BNP Paribas Asset Management Alts: Tackling the Global Maternal Health Crisis Through Impact Investment

Post-partum hemorrhage (PPH) remains the leading cause of maternal death globally, claiming over 100,000 lives annually. While the incidence of PPH is universal, mortality disproportionately affects women in Low-and-Middle Income Countries (LMICs) according to the WHO¹. In light of this disparity, BNP Paribas Asset Management Alts (BNPP AM Alts), acting on behalf of its clients, invested in Alydia Health, a start-up developing a medical device that could effectively combat PPH globally including LMICs. With BNPP AM Alts' backing, the strong health outcomes achieved by Alydia ultimately led to its acquisition by women's health company Organon. Serving as a bridge between the initial innovation and the current large-scale expansion at Organon, BNPP AM Alts' impact investment ensured this response to a critical global health challenge could be both impactful and financially sustainable

Innovating Maternal Care with the Jada Device

Created in 2010 to advance maternal safety, Alydia's Jada device offers a breakthrough in treating PPH. When postpartum bleeding rapidly transforms from manageable to life-threatening, outcomes diverge dramatically by setting. High-resource environments prevent mortality through invasive interventions, though at the cost of trauma, extended recovery, fertility risks, and significant expense. In low-resources regions, where blood supplies and surgical capabilities are limited, the same condition often proves fatal.

Unlike conventional approaches that attempt to compress bleeding by expanding within the uterus, the Jada works with the body's natural physiology: the silicone device applies gentle vacuum pressure to encourage natural uterine contraction, rapidly sealing blood vessels at their source. Clinical results demonstrate remarkable efficacy, halting bleeding in 94% of cases within a median time of just three minutes - leading to FDA approval in 2020. The innovation's value for global health lies in its adaptability for diverse healthcare settings, functioning without complex technical requirements, even where electricity isn't consistently available.

Ensuring Long-Term Impact through Global Access Agreements

While the Jada device is effective in developed and developing countries alike, BNPP AM Alts' investment process prioritized ensuring the technology would reach patients in LMICs. At the heart of this strategy is the Global Access Agreement (GAA)--a binding contract anchoring impact objectives through concrete commitments across three dimensions: 

1. Product Design: Ensuring the technology meets the needs of low-resource settings
2. Affordability: Making the innovation accessible to healthcare systems in LMICs
3. Availability: Ensuring distribution reaches the most vulnerable populations

Crucially, BNPP AM Alts points out that "Global Access Agreements are binding on the company and successors, including in the case of sale of the company, transfer or license of the product", ensuring sustained impact regardless of business changes. To oversee progress towards the global access objectives, a dedicated Global Access Committee, comprising company representatives, investors, and experts, monitors implementation and provides guidance, with a tenure that matches the long-term nature of the goals pursued. 

Strategic Partnerships to Combat Supply Chain Fragmentation

Bringing Alydia's technology to underserved populations required overcoming significant distribution challenges. The BNPP AM Alts team identified a critical obstacle: "The lack of a unified global player dedicated to purchasing these commodities presents a major hurdle" in the fragmented maternal and child health supply chain across LMICs. To address this challenge, BNPP AM Alts and Alydia established strategic partnerships with key international organizations that could facilitate global adoption. These included the Clinton Health Access Initiative (CHAI), Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), International Federation of Gynecology and Obstetrics (FIGO), and the UN Population Fund (UNFPA).

Beyond distribution barriers, the investment confronted broader systemic challenges in women's health innovation. The BNPP AM Alts team observed that "women's health has historically been seen as a niche market despite its significant societal impact," resulting in persistent underfunding and a less robust environment for M&A compared to other healthcare sectors. BNPP AM Alts actively responded by educating limited partners about the critical financing gaps in maternal health and the opportunity they represented for both impact and returns.

Measurable Impacts Aligned with Maternal Health Priorities

By 2024, the Jada device has created substantial impact worldwide, saving or improving the lives of 84,996 women across 10 countries, including 3 LMICs, based on hospital data. Healthcare providers report that the device has significantly reduced emergency interventions, decreased reliance on blood transfusions, and limited trauma in delivery rooms - outcomes that directly support UN Sustainable Development Target 3.1 to reduce global maternal mortality below 70 per 100,000 live births by 2030.

Beyond clinical benefits, Jada delivers compelling economic value. Priced comparably to a single unit of blood transfusion, the device prevents the need for multiple transfusions and intensive care often required in PPH cases. This cost-effectiveness extends beyond direct savings; women return to recovery faster and bond earlier with their newborns, while healthcare providers can transfer patients to lower-resource settings, optimizing hospital resource allocation and reducing overall system costs.

From Startup to Acquisition: A New Potential for Impact

The 2021 acquisition of Alydia Health by Organon for $240 million marked a remarkable milestone beyond just company success - it validated a core principle of effective impact investing in global health. The exit delivered a 5.5x return on investment, challenging the misconception that addressing critical global health needs requires sacrificing financial performance. This outcome exemplifies BNPP AM Alts' investment philosophy that strong returns make impact investing sustainable: far from being in opposition, financial returns enable more impact capital to be circulated and reinvested, creating a virtuous cycle where successful exits fuel future interventions addressing global challenges.

To ensure a responsible exit, investors considered not just the financial terms of the offer but also the acquirer's alignment with long-term impact objectives. With operations in 140 countries including numerous LMICs and a strategic focus on women's health, Organon presented an ideal partner to advance the GAA commitments and scale up the number of beneficiaries. The exit to Organon demonstrates that global health commitments can indeed survive post-acquisition and that the GAA is a valid mechanism for underpinning impact objectives.

BNPP AM Alts maintains an active presence on the Global Access Committee, contributing to and monitoring strategy development, particularly for LMICs. Beyond this direct involvement, BNPP AM Alts shares insights from this investment with the broader global health community, including investors, initiatives, and organizations. This knowledge transfer helps build momentum for scaling impact investing in women's health, transforming one success story into a catalyst for broader change.

¹ "Death from PPH is largely preventable and has been significantly reduced in high-income countries (HICs). Yet women in low- and middle-income countries (LMICs) continue to be disproportionately affected. The vast majority (>80%) of maternal deaths from PPH occur in sub-Saharan Africa and south Asia." WHO, August 2024