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| Comar Health |
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| Summary of Proposed Investment |
| This Summary of Proposed Investment is prepared and distributed to the public in advance of the IFC Board of Directors’ consideration of the proposed transaction. Its purpose is to enhance the transparency of IFC’s activities, and this document should not be construed as presuming the outcome of the Board decision. Board dates are estimates only. |
| Project number | 27984 |
| Company name | Amen Sante S.A. |
| Country |
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| Sector | Hospitals and Clinics |
| Environmental category | B |
| Department | Reg Manufact, Agri & Services, EMENA |
| Status | Active |
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| Date SPI disclosed | November 13, 2009 |
| Projected board date | December 18, 2009 |
| Date revised SPI disclosed | November 17, 2009 |
| Previous Events | Invested: October 26, 2011
Signed: June 14, 2011
Approved: June 18, 2010 |
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| View Environmental & Social Review Summary (ESRS), click here |
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| Overview |
Sponsor/Cost/Location |
Development Impact |
Contacts |
Attachments |
| Project description |
IFC proposes to invest up to TND 10 million (approximately US$7.8 million equivalent) in the form of common equity in a healthcare holding company as well as a healthcare management company (“Amen Sante S.A”) to be established by Compagnie Méditerranéenne d'Assurances et de Réassurances (“COMAR” or the “Sponsor”). The funding will support an investment program of $53.2 million for expansion of an existing private healthcare network in Tunisia, which includes:
i.) a 339-bed hospital in Tunis, which would be the first full-fledged private hospital in Tunisia;
ii.) a 48-bed hospital in Gafsa, located in southwestern Tunisia;
iii.) a 50-bed hospital in Beja, located in northwestern Tunisia;
iv.) an expansion of an existing clinic in Tunis; and
v.) working capital, pre-operating expenses and contingencies |
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| Project sponsor and major shareholders of project company |
Comar Health will be controlled by the Amen Group, a diversified conglomerate (agribusiness, tourism, distribution, IT, healthcare, financial services) controlled by the Ben Yedder family. The single largest shareholder in Comar Health will be COMAR, the second largest insurance company in Tunisia, and the largest among privately owned insurance companies. COMAR underwrites non-life insurance for corporate and individuals (including automobile, transport, health, fire, multi-risk, and agriculture), with life insurance handled by a wholly owned subsidiary. The Group enjoys a strong reputation in the region with skilled professionals managing the Group’s businesses.
IFC has been strengthening its relationship with the Amen Group since the early 1990’s with joint shareholding in Maghreb Leasing Algeria, the second largest leasing company in Algeria. |
| Total project cost and amount and nature of IFC's investment |
| The total project cost is expected at approximately $53.2 million. The proposed investment will be a common equity stake representing 15-20% of the equity value of the existing and future hospital facilities, or, up to approximately $7.8 million equivalent. |
| Location of project and description of site |
| Physical infrastructure investments will apply to one existing and three greenfield facilities. Comar Health currently encompasses two existing facilities located in Tunis, the capital. The private hospital will also be constructed in Tunis, whereas the two new clinics will be constructed in Gafsa, a town in southwestern Tunisia, and Beja, a town in northwestern Tunisia. |
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| Anticipated development impact of the project |
This Project is unique in that it supports private provision of services to publicly funded patients, thereby broadening access to private healthcare to all, including lower socioeconomic segments of the population. More specifically, benefits of the Project include:
• increased access to healthcare services in underserved markets;
• increased access to high quality private healthcare services (complementary to public healthcare sector), provided at affordable prices due to economies of scale from the expansion of the multi-site network;
• creation of 600-650 direct jobs; and
• a demonstration effect supporting private health care, serving as a showcase to other potential investors in the sector |
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| IFC's expected development contribution |
| IFC is expected to have a dual role: (i) provision of risk capital; and (ii) sharing of global knowledge and experience. IFC would provide equity financing, which is still difficult to obtain in Tunisia for a healthcare project like this one. In addition, IFC is expected to play an important role in advising the Sponsor on Project structuring and implementation issues. The Sponsor has already agreed to de-lever the financial structure of the Project through the provision of additional equity. These adjustments should improve the risk profile of the Project. Finally, IFC plans to leverage its broad experience in private healthcare both in the region and across the world to further assist the Sponsor in the area of hospital management. |
| Environmental and social issues - Category B |
IFC’s appraisal included a review of technical, environmental, health and safety, labor, community and social information provided by COMAR including independently designed and monitored quality management system; life and fire safety programs at existing facilities and plans for new clinics and a hospital; human resource policy and procedures; and copies of recent wastewater treatment tests.
While all Performance Standards are applicable to this investment, IFC’s environmental and social due diligence indicates that the investment will have impacts which must be managed in a manner consistent with the following Performance Standards:
• PS1: Social and Environmental Assessment and Management Systems;
• PS 2: Labor and Working Conditions;
• PS 3: Pollution Prevention and Abatement;
• PS 4: Community Health, Safety and Security; and
• PS 5: Land Acquisition and Involuntary Resettlement.
Based on the discussions with the client and visits to the Sponsor’s existing facilities in Tunis as well as the site for the new clinic in Beja, this project will have limited adverse environmental and social impacts. In addition, impacts will be few in number, site-specific, reversible, and easily addressed through agreed mitigation measures. For these reasons, this is a Category B project according to IFC’s Environmental and Social Review Procedure. |
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| For inquiries about the project, contact: |
Contact Name: Dr. Nourddine Cherni
Address: Amen Sante -3 Rue de Monastir -2045 TUNISIA
Telephone / (216) 70 736 736
Fax/ (216) 70 736 266 |
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| For inquiries and comments about IFC, contact: |
General IFC Inquiries
IFC Corporate Relations
2121 Pennsylvania Avenue, NW
Washington DC 20433
Telephone: 202-473-3800
Fax: 202-974-4384
E Mail: Webmaster |
| Local access of project documentation |
Contact Name: Dr. Nourddine Cherni
Address: Amen Sante -3 Rue de Monastir -2045 TUNISIA
Telephone / (216) 70 736 736
Fax/ (216) 70 736 266 |
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