How to Scale Healthcare Access to Billions of People Without Losing Your Mind (or Your Mission)

Most health tech founders dream of making billions of dollars. Ed Booty dreams of improving the health of billions of people – 52% of the world to be exact, who do not have access to reliable healthcare and prescriptions.

The Reach 52 founder took his company from a solo venture bootstrapped in Singapore to a multi-country operation distributing essential medicines across Asia and Africa - all while maintaining profitability and sanity. Well, mostly sanity.

Here’s what makes his journey particularly instructive: Ed didn’t follow the typical venture playbook. He bootstrapped for nearly four years, said no to grants (initially), and focused obsessively on revenue before scale. The result? A sustainable social business that’s actually solving the problem it set out to address.

If you’re building in emerging markets, dealing with government partnerships, or trying to make impact profitable, Ed’s playbook offers some hard-won wisdom worth stealing.

The Problem: 52% of the World Can’t Access Basic Healthcare

Over half the world’s population cannot access essential medicines, doctor services, or basic diagnostics. But here’s the market failure that caught Ed’s attention early: medicines often cost 20-30 times more in low-income countries than in wealthy ones.

Ed saw this firsthand during an internship at a pharmaceutical company in India when he was 21. That experience planted a seed. But it wasn’t just the visible poverty - it was watching a major pharmaceutical company struggle to serve rural markets despite genuine effort. “They were making money in the cities, going rural is harder... even if you get the products into the market, which they did... due to the low awareness education screening, the products didn’t move.”

Market inefficiency meets mission-critical need. That’s where Reach 52 lives.

Lesson 1: Have Just the Right Amount of Competence and Naivety

Ed saved money working in UK consulting for seven years before quitting with a one-way ticket to Singapore. His philosophy? “I always said I’ve had just the right amount of competence and naivety, and I genuinely mean that. I knew my stuff. I’ve worked in healthcare for six years, but I also didn’t know a bunch of stuff and I tried to do stuff that other people wouldn’t do.”

This balance matters more than you’d think. Research on entrepreneurial success shows that domain expertise can sometimes create blind spots - you become “too wise to try” the unconventional approaches that create breakthroughs.

The practical application: If you’re waiting to know everything before starting, you’ll never start. If you know nothing, you’ll waste years learning what veterans already know. The sweet spot is having enough knowledge to be credible while maintaining enough naivety to challenge assumptions.

Explore first, then exploit.

Ed’s naivety led him to try a tech-heavy, data-driven marketplace model early on. It failed. But that failure - and the willingness to try it - opened doors with pharmaceutical partners that still work with Reach 52 today, even though they’ve completely pivoted the model.

Lesson 2: Revenue Before Venture (Even When It’s Hard)

Here’s where Ed diverged from typical startup advice: “I was very tenacious. We were not going to take any grants because I genuinely believe grants can make you a bit lazy from a business model point of view.”

Reach 52 didn’t raise venture capital until 3.5 years in. They bootstrapped through B2B partnerships, selling health education and screening programs to pharmaceutical companies rather than taking free money from donors.

The discipline this created was critical. Ed had to prove the business model worked before anyone would invest. “We actually didn’t raise any money since 2020,” he notes. “We’ve genuinely been focused on revenue versus just trying to raise investment money.”

Why this matters: Studies on social enterprise sustainability show that earned revenue models tend to scale more sustainably than grant-dependent ones. The market discipline forces you to create something people actually want to pay for.

The practical framework:

1. Identify who will pay for impact (B2B partners, governments, end users with ability to pay)

2. Start small - prove the model works at micro-scale

3. Use early revenue to fund expansion, not grants

4. Only raise venture capital when you need to scale something proven

The caveat: “COVID was a hard time. You sometimes need to take grants,” Ed admits. Pragmatism beats purity. But the default should be revenue-generating.

Lesson 3: Map System Friction, Not Just User Friction

Ed’s marketplace model failed spectacularly. The idea was elegant: train community health workers to screen patients AND distribute medicines directly, cutting out expensive middlemen.

But system friction killed it.

Pharma companies worried about “cutting out pharmacy... that actually cuts out their current customers, the doctors and the pharmacies.” Residents didn’t want to pay delivery fees. Quality control was a nightmare. “I mean it would take nine months I think it took to get our first products.”

The lesson extends beyond Ed’s specific failure. While most startups obsess over user experience friction (How many clicks? How many form fields?), social enterprises operating in complex systems need to map ecosystem friction.

Ask yourself:

• Who loses if you win?

• What regulations will you bump against?

• Whose existing business model are you disrupting?

• What cultural practices are you fighting?

As behavioral economist Dan Ariely has documented in his research on market friction, the smallest points of resistance can derail adoption - and in complex systems with multiple stakeholders, friction compounds exponentially.

Ed’s evolved model separated health education (building demand) from medicine distribution (meeting supply), working WITH existing pharmacies rather than around them. More complex. More effective.

Lesson 4: Find the Path of Least Resistance

“My strategy is take the path of least resistance,” Ed says, half-joking. “If you are selling something and it’s selling itself... it is working.”

This sounds obvious until you’re in the weeds. You’ve invested months in a market or product. You’ve told investors you’ll make it work. Admitting defeat feels like failure.

But Ed’s ruthless about following organic traction: “We’ve got distribution in 15 African markets... six are working really well right now. We’re getting decent orders in six. A few of them would be really hard... probably not where we want to start.”

The practical test:

• Throw the net out wide (pilot in multiple markets, test multiple products)

• Watch what sells with minimal effort

• Double down on natural demand

• Kill everything else

When Reach 52 started distributing medicines in Africa in 2023, they didn’t commit equally to all markets. They watched which partnerships generated orders organically and focused there. “If you’ve got 20 things in your basket on your marketplace and people are always buying the nutritionals... focus on the nutritionals.”

The Lean Startup methodology calls this “validated learning” - but Ed’s version is simpler: follow the money and the momentum.

Lesson 5: Learn to Say No (It Takes Experience to Earn)

Early in Reach 52’s journey, Ed was a yes-man. A pharmaceutical company wanted them in Cambodia? Sure! Never mind that it’s a tiny market with limited partner interest.

They launched in Cambodia. It worked for a while. They eventually had to exit.

“I don’t regret doing that at the early stages,” Ed reflects. “You have to get points on the board, you have to learn, you have to grow revenue.”

But today? “I genuinely say we say no to 50% of partnerships now... We know what works. And then it’s just being true to yourself and sticking to the mission and not getting distracted.”

The maturation curve of “no”:

Years 0-3: Say yes to almost everything. You need:

• Points on the board

• Revenue validation

• Market knowledge

• Pattern recognition

Years 3-5: Start filtering with basic criteria:

• Does this align with WHO essential medicines?

• Does it fit government strategy?

• Is it more affordable than current options?

• Can we actually deliver it?

Years 5+: Ruthlessly protect focus:

• Mission alignment becomes non-negotiable

• OKRs determine everything

• Path of least resistance guides choices

• 50%+ of opportunities get declined

Ed’s team heard “it’s absolutely mission aligned, therefore we have to do it” twice in two days before our interview. But they also heard “this won’t move the needle... it’s a no.”

You can’t have this discernment on day one. You earn it through scar tissue.

Lesson 6: Bad Hires Will Decimate Your Company

When I asked Ed about his biggest mistake, he didn’t hesitate: “Hiring the wrong people can decimate your company, early stage, mid stage, late stage. Toxic, bad strategy, wrong - other team members around them quit.”

Harvard Business School research shows that the cost of a bad hire isn’t just their salary - it’s the damage to team morale, the opportunity cost of not having the right person, and the time spent managing problems instead of building.

For social enterprises, the stakes are higher. You’re not just building a business; you’re building a mission. Toxic team members don’t just hurt productivity - they undermine the cultural foundation that keeps people motivated despite lower pay and harder conditions.

Ed’s evolved hiring philosophy:

• Experience matters less than cultural fit, attitude, and drive

• You can’t screen for these things from a CV

• Take time with the process

• When you see red flags, act quickly

You can accelerate it by being methodical: implement structured interviews, do reference checks beyond the list they provide, and use trial projects before full hires.

Lesson 7: Scale Requires Different Rules for Different Teams

Here’s a nuance most leadership advice misses: not every team operates under the same rules.

Ed runs some teams with absolute flexibility: “Do not expect this to be fixed... expect version nine by the end of the year of our credit policy.” He tells them upfront - we’re experimenting, this will change monthly.

Other teams get the opposite treatment: “This plan will not change. We have to deliver this by the end of the year. This is what we’ve committed to our external partners. End of discussion.”

This isn’t inconsistency - it’s sophistication. Some work requires iteration and experimentation (new market entry, product testing, innovation). Other work requires execution discipline (fulfilling commitments, established operations, regulatory compliance).

The key is being explicit about which mode you’re in. Team members need to know if they’re in exploration mode or execution mode. Mixing signals creates confusion and frustration.

As Erin Meyer’s Culture Map framework describes, there are “big D decisions” (slow to make, fully committed) and “little d decisions” (fast, reversible). Jeff Bezos called them one-way doors and two way doors. Ed’s instinct maps perfectly to this: know which decisions are which, and communicate that clearly.

The Geographic Expansion Playbook

Expanding from Philippines to Indonesia to India to 15 African markets sounds daunting. Ed makes it sound almost boring.

“I don’t find market expansion that hard. Everything you’ve said, you used the word challenge - for me, it is just a process.”

His framework:

1. Identify market opportunity - Does the “missing middle” exist? (People earning $5-15/day who can’t afford current healthcare costs but aren’t below poverty line)

2. Validate partner interest - Will B2B partners pay to reach this segment?

3. Test before legal - Find a local partner to pilot before setting up entities

4. Do the boring work - Hire local lawyers, file paperwork, register products

5. Follow organic traction - Watch which markets generate orders without heavy lifting

The honest assessment: Can you actually win here? Market size and need aren’t enough. You need realistic competitive advantage.

For social entrepreneurs specifically: research on social enterprise internationalization shows that mission-driven organizations often underestimate cultural and regulatory barriers. Ed’s “can we win?” filter prevents wasted effort.

The Mental Health Reality

That beautiful passage Ed wrote in 2021 deserves full recognition. Social entrepreneurship is lonely. The stakes are higher, the resources lower, the problems more complex.

Ed’s honest about it: “You’re running a health company, but your work will make you fundamentally unhealthy through long hours, excessive travel, coffee, alcohol, forgetting to eat and constant pressure.”

His rituals:

• Morning workouts (high-intensity classes before the workday)

• Evening beer in the sun (”You can have the worst day... just sitting out there having a nice hazy IPA”)

• Cooking (”Order from chaos... I just find that quite relaxing”)

• Beach holidays (not city breaks - he’s learned what actually recharges him)

The philosophy behind it all? “Use yourself as your own worst critic. Imagine yourself on your deathbed, looking back at what you’ve achieved and what makes you smile.”

This existential framing - “we’re our temporary existence... trying to find purpose and meaning” - gives Ed permission to work hard AND to walk away when needed.

Self-care isn’t optional - it’s what enables sustainable performance. Ed’s rituals aren’t indulgences; they’re strategic necessities.

The Current State: Profitable Impact at Scale

Today, Reach 52 operates across 15+ markets with 250+ staff. They’ve distributed medicines to 26,000+ pharmacies and clinics. They’re actively expanding in East, West, and Southern Africa.

Most importantly: the medicine distribution business (Reach 52 Access) generates enough margin to self-fund health education programs (Reach 52 Impact). The social mission isn’t grant-dependent - it’s built into the business model.

“A majority of this is actually self-funded from the medicines distribution business. And then some of it is B2B or grant funded.”

This is the holy grail of social enterprise: using market mechanics to fund social impact sustainably.

Three Things to Remember

1. Revenue discipline creates resilience. Grants can make you lazy. Customers keep you honest. Bootstrap as long as possible, raise venture only to scale what’s proven.

2. System friction is more important than user friction. Map the entire ecosystem - who loses if you win? What entrenched interests will resist? Design around reality, not ideal theory.

3. Saying “no” is a skill you earn. Early stage requires saying yes to learn. Growth stage requires saying no to focus. You can’t skip the learning phase, but you must evolve to the discipline phase.

Ed’s journey with Reach 52 proves that social businesses can scale profitably across some of the world’s toughest markets. But it requires equal parts competence and naivety, revenue focus and mission commitment, flexibility and discipline.

The 52% of the world without healthcare access won’t be reached by charity alone. It’ll take entrepreneurs willing to do the hard, boring, essential work of building sustainable businesses in underserved markets.

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Resources and Further Reading:

• Ed Booty on LinkedIn - Connect with Ed directly

• Reach 52 Website - Learn more and sign up for their quarterly newsletter

• Ed’s “Dear Ed” Letter - Raw reflections on the founder journey

• WHO Universal Health Coverage - Context on the 52% problem

• Financial Times: “Low-income countries pay up to 30 times more for medicines” - Market failure documentation

• HBR: The Problem with Nonprofit Business Models - Why earned revenue matters

• Lean Startup Methodology - Framework for validated learning

• The Culture Map by Erin Meyer - Understanding decision-making across cultures

• HBS: The High Cost of a Bad Hire - Why hiring matters more than you think

Transcript

Mark Horoszowski (00:10:55):

Ed, welcome to the Helping Billions podcast. I am so excited to be having this conversation. I’ve been following the Reach 52 story for, I should have this memorized, but it’s years, it’s pre COVID time since we first interacted from work and some of our partners had interacted with your work. So it’s been really, really cool to just see the growth, the expansion. We’ve had the joys of meeting in person, and I just can’t wait to introduce you to this community. So without further ado, ed, tell us what does reach 52 do?

Ed Booty (00:12:00):

Hey, mark. Hey listeners, thanks for tuning in. And yeah, thanks for the invite as well. I’ve definitely enjoyed the conversation, so looking forward to the formal one, if you will. Yeah, so brief intro, I’m Ed, set up an organization called Reach 52. We’re headquartered in Singapore, but operate across Asia and Africa. We take our name from the problem and the mission of the company, which is over 52% of the world actually gone up. It’s now 56% of the world since we named the company Cannot Access Essential Healthcare. So that’s basic medicines, doctor services, diagnostics, and therefore we are trying to reach the 52% of the world that lacks access to these essential health services. According to the World Health Organization, what we do in practice is sort of three main parts of the business. Firstly, we collect a lot of data on community health needs. So we go out, we have a tech platform, we train members of community to understand what medicines are available, how much are they speak to residents, speak to doctors, and at a local level. Generally outside of cities, we don’t do much work in urban areas. It’s generally rural, understand the health needs. We don’t monetize data, we don’t sell data. We just collect that as a deeper understanding of local health gaps and access issues and two main parts of the business.

(00:13:24):

Firstly, we do really data-driven health education and screening campaigns. So based on the understanding of a village or a community, we would train doctors, train nurses, train midwives, and then do actual health education events. 50 people, a hundred people would come. We also do a lot of screening across about 20 health issues. Sometimes that’s B2B funded, so we work with a range of pharma companies, consumer health companies, some grants and donors who sometimes fund that work. But the second part of the business called Ridge 52 access is really focusing on selling, distributing essential medicines, small pharmacies, small clinics. We would supply them with products that’s a mix of products from a range of companies, sometimes generics manufacturers, sometimes multinationals. But we’re looking to bring in the affordable products to these communities. Some if the impact programs aren’t funded, sometimes the reach 52 access margins can self-fund the health education and screening. So a majority of this is actually self-funded from the medicines distribution business. And then some of it is B2B or grant funded, as I said, probably. Oh, sorry. Yeah, just final comment. Yeah, we’re sort of heavy in India pretty much nationwide in India across about 15 states, 250 staff growing really nicely in Eastern and southern Africa. And we’ve just hired our West Africa leads as well. And we’ve got a smaller presence in Indonesia, so started in Southeast Asia and grew India, and now a lot of our growth is really happening on the African continent.

Mark Horoszowski (00:15:07):

It is just amazing to see the continued innovation and growth, and we’re going to dive into that, especially the geographic expansion, an area where we see so many entrepreneurs struggle. But I want to just even come back a little farther in time. I think lots of humans know that healthcare is not granted equally, let alone accessible to a lot of people, but you’re actually doing something about it. Tell us just a little bit of the journey into how did you get started taking on especially such an audacious mission?

Ed Booty (00:15:45):

Yeah, I mean, I’ve been asked this question many times. I think I’ve counted seven reasons that kind of coalesced at the right time, that led me to quit my job in the UK comfortable life and moved to Singapore and sort of solo found with a company. Really? Yeah, I mean, going right back, went to uni, was meant to go straight into consulting after uni. My dad was just like my one big regret is having a bunch of kids going into a normal career and never really seeing the world. So he lent me some money and I traveled around India. So we delayed the offer for a year, took a year plus out, well, at least originally a year plus out to go see the world a bit. Yeah, went to India was where I felt I could stretch my 3000 pound loan from my dad most.

(00:16:29):

And yeah, it really changed my mind, changed my worldview very deeply. I mean, a lot of the, I could talk about this for an hour, but one of the first days in Mumbai, flew into Mumbai, landed from the UK driving down the side of the road and there’s just two plastic chairs, bloke sitting on a plastic chair, empty plastic chair next to him, and then just cardboard ripped cardboard, permanent marker. Dentist, dentist. I was like, holy shit. Really shocked to the senses. Obviously India sounds, smells normal, just chaos. But know why some of these health things stood out to me, traveled around India for a bunch of time, ended up with not wanting to leave, being fascinated by emerging markets, volunteered at a few NGOs, really coming out of business school. Really didn’t like the NGO model felt. It was sort of like peripheral to change in the actual problem.

(00:17:20):

It’s like a side project to actual markets and the actual way society functions. So volunteer at NGOs really felt grants and donor models are always going to be fiddling at the edges versus systemic seismic change. But yeah, sort third reason ended up volunteering for a pharma company or interning at a pharma company in India. Didn’t want to leave, ran out of money, and this pharma company was trying to make their products available in rural India, and it was just hard for them every step of the way. Internal challenges, they’re making money in the cities, going rural is harder, have to work with small distributors. Finance don’t like it, collections risk, even if you get the products into the market, which they did. They moved so slowly. They actually did a peer review of this, it’s actually published like 15 years ago, and they got this supply chain model working.

(00:18:14):

Affordable medicines were available, but due to the low awareness education screening, the products didn’t move. So saw went traveling, opened my eyes, didn’t think NGOs worked. Ended up interning for a big pharma when I was 21 and saw one of the biggest pharma companies in the world trying to do good, and they were struggling every step of the way. And then, yeah, went back into the uk, went back to the uk, sorry, had the idea for reach 52 when I was 22, still got the original pitch deck, original two pager, still look at it from time to time and it’s changed a lot, but it’s all still there. And then, yeah, saves up money. I was just the whole time from when I was 21, 22, just banking money said When I get to a certain amount of cash, I’ll quit my job and seed the company and do it.

(00:19:04):

So seven years in consulting, banking money the whole time eventually hit the cash that I thought I needed to started it and sort of quit my job on one way flight. And yeah, that’s how it started. And then people often do ask me, how does it actually start? Then you just build a pitch deck and you start pitching people. I mean, that’s it. Go on LinkedIn, find people, document your idea. I was doing a lot of this on my evenings and weekends before I quit my job. Built the website, built all the collaterals, started out reaching people, had the cash and then yeah, we were originally very southeast Asia focused, so therefore here I’m in Singapore.

Mark Horoszowski (00:19:42):

And so let’s go into that time a little bit more. So you’ve got the idea, you’ve got a website, you’ve got some cash, you’re going out and raising. Are you also working on mission delivery or customer acquisition at the same time, or were you first trying to raise investment to then build anything? Talk to me about that stage.

Ed Booty (00:20:01):

No, I was, and to some extent still am quite stubborn on this, so we never really took any grants until COVID was a hard time. You can’t need to take grants. I was very 10. We were not going to take any grants because I genuinely believe grants can make you a bit lazy From a business model point of view. I think it would make me a bit lazy and yeah, we had to be revenue generating. We had to prove the business model before we got investments. So we actually didn’t raise any venture money until three and a half, close to between three and four years in. So yeah, it was straight into customer acquisition. Yeah, small pilot fund it myself, build the team myself using my own cash for this that I’d saved up. And then straight into let’s make money. Yeah, let’s actually build the business model first. Let’s get some actual traction. And then, yeah, we haven’t actually raised any money since 2020.

Mark Horoszowski (00:20:54):

2020. Wow.

Ed Booty (00:20:55):

We’ve genuinely been focused on revenue versus just trying to raise investment money really.

Mark Horoszowski (00:21:04):

So of the three pillars at reach 52, where did the first cash come into the business? Was that on the community data side? Was that the education? Was that on the pill distribution?

Ed Booty (00:21:17):

Yeah, good question. So the health education and screening programs, we call that reach 52 impact. That was the business model up until about mid 2023. So yeah, first cash was health education and screening funded by B2B partners, well with most of the big pharma companies and health companies as well as grant makers, save the children UNICEF a bit. There were more funding us to do service delivery versus free money kind of grants. And then, yeah, the re 52 access side was kind of like a bolt on mid 2023. We evolved. Late 2023, we got our first revenue, and then really just last year was where it grew across India and into Africa. So most of that’s past 12 to 18 months.

Mark Horoszowski (00:22:02):

Yeah. Wow. Yeah, so cool to hear about that growth. So one area that I want to go even deeper on is you mentioned you saw nonprofits working in this space around health education. You had had some of that experience. Knowing you, I know there was a ton of research I’m sure that you were doing, especially with that consulting background, you decided to not do the nonprofit model. You didn’t want to be relying on donations. You said, Hey, there is a way to monetize it, and you were able to draw the connection of, hey, there are companies trying to distribute in this market, but without education, the pills aren’t going to go there. How did you find that bridge where obviously so many people haven’t been able to find that bridge? Did you have contacts from your consulting days? Were you hammering the phones on farmer contacts to figure out how did you actually find out that those business to business buyers would pay you money in order to deliver that health education?

Ed Booty (00:23:03):

Yeah, I’ve never genuinely thought about that. I guess in a way I found out because I was on the inside, so it was working for a pharma company, seeing it firsthand when I was 21 that gave the idea, I saw a pharma company that I was working for trying to do it and struggling. So I guess the deeper understanding of the needs came from being on the inside. But I mean, I could probably challenge even that question actually. I mean, there’s been financial Times articles, world Health Organization reports, inea ad blah, blah, blah. I’ve seen all sorts of stuff online medicines are more expensive due to often parallel imports. Companies don’t launch medicines in smaller markets. It’s not worth it for them. Therefore, the smaller markets buy from bigger markets. So in Kenya, you might have UK packs of medicine. They are literally sold in the uk, exported to Kenya, available in Kenya, and it’ll be more expensive than the UK because you add on the freight, you add on the margin, generally double if not quadruple Financial times article, low-income countries pay 20 to 30 times more for certain medicines than rich countries.

(00:24:11):

When I go from Singapore mature market for which I live to Philippines or Indonesia, medicines are more expensive. You would save money. I would often save money buying my medicines in a rich country, US is different of course. And obviously it’s not uniform, but generally it’s a known problem. The slight challenge is that if you are purely profit driven or a big company, I mean, I don’t blame big companies that are shareholder listed and have to deliver shareholder returns or whatever. What are you going to do launch one more product in the US or launch a bunch of products in a bunch of small markets where regulatory’s hard, the market’s small, there’s comparatively. So I think it’s a known problem, but I think it’s basically having that pure play business focus to go after slightly harder markets which aren’t technically as lucrative, and therefore you have to have that social business blend.

(00:25:08):

I think the other big way that we found out the problem looking back is also just the first, I won’t even go into it now, but the first iterations of Reach 52 impact health education and screening. They were really tech heavy. They were really data heavy. We were talking about AI back then. I remember this pattern market didn’t want that. That was our original proposition. A lot of the companies were just like, we just want to screen more patients. We don’t really care about having all the data and the fancy tech and the fancy tools. So a lot of the learning also came from the early pilots, I’d say. And yeah, we definitely iterated every year to the current model, and that was definitely learned by doing in terms of the actual service that we now have.

Mark Horoszowski (00:25:52):

Yeah, okay. Very, very cool to hear. So if I’m hearing you, you saw from research, again, consulting mindset, but if you just kind of looked at it with a financial hat on, there’s a market inefficiency. There’s big markups going into areas, even if production is elsewhere because of where these products are distributing. So you’re seeing a big market inefficiency. So you’re saying, okay, there’s got to be more effective ways to do this. You’d seen attempts to deliver products in these markets and saw the real friction points. What was keeping users from absorbing products had a hypothesis about how you could get through it. So you went to market, you shipped something. Sounds like you had a very kind of tech heavy, I’d imagine, costly approach to trying to deliver that and saw that the solution was actually simpler. But it wasn’t until you were in market testing that you saw that

Ed Booty (00:26:42):

No. Yeah, yeah, exactly.

Mark Horoszowski (00:26:47):

How do you think about testing, right? I think I speak to entrepreneurs in so many different industries, so many different segments. And testing always looks different. Some people are really structured hypotheses written up on a board somewhere and they’re running a bunch of experiments. Others are saying, Hey, we’re going to go out and try and ship this, and if we get X percent of a population engaging with it, and that’s good for you. When you say testing and learning, what did that process look for you look like for you? How did you know to keep going? How did you know to change?

Ed Booty (00:27:28):

Firstly, I would actually flag this as one of the mistakes actually. I’ve made obviously many, many mistakes in the course of 3 52. One of them was we

Mark Horoszowski (00:27:36):

Love talking about mistakes.

Ed Booty (00:27:38):

I definitely assumed, and even now I sort of assume that what I’m doing right now is the right model. Yet in my heart and my gut, I know that it’s going to evolve again, but we’re sort of scaling this model, and that’s the right mindset. So in a way, we were, first model was very tech heavy, whatever. We tried to scale that. I mean, it was like we got the solution, we scaled it, and then by scaling it, and then we launched in many markets and then within re 52 we’re launching a new business unit and offering, and that would go to the markets. And then the change became months, not days, half years, not days, because doing X and then X didn’t work. But then we’ve got to go to Y and then try to pull the team from X to Y. When we just launched it, definitely, we grew too fast in early years

Caroline (Producer) (00:28:22):

And

Ed Booty (00:28:23):

We tried to scale things too fast. Now,

Mark Horoszowski (00:28:28):

Can I say clarification question there? When did you scale something that wasn’t working too fast? You thought it would work better than it did, so you pumped a lot of resources into it and then it just wasn’t working as fast. So then you were kind of caught and like, ah, we still have to deliver it this thing, but the margins aren’t working, it’s not growing, and so we got to kind of start building something adjacent. Is that accurate or correct? That for me?

Ed Booty (00:28:54):

Yeah, that’s generally accurate. I mean, I could think about it. I mean, if I could just go through the different iterations of read 52. Firstly, it was tech heavy. We were getting the health workers to do health education and screening. We always wanted to do medicine access. Originally we started having the health workers also having a marketplace of products. So you could do the screening, they would also do the distribution. We got partners for that. Pharma companies willing to give us discounts, but it was a compliance nightmare doing the screening and diagnosis support. And the product access was hard. Quality control residents didn’t want to pay delivery fees. If the product was $1, they wanted to pay $1, very limited ability to pay. So then we evolve from that to doing more, trying to be a distributor. But then the margins are pretty hard and there’s a lot of big distributors that have the volumes.

(00:29:42):

So for what we do now, we sort of split it, health, education and screening team one, medicines distribution, sales marketing, supply chain support team two, and then kind of tech sits across the top or underneath, depending on which way you look about it. But then, yeah, the way that we’re sort of thinking about it now, because I’m still very startup minded, but we have got more scale now. We’re at 450 distributors. We distribute 50 60 products, and that’s growing, growing products available in like 26, 20 7,000 pharmacies. So now we do have pharmacies and clinics, sorry. So now we have pretty reasonable scale. I mean, in our field, rural health access or tier two market health access, we’re one of the reasonably scaled players. So I do have this current plan. It’s actually not on the website or anything yet, but I do have it in the decks of reach 52 labs where we’ll have health education and screening. This is just raising awareness, call it marketing, patient engagement, whatever you want to call it. And this is distribution. We can distribute medicines. We absolutely should talk about diagnostics. We absolutely should talk about health insurance. We absolutely should talk about consumer health products. We absolutely could talk about other financial services such as health loans. I mean all of that could be distributed through events and engagement or physical product distribution.

Mark Horoszowski (00:31:07):

And

Ed Booty (00:31:07):

Therefore we will have to have this reach 52 labs concept slash team that would really focus on that pre-market testing. When it works, it would go in this team or it would go in that team. So the way I therefore think about it is scale the basics in a way, scale the foundational thing, but then keep agility on the products. That could be a feature, that could be whatever, but you do have to scale the other just for this, well, I dunno who listens in a way, what sort of companies they’re doing. But for us specifically, if we went to a big pharma company and said, we’d like a discount on medicine for poor people, please, by the way, we can reach 20,000 people in one country, a small subfraction of one country. It was a non-starter. Now we start talking about 15, 16 markets. We’d like to aggregate procurement across a significant scale. We’d like to place this sort of order. The discounts start coming to 30, 40, 50%. So for us, our play, almost the product market fit is having scale. But for other solutions, of course, you’d want to test app, like a real tech heavy solution. You’d want to make sure that was really working with 10 users first. But for anything like aggregation of distribution, aggregation of products, aggregation of people, for us, we really needed scale.

Mark Horoszowski (00:32:38):

I always think that’s such a, well, I’ll use the word brave. I think it’s a very brave, and I think a lot of entrepreneurs do this, right? But it’s very brave to say, okay, this will work when we get to certain levels of volume because reliant on these things like better prices, more efficient distribution, et cetera. In order to justify that, to justify that to your team, to yourself, to investors, did you have crazy financial analysis? Was this gut instinct? How did you come to realize that that model not only had potential to work, but that you could actually deliver on it and it would work for you?

Ed Booty (00:33:31):

The way I processed this, I’ve often said my strategy is take the path of least resistance. And I say that sort of as a joke, but also because if you are selling something and it’s selling itself, hypothetically, any market, you’ve got a new drink and it’s flying off the shelves in a pharmacy or whatever it is working. It tastes good, it smells good, whatever it is working. So I guess within re 52, we’ve often tried some stuff, all the different business models, and it was a hard sell. Sometimes we stuck to our guns, eg. The marketplace. I mean, we lost a bunch of money on that. It did not work. We definitely committed, invested. The first funding we raised was almost to launch this, we burned out money on this. It didn’t work. With hindsight, it was a path of much resistance from the pharma companies, compliance, quality, blah, blah, blah, from the residents.

(00:34:29):

They didn’t want to pay delivery fees, et cetera. We should have pivoted earlier. So yeah, the way I definitely now think about it is even with the, we’ve got distribution in 15 African markets, distribution partners, we could sell medicines within 15 African markets. Six are working really well right now. We’re getting decent orders in six. Two of them would be really hard. We’ve got the partner, but for various whatever, legal, tax, financial partner interest reasons, probably not where we want to start. So yeah, I guess it’s, I think about it as throw the net out wide and then find the path of lease resistance and that kind of is where you should focus effort if it has that sort of organic traction, I think that would be true for anything. If you have an app and people are really using a certain feature, always clicking that button, they seem to love that bit. Focus on that. And if you are

Mark Horoszowski (00:35:21):

Selling

Ed Booty (00:35:21):

Products and you’ve got 20 things in your basket on your marketplace and people are always buying the nutritionals in your multifaceted ePharmacy, focus on the nutritionals, that’s where there seems to be natural traction. So yeah, I’m a big fan of start wide and then work out the organic demand and then filter to where you should focus. And that’s definitely what we’re doing now a lot more.

Mark Horoszowski (00:35:44):

Yeah, very, very interesting. Now, you said something that I really want to come back to, which is like, oh, we should have pivoted earlier with the marketplace going back in time. Wish we could all do that on the entrepreneurial journeys. I know I’ve got many of those. Are there any signs that in retrospect were obvious, right? Almost imagining you’re talking to another entrepreneur here and it’s like, okay, if you see these signs, you got to be having real talk with yourself about the need to pivot. What were those for you?

Ed Booty (00:36:22):

I guess just very low demand if you are convinced of something being a good idea, but the market’s not buying it. For example, with the pharma companies, we want to sell your products, we want to do this way. They were worried about cutting out pharmacy. So they go via our marketplace that actually cuts out their current customers, the doctors and the pharmacies, because going via this decentralized marketplace. So there was a lot of resistance from the big pharma. I mean it would take nine months I think it took to get our first products because we were going through compliance. How are we going to do quality assurance? How are we not going to piss off the existing partners to buy our products? And there was resistance. And then when we were selling it in the communities, they didn’t want to pay this. They didn’t want to pay that. I mean the signs were there. So I guess it’s looking for those points of friction and then it’s like whether you could solve it, I mean possibly it’s like your app’s not working and you can solve it by doing A or B. So you’re looking for that friction point to either revolve, but for us, yeah, there was enough friction points that meant that were not solvable probably at least in the short term with our resources that men should have just pivoted earlier. Yeah,

Mark Horoszowski (00:37:30):

Yeah. I love the mention of friction. We recently did a workshop with Dan Ale. He’s like a behavioral psychologist and economist, and his advice to every effort, pure for-profit and mission-driven is at a very human level do friction mapping. And I think we hear about that a lot from a user perspective. For an individual to use something, map out the points of friction. Do they have to remember something? Do they, do they have to go somewhere? Do they experience any pain when they pull out their wallet at any point of friction? Just get rid of those. Get rid of those, get rid of those. So I love the,

Ed Booty (00:38:16):

And sometimes, I mean that’s what I’ve learned. And then sometimes this is valid, map it out, and then you can either build a great service to remove all those friction points, whatever stripe and payments or whatever it is is a beautiful experience, Uber or whatever. But then, yeah, sometimes just the market’s not ready. I mean, that’s it. This would be one where I’d say perhaps we were like, maybe this will work one day, maybe it won’t. But it was too early for the market. The whole structure there was too much friction to basically bulk you down versus friction that you could solve and build a great service around it.

Mark Horoszowski (00:38:50):

Right? Well, and I think that’s such an interesting thing that in the way that you’re using friction, it’s like system friction, right? It’s because I think so often social entrepreneurs, right? Entrepreneurs that are using the power of the market to address and advance on social and sustainability issues, we are often operating in more complex systems, especially if you have business to business sales motions, customers, international corporations. And so mapping that entire system seems like you got there from an understanding. But if you were, and I’m kind of repeating back, hindsight’s always 2020 on that. But if you had really understood the friction in that entire ecosystem, the importance of local pharmacists in there, the importance of the other

Caroline (Producer) (00:39:42):

Educational

Mark Horoszowski (00:39:42):

Organizations, all of these different players, even though your solution made perfect sense for the end user, because there’s such an entrenched distribution and education channel, the points of friction that you had to get around were in that case, not possible. But in other parts of your business model, you have been able to find ways around that. Does that resonate? I’m curious.

Ed Booty (00:40:08):

Yeah, it does resonate, but then I would also, I mean the way I’m actually processing this in a slightly different way, which is because even if I had a perfect understanding of the market, it is difficult. I always said one of my historic, I haven’t used this phrase for a while, but I always say I started reach 52 and I’ve had just the right amount of competence and naivety, and I genuinely mean that I knew my stuff. I’ve worked in healthcare for six years,

Caroline (Producer) (00:40:34):

I love it,

Ed Booty (00:40:34):

But I also didn’t know a bunch of stuff and I tried to do stuff that other people wouldn’t do. And that became quite good because when you were going to pharma companies, this new solution, it had too much friction. Yes. But from a enthusiastic young person doing something different, a hundred percent got us our first customers, clients, partners. Did it work? No. Do those partners still work with us? Yes. So there’s something about also trying really hard things, not hard things, but trying to do something new. I mean, you shouldn’t just be bogged out, do a bunch of research, it’ll never work. It’ll never work. I could give you still eight to 10 reasons why reach 52 would not work. And I’ve been told many, many times by many people, more senior than I, with more gray hairs than I, that reach 52 won’t work right now. Would if you had a third person on this podcast that was skeptical about rural markets, corruption, fraud, risk, all these problems, there would be somebody that would say RE 52 can’t work. Many people that would say Read 52 can’t work even now. But you have to sometimes do these naive things. It is important to push and try and it’s also how the world changes, I’m sure. Yeah, the Ubers of the world and Canva, is it Canva that design one of those design apps,

(00:41:53):

A hundred VC pitches, everybody said, no, Adobe’s too entrenched. You’re never going to get round, blah, blah, blah. Uber got turned down Airbnb, no one’s ever going to stay in other people’s houses. So many of these big game changing ideas have been counter narrative and have been naive and have had nos, but subsequently pivoted and subsequent or sometimes pivoted, sometimes didn’t, but subsequently became hugely successful industry defining companies.

Mark Horoszowski (00:42:21):

So

Ed Booty (00:42:21):

I don’t regret the naivety, and in a way, I don’t regret not having the knowledge to know it was a bad idea to start, but starting something, you’ve got the knowledge. That

Mark Horoszowski (00:42:32):

Was a

Ed Booty (00:42:32):

Weird sentence, but

Mark Horoszowski (00:42:34):

No, I’m totally tracking. I have this quotes to live by library, and one of them that just came across that I literally just added, it’s the third from the bottom, is that geniuses do all their best work before the age of 30, when people are still brave enough to do the things before they’re too wise to try. And so yeah, I totally hear that. I love that. It’s like the confidence and the naivety. So cool. I want to keep talking about then the growth of your organization. So India was where you were really finding your first real successes, so to say, that’s where your enterprise was growing the most. And you’ll correct me if I’m wrong there, but India was really your first kind of market, correct?

Ed Booty (00:43:24):

Philippines, Indonesia, for the reach 52 impact side, India is where we’ve got more mature pharmaceutical market, slightly easier regulation to actually become a pharma company because it’s a pathway trodden. So yeah, the reach 52 access has taken off in India, but definitely Philippines, Indonesia, were the first sort of impact markets, but the medicine distribution side is a lot harder there just yet, not a path. Well trodden. So yeah, India’s kind of got that recent spike, but yeah.

Mark Horoszowski (00:43:56):

Talk to me a little bit about market identification, right? Indonesia and Philippines, not next door India as well. What analysis did you do? How did you decide to roll out? Obviously it sounds like the India, it makes sense from where you had experience where you firsthand, but yeah, how did you choose Philippines and Indonesia as markets for impact?

Ed Booty (00:44:31):

RE 52 is a social business. We want to make healthcare affordable. We don’t want to work in the richest segment, but we also don’t want to work below poverty line. I mean, we are not a charity. There’s fortunate, there is some segments of society where charity, NGOs, donors, they have to work. It’s absolutely essential, et cetera. But we want this kind of what we’ve often called missing middle, and they need to be somewhat concentrated, missing middle spread out everywhere is difficult. So yeah, it is basically just looking at availability of health services has to be low. So somewhere like Thailand, some of the best universal health coverage in the world, super efficient. I can’t remember the amount they spend per head. They’ve got really good health services. Malaysia is pretty decent. Vietnam is pretty decent. Indonesia, Philippines, still significant gaps in healthcare access, heavily out pocket markets.

(00:45:27):

And then you have these regions often we don’t want to focus on the whole country. We’d have target provinces or districts or states, whatever you would call it, in each market where there is this density of slightly too wealthy for charity and slightly too poor for the current commercial rates for health services. And that’s the missing middle. And these markets, 20, 30 to 40% of the population regions would fit into that category. And that’s where we launch in the market 30, 40, 50 million people or more that would fit that category. And they’re in province 1, 7, 8, 10, and then that becomes our launch strategy. So yeah, basically understanding the income profile, population distribution and overall sort of quantum against the health access barriers basically. Yep.

Mark Horoszowski (00:46:19):

Okay, cool. So as you kind of thought about the different markets you could go into, if I’m summarizing that, you’re saying, okay, within this general part of the world, this is where we’re operating, these are within our time zones, this is easy for us to operate within these places, essentially, where is the biggest market opportunity? This is almost entrepreneurial basics, right? Market

Ed Booty (00:46:42):

Impact. I would say market. Market impact. Market impact, right? I mean, yeah. So these people, yes, they have five to 10 to $15 a day of income. Poverty line is $2. So five to 10 to 15 is reasonable money, but the health services are too expensive. So you can sort of build a purpose built offer for these five, 10, $15 a day people that lower healthcare. So it’s affordable to them in heavily out of pocket markets. So we’re generally working in markets where people have to pay every time they see a doctor. Highly out pocket paid market.

Mark Horoszowski (00:47:17):

Yeah. Okay. Yep. Okay, cool. So you say you had enough market traction to know, okay, that’s where we deliver real value. These are the markets that we can kind of move into, still needed validation, but then you’ve been able to move into those effectively.

Ed Booty (00:47:31):

And then on the other, I wouldn’t call it quite a platform, but on the other side of the platform, companies, businesses, people with products, that’s also a segment they’d be interested in accessing. Can’t be the same price, it’ll have to be a discount. But if we aggregate enough of these missing middle people, it becomes a opportunity. So opportunity on this side of the platform, impact on this side of the platform. They drop prices a bit they can afford, therefore it’s a market and impact opportunity where kind of everybody wins. I’ve thought about this a lot over the years. We are one about our logo is the dots. The dots on the reach 52. Our tagline used to be joining the dots of healthcare access. So we’re trying to work with the companies, with the distributors, with the governments, with the residents where everybody can win. We are genuinely trying to join the dots of health, healthcare access to kind of make

Mark Horoszowski (00:48:23):

This

Ed Booty (00:48:23):

Analogy come to life.

Mark Horoszowski (00:48:27):

And bring me a little bit more in terms of your decision making, because anytime you expand into a new market, there are challenges you have the staffing challenges, delivery challenges, legal challenges, taxation challenges. When you decided to kind of expand, so now you’re kind of operating at least at that time in three different countries. Can I ask, were you fully profitable at that point in time? Were you still operating in the red? And did you make that leap in order in hopes of getting to more impact or to getting to profitability? What led you to make that? Where were you financially health wise, and what led you to then make that decision at that time?

Ed Booty (00:49:13):

Yeah, definitely would’ve been still loss making back in Philippines to Indonesia. India. Indonesia to India would’ve been loss making. So we raised, we got Philippines working and then we raised money and that money was kind of to expand. And so part of raising venture money was to enter markets like India. I mean we entered India early 2020. It was the last trip I did before the COVID lockdowns. I sort of flew back in the borders shut. And we raised money 20 19, 20 20. So we were raising money to scale basically. And that was because we know we needed scale to start talking meaningfully to big pharma. We were getting the conversations, we were getting the FaceTime or Zoom time, but we were just too small. And the problem is if you’re just in one country in the Philippines and they’ll say, go and speak to the Philippines general manager. But we were trying to sort of be above market, regional aggregator, Asia and Africa, new business model so, so we definitely still lost making and raise money to do that. I dunno if it’s just, I don’t find market expansion that hard. Everything you’ve said, you used the word challenge for me, it is just a process. You’ve set up a company. Is it easy? Well kind of, yeah, actually you just find a lawyer, it’s more boring. It’s just genuinely boring.

(00:50:37):

Lots of paperwork and I have to sign an inch of paper or go to the embassy or go to notarize or it’s not hard hiring.

(00:50:48):

You have to speak to a lot of people. Are there lots of awful interviews? Yes. Are there a smaller number of really great interviews? Yes. So it’s just like a process. And I don’t even see it now if said, we know if there was the right opportunity and we had to launch in, I dunno, Mexico a completely new region, a bit daunting, but just understand the market. Does the market work for us? Would there be significant client interest? Are we having business on financial impact? And then research online, ask for recommendations to find a lawyer in Mexico to list a job on LinkedIn, filter the cvs, speak to people. And then yeah, it’s often quite a nice feeling because often when I’m flying to the countries for the first time, it’s obviously companies in a way like ethereal social constructs, they’re not real, right? It’s like a sort of makeup thing where we say read 52 is a company, but it is very interesting on the first flight to a country, I often sit there with, because I try to travel really light.

(00:51:44):

So I’ve got my little backpack and I don’t have my hand. I’ve got my little backpack and I’ve got my laptop in my backpack. And it is often a very weird, I like the touchdown because you’re like, okay, fine, re 52 is not here, it’s not a thing now. But in six to 12 months, re 52 will be a thing. We’ll be selling medicines and doing health education and doing screen. But yeah, market launching and medicine regulation. If you want to launch a medicine in the market, you have to work with the government and you have to register that product to make sure it’s safe and quality and everything else. Is there any shortcut to that? No. Is it fun? No, but it’s just a sort of process. You just have to get on board with it. And it’s not a challenge, it’s just more time and effort and just doing it. But that said, actually, if I was to also just make one comment for a newer entrepreneur, and if that is still effort and often shutting down a company is harder than opening it, it takes two years or filing, putting stuff in newspapers, all sorts of wacky stuff. So if you could find a way to concept test a market, work through a partner, try out before doing that sort of legal legwork would certainly be better. But then after you want to do it, just commit and yeah, it’s a lot of time on the phone basically.

Mark Horoszowski (00:53:02):

Yeah. So then the real thinking, the real analysis, the real doing, is there a market problem? If we solve it, can we create impact are the needs and the opportunity there? And then how can you test that as quickly as possible? And then once you build validation there, then might not be the most fun part. And there might be bureaucracy and there might be lots of steps to take, but there’s local lawyers, find them, they’ll help you walk through the whole process of

Ed Booty (00:53:33):

Recommendations. Yeah, exactly. Yeah. And then it is not easy, but then it’s done. Also, there’s an interesting dimension as well of like, can you win as well? I do. For example, China, there might be a lot of need in China. I don’t speak Mandarin. And China’s obviously going down a huge domestic in a good way, in my view, actually building up their huge domestic capacity, decent industrial strategy, local pharma companies, local distributors and China might have need. China might be huge. We could set up a company in China. Do I think we’d actually win in China as reach 52 as a foreign led entity in the space of collecting health data? No. So it’s also just, I think that’s actually quite important because it’s like that it is a rational gut feel of, and this is similar for many African markets. I mean some are very open to foreign led innovation, et cetera, et cetera. Some are really going down that domestic strength and more protectionist mindset. Even like Indonesia is doing a lot more, Trump is filling the headlines with his tariffs, but many markets put tariffs on foreign made pharmaceutical companies and have done for many, many years, and many international companies are exiting those markets. So you have to kind of look at the friendliness and your ability to win as well, which is

(00:55:01):

Above all that.

Mark Horoszowski (00:55:04):

Now, I’d be curious to know, especially knowing who some of your corporate customers are, your big pharma customers, have you ever had, and you’ve also taken investment money, have you ever gotten pressure to try and move into a market or to sell into a product that you did not think was right or was not good? And then if so, how did you kind of navigate the tension that would come from that?

Ed Booty (00:55:35):

So I’ve obviously got entrepreneurial friends and definitely I’ve heard this many times. So yes, we have had that. Companies want us to go, it’s money. You are excited, it’s growth, et cetera. And therefore we said, yes, a hundred percent that’s happened a hundred percent. We said yes. We’ve subsequently exited some markets because we had one customer and it wasn’t aligned to our strategy and it wasn’t a big enough market to have the missing middle density. And I’ve had, I think there’s another company, I obviously won’t name them, but I think they were in 17 markets pushed around by one of their companies who wanted them everywhere. They’re now M four I think, or three. So serious expansion for one customer and then 16 to three countries when that funding went out. I think my honest view on it would be, again, I don’t regret doing that at the early stages.

(00:56:25):

And this is like we were actually in Cambodia, we launched in Cambodia, we got our first contracts in the Philippines. This partner really wanted us in Cambodia. We launched in Cambodia. Cambodia went quite well for us for a while, but it is a very small market. There’s limited partner interest. We did unfortunately have to exit that market two or three years ago, but it was the right decision at the time because you have to get points on the board, you have to learn, you have to grow revenue. It was absolutely the right decision. I loved working there. Genuinely I miss going there. It’s unfortunate that it didn’t work, but I guess now it’s just being true to you. We have the quasi luxury of being true to our own strategy, and then we’ll just say no. And it’s similar just for products. It’s partly market expansion, but it’s also product.

(00:57:11):

Like if we speak to a pharma company, which I do a lot, and they’re trying to sell a expensive product, that just won’t work. Probably originally I would’ve been like, okay, fine, we have to try at least. But now I’m just like, that’s not going to work. But the early stage, I do think it’s important to get points on the board, even if it is pilots, et cetera. Now it’s just having a pretty clear playbook of the products and markets that we want to operate in and scale. And if it doesn’t work, we have to say no. I would genuinely say we say no to 50% of partnerships

Mark Horoszowski (00:57:50):

Now.

Ed Booty (00:57:51):

Maybe. I mean, I was just checking my emails, obviously morning in Singapore evening for you, but I was checking my emails this morning and I’m like, I want to do this product. And the team in Africa were just like, no, we’re not doing that. So yeah, I genuinely say of the products we get offered of the market opportunities, they want to do A and b, 50%, maybe more actually. I mean, yeah, it’s like significant. And that’s just like we have to go, we have to grow. We know what works. And then it’s just being true to yourself and sticking to the mission and not getting distracted. I mean, I’m a bit hot on this with the team at the moment. Yeah, we

Mark Horoszowski (00:58:32):

Focus,

Ed Booty (00:58:32):

Focus, focus. And I say no to a lot of stuff.

Mark Horoszowski (00:58:35):

Yeah. Now saying no is one of these things that we always kind of hear. As entrepreneurs, you have to get good at in execution, way harder. How do you build the strength? Do you get good at saying no? Is there a mental model that, do you have some type of structured goals of the quarter up on the wall? And if it’s not related to that, bring me actually into the halls. Even the virtual halls of Reach 52 here, how do you build up that muscle for you to get good at saying no and your team members as well?

Ed Booty (00:59:15):

No. Yeah, I guess I’d probably think about it in three ways. So yeah. So firstly, we do have a one slider that I do refer to probably not every month, but frequently where it’s sort of like, here’s a sort of process map. We want to do stuff. Does it align to the World Health Organization definition of universal health coverage? So if you’re trying to get us to do wacky product, that’s not deemed as an essential medicine. It’s generally a no. Does it align to government strategy? Many things we want to help the country. We don’t want to come in and push something that’s not needed. Generally a no if is the product more affordable? So if it’s a yes on WHO list, government likes it, we’re going to increase the price 50% with this partner, it’s generally a no. And then fourthly, can we deliver it?

(01:00:06):

So you might come to me now with a breast cancer product. Absolutely. It could tick yes to all three. We are not strong enough right now to do breast cancer. Oncology is complex new supply chain. We’ve never done breast cancer screening. That would be really complex. New hospital partnerships that we don’t have, et cetera. So we don’t have to have done it before. But even right now, I would say that we’re not quite strong enough to do something that’s complex as cancer screening treatment training oncologists, maybe next year. But right now, I don’t think we’d be strong enough to do that. So yeah, do we do it? Can we do it? Is it within a feasible delivery timeline?

(01:00:51):

I’d often say this to the team. That is a also, I said it yesterday. Yesterday and the day before on two different team calls. Does it align to the mission? I mean, I constantly come back to the mission and generally I will make more effort to say yes in those four categories if it will move the needle on reaching the 52% of the world. And the team know, I mean, they heard it yesterday and the day before. This is tough. This is going to suck, but it’s absolutely mission aligned, therefore we have to do it. But sometimes it’s like, this is tough. It’ll suck, but it’s not going to move the needle. It won’t get scale. It’s probably going to be not worth it materially for the mission of the company, and therefore it’s a no. So our name is often the problem, 50% of the world, the mission, we’re trying to get scale of essential health products and services. And yeah, it does become this sort of guide as well of a yes or no.

(01:01:48):

Yeah, more simply. Yeah, of course we have OKRs. We have a strategy. We actually just the day before yesterday did our H two strategy refresh. Every team, every region has a one slide strategy and plan. And then that maps into OKRs. And even after the team call, one of the teams had a big idea that they wanted to do with me. And I’m just, no, not right now. We’re going to focus on this and this is the six month plan. But I would actually say, I mean, it’s interesting the way, sorry, final thought. It’s interesting the way you asked the question as in it is hard to build up confidence to do it. And I was definitely more of a yes man to start. And that is just experience that is just doing enough stuff to know

(01:02:36):

The market well enough to know that A or B won’t work, but C might be an absolute winner. And that is kind of coming from trialing a lot of stuff, failing a lot of times, launching in markets that didn’t work, launching products that didn’t work, hiring people that were awful on a spectrum of awful to toxic. You start to build a gut feel or a knowledge or a experience base that allows you to have the confidence. I mean, yeah, now you could come to me with an idea and I’d be able to critically evaluate it. And that’s, I’ve been doing this for the last seven years and you don’t have that overnight. And that’s why I do think pilot test, learn, say yes more do stuff is actually a very good strategy for the first 2, 3, 4 years. But then after a while, you have that knowledge to double click on something and commit to it.

Mark Horoszowski (01:03:27):

Yeah, so as long as you’re testing and really learning from it. I mean, I’ve read, in fact, we’ll get there pretty shortly here. I’ve read some of the things that you’ve posted about your entrepreneurial journey, which we’re going to share in the notes, in the show notes because fantastic reading. But there’s a level of introspection that I think you do to accompany all your failures experiments. And so it seems like you’re really, really internalizing the learnings from that by virtue of what I do via my work at Moving Worlds, by virtue of this podcast, I get to talk to a lot of entrepreneurs by virtue of my own curiosity and the opportunities that I have to get on stages. I get to talk to a lot of entrepreneurs.

(01:04:08):

Your level of introspection is inspiring, right? It is aspirational. And it seems like you’ve really kind of brought that in into your work. But very structurally here, I think what I want to pull out and what I want to make sure of is as you operate your organization, now you have a very, very clear mission. And it seems like everybody across the organization, including investors, including partners, is indoctrinated in that you have very clear OKRs in terms of this is what we’re doing. And you said six months. So you’ve got a very clear goal statement over the six months. And then it seems to some degree, there’s a one page ish plan slash priorities. So you have these different assets within your organization. And so as new opportunities come up, if somebody else in the organization is bringing these opportunities up, you’re able to quickly say like, okay, is it mission aligned check? Is it okay R aligned? Okay, is it plan aligned? No, hey, we can’t do that. And now you actually have the experience and the reach and so to say the revenues to sport saying you don’t have to chase that in order to stay in business or learn because you’ve learned from that. Yeah. Would you correct anything that I’ve said? Would you nudge, would you add anything to that?

Ed Booty (01:05:33):

I’d say it’s correct in terms of process, but as you were talking, I also know that if a big opportunity came along, we’d scrap the plan. So it’s a fixed focus mindset with a genuine open ability. I mean, we’ve got some huge funding proposals out at the moment,

(01:05:50):

Big, big stuff. If that happens, all bets are off and we’re doing a new plan. So it is absolutely true. And I think that’s actually where I think I’ve talked to a lot of entrepreneurs in general as well. Cause I do try to introspect only speak to other entrepreneurs and share failures. We used to do founder fishing trips in Singapore that was organized. I’ve always enjoyed chatting to people and as well, and it’s interesting because often the biggest opportunities come along when you least expect and you have to maintain that openness and low ego. If I met someone I really respected and they said, your plan is off, you’ve missed this. In the next six months, you might be spinning your wheels. You have to also have that low ego ability to change and be wrong. But yeah, 90% of the time I’d say our plans are fixed. But I could also think of times where someone like, well, yeah, that’s a way better idea. Someone quits. I mean, do you Then you’ve got your perfect, you’ve got seven teams. What if somebody quits? I mean that slide is keep alive the team versus talk about scaling it. So yeah, you’ve got to do that. But also ability and willingness to change due to critical feedback, but also curve ball, left field stuff that within the next six months, our plan will not be perfect or 100% golf track. And certain times we’ll have to replan and do,

(01:07:13):

But I hope 80% of it’s correct, at least.

Mark Horoszowski (01:07:16):

Yeah. Well, I think that’s something where really mission-driven entrepreneurs and here in this context on this show, when we say mission-driven entrepreneurs, entrepreneurs with their entrepreneurial vision, that is absolutely and inarguably existing here to make life better for people. And when you have that mission and purpose, so front and center, I do think it creates a really nice north star for an organization and says, yeah, we can pivot from the plan because it’s still really in line with our mission. I’d be curious from a management perspective, so you’ve built alignment with people, presumably they’re on board with the mission, they’re on board with the OKRs, they’re on board with the plan, and then this new big opportunity comes in general, my experience we see many others is once a team or once employees are working on a plan, trying to then move set resources, move set people to then focus on this new opportunity. Sometimes that’s challenging, but it seems like you’ve done that a couple times. Any tips from your experience in terms of, Hey, I know we’ve all kind of agreed to this plan, but we’re shifting, right? How do you quickly mobilize the team? What’s worked well for you in order to help many people on your team change direction?

Caroline (Producer) (01:08:54):

I think,

Ed Booty (01:08:59):

Well, we’re doing this now. I mean, yes, it’s a funny time to ask the question. We did all of our, my QQ three OKR sessions were yesterday 12 hours of calls day before with the Q3 kickoff with the whole team, the whole team kickoff. And then okay FI think for some of the teams, we know it’s fixed, the team’s quite mature, we just have to do A or B lives improved revenue or products available. That’s that kind of metric. So it’s just like clean. Some of the teams are in, some of the projects within the OKRs are likely to change, and then it’s just being really explicit. So some of these OK R emails I was doing yesterday was just, so we got a lot of people joining this team recently. Some of ‘em have come from big companies. I said it very explicitly, do not expect this policy. We said policy about giving credit to distributors in Africa. So we’re launching in Africa, how do we give credit? How do we think about credit scoring? How do we think about assessing financial risk and liabilities and how do we issue and allocate credit, but a limited pool of cash that we have across a technically unlimited opportunity. I’ve said to them, expect version. I think I said version five, but my colleague said version nine by the end of the year of our credit policy.

(01:10:12):

So we just aligned our expectations up front. So I know that’s going to change. We’ve done V one, V two. I openly said to the team, get your mindset that into the game that this will probably be V three next month and it’ll probably be V five or V eight depending on if you speak to me or my colleague by the end of the year. So I think it’s just like, and I do and I do this within the team in general, genuinely. And I’ve done this before, wrongly, incorrectly, where we have implied or it has been a sort of implicit subtext that something is more fixed. And then when you try and change, they’re like, eh, I thought we were doing the marketplace, now we’re doing this. But if you just double click on double underline something and just say, this is a pilot, it might not go well, we might be changing this as soon as next month.

(01:11:02):

You voice that upfront I think is how I think about it. And for us, as I say in the future, we have this read 52 labs concept where we do health education and screening. We do product distribution and everything that’s new gets tested here. And that’s also a statement of having that agile mindset for us, I want us to scale and I want us to be a startup and therefore having this innovation unit kind of thing is sort of trying to make sure it’s always clear that we’re always learning and we’re always testing, learning, failing, et cetera. So having a team or a person dedicated is sort of the statement of needing that mindset.

Mark Horoszowski (01:11:41):

Yeah. Okay. That’s really helpful to hear. So it seems just even culturally within the organization, there is an understanding that we are going to be evolving when you’re onboarding team members, you’re talking about that when there’s a plan, you’re talking about this is the plan today, it will change multiple times between now and now, so let’s go.

Ed Booty (01:12:00):

Yeah. But then for other teams, I would be the opposite. I’d be like, this plan is not O OK R calls yesterday, some calls the last one, last end, late night last night. It will not change. We have to deliver this by the end of the year. This is what we’ve committed to our external partners. End of discussion. This is your goal and it will not change. It’s like so set in stone, go and do it. And there’s no discussion anymore. Some behaviors, yeah, we’re going to be on version two next month.

Mark Horoszowski (01:12:26):

Yeah, I think that’s really interesting and that’s really helpful to hear even specifics within different teams. Yeah,

Ed Booty (01:12:34):

I read a book once, is it Culture map? You have the culture map that NC professor, Erin, somebody, but that talked about decision making in different cultures and there’s big decisions, capital D decisions and little D decisions like capital D and I like that framework, like Japanese and German companies. I think it was, I read this book five or 10 years ago, have capital D decisions, slow to commit consensual, blah, blah, blah, decision making structures. But then if they do it, they commit to it for the long haul and they invest

Mark Horoszowski (01:13:03):

Interesting

Ed Booty (01:13:04):

Silicon Valley startups, much more empowering, much more decentralized. But it can be a decision in meeting one Tesla and pivot fail, and it can be a different decision in meeting two. And some of that’s cultural, but some of it country specific cultural traits, some of it is company specific cultural trait, but this is concept of big D and little D decisions, which I’ve

Mark Horoszowski (01:13:28):

Always

Ed Booty (01:13:28):

Liked as well. Similar

Mark Horoszowski (01:13:30):

Concept, similar. And there’s another analogy in West coast United States, it’s kind of big along the tech scene, which is one way doors in two-way doors. It’s kind of, if it’s a one-way door, you’re putting a lot of thought and analysis. If it’s a two-way door and you can back out of it easy, let’s move quickly. But I think that that’s often something, at least from my experience, that tends to be seen at later stage. Like more mature organizations, I think earlier stage startups, almost culturally, everything is just, I mean you probably shouldn’t reference Facebook. There’s just move fast and break things. It almost seems like they didn’t care and then seen other startups where they’re just obsess about everything and culturally it really embeds within the organization. In some cases it slows experimentation. I can tell you from my own experience, that was one of my big learnings. So anyway, I think it’s very mature and astute of you to really be looking at that and communicating that clearly with team members.

(01:14:33):

And this time is flying, but we’re about to get to what I call our inspiring impact round where I’m going to ask you a few quick questions. But before I do that, I want to read something that you wrote and then I just kind of want to have a quick conversation around it because, and as a setup for this, one of the things that we cover in this show is for social entrepreneurs. So for entrepreneurs that are going to impact, first, we are pursuing purpose and impact above profits, and there’s data beyond anecdotal that we’ve encountered. There’s data that supports this as well, that there is more mental pressure, more mental health challenges, more stress, more anxiety, right? Because you don’t just care about the sale, you care about, did I make life better? You don’t just care about having people you care about, did I enrich the lives of my employees?

(01:15:37):

You care about the communities that you operate in. And so every decision that you make has more gravitas. It’s not just profit. It’s like you really care about humans alongside of lines. And I know that some of the things that you’ve kind of encountered in your work have created a heavy mental load. And so I want to read a passage and then what I want to talk about with you briefly before our impact round here is what are the things that have really helped you move through the really mentally challenging areas of social entrepreneurship? So this is from a great article that you wrote in 2021 called Dear Ed. So I hope you don’t mind putting on the spot here. I won’t read the whole thing, but I read one paragraph that really jumped out to me. So the ironies of life you’ve chosen are stark.

(01:16:28):

You make progress yet feel more behind. You’ll hit your goals than increase them. You have complete flexibility in your work schedule, but end up with no free time. You’re running a health company, but your work will make you fundamentally and healthy through long hours, excessive travel, coffee, alcohol, forgetting to eat and constant pressure because you’re seen as strong people will check in on you less. You raise money and grow expecting that will reduce pressure, but it’ll just get more complex. Hiring people are the right fit will be the number one challenge, not fundraising. You’ll realize that experience is nothing compared to cultural fit attitude and drive, but you can’t screen that from a cb. You’ll have the best and worst job in the company you created. And although you feel fine going solo, you’ll come to regret not looking for co-founders upfront. You won’t pay yourself for over two years, but you’ll pride yourself that the team is never paid late. You’ll be surrounded by supporters and colleagues and good people trying to help personally and professionally, but often they just don’t get it. And you feel more isolated. You can see the big picture. You often feel so burnt out that you won’t notice the obvious smaller things. First off, fantastic writing. The post is awesome. We’ll be in the show notes for you.

(01:17:36):

What it’s like helped you, if there’s rituals, if there’s a mental belief, if there’s something spiritual, what has helped you find the kind of mental fortitude to keep going and to stay focused on mission when things have gotten so hard and so isolating?

Ed Booty (01:17:57):

Yeah, it’s funny actually, that is 2021. I remember writing that. That was COVID time, COVID free time, led to a wild era writing led to a brief spell into blogging and whatever, writing stuff like that. It slipped out habit. Actually now I actually want to do it. I’m taking a holiday next month for my birthday and I’m going to try and take 10 days off or a week off and write some stuff again.

Mark Horoszowski (01:18:18):

Oh good. Well, I would love to see what you write.

Ed Booty (01:18:20):

It was not heard that for send out for a while. So it was reminiscent, but probably also quite true. Yeah, probably still quite true and given it’s four years ago, actually, probably more true in a funny sort of way. No, I mean a lot of it is startups are hard. I’ve mentored or been part of some really early stage startups, and I do say to them, I mean you have to not be doing it for the money. You have to really care about the mission. It is a tough path in life and it’s three times harder than you expect, and you need three times more money than you realized. And so I think a lot of it is just like having the right foundations of why we’re doing the company. I do have various rituals. I mean, I’m not spiritual, but I do believe we have temporary time on this earth.

(01:19:07):

Do something useful with your time, like existential kind of stuff. But translating that into doing something that the purpose is more important to me. Not the most happy topic, but I had said it to a colleague last week as well. Imagine yourself on your deathbed, looking back at what you’ve achieved and what makes you smile. I think we’re our own worst critics and I judge myself for stuff I’ve done in the past. Therefore, if I imagine myself in the future, looking back on my current self, it becomes a bit of a moral compass person. Hypothetically, if I was in a job I hate with people, I hate getting out of bed every morning to do something. I hate if I look back on my life in 50 years, I don’t think I’d be happy about the decisions I made now. So yeah, do it for the right reasons and commit and know it’s going to be hard.

(01:19:56):

Use yourself as your own worst critic. I do that quite a lot and I think everything is true. I mean, it is obviously isolating and you can’t talk to people about it. Even now, I was chatting to someone yesterday about problems we’re facing and it was well-intentioned advice and it was just so frustrating from obviously I’ve thought that obviously I’ve thought about that. That doesn’t work. God. Yeah, it’s like, but I do have some very good, so in terms of rituals, I am get outside more, take a walk. I love a beer in the sun at sunset. You can have the worst day, but especially in Singapore with the humid weather, just sitting out there having a nice hazy IPA. So I invest a little bit in decent beers from America, work out, try and work out every morning. I mean, yeah, this is obviously early morning for me, just done my high intensity class.

(01:20:48):

But yeah, just try and get into a routine that works for you and for me it is work out every morning, have a sucky day. Generally it’s pressured and difficult. Sit there in the evening, cook, I like to cook, have a beer, get back to work after holidays on the beach. I’ve learned actually that I don’t like going to Tokyo or something like active city based holiday is the worst way for me to unwind. So try and do a decent stint on the beach just to read sun. Yeah, unwind work out every day. So yeah, I think ultimately it’s commit for the right reasons. Use yourself as a moral compass and just work out a routine that relaxes you. I mean, yeah, I’ve got mine and I absolutely guarantee it’d be different for someone else, but work out how you unwind and do that regularly. Make time to do that. Could be whatever, crochet or whatever, but just do that. Make sure you have time to do that on a daily basis.

Mark Horoszowski (01:21:49):

Yeah, very cool. Well, thanks for sharing and giving us a little peer into the personal side of your life as well. And okay, we, time is flying. I can’t believe it, but I know you’ve got a day ahead, I imagine our listeners do as well. And so I want to jump into four quick questions and we call this our inspiring impact round. Just a couple of quick, short, punchy answers, and we’ll start with the first one. What is the mistake you’ve made that you hope future entrepreneurs won’t make?

Ed Booty (01:22:27):

Hiring the wrong people can decimate your company, early stage, mid stage, late stage, toxic, bad strategy, wrong other team around them quit. So yeah, hiring genuinely bad or toxic people can kill your company at worst and significantly harm at worst, at best. Sorry, but yeah, hiring wrong, people

Mark Horoszowski (01:22:54):

Especially

Ed Booty (01:22:54):

Felt really bad or really toxic, dodgy, whatever.

Mark Horoszowski (01:22:57):

Yeah, the toxic piece came up a couple times there. So yeah, that topic alone could be a whole podcast in and of itself. Okay. Talk to me, what is one thing that you wish all impact investors would know and really internalize when they’re working with impact entrepreneurs such as yourself?

Ed Booty (01:23:22):

That there is opportunity. Medicines are more expensive. You could actually launch, hypothetically if you came to me with an investment, we could launch medicines in Singapore. It’s actually Well’s, a saturated market with cheap pricing, hypothetically, right? Going over here. It is less saturated and the prices are higher and you can drop the prices and have a not uncompetitive market. So yeah, there is opportunity and there’s more opportunity, more greenfield, more innovation. That’s definitely key. I think for some as well. Obviously venture funds generally, generally have a 10 year fund life, which I’m sort of on board with. That’s how the venture model works. But I do think impact and actually impact, I think health takes longer. I think if you are doing something with hospitals in America, it’s hard to do that within a 10 year period because it’s so bloody structured. It’s a huge market, profitable, et cetera, et cetera. But a 10 year fund life to deliver execute and on down with all that sort of structural systemic stuff is hard. So yeah, I guess health slash impact is kind of hard and slow compared to B2B, SaaS, Silicon Valley chap GT Hypergrowth kind of stuff. So yeah, a bit of patients I think is key. And that’s not actually about impact. I genuinely think that’s about certain sectors that are heavily regulated basically.

Mark Horoszowski (01:24:38):

Cool. Yep. Resonates. Now, maybe on a more personal note here, what is one leadership or manager skill that you wish yourself you could turn on in yourself more that would make you more effective than you are today?

Ed Booty (01:24:58):

Time management. I think I’ve got better at giving critical feedback, having hard conversations, making tough decisions if somebody has to go there. Over the last two years I’ve built the, it’s a brick where sort of a conflict averse, polite types, and that’s

(01:25:17):

A skill that, yeah, you Americans tend to have more than aspir. But I think I’ve got a lot of that stuff, but I’m still not good enough at magic time. I feel like I need, when I get up in the morning, I do my workout, I want to answer emails to make sure people are set for the day, but that’s usually my most active brain time to do something. I could do half asleep at 9:00 PM So yeah, time management and really ruthless prioritization and sort of sticking to that. I think I’d be more effective. And I’m actually trying to work on that a lot at the moment. Do stuff that I can do half asleep at night and do the stuff that requires most brainpower first, which is yet in all sorts of management textbooks, but it’s harder than it sounds to actually do. Oh yeah.

Mark Horoszowski (01:25:59):

Way easier to talk about than to execute in a day to day. Yeah. Cool. Okay, last question is, and maybe you even covered this already, so fine if you’re redundant here, but what is a quote ritual or activity that you turn to for strength when things are super hard?

Caroline (Producer) (01:26:23):

That’s

Ed Booty (01:26:23):

A good one. Yeah, I mean I talked about some of the rituals, right? I like cooking. I mean, the simple one is just like I find it quite relaxing. Order from chaos, this pile of vegetables, methodically do it clean up. I just find that quite a nice sort of ritual. So yeah, I’ve got my things that help me unwind and I try to do that, working out, beer in the sun, cooking generally, walking, hiking, whatever wise, I’ve got a tattooed on me. I like the word matter, the sort of the link between physical matter being atoms, quarks, universe, big physics, small physics, quantum mechanics, right up to astrophysics. I’ve always liked this concept of matter being temporary and we’re all made up of carbon effect, whatever. But then also finding purpose. So yeah, I often reorient it often actually, probably daily around the word matter, which is our temporary existence and our sort of physical construct that is finite and trying to find purpose and meaning and having a life that matters within the finite matter, the time that we have with our physical matter. So yeah, that’s not a very good way of explaining that tattoo. But

Mark Horoszowski (01:27:40):

Yeah, I think it’s an excellent, I’m like,

Ed Booty (01:27:42):

I do really like the word matter, smallest things within us, but also when we lie in our deathbed, whether or not we found purpose. So

Mark Horoszowski (01:27:50):

Yeah. Yeah. No, I kind of love it. What a great way to kind of wrap us up here. And I’m actually holding myself back. I feel like we could go another 90 minutes just on what’s behind that, but I think that that’s a powerful way to leave us. And I really, really want to thank you for your time. I really want to thank you for the work that you’re doing. I know, like I said, I know some of the partners that I know, some of your customers, and they’ve all said just incredible things about you. So it’s really fun to dive deeper into conversation with you. And yeah, I’m excited to share you to the community, share some of your readings as well. We’ll include all those things in the show notes. So thanks so much for joining us today and just keep up the incredible work.

Ed Booty (01:28:38):

No problem. Yeah, genuinely thanks for the invite. Enjoy doing these things. Makes me reflect a bit as well. And yeah, thanks for listening. If you come this far and definitely reach out. I’m happy to talk about health access stuff or startup stuff, so feel free to reach out to me on LinkedIn or whatever. There’s only two echo booties, both in Singapore. I’m not the marketing guy, I’m the reach 52 guy. Sometimes people get mixed up.

Mark Horoszowski (01:28:59):

I’m so glad you said this and I’m kicking myself because this is in my script and I missed it. And how should we follow you? So the Reach 52 website, Edward Booty on LinkedIn.

Ed Booty (01:29:10):

And we do try to do a pretty interesting, if you go to the website, we do try and do a quarterly newsletter where we share, not marketing these stuff. I try to do quite, here’s some data we’ve collected, here’s some real projects, some real learnings, here’s some real partnerships. So we do try and do a quarterly newsletter that’s not marketing stuff, more like real data stuff. So yeah, that’s also something we’re keen to promote.

Mark Horoszowski (01:29:35):

Cool. We will get that in the show notes and we will sing your praises from the social media channels. And thank you so much for joining us today.

Ed Booty (01:29:45):

Thanks so much. Have a good day ahead.