Axmed Stakeholder Letter 2025

9th February 2026


To the Valued Stakeholders of Axmed: 

Our Investors, Customers, Advocates, and most importantly, Patients –  

In 2024, we made the deliberate decision to begin publishing an annual impact report. We have no legal or regulatory obligation to do so. However, we believe that if you have entrusted us with your capital, your goodwill, or the health of your constituents, you deserve a straightforward accounting of how we are holding up our end of the bargain.

Our mandate is simple to articulate and challenging to execute: to accelerate access to high-quality medicines for those who need them most. This report reflects our progress, but it also details the trade-offs and challenges that come with doing hard things at scale. As the saying goes, “to whom much is given, much is expected.” Earning trust through transparency and rigor is our commitment, and a lifelong responsibility that we take seriously. 

It is in that spirit that we share what is working, what is not, and what we are learning along the way.


The Underdog

If I had to sum up 2025 in three words, they would be: steep learning curve.

From day one, we were the underdogs. We entered a landscape shaped by established actors, many operating within systems that benefit from fragmentation and inefficiency, and few that had fully leveraged technology to change the economics of procurement. That created two challenges. First, we had to build awareness from zero, demonstrating that scale-driven efficiency was achievable. Second, we chose to compete directly with well-capitalized incumbents while simultaneously building defensible infrastructure.

Our technology-first approach to demand aggregation gave us an early advantage, but we never mistook being early for being easy. From the outset, we committed to the long game, measuring ourselves against three fundamentals: the populations we serve, the services we offer, and the people we hire. Progress across each required our scarcest resource, time. What first appeared as obstacles; cross-border aggregation of demand, rebuilding trust with discouraged buyers, and navigating fragmented systems, ultimately became the learning that now forms the foundation of our competitive advantage.

We’re still the underdogs, but the evidence is beginning to speak for itself. 

Measuring Our Progress

1. Populations Served: 

Impact is our ultimate metric. In 2025, we expanded reach by more than 450 percent, serving over 4.2 million patients, up from 750,000 in 2024.

We enabled delivery of more than 1,800 metric tons of health products, roughly the equivalent of ninety large 40-foot shipping containers reaching communities often overlooked by traditional systems. Through demand aggregation and price transparency, buyers achieved average savings of 35 percent (and 22% median cost savings). For health systems under budget pressure, those savings could determine whether some patients receive care at all.

2. Service Offered: 

Our North Star remains clear: the right medicine, at the right price, where it is needed. To reach that goal, we do not just provide a tool, but also expertise to ensure it works in the real world. We think of these two pillars, the Platform and the Global Health Advisory Unit, as the engine and the navigator. One provides the power to move, while the other ensures we are taking the most direct route to impact.

The Marketplace Platform 

We are building a marketplace that earns trust and loyalty, not one that simply functions. Operating across eight markets in 2025 required us to embed the lived realities of each ecosystem directly into our software. Marketplaces are notoriously difficult. You are constantly solving the "chicken and egg" problem in real time. This process took longer than we initially anticipated, but the result is a materially stronger and more resilient platform. We are not standing still. Our next phase focuses on embedding agentic AI capabilities to increase speed, precision, and decision intelligence. If the platform is the engine of access, these upgrades are the turbocharger.

Global Health Advisory 

While our platform provides the infrastructure, our Advisory Unit provides the launch-expertise and "last-mile" implementation. We support a highly selective client base in their most ambitious efforts, particularly the introduction of novel therapies targeting high-burden diseases. This delivers the strategic heavy lifting required to ensure that life-saving medicine does not just exist, but actually reaches the patient. By combining our digital marketplace with this deep, implementation expertise, we ensure that the "North Star" is not just a distant light, but a destination we are reaching every day.

3. Our People: 

Our team is what I am most proud of. We hire for integrity, intelligence, energy, and judgment. In 2025, we built a team that combines technical excellence with deep, firsthand understanding of healthcare systems in growth markets. We hired for judgment, not pedigree. Strategy and technology are necessary, but in our world, people determine the outcomes.

A Word on Capital and the "Thin Ice"

Driving impact at scale is demanding. Done correctly, it can feel like walking on thin ice. Approximately 400 billion dollars is spent annually on healthcare procurement across growth markets. Redirecting even a fraction toward greater efficiency and equity is a generational opportunity.

If our goal had been short-term profit alone, we could have hit current revenue levels far sooner. Instead, we chose to redesign procurement dynamics for long-term system value and sustainable investor returns. This path requires founders willing to take risk, investors with patience, and above all, trust. We are grateful to our partners at the Gates Foundation, whose commitment to purpose-aligned capital has helped millions benefit this year.

Financial Performance

We have long believed that technology is the only tool powerful enough to bring structure to the nearly $400 billion annual healthcare procurement spend across growth markets. In 2025, that belief translated into results. Annualized revenue increased twelvefold (12x) year over year, and twenty-three-fold (23x) when including performance obligations, taking us well into seven-figure territory.

Yet the metric I value most is our 70 percent repeat purchase rate.

In the marketplace business, a high repeat rate is the ultimate "truth serum." It tells us that our customers are not just trying us out – they are relying on us. It is far more profitable, and far more sustainable, to deeply serve a loyal base than to constantly chase new, one-off transactions. We are building for "owner-earnings" over the next decade, not just for a headline in the next quarter.

Looking ahead, we see three primary engines driving our long-term value:

• • A Widening Moat: As more national procurement agencies and global buyers see our track record, our competitive edge sharpens. In business, reputation is a slow-growing tree, but once rooted, hard to topple.
  • The Shift Toward Sovereignty: Governments are increasingly demanding models that deliver more value for less money. We are positioned directly in the path of this structural shift.
  • The Data Compound: Every transaction provides us with deeper visibility into procurement patterns. This data does not just help us today; it makes the platform smarter and more indispensable for every year that follows.

We will continue to manage Axmed with the mindset of an owner who intends to hold the business forever. That means we will sometimes sacrifice a short-term "win" if it protects the long-term integrity of our platform or the trust of our users.

A Change in the Funding Weather

The global health financing landscape shifted materially this year. After a prolonged period of relative liquidity, 2025 brought tighter capital conditions across many growth-market ecosystems. In several cases, funding did not simply become more selective, it became constrained.

In this environment, disciplined capital deployment is not optional but foundational to continuity and impact. Lean periods have a clarifying effect. When funding is less constrained, systems can absorb inefficiencies: fragmented procurement, inflated logistics layers, and redundant intermediaries. When resources tighten, those same inefficiencies directly limit patient access.

This shift has introduced a necessary level of rigor across the sector. It has distinguished short-term, subsidy-dependent models from those built on structural efficiency and long-term viability. 

For Axmed, the environment has reinforced the relevance of our model. While some organizations scaled around temporary funding conditions, we focused on building infrastructure designed to permanently lower the cost of accessing quality medicines.

We have leaned into this discipline by intensifying our focus on operational precision, capital efficiency, and measurable value creation for partners. By enabling buyers to stretch constrained budgets further, we demonstrate that sustainable impact does not come from episodic funding cycles. It comes from systematically reducing the underlying cost and friction of delivering care.

What Comes Next

The next phase of growth demands a different kind of rigor. Capital must be deployed carefully, governance must remain tight, and ambition must be matched by operational discipline. We see AI not as a shortcut, but as an "impact multiplier" that frees our teams to focus on work that requires human judgment. 

Scaling access to medicines will not be achieved by any single organization acting alone. It requires manufacturers, funders, and governments to align around long-term outcomes. 

Our role is to build that connective tissue and to do so in a way that is not only durable and transparent, but most importantly, worthy of the trust you have placed in us.

Thank you for standing with us.

Emmanuel Akpakwu Founder & CEO, Axmed