Raps Otukile is a man who always has money on his mind. Previously an investment banker, he later found a new career path in pharmaceuticals.  When Raps fell sick he discovered how expensive and inaccessible medication was in his home country of Botswana. "I'm an avid farmer, so I drive to the farm like any other Botswanan man, as a weekend pastime. Because of my stressful job that I had, I fell sick driving back and forth to the capital city. My farm is about 600km (372 miles) from where I live. The closest pharmacy or access to medication I had was in Gabs (Gaborone). In remote areas you don’t get private healthcare investments, they’re mostly concentrated around urban areas in the cities. That situation is what drove me to say that I needed to find a solution for this.”

Raps started Pilane Pharmacy three years ago in an attempt to make affordable and accessible medication a reality on the outskirts of the capital Gaborone. Since then he has seen Pilane grow and become competitive.  “I do pharmaceutical distribution, both from the wholesale side of things as well as retail. We’re actually planning on opening a few more retail pharmacies around the country, because the idea was that we wanted to create direct affordable access to patients in all of Botswana.”

Throughout the continent of Africa, only about 2% of all medication is manufactured there, making it expensive to buy and distribute. By the time it reaches Pilane Pharmacy, it has gone numerous price increases so each distributor can make a profit. When Raps goes through the traditional channels to buy medication wholesale, the medication has to be imported from the manufacturer, who then sells it to a distributor, who sells it to a regional distributor that he then buys from. “There’s too many middle men in terms of the value chain, and then they actually form groups that do a lot of price fixing. We aim to cut out all of that and import directly from the manufacturer and we’re now licensed to do that.” By circumventing the distributors and buying directly from the source, Raps is slashing the price which will make it more affordable when he puts medication on sale in his pharmacy. To further bring costs down, Raps hopes to implement a cooperative where people have a monthly subscription that contributes to the pharmacy buying in bulk.

Unlike the United States medical insurance isn’t very big in Botswana, some people have insurance, but most people are serviced by the public health program.  “On the retail side we do have medical insurance but not a lot of people are on it. We have public health service, and a majority of the population is on it. The challenge with that is that there is always a shortage with medication and funding. So, we have seen that because of that challenge patients can't actually afford to buy medication from private pharmacies like ours and that creates an access problem. "

While Pilane is seeing steady success, the journey to start his pharmacy wasn’t easy. The first year Pilane was open Raps and his pharmacist didn't do any customer discovery. At the end of the year this led to having expired medication that almost totaled the cost of opening the pharmacy.  "We didn't know what we were doing. We tried to implement a Gaborone, an urban area, model onto a rural area and we paid dearly for it. Our second year was tough too, but what kept us going was the fact that our customers kept coming and we could see that we were making a difference in our community."

Raps also came solely from a finance background and had to start from scratch to learn about pharmaceuticals and the pharmacy business. “Coming from a finance background you can’t tell yourself you know these things. The healthcare industry is highly regulated so you kind of have to follow what is required. I don’t do shortcuts and I’ve been trained to follow protocol. The competitors have been in the game for quite some time, so it’s costly for us who are new in the market to follow the rules.” In addition to the learning curve, Raps had to find an experienced pharmacist to join him and figure out how to fund his venture. They've forgone profits to make sure people have access to affordable medication.

Pilane currently offers multiple programs. One program they offer is called Elder Care, which involves waiving tax and copay for pensioners. Pilane will also deliver medication, perform a brief checkup and a consultation on medication for them once a month. Raps also recognized that there was a need to be flexible, so they could build community trust as well. "We're really considerate that we exist within a community. We serve a lot of marginalized people and because of the access issue in terms of payment we're flexible. If a person can only pay for a week's worth of medication we open a box and give them a week's worth of medication, so we have a lot of weekly patients." The pharmacy balances this excess cost out with their profitable wholesale side and the fact that they offer so many varied products.

Although pharmaceuticals are still a relatively new field for Raps, money is still at the center of it. Raps is passionate and driven to make sure affordable medication is accessible for the people of Botswana. “It hit home that I was actually selected [for the fellowship]. It meant that what I was doing was something that could make a difference. I’m very passionate about my project because I believed that if we could do it and give ourselves the next two decades we could really make a change. I never lost sight of why I started this business. No matter how difficult it gets or what happens, the tenacity we have as a team and the passion we have for making a difference keeps us going. "