Dr Rochdi Talib, President-Director General of Morocco's leading private healthcare group, AKDITAL, on the impressive growth trajectory that brought it to a USD 100 million revenue milestone in 2022. He also discusses how the Group has extended its presence across the country and evolved along with Morocco's improving healthcare landscape and the rollout of universal heathcare, and outlines the strides it has made in terms of digitalisation and attracting talent, as well as the positive outlook for investments in Morocco.
As this marks our first encounter, could you give an overview of AKDITAL, Morocco’s leading private healthcare Group, which you have been leading since 2011?
The foundation for the Group was laid with the establishment of the JERRADA OASIS clinic in 2011 although the notion of a conglomerate was not yet conceived at that point. Subsequently, recognising the potential of the JERRADA OASIS model, which had proven highly efficient, we decided to replicate it, primarily within Casablanca. This initiative bore fruit in 2017 with the formation of Group AKDITAL. The blueprint was disseminated across several sites in Casablanca and later, rolled out on a nationwide scale. Our initial step encompassed the coverage of Casablanca, including five clinics.
While the advent of the COVID pandemic brought challenges, it catalysed a heightened awareness among policymakers regarding the significance of inclusive and mandatory healthcare for all Moroccans. This pivotal juncture prompted a strategic overhaul, wherein the Casablanca model was slated for replication on a broader canvas. Currently, we are extending our presence across eight cities, poised to expand to nine by year-end, operating 21 facilities comprising 2,200 to 2,300 beds, and creating 4,000 direct jobs. The Group achieved a USD 100 million revenue milestone last year, with projections indicating 200 million by the close of 2023. This remarkable journey underscores a substantial growth trajectory that facilitated our listing on the stock market after a mere 4 to 5 years of existence; a testament to our remarkable achievement.
It is reasonable to assume that the funds secured through the Group’s successful listing on the Casablanca stock market are earmarked for the expansion of new facilities and hospital units. Could you elaborate on the transformative potential or the ongoing transformation this influx might engender for the Group’s advancement?
Until recently, prevailing healthcare options often failed to align with public expectations. Many entailed limited spaces and services, catering primarily to uncomplicated pathologies. Addressing complex pathologies mandates requisite infrastructure, technical prowess, and specialised skills—key elements encompassing the appropriate infrastructure and adept medical and paramedical professionals.
Significantly, our Group is steered by medical experts who have effectively rallied a cadre of skilled surgeons and physicians. Our consistent practice of selecting the finest talents converged around the Group’s mission. Simultaneously, a core objective has been ensuring universal accessibility to quality healthcare within Morocco. Presently, our focus extends beyond Casablanca and its vicinity. Launching facilities in Tangier in the north as well as Agadir, and Safi in the central regions, among others, underscores our commitment to addressing the scarcity of high-quality care across various cities.
What underlies this disparity in healthcare provision within Morocco and how best can it be addressed?
Undoubtedly, the emergence of healthcare consortia is advantageous, potentially serving as a source of inspiration for similar endeavours. Encouraging emulation and even replication will invariably enrich the healthcare landscape. However, the crux lies in charting the course and shouldering the inherent risks, spanning managerial intricacies to multifaceted operational challenges. Our initiative revolved around setting a national precedent, subsequently paving the way for potential emulation. This collective stride towards diversified healthcare providers is essential, as comprehensive healthcare cannot be borne by a single entity. Rather, it necessitates the synergy of several entities, thereby ensuring the dispensation of quality healthcare across diverse regions.
How pivotal was AKDITAL’s Initial public offering (IPO) in terms of propelling technological advancements, elevating healthcare services, and fostering a culture of quality and transparency within the organisation?
Before the IPO, our transition to institutionalisation started with the involvement of the MCP fund three years ago. This collaboration yielded invaluable good governance practices, an imperative aspect considering the management of multiple clinics. This alignment with the MCP fund, providing EUR 25 million, facilitated our evolution. With an expanded vision and recalibrated strategy, the idea of an IPO was conceived. The IPO not only furnished the necessary financial impetus for accelerated development but also symbolised transparency. This step was instrumental in debunking the notion that healthcare clinics operate in opacity. Contrary to this perception, we have demonstrated that operating with transparency is viable. With 30 percent public ownership, the profound trust extended to us by many individuals stands as an honour. This transition, symbolised by the public listing, signifies our ascent from a modest Group to a substantial player, with hopes of inspiring others to traverse this path in the coming years.
Do you see the implementation of universal health coverage as a threat to AKDITAL’s operations, given the now more pronounced emphasis on the public sector?
Quite the opposite, it signifies a favourable prospect. Prior to the full implementation of healthcare coverage, nine out of every ten insured patients regularly sought medical care at private clinics. Irrespective of their insurance status, almost 60 percent of the population favored private clinic services. In essence, Moroccans placed their trust in private healthcare. These clinics were known to offer quality care, arguably superior to what the public sector provided. This is a reality. With the implementation of universal coverage, I hope to see a diminished distinction between the public and private sectors.
The essential goal is to serve Moroccan citizens, as well as foreigners, uniformly and under improved conditions, be it in the public or private domain. A healthy competition, one that ultimately benefits the population, is something we should welcome. However, it is possible that such a duality, this competition, will emerge. But for now, the more individuals covered by health insurance, the better it is for the private sector. However, the quality of private healthcare varies significantly. There are establishments offering high-quality services, while others are still somewhat antiquated.
You mentioned the importance of quality healthcare. Could you elaborate on this, as it seems to be a cornerstone of your approach?
The AKDITAL Group has nothing to envy when compared to private hospitals in developed European or American countries, or even public institutions in those nations. I can assure you that our equipment is on par. The majority of our equipment is manufactured in developed countries. Whether in an advanced nation or within Morocco, patients enjoy access to identical cutting-edge medical equipment. A scanner, for example, in our clinic in Morocco, is equivalent to what you would find in the United States, be it in a public or private hospital.
Therefore, when we allocate all the necessary resources and commit to achieving excellence, we provide the local population with facilities that match those available in developed nations. Moreover, there are the competencies, both medical and paramedical. Healthcare professionals are, fundamentally, human beings. Whether they be Moroccan or American, they possess varying levels of intellect and expertise. Our goal is to attract the best talent.
How do you approach talent retention, given that top medical professionals from developing nations often move abroad in search of opportunities?
We must seek talent where it resides. For instance, I know that there are many highly skilled Moroccan doctors permanently settled in France. Some are hesitant to return to Morocco, fearing they will work in unfavourable conditions, both professionally and financially. We are gradually instilling confidence in them, especially through organisations like AKDITAL. It is a source of great pride that we have successfully attracted top talent. We have brought cardiovascular surgeons, catheterisation specialists, and more. These individuals were once determined to conclude their professional careers abroad. Nevertheless, we managed to change their minds, and they now share their expertise for the benefit of our patients. This is only the beginning of our journey to reassure them. It starts with the right infrastructure, working conditions, and financial incentives. The initial phase may not be without challenges, but word of mouth will eventually work in our favour. Rest assured, Morocco boasts state-of-the-art medical facilities and excellent working conditions.
The more affluent segment of the Moroccan population has, in the past, tended to seek complex medical treatments abroad. Has this trend continued or evolved in any way?
To go even further, within Morocco itself, prior to our creation in Agadir, individuals seeking complex procedures often travelled to Casablanca or Marrakech. Since our presence was established there, we have successfully addressed this issue. Thanks to the commendable efforts of our communication department, they have highlighted the quality of care provided by the AKDITAL Group, establishing it as a national benchmark. We constantly receive requests from authorities and the public, urging us to bring our services to cities lacking adequate medical facilities. There has historically been a considerable issue with people from underserved areas traveling elsewhere for proper treatment. While we have made progress in alleviating this need for travel in specific regions, we have not yet achieved this nationwide. In the months ahead, we will announce forthcoming projects that aim to enhance healthcare coverage and quality across the entire nation, from north to south, and from east to west, leaving no area overlooked.
Is the population increasingly aware of the quality of healthcare available in the country?
Absolutely. At one point, Moroccans did not have access to cardiovascular surgery, as is the case nowadays in sub-Saharan Africa. There was a time when there was no radiotherapy. Individuals, particularly the affluent, would travel to Europe or the United States for heart surgery or open-heart procedures. Today, we can proudly say that we have achieved full medical autonomy within our country. Personally, if I were to face a medical issue, I have complete confidence that I would receive appropriate treatment in my country and within our Group.
‘Autonomy’ is a key word for the Moroccan government today; how would you characterise AKDITAL’s own contribution to building up this autonomy?
AKDITAL’s contribution has been substantial. Our efforts are not solely driven by financial gain but rather by the desire to serve our fellow citizens and our beloved nation. It fills us with pride to no longer witness our citizens seeking treatment abroad due to a lack of faith in our healthcare system, which now delivers high-quality care. I also hope that the public sector continues its efforts, and the government’s monumental strides in elevating the standards of its hospitals and healthcare facilities. In the private sector, there is no room for mediocrity anymore. The time has come to put an end to improvised medical approaches and inadequate healthcare. Change is imperative.
Could you provide an overview of the different services that your Group offers today and highlight any areas where it has been able to introduce advanced technology?
Our active involvement in oncology places a spotlight on patients undergoing treatments such as radiotherapy. The successful treatment of these patients hinges on the presence of a robust technological infrastructure. These individuals are grappling with the challenges of cancer treatment and are in a state of extreme vulnerability. Their ongoing chemotherapy further weakens their immune system and physical resilience. Considering these conditions, there is a compelling demand for cutting-edge imaging capabilities. Achieving optimal outcomes necessitates meticulous planning, intensive care, a framework of skilled medical professionals, and, most critically, access to advanced equipment. Historically, radiotherapy posed the risk of collateral damage, impacting healthy areas of the body due to its lack of precision. To give an example, in cases of laryngeal cancer, it could adversely affect jaw joint function. Nowadays, we have transitioned to what is known as radiosurgery, a highly precise yet financially intensive approach. Nonetheless, it dramatically enhances the quality of cancer treatment.
Have you been able to leverage digital technologies and systems to enhance the efficiency of AKDITAL’s hospitals?
Today, the entire Group is 100 percent digitalised and we fully embrace digitalisation. A patient’s healthcare journey, from entry to discharge at one of our hospitals or private clinics, involves zero paperwork. All medical records are stored on servers, eliminating the need for physical documents.
Let me provide you with an example: an MRI performed at 3 AM in Tangier does not need to be interpreted on-site; it can be interpreted in Casablanca. We do not need to mobilise a doctor to perform the scan; we have technicians on-site. The doctor interpreting the scans can be in Casablanca, analysing various examinations conducted nationwide within our Group, thanks to digitalisation. We have an exceptional team in our information systems department, comprising approximately 80 dedicated individuals. It is almost like a separate enterprise within our organisation. They are highly motivated and have made significant strides in terms of digitalisation. When a patient enters, they receive an electronic bracelet, allowing them to be comprehensively monitored. As an example, this acts as a deterrent to nurses discouraging them from potentially inputting incorrect readings. They are required to physically scan a bracelet, rather than entering temperature data. This digitalisation has allowed us to achieve remarkable advances in healthcare efficiency.
How do you evaluate the level of cooperation between the public and private sectors in Morocco today?
It is in an early stage, with potential for further improvement and strengthening of intersectoral partnerships. I hope it will evolve positively. The goal is to establish seamless collaboration between the public and private healthcare sectors. We aim to create a unified healthcare system that respects the national healthcare roadmap, serving both public and private interests. We must avoid redundancy in some areas while leaving others entirely underserved. The private sector requires support from the government, and similarly, the public sector benefits from private contributions to treat Moroccan patients effectively.
Morocco is forecasted to achieve an economic growth rate of approximately 3.1 percent, surpassing some neighbouring nations. What are your insights regarding the country’s trajectory over the next three to five years? Do you have a positive outlook?
This is not enough, achieving a steady six percent growth is necessary to improve our economic standing. However, I am extremely optimistic as we have witnessed developments that support entrepreneurship. There is an investment charter that offers significant incentives for private-sector investment, this is very encouraging. For instance, it includes significant subsidies, up to 30 percent for investment in remote areas. It also facilitates hiring, offering substantial subsidies for employment, providing half of the minimum wage’s cost for up to nine to twelve months during the first year of employment. Regarding exports, the ‘MOROCCO NOW’ initiative is gaining momentum. We are contributing to the country’s revenue by exporting healthcare services, as there is a growing influx of patients from various African nations seeking healthcare in Morocco. Our optimism about the future remains steadfast.
About three percent of our revenue is generated from providing medical evacuations for patients coming from other African nations to receive treatment in Morocco. Our goal is to raise this to twenty percent in the next four to five years. We have established an International Development Division to focus on South-South cooperation, eliminating the need for lengthy visa processes and providing efficient, affordable care closer to home. This shift aims to reassure sub-Saharan patients, making quality healthcare more accessible.
Can you provide some insights into AKDITAL’s general direction over the next three to five years? What are your ambitions and objectives?
Certainly, you will undoubtedly find us expanding our presence across Morocco, reaching approximately 20 cities by the end of 2024 and 2025. You will be impressed by our extensive coverage within Morocco itself. Our primary focus as a Group is to serve the Moroccan population, and we will continue to extend our services to rural areas in the coming three to four years. Looking further ahead, in four to five years, you will find us in sub-Saharan Africa, expanding internationally and providing our services on a continental scale, possibly even in the MENA region. Our objective is clear: by 2025-27, you will find us on the international stage. I cannot reveal more at this moment, but you will indeed witness our international presence after completing our mission in Morocco.
To conclude the interview, would you like to share a message for our international audience, including potential investors from Europe, Africa, and the Middle East?
In emerging nations like ours, there are countless business opportunities waiting to be seized. Have confidence in countries like Morocco, where unimaginable opportunities await. Invest in AKDITAL to explore a promising investment avenue. We are putting our best efforts into providing quality healthcare services and advancing our healthcare system.