This edition explores the impact of global PE’s growing presence in Indian healthcare and the rising investor interest in sustainability-linked sectors such as waste management.
PE funding and the future of Indian hospitals
Global PE funds are making deep inroads into India’s healthcare sector, and their influence and impact are only growing with each passing year.
In the most recent development, KKR-owned Baby Memorial Hospital (BMH) is understood to have acquired a majority stake in Meitra Hospital, both based in Kozhikode, Kerala.
The deal reportedly values Meitra at Rs 1,000–1,200 crore ($112–135 million), and marks KKR’s third hospital investment in Kerala in just two years.
KKR had earlier acquired a controlling stake in BMH in 2024, and is now also in early discussions to acquire Star Care Hospital, another Kozhikode-based chain.
Last year, the global PE major also acquired the 350-bed Chazhikattu Multi Speciality Hospital in Thodupuzha, in central Kerala.
The speed and scale of this consolidation prompts a deeper question: What happens when one of the world’s most powerful financial institutions begins to own not just hospitals — but an entire local healthcare ecosystem?
The answer isn’t simple — because private capital in healthcare is not inherently problematic. In fact, there are compelling arguments both for and against it.
KKR, of course, is not alone. From Temasek to Blackstone, CVC Capital, and General Atlantic, global funds are increasingly investing in India’s fast-growing healthcare sector — projected to reach $638 billion by FY2025, according to industry estimates. That growth trajectory — making healthcare one of India’s largest sectors by revenue and employment — is exactly what PE firms are looking to capitalise on.
That’s the story in India. But globally too, the growing role of PEs in healthcare has raised red flags. A recent Times of India report cited a study by Harvard Medical School, in collaboration with the universities of Pittsburgh and Chicago, which found that patient mortality rates in emergency departments rose after US hospitals were acquired by PE firms.
As PE ownership expands across Indian hospitals, such studies serve as a cautionary tale, underscoring the need for transparency, accountability, and public scrutiny in how healthcare is financed and delivered.
“The danger is real,” Ramesh Kannan of homegrown healthcare PE firm Somerset Indus Capital Partners had earlier told DealStreetAsia. “We cannot fall into the trap of Western models where the cost of healthcare and insurance has gone beyond redemption and control.”
However, he also acknowledged that PE drives expansion, technology adoption, efficiency, job creation, and attracts top talent.
So, it’s not all black and white, especially since with PE funding, technology can drive better clinical outcomes and limitations around access, doctors, and clinical talent can also be partially addressed.
Sunil Thakur, Partner and Head of South Asia at Quadria Capital, argued that PE funding in healthcare is often misunderstood as a cost driver.
“In reality, its objective is to deliver quality care at a sustainable and commercially viable price point,” he said. The returns, he added, help sustain long-term quality, “ultimately strengthening the healthcare ecosystem rather than burdening it.”
Balancing act
Where to draw the line on private investment — or whether a line should be drawn at all — remains the key question.
India’s healthcare system urgently needs capital to expand infrastructure and meet growing demand. But it also needs guardrails to ensure that access, affordability, and ethics aren’t sacrificed at the altar of profitability.
So, does this call for thoughtful, forward-looking regulation? Experts argue for channeling PE funding into affordable, inclusive models that serve the broader public interest — not just shareholder returns.
The demographic trends alone are staggering. Of the world’s 8 billion people, 4 billion live in China, India, and ASEAN countries. By 2030, nearly a quarter of this population will be over 65 — likely driving a surge in chronic conditions such as cardiovascular disease, cancer, and stroke.
If India wants to build a world-class healthcare system, it must ensure that capital works in the service of care — not the other way around.
PE firms see value in waste
Actis’ acquisition of Singapore-based environmental services company 800 Super Holdings comes just three years after the last transaction involving the company, in an indication of private equity demand for such businesses.
The deal to buy a 90% stake in 800 Super from units of Singapore government-linked conglomerate Keppel values the company at more than S$600 million. That is nearly 60% more than its previous valuation: In August 2022, Keppel had acquired the stake for S$304 million, valuing 800 Super at S$380 million. That was about three years after the company was delisted from the Singapore stock exchange in a management buyout financed by debt and structured equity from KKR.
800 Super, founded in 1986, made its market debut in July 2011 as one of only four licensed municipal waste collectors and cleaners in the dense, highly urbanised city-state, raising just under S$7 million.
The company’s revenues grew from about S$70 million for the full year 2010 to nearly S$137 million for the nine months in 2019, before it was privatised. Earnings went from S$5.2 million in FY2010 to a high of S$20.7 million in FY2017.
In November last year, the infrastructure unit of global PE giant CVC acquired a 49.9% stake in Singapore-based hazardous waste management company ECO. The deal was CVC DIF’s first investment in Asia, and was made through DIF Infrastructure VII.
In 2023, another Singapore waste management company, Sembwaste, a unit of government-linked Sembcorp, was said to be getting interest from buyers, including KKR and Macquarie Asset Management. That July, some three months after reports of a potential sale, Sembcorp said it was terminating the process amid a portfolio review.
Separately, Singapore-based PE firm Dymon Asia Capital has invested in Chye Thiam Maintenance, a family business that operates autonomous road cleaners and e-waste and material recovery facilities in Singapore.
Most recently, it was reported that Swedish firm EQT is looking at a US IPO for North American waste management business Reworld Waste, which it took private in 2021 for $5.3 billion. In October last year, Singapore sovereign wealth fund GIC acquired a 25% interest in Reworld for an undisclosed amount in a mix of primary and secondary capital.
Ultimately, the global waste management industry is set for growth, with steady, recurring income for businesses as burgeoning populations continue to generate copious amounts of waste for collection, disposal, and processing into recycled materials and even energy. It makes for a business case that is far from rubbish.
Top PE developments
Fundraising
Pan-Asian asset manager HOPU Investments, based in China, is in talks with a group of investors to move its minority stake in French animal health company Ceva Animal Health into a CV.
I Squared has launched ISQ OpenInfra, a platform designed to bring institutional-quality infrastructure investments to the private wealth market.
Deals
Food and grocery delivery platform Swiggy said it will offload its entire 12% stake — worth $270 million — in ride-hailing company Rapido. While Dutch investment firm Prosus NV’s unit will acquire shares worth $221.63 million, the remaining stake will be picked up by US-based WestBridge Capital.
In another major Indian transaction, Axtria, an AI-first data analytics and cloud software company serving the global life sciences industry, raised $240 million from homegrown private equity firm Kedaara Capital. The deal marks one of the largest employee-centric liquidity events in the country.
Moving to Southeast Asia, Telkom Indonesia is understood to have advanced its plan to divest a significant stake in its healthcare subsidiary AdMedika, attracting strong interest from investors such as TPG, Fullerton Fund Management, Quadria Capital, and Advantage Partners.
IPO frenzy
JPMorgan Chase made headlines earlier this week, saying it expects India’s IPO market in 2025 to surpass last year’s highs, with several billion-dollar issues lined up in the coming months. Those who recently filed their draft papers with the capital markets regulator include payment app PhonePe and Purple Style Labs.
In Malaysia, MMC Port, the country’s largest port operator, has secured approval from the Securities Commission, clearing a major hurdle for its planned listing on Bursa Malaysia in October. Notably, it is set to be the country’s biggest IPO in 13 years.
65 Equity Partners-backed AvePoint also made a Singapore stock market debut, becoming the largest publicly traded SaaS firm in the region and 65’s first major public liquidity event.
