[East Africa Business Week] Bob Koigi: East Africa

East Africa is positioning itself as one of Africa's most attractive investment destinations, and nowhere is this clearer than in the digital health sector. The recent selection of three Kenyan startups—Dot Glasses, Zuri Health, and Mamy Eyewear—into the Africa Eye Health Accelerator programme underscores a fundamental shift in how the region is tackling healthcare delivery and creating commercially viable solutions to endemic medical challenges.

The eye health crisis across East Africa represents both a humanitarian imperative and a compelling investment thesis. The World Health Organization estimates that approximately 258 million people globally live with vision impairment, with sub-Saharan Africa accounting for a disproportionate share due to limited access to optometry services, diagnostic equipment, and affordable eyewear. Kenya, Uganda, and Tanzania combined have fewer than 800 qualified optometrists serving over 180 million people. This massive service gap—equivalent to roughly one optometrist per 225,000 residents—creates ideal conditions for technology-enabled disruption.

What distinguishes the current wave of East African health startups from earlier iterations is their focus on scalability and unit economics. Dot Glasses leverages telemedicine and AI-assisted prescription validation to enable remote eye examinations, dramatically reducing the cost per diagnosis. Zuri Health integrates electronic health records with community health worker networks, making eye care accessible in rural areas where traditional clinics are economically unviable. Mamy Eyewear targets the affordability angle through local manufacturing and direct-to-consumer distribution, effectively eliminating margin-heavy middlemen that inflate eyewear costs 300-400% above production value.

The Africa Eye Health Accelerator's backing—which includes support from established development finance institutions and impact investors—signals institutional confidence that these models can achieve both social impact and financial sustainability. For European investors accustomed to mature healthcare markets, this represents a rare opportunity to enter high-growth segments at seed-to-Series A stages, before valuations reflect the sector's explosive trajectory.

The regional context amplifies this opportunity. East Africa's fintech infrastructure—M-Pesa penetration exceeds 70% in Kenya—enables frictionless consumer payments and corporate B2B transactions that would be far more difficult in less financially digitized regions. Additionally, Kenya's regulatory environment for medical devices and telemedicine, while still evolving, is increasingly aligned with international standards. This creates a "Goldilocks" environment: easier market entry than Europe's heavily regulated landscape, yet stronger governance frameworks than fragile states in West Africa.

Market sizing is material. At 140 million people across East Africa, with 15-20% requiring corrective eyewear and penetration currently below 10%, there exists a serviceable addressable market exceeding €2 billion. Even at conservative 5-year CAGR assumptions of 25%, this represents a compound opportunity set.

However, European investors must account for execution risks. Currency volatility (KES, UGX, TZS have each depreciated 8-15% against EUR in the past 18 months), regulatory inconsistency across borders, and talent retention in competitive tech hubs remain substantive headwinds. Additionally, the accelerator model itself has a 40% failure rate in Africa, meaning not all three Kenyan startups will achieve meaningful scale.