When Bavaguthu Raghuram Shetty (B.R. Shetty) set out to build a healthcare business in Abu Dhabi in the 1970s, he used to apply hair oil on his head before going to bed to get a good night’s sleep. Building a business is not easy, and it’s even tougher if you’re away from home as was the case with Shetty, who hails from Udupi in Karnataka. “You will face financial problems, staff problems, and many other problems. And at that time I didn’t get sleep,” says Shetty, the billionaire founder and chairman of NMC Healthcare, which was started in 1974 and is now the largest private healthcare provider in the United Arab Emirates (U.A.E.).

The age-old tradition of applying hair oil at night to calm one’s mind worked for Shetty. A little over three decades after he began, the former pharma salesman and part-time actor has built multiple businesses across diverse industries from hospitals to financial services stretching all the way from the Gulf region to India, Nepal, and Afghanistan. Healthcare is one of the biggest businesses in his portfolio: NMC Healthcare has over 200 facilities across 17 countries and had a market cap of over $11 billion last August, which he says was built on his “sweat and goodwill”. “Now I sleep very well, so I don’t apply hair oil at night,” laughs the 77-year-old Shetty, who has an Indian passport but has been living in the U.A.E. for over three decades.

But he might have to start applying some oil again soon. It’s been a rough year for NMC Healthcare on the stock market. The company’s market cap has almost halved with shares of NMC Healthcare, which trades on the London Stock Exchange (LSE), falling over 40% over the last year.

A recent Bloomberg report said short-sellers had targeted the company amid concerns over corporate governance, high debt, and opaque accounting. The report added that a spokesperson from Shetty’s office said in an e-mailed response the company was focussed on “fundamentals to create long-term shareholder value”.

Shetty remains undaunted. Part of his confidence perhaps stems from the company’s financials: It logged a profit of $251.9 million in calendar year 2018 on revenues of $2.05 billion, up 20.4% and 28.3%, respectively, over the previous year. He asserts that “passion” and “integrity” have been the cornerstones to his success in building multiple businesses. These include NMC Trading, the exclusive distributor in the U.A.E. for brands such as Nivea, Nestlé, Unilever, and Samsung; financial services company Finablr, which listed on the LSE in May; pharmaceutical company Neopharma, which has collaborations with global bigwigs such as Pfizer, Merck, and GlaxoSmithKline; and BRS Ventures, which focusses on healthcare in emerging markets such as India. “Opportunity comes once in a lifetime, so encash it,” Shetty tells Fortune India during a recent trip to Bengaluru.

Next on Shetty’s to-do list? After building an over $6-billion healthcare empire with over 2,100 hospital beds, he’s set his eyes on expanding in India. He plans to invest billions of dollars to operationalise 20,000 hospital beds, at an average spend of ₹1 crore a bed, over the next five to 10 years through BR Life, a subsidiary of BRS Ventures. The company already operates five hospitals in India with 1,600 beds.

His India plans kicked off as early as 2013 when Shetty took over the SUT Hospital Pattom in Thiruvananthapuram. Since then, he’s taken over many other failing hospitals, invested in them, and turned them around. In February 2018, he acquired Odisha’s first super-speciality corporate health centre, Kalinga Hospital in Bhubaneswar, for about ₹200 crore.

“He is a great entrepreneur,” says Ranjan Pai, chairman of Manipal Education and Medical Group, who’s also a close friend of Shetty’s. The two billionaire entrepreneurs from Karnataka have signed a memorandum of understanding (MoU) to set up a medical school in the U.A.E. “He has done very well in the U.A.E. and I wish him well for his India foray... The market [in India] is big enough for a lot of players,” says Pai, whose healthcare network, Manipal Hospitals, operates about 3,500 beds in India.

Shetty plans to meet his India goals through a combination of greenfield projects and acquisitions. Last October, BR Life won the sale bid for Mumbai-based SevenHills Hospital, which had been declared insolvent. Shetty was the sole bidder for the health care company, which operates a 1,500-bed facility in Mumbai and a 300-bed facility in Visakhapatnam. However, the hospital’s founder and managing director, Jitendra Das Maganti, and a few investors objected to Shetty’s low bid and dragged the matter to the National Company Law Tribunal (NCLT). The NCLT ruled in Shetty’s favour in April this year though the modalities of the takeover are yet to conclude.

“India desperately needs at least 2 million [hospital] beds; we need many more people like B.R. Shetty to change the landscape of Indian healthcare,” says Dr Devi Prasad Shetty, chairman of Narayana Health, which operates over 6,000 hospital beds in India. “I have no doubt in my mind about his capabilities to transform Indian healthcare... Unless one dreams of massive scale operations we cannot reduce the cost and offer affordable care.”

BR Life has plans for a $2-billion medical city spread across 100 acres in Amaravati, the new Andhra Pradesh capital city. The project will have a medical, nursing, and dental college; and an over 1,000-bed super-speciality hospital. It will also have a five-star hotel, mall, school, residential complex, and a convention centre. “Right now, the project is on the drawing board. We have already acquired the land,” says Hemraj Singh Parmar, chief executive officer of Bengaluru-headquartered BR Life. The company has also signed an MoU with the Maharashtra government to set up a 1,000-bed super-speciality cancer hospital in Mumbai.

Photo: Narayana Health, Art: Rajesh Kumar Chawla
Photo: Narayana Health, Art: Rajesh Kumar Chawla

In a bid to boost vertical integration with its hospital network, he company is also building a pharmaceutical manufacturing facility in Visakhapatnam. Last year, Shetty bought a generic drug manufacturing unit in Hyderabad from Dr. Reddy’s Laboratories. “With this, we are trying to backward-integrate to further subsidise the costs of the patients,” says Parmar. “Having a large pharmaceutical company to supply medicines at an affordable price can make a big difference,” adds Devi Shetty.

It certainly won’t be easy. To be sure, India needs large hospital chains but the industry is also going through some churn. Many healthcare entrepreneurs started hospitals and then were forced to sell out as they found them difficult to run. Moreover, multi-speciality hospitals are going through a bad patch due to regulatory caps on the price of medicines, medical products, and trade margins. Even India’s largest hospital chain operator, Apollo Hospitals, took 30 years to grow to 10,000 beds. But analysts are confident of Shetty’s ability to surmount these challenges. “Even if he [B.R. Shetty] is able to open 10,000 beds, he would have done a tremendous job,” says an investment banker who tracks the Indian healthcare market but didn’t want to be named. “Shetty, though, is a serious investor to watch out for.”

Photo: Biocon, Art: Rajesh Kumar Chawla
Photo: Biocon, Art: Rajesh Kumar Chawla

India’s woeful healthcare infrastructure needs millions of rupees of investment. According to an India Brand Equity Foundation report, the hospital industry in India stood at $61.79 billion in FY17 and is expected to touch $132.84 billion by FY22. The report added that rising income levels, greater health awareness, increasing lifestyle diseases, and improved access to insurance would be the key contributors to growth.

India currently has about 1.2 million hospital beds with 60% of the inventory being government-run hospitals. Hence, room for growth amongst large private hospital operators such as Apollo Hospitals, Fortis Healthcare, Manipal Hospitals, and Narayana Health is large. Now, add BR Life to that list.

“Personally, I believe it’s not about creating 20,000 beds. It’s about investing in good infrastructure, technology and human resources, which would make it [the hospital chain] a huge success,” says Kiran Mazumdar-Shaw, chairperson and managing director of Biocon, who has a joint venture firm with Shetty in the U.A.E. to market Biocon’s biopharmaceutical products.

Photo: Manipal, Art: Rajesh Kumar Chawla
Photo: Manipal, Art: Rajesh Kumar Chawla

Shetty sure has come a long way. Entrepreneurship had never crossed his mind and his dream was to become an Indian Air Force (IAF) pilot. During his first year as an undergraduate at MGM College in Udupi where he was getting a B.Sc degree, Shetty applied for a pilot’s course in the IAF. While he cleared his interview, he overshot the age limit by eight days and wasn’t selected. He was later offered an accountant’s job in the Super Constellation division of the IAF in Mumbai, which he took up and subsequently dropped out of college.

After a brief stint with the IAF, Shetty bagged a sales job with the Pune-based Chelsea Chemical Laboratories. From being a medical representative of the company, he worked his way up to becoming a distributor and then opened a distribution store in Udupi. When he had to appoint a pharmacist to take care of the store, Shetty decided to take matters into his own hands. He enrolled himself into a pharmacy course at Manipal College of Pharmaceutical Sciences. “It is also the struggle for survival that made me take this decision,” says Shetty. At the age of 26, he became a clinical pharmacist.

STORY IN NUMBERS

8.5MILLION
The number of patients NMC Healthcare treats annually.
200 FACILITIES
The company is present in that many locations across 17 countries.
$3.6 BILLION
The net worth of B.R. Shetty, who founded the Abu Dhabi-headquartered company, according to the Hurun Gulf billionaires list.

In 1967-68, Shetty, a member of the erstwhile Bharatiya Jana Sangh party—which later morphed into the Bharatiya Janata Party (BJP)—got elected as vice-chairman of the Udupi municipal council. While there was a chance “of a good political career”, he says, there were “other personal commitments” for which he needed money. He had taken a personal loan from Syndicate Bank for his sister’s marriage. Though it was a small amount, he couldn’t pay it back. That’s when he decided to look for work in the U.A.E., which at the time was seeking labour from India.

In 1973, he left for the U.A.E. in search of greener pastures. But it wasn’t going to be easy. As Shetty recalls, “As a pharmacist, I couldn’t get a job as I didn’t know Arabic. Somehow, I managed to become a salesman with a pharmacy. In the end, I started selling salt, chilli, butter, and biscuits.”

Within a year of working in Abu Dhabi, he repaid his loan but returning to India wasn’t on the cards. In 1974, Shetty, along with his wife, Dr Chandrakumari Shetty, set up New Medical Centre (NMC), a pharmacy and diagnostic clinic. Today, NMC’s healthcare facilities include hospitals, medical centres, long-term care facilities, day surgery centres, and fertility centres. And it treats about 8.5 million patients a year.

“My mother gave one advice: ‘Do something that always helps the community’. So when I cleared my own debt, I said, ‘Let me now realise my mother’s dream’,” adds Shetty, who has pledged 50% of his personal wealth for the treatment of non-communicable diseases to the Bill & Melinda Gates Foundation. According to the Hurun Gulf Self-Made Billionaires 2018 ranking, Shetty’s personal wealth is pegged at $3.6 billion.

After setting up the healthcare business, in 1980 he saw a business case in helping Indian immigrants in the U.A.E. repatriate money home. He then set up UAE Exchange, which operates across 45 countries today and is now part of his listed financial services firm Finablr. According to Shetty, UAE Exchange (known as Unimoni outside the U.A.E.) handles 6.5% of total global remittances. “I don’t leave any opportunity,” he says.

Shetty has also been diversifying his business interests beyond healthcare in India. Last year, he received a proposal to buy the ailing Assam Tea Company. Without much thought, he bought the 180-year-old firm for over ₹1,000 crore. “When I met him recently, I asked him why he bought Assam Tea Company and why he paid so much. While he didn’t give a specific answer, he seems to have his own logic,” says Harish H.V., managing partner at environment, social, and governance platform ECube Investment Advisors. When asked the same question by Fortune India, Shetty says, “I don’t know for what. But I will have my own [tea] brand.” He has also bought close to 250 acres of coffee plantations in Karnataka.

All businessmen, more so billionaires, have deep political connections and affiliations, and Shetty is no exception. In fact, Shetty’s affiliation to the U.A.E. is far more prominent as he proudly wears a brooch with an image of Sheikh Zayed Bin Sultan Al Nahyan, the founding father of the Arab nation. He also wears an Order of Abu Dhabi medallion that was conferred on him by their government in 2005. “He seems to be quite well connected with the government, both at the centre and in various states. You see him at all key [government] functions,” points out Harish. While Shetty proudly reminisces about his days in the Bharatiya Jana Sangh, he clarifies he is not a member of the BJP.

When Shetty is not busy looking for new business opportunities, he takes time out to pursue his passion: acting. He played the role of Dharma Raja Karthika Thirunal Rama Varma, the maharaja of Travancore, in the documentary Travancore: A Saga of Benevolence in 2012. He also had a key role in Estimrariya, a 2018 short film which was a tribute to Sheikh Zayed.

“What is life? Nothing but acting,” quips Shetty. He’s now drawing up plans to produce a two-part film on the Mahabharata in which he will also act. “I don’t know what character I will play as of now,” says Shetty.

This story was originally published in the September, 2019 issue of the magazine.

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