Rebel succeeds with dialysis PPP and the first transaction in Kyrgyz Republic


A new PPP for dialysis in the Kyrgyz Republic has just reached successful commercial and financial close. This is the first PPP deal to be awarded in the country, and the first under its new PPP law. Rebel was transaction advisor for the Ministry of Health and IFC/KfW, working with Dentons and Kalikova & Associates from due diligence, through PPP structuring and procurement, to successful award.

The project is awarded to Fresenius Medical Services, a highly credible international provider. It covers building, equipping and operating dialysis facilities across the country, providing essential dialysis services for 10 years so renal failure patients can live productive lives.

We’re especially proud of this project because of the high social benefits, and having achieved the first successful deal structure signed with a major international firm in this early stage Central Asian market. Having involvement in advanced and emerging markets, deep experience in healthcare, and Rebels who are Russian speakers were essential, together with excellent team work by the firms involved.

The project includes some innovations for dialysis PPP projects. For example, performance is centered on patient outcomes; Peritoneal Dialysis is included to increase access for children and for remote areas; there are smart mechanisms for demand sharing and scalability; kidney transplantation is promoted.

The deal has set the standard for PPP procedures and transaction documents in the Kyrgyz Republic. This will be important for the deals to follow. We are currently transaction advisor for several new PPP projects being prepared in the country.

Rolf Dauskardt,
Barend van Lieshout,
Evija Belanina,