Innovative Development Impact Bond Partnership for Increasing Breast Cancer Care Survival in India

Ian MatthewsArticle

Opportunity for diagnostic & device companies and other parties to join a life-saving initiative

By Pam Bolton, Head of Partnerships, Tech Care for All

Leading impact investor KOIS is seeking companies, foundations, impact investors, and bi- and multi-lateral agencies to join a bold new initiative to transform India’s cancer care through innovative finance. This effort exemplifies the range of novel financing techniques that are gaining traction as approaches for de-risking health sector initiatives that investors might otherwise regard as too risky.

Breast cancer is the most common cancer in India, accounting for one-fourth of all cancer cases in women and killing about 90,000 women every year. Worse, breast cancer exerts a disproportionate burden on India’s young population, with huge economic consequences. One of every five breast cancer deaths in young women globally is from India.

KOIS, in collaboration with Tata Memorial Hospital, and with the guidance of the United Nations’ Defeat–NCD Partnership, is structuring an ambitious Development Impact Bond (DIB) to improve breast cancer outcomes for five million Indian women and create proof of concept for a sustainable cancer care model for India. KOIS, an international impact finance firm based in Brussels and Mumbai, specializes in structuring innovative financing products such as impact bonds.

The Center for Global Development defines DIBs as bonds that “finance development programs with money from private investors who earn a return if the program is successful, paid by a third-party donor. The outcomes to be measured are agreed upon at the outset and independently verified. With greater focus on outcomes instead of inputs, DIBs create space for more innovation, local problem-solving, and adaptation.”

The proportion of health spending that comes out of pocket in India, at 65%, is much higher than in most other countries. Indeed, financial hardship is a major reason women discontinue their care and become lost to follow-up.

The economic losses from early and preventable breast cancer deaths in India will reach US$4 billion over the next decade alone. The potential for innovative health financing structures to benefit economic growth is an additional aspect that makes them attractive destinations for development funds and investment.

Based on extensive research with 22 major hospitals, the DIB investors believe well-targeted interventions—to diagnose women earlier, improve quality of care and increase patients’ financial access to treatment—can deliver better care to 67,000 patients over five years and increase survival rates by as much as 40%. The initiative is kicking off in ten of India’s largest cancer care hospitals, including Tata Memorial Hospital, PGI Hospital and the Adyar Cancer Institute.

This collaboration may be a real game-changer both for innovative finance and for how cancer care is delivered in low- and middle-income country settings around the globe.

Companies in the diagnostic and device space are especially encouraged to consider this strategic opportunity to save women’s lives across India. To learn more, contact me at or Apoorv Shukla at

Ian MatthewsInnovative Development Impact Bond Partnership for Increasing Breast Cancer Care Survival in India