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

Agenda OPIC Background OPIC Solutions for Health Care Industry Contact Information Addendum: Illustrative Case 2An Agency of the U.S. Government

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

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. Our Organization 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. Shading denotes OPIC-eligible countries 4An Agency of the U.S. Government

Administration Development Priorities OPIC is uniquely positioned to support the administration’s new development strategy Foreign Policy Development US Business OPIC OPIC’s Unique Position Administration Priorities “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 n Supporting broad-based, sustainable economic growth n Proactively targeting specific countries, regions, sectors, and technologies n Mobilizing private sector investment n Elevating development as a central pillar of national security policy 5An Agency of the U.S. Government

Our Impact OPIC By the Numbers* OPIC In Georgia 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 n Since 1993, OPIC has supported 25 projects in Georgia 19 financed 9 insured n over $250 million of investment n Active pipeline of loan applications *Since 1971 Total Investment Supported $188 billion U.S. Exports Supported (Projected) $74 billion U.S. Jobs Supported (Projected) 274,000 Total Projects Supported 4,000 6An Agency of the U.S. Government

OPIC offers innovative financial solutions to support private investors, including debt financing, insurance, and investment funds Our Solutions Products Current Portfolio * n 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 n Insurance ― Offers coverage for risk of expropriation, political violence, and currency inconvertibility n Investment funds ― Provides debt that is matched by privately raised equity to support funds investing in emerging markets n Other financial products ― Designs hybrid financial products to help private investors mitigate risk $14B Investment Funds Insurance Debt Financing *As of September 30, An Agency of the U.S. Government

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

Our Policy Standards Eligibility Criteria for Investors Policy Standards for Projects Investors and project proposals must satisfy certain policy criteria to receive OPIC support 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 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) 9An Agency of the U.S. Government

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

Insurance Coverage for Health Care Sector Private Hospitals and Clinics Mobile Clinics OPIC may compensate for income loss due to political violence or confiscation by the host government 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 11 An Agency of the U.S. 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

Insurance Coverage for Health Care Sector Medical Manufacturing Operations Healthcare Infrastructure Investment Funds For U.S. equity investors in healthcare infrastructure projects abroad, OPIC insurance can protect assets and business income from losses due to political violence 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). 12 An Agency of the U.S. Government 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

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

Financing the Health Care Sector Equipment Leasing and Training Companies Laboratories 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. 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. 14 An Agency of the U.S. Government Selected Case Studies

For more information, please contact: General Inquiries OPIC Main Phone: Iman Kennerly Phone: Contact Us 15An Agency of the U.S. Government

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

OPIC provided risk mitigation products critical to financing medical equipment and training 1.Samara Oncology Center No bed state-of-the-art oncology center 1.13 billion RUR ($41 million) 12-year local currency financing 2.Samara II Oncology Center No. 1 and other medical institutions 1.32 billion RUR ($47.7 million) 12-year local currency financing Samara Oncology Center No. 1 An Agency of the U.S. Government17

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

Primary Agreements & Structure 1.Supply Agreement between ACD Research and Samara Oblast 2.Receivables Purchase Agreement between ACD Research and Deutsche Bank ACD Research Oncology Center Samara Oblast Deutsche Bank RPA – 90% of ~12 year receivable RUR scheduled payments converted to USD Construction, medical equipment installation & training services Supply Agreement ~12 year receivable Expropriation & Inconvertibility Insurance 19An Agency of the U.S. Government