15 Dec Interview with Adrian Gore, CEO of Discovery Ltd, South Africa
How has Discovery’s evolution shaped South Africa’s health insurance landscape and what does its growth story say about the potential of South African entrepreneurs on the global stage?
Discovery Limited covers 60% of South Africa’s private commercial health insurance market. We launched around the end of apartheid, during Nelson Mandela’s presidency. Healthcare then was a reflection of the country’s broader challenges. I believed we needed a sustainable health insurance model to address the nation’s diverse needs. The challenges were significant. Low doctor density, high disease burden — about four times higher than in other developing markets. With limited control over the supply of doctors and high demand of disease burden, we needed a different solution. Our breakthrough was shifting focus from simply covering illness to preventing it. We asked, “What if we could make people healthier and reduce the need for healthcare?” At the time, there was little data linking behavior change to health outcomes. However, we developed a simple concept: incentivize healthy behaviors and incorporate that into the insurance model. This innovation became the foundation of Discovery’s success. We pioneered the concept of incentivizing behavior change through a shared-value model.
The idea is simple: when people adopt healthier behaviors, it aligns with our interests. If you are healthier, we are more profitable. We reinvest those profits to further incentivize healthy actions, creating a virtuous cycle. This model has evolved significantly from basic incentives to personalized recommendations driven by AI, tailored to individual risk profiles. It’s not just about preventing illness; it’s about managing chronic conditions and improving outcomes for those already sick. Ironically, South Africa’s complex healthcare environment — limited supply of doctors, high disease burden and strict regulations — forced us to innovate. We developed a model that now works globally. We have expanded into health and life insurance across markets like the U.S. with John Hancock, China with Ping An, Europe, Japan and over 40 other countries. Three global trends have made this model highly relevant: Purpose-driven insurance, sp companies now aim to promote health, not just offer transactional coverage; technological advancements such as wearable devices, AI and real-time data enable us to track and influence behavior. Rising chronic diseases, aging populations and chronic illnesses are universal concerns. Our shared-value model transforms health and life insurance by aligning economic success with healthier populations.
It’s a scalable, globally adaptable solution that continues to drive our growth and success. Our model has achieved remarkable success and with the power of AI and data, we are well-positioned to scale globally. At the same time, we have launched a bank in our home market based on the same behavioral principles, encouraging better financial management. The bank now has over two million accounts and is growing rapidly. Balancing local growth with global expansion is a significant challenge. While we have made great progress, it still feels like we are just getting started — there is so much more to accomplish.
How are you and Discovery’s leadership supporting President Ramaphosa to address key national priorities and what role do you see business leaders like yourself play in this?
South Africa faces significant challenges with unemployment, inequality and poverty. Yet, it remains a sophisticated economy with skilled talent and strong goodwill. About 18 months ago, the business community partnered with the government to address key issues through focused workstreams aimed at driving growth. The idea was simple: growth creates jobs, jobs change the narrative and a positive narrative fuels further investment and growth. We focused on three critical areas: energy, meaning addressing load shedding to stabilize power supply; transport & logistics which means improving railways and ports to boost exports, especially minerals; crime & corruption — removing SA from the financial action task force (FATF) grey list. This public-private partnership, led by the president and a structured governance framework, brought together CEOs and government officials in regular, results-driven meetings. In just eight months, we significantly reduced load shedding. After years of power cuts, South Africa has now gone over 200 days without load shedding.
The success lies in the collaboration: over 50 companies contributed expertise, resources and millions of rands to support the effort. It’s a model that could work for other developing nations — leveraging private sector skills to address public sector challenges. This initiative, led by the presidency and supported by the private sector, leverages significant resources and expertise in a structured, collaborative way. We have now entered phase two, focusing on driving economic growth. South Africa has a history of creating jobs when the economy grows and growth, in turn, changes the national narrative. Our biggest challenge is perception — the reality of South Africa is far better than the narrative projected outside the country. Improving this perception is critical, especially given its impact on elections and public confidence. For example, drastically reducing load shedding has already shifted public sentiment, making people more optimistic and less polarized. As we move forward, we are focused on ambitious goals such as adding four gigawatts of renewable energy by 2025, increasing freight tonnage across the rail network and addressing regulatory challenges like removing South Africa from the FATF grey list.
Each workstream is carefully managed, with measurable outcomes and we may expand into new areas. This year has been remarkably successful and it’s reshaping the country’s potential. We are optimistic about what’s ahead. What is remarkable is that we were able to get CEOs from 160 major corporations to sign a pledge supporting South Africa’s potential. At the time, many were deeply concerned about the country’s challenges, especially the power crisis. We asked them to look beyond the present and commit to the country’s future and they enthusiastically did. We expected it to be difficult, but instead, companies, including international ones, were eager to join.
The success lies in combining this pledge with a structured governance framework. It’s not just symbolic; it’s backed by clear goals, accountability and regular feedback, driven by the president. This balance of aspiration and execution is what’s making it work. We are now in a critical phase with the GNU and it’s essential to keep the momentum going. While interest in the model is growing, we still need to document it properly as a case study. That is the next step. For now, we are optimistic and feel good about the progress we have made.
How do you see the collective pledges by business organizations reshaping South Africa’s economic trajectory in the years to come? Why should the international business community, including from the USA, buy into this grand new ambition for SA?
Our economy is often seen as risky, yet it rarely contracts. However, without sustained growth, we cannot move forward. Our incredibly ambitious goal as a business community is to reach a 3% growth rate by the end of 2025. It may seem hugely ambitious, but once we hit that momentum, growth will start to flow. The key is achieving inclusive economic growth. South Africa is rich in resources—tourism, minerals and natural beauty. If we can keep turning the wheel, the potential is immense. I’m optimistic, but it will require hard work.
The country’s narrative is often worse than the reality and there is much more potential in the people. It’s more resilient than most realize. The country is rich in resources including minerals, agriculture, tourism and holds tremendous potential. It’s a nation of goodwill, with a remarkable history from apartheid to post-apartheid. Our business-government partnership proves how quickly the country can adapt, as demonstrated by the impact we’ve had in just one year.
Which markets or regions do you see as the most promising opportunities for expansion for Discovery?
We operate in key markets globally. In the UK, we are a leading insurer with Vitality driving growth. Our partnerships in China and Asia-Pacific with AIA, along with our work in the U.S. through John Hancock and health plans are major growth drivers. In Europe, while our presence is more focused, there is significant potential. What is remarkable is how consistent the data is across all markets. Our research on physical activity shows a clear link to reduced mortality. Regardless of age or health status, moving from no activity to high activity dramatically lowers death rates. For example, optimal daily steps hover around 7,500 and this effect holds across different ages and chronic conditions. Habit formation is key—it takes 7 to 15 weeks to establish lasting change. Once a habit forms, the impact on health and longevity is profound.
In the past, health and life insurance was solely about pricing, with no focus on behavior change. Our goal is to shift this model to one that rewards behavioral change. The challenge is that people don’t naturally change behavior, so we incentivize it. For example, we offer free Apple Watches where monthly payments decrease with increased exercise. If you meet your step goal, the watch is free. We have worked with Apple globally to create various behavioral incentives, improving lives in the process. Last year, we generated 500 million healthy activities and we track this from an ESG and sustainability perspective as part of our accountability measures.
What makes you optimistic about South Africa’s future and what final message would you like to share with the readers of USA Today about the opportunities and potential of SA?
I’m optimistic because the country is resilient, with great potential in its people and assets. Despite its apartheid past, there is strong goodwill and with the right leadership, it can be harnessed. The country is underpriced and underinvested due to its narrative, but as we turn the flywheel, its potential is clear. South Africa has a sophisticated private sector of 10-15 million people, but also faces significant poverty, inequality and unemployment.
Due to the government’s inability to provide a comprehensive and society-wide safety net, the insurance industry fills this gap, particularly in pensions and healthcare. South Africa pioneered products like dread disease and critical illness coverage, and the concept of shared value insurance. With deep fiscal and other constraints on government’s ability to provide quality healthcare to all, the private sector covers everything for the insured, from minor ailments to major surgeries. This unique model emerged from a culture of high sophistication in insurance, as there is no national safety net. Our shared value model is well-known in the industry and increasingly being copied, which is positive. We welcome collaboration and hope to transform the entire industry.