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Duncan Maru

Duncan Maru, MD, PHD is Co-Founder and Chief Strategy of Possible, a healthcare non-profit company based in rural Nepal. Possible delivers public sector healthcare in government facilities via an accountable care systems approach that targets affordability, equity, and quality. Duncan has published over 40 peer-reviewed articles. He has received a number of awards including: High-Risk, High Reward Early Independence from the National Institutes of Health; USAID PEER; Skoll Global Threats; and Schwab Foundation Social Entrepreneur of the Year. He is an Assistant Professor of Medicine at Brigham and Women's Hospital, Harvard Medical School, and a pediatrician at Boston Children's Hospital.

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Non-profit Social Enterprise
Areas of Impact
North America, South Asia, Nepal


Possible is a non-profit healthcare company that delivers high-quality, low-cost healthcare to the world's poor in rural Nepal. The organization has built an innovative healthcare delivery model called durable healthcare, where the Nepali government pays them on a performance basis to deliver high quality, low cost healthcare within their infrastructure. This design brings together the best of each sector: access from the public sector, quality from the private sector, and innovation enabled by philanthropy. Because the Nepal government grants universal healthcare to its citizens, the care is free for their patients (who make less than $1 a day), and Possible’s performance-based financing system means they get paid only if they deliver population-level health outcomes.

A significant emphasis of durable healthcare is decentralising service delivery: Possible operates through a hub and spoke structure with a main hospital, 13 clinics, and over 160 health workers. The hub is Bayalpata Hospital, which is situated atop a hill in one of the remote regions of Nepal—36 hours away by bus from Kathmandu. The hospital stood empty for 30 years before Possible partnered with the government to reopen and scale up its services.

To date, Possible has treated over 235,000 patients at a cost per patient of $26 and cost per capita of $4.8, as opposed to the government’s current spending of $6-7 per capita. Possible clinical team partners with Harvard’s Division of Global Health Equity and the Brigham and Women’s Hospital to provide clinical guidance and resources to its team who is 98% Nepali.


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