Georgian Health Care 2020: MEDEA 2011 OPIC Financial Solutions for Health Care

1. Georgian Health Care 2020: MEDEA 2011OPIC Financial Solutions for Health Care Iman Tariq Kennerly Overseas Private Investment Corporation An Agency of the U.S. Government

2. Agenda An Agency of the U.S. Government

3. Overseas Private Investment Corporation Background An Agency of the U.S. Government

4. Our Organization As the U.S. Government’s premier development finance institution, OPIC mobilizes the participation of U. S. private capital to support sustainable economic development in emerging markets. Shading denotes OPIC-eligible countries OPIC currently manages a $14B portfolio of projects in over 150 countries and operates on a self-sustaining basis at no net cost to the American taxpayer. An Agency of the U.S. Government

5. Administration Development Priorities OPIC is uniquely positioned to support the administration’s new development strategy Administration Priorities OPIC’s Unique Position Foreign Policy Development • “We’re changing how we define development…we need to harness all the tools at our disposal—from our diplomacy to our trade and investment policies.” • ~President Obama, 9/22/10 • Supporting broad-based, sustainable economic growth • Proactively targeting specific countries, regions, sectors, and technologies • Mobilizing private sector investment • Elevating development as a central pillar of national security policy OPIC US Business An Agency of the U.S. Government

6. Our Impact Over the past 39 years OPIC has supported over $188 billion of investment in developing markets that is projected to support over 274,000 U.S. jobs OPIC In Georgia OPIC By the Numbers* • Since 1993, OPIC has supported 25 projects in Georgia • 19 financed • 9 insured • over $250 million of investment • Active pipeline of loan applications Total Investment Supported $188 billion Total Projects Supported 4,000 U.S. Exports Supported (Projected) $74 billion U.S. Jobs Supported (Projected) 274,000 *Since 1971 An Agency of the U.S. Government

7. Our Solutions OPIC offers innovative financial solutions to support private investors, including debt financing, insurance, and investment funds Current Portfolio * Products • Debt financing • Ranges from large structured finance to small business loans • Loan amounts up to $250M with fixed rate terms for up to 20 years • Insurance • Offers coverage for risk of expropriation, political violence, and currency inconvertibility • Investment funds • Provides debt that is matched by privately raised equity to support funds investing in emerging markets • Other financial products • Designs hybrid financial products to help private investors mitigate risk $14B Investment Funds Insurance Debt Financing *As of September 30, 2010 An Agency of the U.S. Government

8. OPIC Financial Solutions for the Health Care Industry Insurance and Finance An Agency of the U.S. Government

9. Our Policy Standards Investors and project proposals must satisfy certain policy criteria to receive OPIC support Policy Standards for Projects Eligibility Criteria for Investors • To be eligible for OPIC financing and insurance, applicants must: • Have a commercially viable business plan and successful track record. • Have U.S. ownership: • Loans: Borrower must have 25% U.S. ownership • Insurance: Policy Holder must have >50% U.S. ownership • Funds: managed by a U.S. manager or involve U.S. equity investment • Maintain private sector control (<50% government ownership) • OPIC supported projects must: • Contribute to sustainable development goals • Be located in one of our ~150 eligible countries • Comply with international environmental standards • Support international human rights and worker rights regulations • Cause no loss of U.S. jobs or adverse impact on the U.S. economy An Agency of the U.S. Government

10. Political Risk Insurance OPIC has insured $373 million of investment in more than 40 healthcare projects in 21 countries Health Care Sectors Success Stories • Insured investments include hospital construction, pharmaceutical manufacturing, medical consulting services and more • OPIC can also insure: • Mobile Clinics • Medical Training Facilities • Medical Device and Pharmaceutical Manufacturing Operations • Contracts with government or government-owned entities • India: Diagnostic imaging equipment manufacturing • Russia: Medical equipment supply and training for a state-of-the-art oncology hospital • Brazil: Medical consulting services contract • Egypt: Development of a diagnostic medical laboratory *Since 1971 An Agency of the U.S. Government

11. Insurance Coverage for Health Care Sector Mobile Clinics Private Hospitals and Clinics • OPIC can compensate investors in private hospitals and clinics where there is no government ownership against loss of debt and equity investments due to expropriation, political violence, or inconvertibility of currency • For investment projects where there is government ownership, OPIC can insure against losses due to breach of contractual obligations for: • Service providers, for example hospital management firms and consultants that have a contract with the government, and • Contractors and exporters who enter into supply agreements with government or state-owned entities OPIC may compensate for income loss due to political violence or confiscation by the host government Training Facilities For medical device manufacturers and other investors who develop training facilities in emerging markets, OPIC can insure valuable buildings and equipment Medical Equipment & Supply Agreements OPIC can compensate suppliers if the government counterparty breaches its contractual obligations Inconvertibility coverage ensures the conversion of local currency into U.S. dollars and transfer out of the host country of contractual payments received under a supply agreement An Agency of the U.S. Government

12. Insurance Coverage for Health Care Sector Healthcare Infrastructure Investment Funds Medical Manufacturing Operations • OPIC can compensate investors in manufacturing operations for loss of debt and equity investments due to expropriation, political violence, or inconvertibility of currency. • Coverage is also available for business income loss resulting from damage to specific sites outside the insured facility (e.g. critical railway spur, power station, or supplier). For U.S. equity investors in healthcare infrastructure projects abroad, OPIC insurance can protect assets and business income from losses due to political violence Institutional Loans to Healthcare Enterprises OPIC’s institutional loans program insures debt service payments to U.S. lenders from eligible healthcare projects in emerging markets An Agency of the U.S. Government

13. Finance OPIC has financed over $51 million of investment in more than 6 healthcare projects in over 10 countries Health Care Sectors Success Stories • Financed investments include treatment centers and clinics, equipment leasing companies, laboratories, and more. • OPIC can also finance: • Medical Training Facilities and Universities • Medical Device and Pharmaceutical Manufacturing Operations • Consulting contracts • Poland: Development of oncology care facility, Network of private health care clinics • Various: Diagnostic medical equipment leasing and financing operation • Brazil: Medical consulting services contract • Ethiopia: Development of a diagnostic medical laboratory *Since 1971 An Agency of the U.S. Government

14. Financing the Health Care Sector Selected Case Studies Laboratories Equipment Leasing and Training Companies A $28 million OPIC loan to DVI, Inc., sought to bring more sophisticated medical care to people in Central and Eastern Europe and Turkey. DVI specializes in leasing and installing state-of-the-art diagnostic medical equipment — such as magnetic resonance imaging (MRI scans), computerized tomography (CT scans), ultrasound, radiation and gamma knife equipment — in hospitals, clinics and other specialized patient centers. With private sector funding unavailable, OPIC’s loan helps DVI meet its corporate strategy of responding to growing international markets. Doctors and technicians will receive professional training to use the equipment, which is expected to result in better preventive health care, lower medical costs and fewer procedures for patients. A $500,000 OPIC loan to MedPharm, Inc., the U.S. member of the ICL joint venture, was made to help establish a medical diagnostic testing lab, which will perform according to international standards. The lab will serve the majority of the country and introduce testing technologies not currently available in Ethiopia. In addition, ICL will promote health issues and awareness about AIDS, tuberculosis and malaria through health fairs, screening programs and other outreach efforts. An Agency of the U.S. Government

15. Contact Us For more information, please contact: General Inquiries email: info@opic.gov OPIC Main Phone: 202-336-8400 Iman Kennerly email: ikenn@opic.gov Phone: 202-336-8586 An Agency of the U.S. Government

16. OPIC Support for Health Care Illustrative Case: Samara Oncology Center No. 1 An Agency of the U.S. Government

17. Samara Oncology Center No. 1 OPIC provided risk mitigation products critical to financing medical equipment and training • Samara Oncology Center No. 1 • 550 bed state-of-the-art oncology center • 1.13 billion RUR ($41 million) • 12-year local currency financing • Samara II • Oncology Center No. 1 and other medical institutions • 1.32 billion RUR ($47.7 million) • 12-year local currency financing An Agency of the U.S. Government

18. Samara Oncology Center No. 1 An Agency of the U.S. Government

19. Primary Agreements & Structure • Supply Agreement between ACD Research and Samara Oblast • Receivables Purchase Agreement between ACD Research and Deutsche Bank Deutsche Bank Expropriation & Inconvertibility Insurance RPA – 90% of ~12 year receivable ACD Research Supply Agreement ~12 year receivable RUR scheduled payments converted to USD Samara Oblast Construction, medical equipment installation & training services Oncology Center An Agency of the U.S. Government