Medical Action Myanmar: A Financial Model Behind a Multilateral Refinancing

Wiseworth Financial Modelling and Advisory built a five-year financial model for Médecins Sans Frontières in Yangon, Myanmar. The organisation needed to spin off a series of HIV/AIDS clinics into a separate NGO, which required attracting funding from large multilateral development funds run by the United Nations. The model formed part of the business plan behind that application. The result was a successful refinancing and the establishment of a new NGO, Medical Action Myanmar, which is still saving lives today.

FAST FACTS

  • Client: Médecins Sans Frontières, Myanmar

  • Location: Yangon, Myanmar

  • Services: Forecasting, scenario analysis, corporate restructure and multilateral refinancing

  • Model type: Five-year financial model with scenario analysis

  • Outcome: Successful refinancing and the establishment of Medical Action Myanmar

ABOUT THE CLIENT

Médecins Sans Frontières, also known as Doctors Without Borders, had established a series of HIV/AIDS clinics in Yangon, the capital of Myanmar.

THE CHALLENGE

Médecins Sans Frontières wanted to spin the Yangon clinics off into a separate operation under a new NGO. To do that, the new organisation had to attract funding from large multilateral development funds run by the United Nations.

Funders at that level do not release capital against intent. They require a full business plan and a financial model showing that the standalone entity can operate, that its costs are understood, and that the funding sought matches what the operation will actually consume.

That is a harder modelling problem than a commercial forecast. The cost base is driven by clinical activity rather than by sales, the revenue is grant and donor funding rather than trading income, and the assumptions that matter most are medical.

WHAT WISEWORTH BUILT

Wiseworth built a five-year financial model forecasting:

  • Clinic costs

  • Head office costs

  • Patient numbers

  • Drug costs

  • Death rates

  • Financing from global NGOs

  • Other revenues

Scenario analysis was built on top, so the funding case could be examined under different assumptions rather than presented as a single fixed projection.

Death rates and patient numbers are unusual model drivers, and they are the ones that make this model work. In a clinical operation they set the drug volumes, which set the largest cost line, which sets the funding requirement. Modelling them explicitly is what allowed the plan to show funders a credible five-year cost base rather than an estimate.

THE RESULT

The result was a successful refinancing and the establishment of a new NGO, Medical Action Myanmar, with funding from various international donors and is still saving lives today.

In 2024, MAM supported 10 clinics, with 1,918 community health workers trained, 59 mobile medical teams operational, and doing 1.9 million patient consultations per year.

FREQUENTLY ASKED QUESTIONS

Can a financial model support an application to a multilateral development fund?

Yes. Funding at that level generally requires a full business plan with a financial model behind it, showing the operating cost base, the funding requirement and how the two connect over the funding period.

How is a financial model for an NGO different from a commercial model?

The cost base is driven by activity rather than by sales, and the income is grant and donor funding rather than trading revenue. In this engagement the drivers included patient numbers, drug costs and death rates, none of which appear in a commercial forecast.

Can a financial model support a corporate restructure or a spin-off?

Yes. This model was built to support the separation of a clinic network from its parent organisation into a standalone NGO, which required demonstrating that the new entity could operate and fund itself.

How far ahead should a funding model forecast?

It depends on the funding period being sought. This model forecast five years, which matched the horizon the multilateral funders were assessing.

Does Wiseworth work with not-for-profits and NGOs?

Yes. Wiseworth Financial Modelling and Advisory has worked with not-for-profits, social enterprises and international NGOs, including this engagement in Myanmar.

Who builds the model?

Mark Jeanes builds every Wiseworth model personally, from the first assumptions sheet to the last balance check. He spent 20 years at NAB, ANZ, Banque Paribas and Deutsche Bank before founding Wiseworth.

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