Case Study

Pyramid Group

January 7, 2021

Pyramid Group is one of the fastest-growing healthcare companies in Africa. It has two operating subsidiaries: Pacific Diagnostics and Pyramid Pharma. With origins in Dar es Salaam, Tanzania, and operations in many other African countries, Pyramid Group's two major businesses have acted to resolve some of the most difficult problems in the healthcare sector in the region.


For example, Pacific Diagnostics has developed an innovative and effective approach to managing and maintaining complex medical equipment over time. This is important because many health facilities that purchase or receive donated medical equipment may not also have allocated resources for the after-sales service needed to keep the equipment functioning properly. In fact, there may not be trained service people in the area with the required skills to maintain the medical system being acquired. The problem is that when a machine doesn’t receive preventative maintenance, it can often break down; and if it’s in a rural area, it may be prohibitively expensive to have it fixed. This recurring pattern can inhibit care for people in need and can sometimes cost lives. It also leaves health facilities, which often already have impossibly tight budgets, with sunk costs that can’t be easily recouped, and very little capital investment left for the future and no protection on their investment. 

Pacific Diagnostics developed a system for dealing with this. When it sells diagnostic or surgery equipment—such as imaging, X-ray and ultrasound equipment, laboratory equipment or anesthesia systems—the company provides also a plan for training, support, and after-sales service. This support is multi-faceted: it includes training for hospital staff, management of replacement components, remote monitoring of preventive maintenance, and the presence of certified specialists in the country; they can visit sites and make minor adjustments to keep the equipment running, without the time and expense of having someone fly in from elsewhere. Pacific Diagnostics can also install full solutions for hospitals and clinics; for example, it has set up fully functioning catherization laboratories and it opened the first cardiac procedure facility in Tanzania. 

The other subsidiary, Pyramid Pharma, has addressed another difficult ongoing problem: the inefficiency of many existing supply chains for pharmaceuticals and basic medical supplies. As a healthcare distributor, Pyramid Pharma has simplified the path from the import dock to the supply cabinet for hospitals, clinics and pharmacies. Many of its customers are non-governmental organizations and faith-based organizations, often located in hard-to-reach rural areas or unsupported by government-based supply chains. Pyramid Pharma carries branded and generic medications; consumables (supplies consumed, or fully used within a short period of time, including treatments for cancer or diabetes and vaccines); and basic supplies such as sterilization products, syringes, cardiology devices and surgical supplies. Its significantly competitive prices, which are made possible by having local expertise, enable many healthcare facilities to conserve their resources and expand operations.

In their lines of business, Pyramid Group’s leaders have discovered that the most critical factor is not just the product line, but trust and relationships. They have needed to convince hospitals to make preventative maintenance a priority; manufacturers to provide training and certification at the same level as in developed countries; distributors and customers to work with a more streamlined system; and their own staff to adopt a quality-oriented frame of mind.

The continued success of both Pacific Diagnostics and Pyramid Pharma is based on their ability to produce higher quality at lower costs, their track record in process innovation, and their ability to be a trusted partner among vendors. These are qualities well-suited to a private sector company. Along the way, founders Abraham Okore (of Pyramid Pharma) and Prashant Gokarn (of Pacific Diagnostics) have deliberately sought to inspire similar levels of engagement and transparency from their customers, suppliers, employees, and leadership teams. The company is increasingly called upon to provide installation and after-purchase services for other medical device suppliers, occasionally in places with military conflicts or natural disasters that make it difficult to get through. Pacific Diagnostics was recently featured as one of the first “success story initiatives” in a new series of videos from Siemens.




I. Provide Full Solutions for Complex Technology

Complex devices are often sold or donated without planning for the longterm support, maintenance, and training that they require. Technology needs to be seen as a whole system, not a series of one-off purchases.  This is particularly important for health facilities, to improve their quality of care.

II. Invest in Your Company’s Capabilities

Successful businesses in emerging economies must make long-term investments in their people and skills, even if that seems risky.  

III. Expand Geographically with an Eye Toward Differentiation

Practices that succeed in one emerging market can make a company seem unique enough to be invited elsewhere.  

IV. Live by Values

An enterprise is stronger and more influential when it operates with a dedicated, ethical, responsive culture.  



Healthcare is one of the fastest-growing sectors in Africa, because of population growth, an emerging middle class, and increased foreign investment. But the industry has not yet caught up with the recognized need for higher-quality, less expensive healthcare supplies, technology and practices.

Pyramid Group’s case provides a noteworthy example for other entrepreneurs in this field. It is the leading medical devices supplier in the territories where it operates, with a very large market share in some of its product lines, such as sophisticated radiology imaging, laboratory equipment, surgical and cardiac implants products in the territories that we manage. It is also a favored supplier for nongovernment and government-owned medical facilities in the countries where it does business. Its story demonstrates how a company’s innovative business model and operational skill can lead to simultaneous financial and societal benefits.

When IFC and Leapfrog co-invested in Pyramid Group in 2018, the goal was in part to enable an entrepreneurial company with a successful business model to continue to expand. But there was also a broader societal purpose. The investors saw an enterprise, which was seeking to deliver on promises that, if fulfilled, would lead to further beneficial developments in the countries where they operated.

IFC’s decision makers had already seen what happens in healthcare when supply chains are inefficient, or when machines are not working. They saw in in Pyramid Group a possibility for partnership to foster kinds of changes they hoped to see throughout the sector. Suppliers like Siemens and Medtronic saw the same potential.

But no one would have seen it if the leaders of Pyramid Group's had not seen it themselves first. They recognized the logic of social ventures—where a for-profit enterprise becomes a catalyst for beneficial social change  , because of the nature of its business model. In their quiet, persistent, matter-of-fact way, Pyramid Group’s leadership put that business model into play and became a company to emulate.

The trajectory for the company is continued growth, and potentially further expansion into the Middle East. Enterprises like Pyramid Group appear to have hit on an essential formula for health-related industries. They treat suppliers, customers and staff with candor. They look for opportunities to solve entrenched problems. And they combine operational focus with a human touch.

Read Full Case Study