By James Fraser, President & CEO, Madiro

June 17, 2025

When I first began working in Africa almost three decades ago, the global development model, although inadequate, was functional: donors provided funding, international and local organizations implemented programs, and progress was measured in reports to funders thousands of miles away. Millions of lives were saved, but too often, solutions were airlifted in with little understanding of the local context and carrying significant financial and personnel overhead. When funding ended, so did the work, resulting in fragmented progress and missed opportunities for sustainable impact. Today, the development landscape across Africa has irrevocably changed. While US and European aid budgets shrink, a new class of young, skilled, highly motivated African entrepreneurs are bringing bold solutions to address systemic problems in health, education, agriculture, and more. Madiro is encouraging this new approach to development by supporting early-stage entrepreneurs, social enterprises, and innovators in Africa’s healthcare sector.

Africa’s entrepreneurs are leading—philanthropy must follow

Across the continent, a generation of African innovators is designing and delivering innovative solutions to persistent development challenges. This momentum is fueled by Africa’s greatest asset: its people. With roughly 60% of the population under the age of 25 and a median age of 20, Africa is the youngest continent in the world. This demographic shift is not just a statistic; it’s a signal that the future of the continent will be defined by the choices made for and by this rising generation.

What sets this generation apart is more than just age, it’s their mindset. In 2023, 79% of Africans between the ages of 18-24 said they planned to start a business within the next five years. A youthful, entrepreneurial population means enormous potential for innovation and for impact, but only if young people have sufficient tools and resources to act on their ideas. This calls for a new kind of capital that is flexible, risk-tolerant, and responsive to the unique dynamics of early-stage  innovation in emerging markets. And that’s where philanthropy can and must step up.

The Madiro model: Philanthropy as Venture Catalyst

Madiro’s current approach was launched in 2023 as a reimagined development model—one that sees entrepreneurship as the most direct path to sustainable impact. Madiro does not operate like a traditional NGO, and we’re not a venture capital firm either. We exist in the space between, offering a philanthropic impact investment platform designed to support African entrepreneurs who are solving real-world health challenges.

Our model is purpose-built for long-term impact:

• We have an open fund model where we raise donor funds and deploy them into the most impactful health social enterprises we can find: there are no fixed timeframes for a financial exit, and a commitment to reinvest returns into the next wave of innovators.
• We operate with a rigorous venture mindset, backing creative, scalable startups before traditional, growth-focused investors are ready.
• We are powered by mission-aligned donors, not return-seeking LPs. Our donors share our commitment to measurable, long-term change.

In addition to our financial investment, we offer our holistic, hands-on engagement. This includes technical assistance, capacity building, and implementation support, all aimed at fostering the widespread adoption and greater impact of their solutions. Madiro’s purpose is not profits, but impact—fueling a virtuous cycle of continued investment in service of sustainable, African-led innovation.

Investing in local healthcare innovation with Benacare

One of Madiro’s partners is Kenya-based Benacare, founded in 2016 by Naom Monari. It’s a tech-enabled, home-based care model tackling the dual burden of chronic illness and hospital costs. By bringing nursing and other essential health services into patients’ homes, Benacare reduces healthcare expenses by approximately 52% compared to hospital care while delivering better patient satisfaction.

Benacare’s model blends clinical insight (Naom is a nurse by training) with business acumen. It’s affordable, dignified, and deeply responsive to community needs. And it’s working—Benacare is now reaching hundreds of Kenyan families and expanding quickly. Since its inception, Benacare has served 15,000 patients, trained 1,342 family caregivers, and generated significant healthcare cost savings totaling $50 million, which amounts to approximately $5,000 per patient.

When we met Naom, her mission was clear: healthcare at your doorstep. What she needed wasn’t a one-time grant, it was catalytic, mission-aligned capital, and that’s exactly what Madiro provided. Benacare is proof that when you back local innovators with the right resources—time, money, trust—they can build scalable, equitable solutions that change lives.

Why DAFs and foundations matter now

Aqueduct’s community of philanthropic leaders is well-positioned to move the needle where it matters most. Donor-Advised Funds, family foundations, and social impact investors have the freedom to back the kind of high-impact, early-stage solutions that traditional development often overlooks.

In Africa, the need and the opportunity are clear. With the world’s youngest population and rapidly expanding urban centers, the continent’s trajectory depends on job creation, local innovation, and robust infrastructure. Entrepreneurs are leading the charge, but they often hit a funding cliff just as their solutions start to gain traction. Incubators and accelerators help them start, but few investors help them cross the chasm from start-up to more mature companies that can attract growth capital. . This is where philanthropy can make a meaningful impact. Not with short-term grants, but with catalytic, risk-tolerant capital that fills a gap the market is reluctant to fill.

A blueprint for action

Madiro’s model offers a blueprint for what’s possible when philanthropy fills the gap between early traction and scalable growth. It trades rigid timelines for flexible funding, prioritizes long-term growth over quick wins, and treats reinvestment as a core part of its return strategy. It measures returns primarily in health impact, not only in revenue: stronger health systems, stronger leaders, stronger local economies.

For DAF holders and foundations ready to reimagine their role, the opportunity is simple: put capital to work in ways that unlock local health entrepreneurship and long-term impact. Backing African entrepreneurs isn’t just a bet on individual social enterprises; it’s a strategy for building healthier systems and more resilient communities.

To learn more, contact [email protected].