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with a Nobel Peace Prize in 2006. Its founder,
Mohammed Yunus (Grameen Healthcare Trust,
2009; 2007), advocates that social business is a
cause-driven business. In a social business, the
investors/owners can gradually recoup the money
invested, but cannot take any dividend beyond
that. There are two types of social business. The
purpose of the investment in the first type is to
achieve one or more social objectives through
the operation of the company. The company must
cover all costs and make profit, achieve social
objectives, such as healthcare, housing, financial
services for the poor, nutrition for malnourished
children, renewable energy usage etc. The second
type comes into force when the investors can take
up any profitable business as long as it is owned
by the disadvantaged category and they can still
gain through receiving direct or indirect benefits.
Social business if based on six rules:
ing countries needs to be reinforced. A strategy
to achieve this at a global level should involve a
number of actors ranging from ministries and uni-
versities to non-governmental organizations and
donors. The unprecedented financial support for
improving health care (26% growth between 1997
and 2002 (De Maeseneer et al., 2008a)) seems to
be directed towards disease specific projects (also
called “vertical programming”) rather than broad-
based improvements in health, such a primary
care, preventive medicine (termed “horizontal
programming”). As most of the programs that
have adopted a vertical approached performed
poorly according to literature, this failure pre-
vented health in developing countries to reach
its main objective: better coverage for those with
the most stringent needs. Vertical programming
has a tendency to ignore their patients' need for
access to broader health services. Moreover, they
duplicate structures, whereby each disease control
program requires its own bureaucracy, facilities
are underused and gaps in care appear. These pro-
grams also reduce the government responsibility
and undermine their capacity to improve health.
Being given this disparity between vertical and
horizontal health care, the 15by2015 initiative
proposes that by 2015, 15% of the budgets of
vertical disease-oriented programs be invested
in primary health care systems and the percent-
age would increase over time. This investment
would allow developing nations to improve their
capacity to address health problems through an
adequate primary care system. Basically 15% of
the vertical funds from donor organizations should
be diverted into a government common health
fund and be used for strengthening primary health
care through investment in infrastructure, health
education and human resources (De Maeseneer
et al., 2008a; De Maeseneer et al., 2008b). The
previous two examples are useful for creating a
viable business model, while this third one is a
great opportunity for scaling the business model.
Business objective is to overcome poverty
and tackle one or more stringent issues
such as health, education etc.
It has to be financially and economically
sustainable;
Investors can only recoup their profits;
All profits stay with the company for
investment;
It has to be environmentally friendly;
The salaries of the workforce are mar-
ket aligned, but there are better working
conditions.
The “15by2015” Campaign
The last example is the case of the “15by2015”
campaign, which proposes a mechanism for fund-
ing primary health in developing countries. The
weaknesses in primary health care result typically
from a variety of forces, from economic crises to
market reforms, which limit their coverage and
range of services and impact on health. Nowadays,
community focus primary health care in develop-
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