Pakistan’s healthcare system faces structural challenges, including constrained public sector capacity,  high out-of-pocket healthcare expenditure, dependence on imported medical inputs, and uneven  access to essential health services across regions. In this context, private sector healthcare providers 

play a critical role in complementing public provision by expanding service availability, improving  efficiency, and introducing innovation- particularly in diagnostics, specialized care, and the local  production of essential medical supplies and medicines. 

Recognizing the importance of sustainable private sector participation in healthcare delivery,  Karandaaz Pakistan has provided financing alongside strategic support to selected healthcare  enterprises (diagnostics, pharma etc.) with the objective of strengthening access to affordable, high quality healthcare. Karandaaz has sought to enable scalable healthcare business models that address  systemic bottlenecks, reduce import dependence, and contribute to a more resilient domestic health  system. 

Karandaaz’s financing in Renacon Pharma Limited, Excel Labs (Pvt) Ltd., and BF Biosciences Limited  reflects a deliberate strategy to strengthen critical healthcare supply chains and service delivery in  Pakistan. Karandaaz supported Renacon through financing for a state-of-the-art manufacturing facility  meeting international standards, enabling the local production of life-saving haemodialysis  concentrates and improving availability, affordability, and supply reliability. Karandaaz’s investment in  Excel Labs facilitated its transition from a pathology laboratory to a full-fledged nationwide diagnostics  services provider, expanding access to quality diagnostic services across multiple cities and supporting  early detection and continuity of care. BF Biosciences Limited, Pakistan’s first biopharmaceutical  manufacturing facility built to USFDA and EMEA standards, leveraged Karandaaz’s support and a  licensing arrangement with Gilead Sciences to expand domestic production of both biotech and non biotech pharmaceuticals. In particular, the local manufacturing of Remdesivir-a drug developed by  Gilead Sciences and widely recognised as one of the most promising treatments for Covid-19.  Moreover, Karandaaz maintains a healthcare portfolio through its financing agreements with partner  financial institutions. In addition, Karandaaz has also conducted comprehensive sector research on  Private Healthcare in Pakistan, generating substantive evidence on market gaps, opportunities and  possibilities within the sector.  

Karandaaz’s Development Impact (DI) team intends to commission a study to generate evidence and  insights on the role of its healthcare investments in strengthening access, affordability, quality of care,  and overall health-system resilience in Pakistan, while exploring pathways for scale and sustainability.  In parallel, Karandaaz intends to undertake a healthcare financing landscape review that examines how  development capital has contributed to building capacity within Pakistan’s healthcare system. The  exercise will generate evidence on how private sector investments have strengthened service delivery,  expanded access, enhanced operational resilience, and supported system-level improvements, while  identifying lessons to inform future investment strategy and pipeline development. 

a. Study Objectives and Scope 

The Development Impact (DI) team at Karandaaz intends to undertake a study  

of the development impact of its healthcare financing portfolio. The study will  

be guided, where relevant, by the CDC Health Impact (Figure 1), which  

examines the impact of healthcare financing across both patient-level  

outcomes and health system strengthening. Through this framework, impact  

is assessed across four interrelated dimensions. Access and Quality capture  

patient-level outcomes, while Workforce and Stewardship reflect ecosystem 

level factors. Together, these dimensions provide a holistic lens to assess how  

Karandaaz’s healthcare financing contributes to improved health outcomes Figure 1: CDC Health Impact Framework

and a more sustainable healthcare ecosystem. The bidder may propose an alternate assessment  framework, with its merits. 

The study will generate actionable evidence and economic insights to strengthen healthcare financing  solutions, enhance quality of care, and reinforce system resilience. It will inform Karandaaz’s strategic  direction for future healthcare financing-clarifying where and how the institution should deepen,  adapt, or refine its approach to supporting scalable, sustainable, and high-impact healthcare business  models in Pakistan. 

Following are the objectives of the study:  

1) Measure the outcomes and contribution of KRN’s financing in the healthcare sector.  2) Generate evidence on how development capital can address key challenges in the healthcare  systems and create a demonstration affect for the private sector uptake.  

The assessment approach should be structured to address the following key impact questions:  

1) Overall Portfolio Impact: How and to what extent has Karandaaz’s healthcare portfolio particularly its investments in pharmaceutical manufacturing capacity and integrated  diagnostic services, contributed to improved access to affordable, quality healthcare in  Pakistan, while strengthening health system resilience and ecosystem capacity? 

2) Access: How has the healthcare portfolio expanded access to essential diagnostics and  pharmaceutical products by improving affordability, geographic reach, and continuity of  supply? 

3) Quality: How and to what extent has the portfolio improved the quality, safety, and reliability  of healthcare products and diagnostic services, including adherence to clinical and  manufacturing standards, consistency and accuracy of diagnostics, and relevance to patient  and provider needs? 

4) Workforce: How and to what extent has the portfolio contributed to strengthening workforce  capability and capacity across pharmaceuticals and diagnostics, including jobs support,  enhancement of technical and quality-assurance competencies, and operational readiness  along the healthcare value chain? 

5) Stewardship: How and to what extent has Karandaaz’s healthcare portfolio strengthened  responsible stewardship within the health ecosystem, including domestic pharmaceutical  manufacturing, reduced reliance on imports, development of strategic partnerships, and  enhanced system resilience during periods of stress (e.g., COVID-19)?