academy for healing the soul. Impulsarte has a both powerful and touching story of how the founder healed himseld from an accident through music.
So how is this investment thesis different?
There is certainly a billionaire race to healthcare including Bill Gates, Mark Zuckerberg, Jeff Bezos, Warren Buffett and Jamie Dimon. If you look at the investments they have made and their future investment thesis there is a common thread focus on 3 things: medicine (vaccines, new drugs for diseases, biotech, early detection devices, diagnose-tech, among others), insurance and hospital infrasestructure and control of health information (patient records, medical journals, DNA, cells,). I would rename their investments to Medicine investments, or investments for survival, because survival is to endure or persist despite the difficulty. But if we want thriving life their investments need to evolve towards flourishing, blossoming, and prospering life. An investment portfolio that lays out the conditions for human existance in our best expression of self-actualization.
Our proposal is that an ideal investment portfolio for health would use most of the resources in the portfolio to facilitate the conditions for balance and wellbeing in the physical, mental and community sense and then a portion of it could include some resources for healing of diseases.
I was very surprised to find that Ghana has already implemented some of these Regenerative Health practices. “The central idea behind Regenerative Health is that through the implementation of healthy lifestyles, dietary practices and mother and child care practices, we can eliminate many of the diseases presently impacting upon the citizens of Ghana. Ghana is the first nation state to make Regenerative Health and nutrition the focal point of its national policy. Regenerative Health is seen as a sound strategy and pragmatic course for a developing nation in addressing the broader determinants of health.”
I once heard Marco Vangelisti on a Slow Money conference say one of his fundamental values for making an investment decision is his love of life or biophilia. Let’s make health investments that portray our love of life.
Laura Ortiz is the founder of SVX México a firm that facilitates impact investments in Mexico, and is passionate about Regenerative Capitalism and Systems thinking and doing.
