On episode 7 of season 3, Cyriac Alappat joined us for a conversation about impact investing. Cyriac is Principal at Cross-Border Impact Ventures (CBIV), a $90 million fund focused on improving women’s and children’s health in developing countries. Before CBIV he managed investments at Grand Challenges Canada (GCC) and helped shape one of the first equity vehicles in global health.
Impact Investing
Traditional venture capital (VC) chases returns; impact VC chases returns and measurable social good. CBIV’s sweet spots are health tech and med tech that:
- Generates strong margins in high-income countries.
- Has viable commercial model in developing countries.
Why Venture Capital Matter to Healthcare
Investing in early-stage health tech and med tech companies is considered risky by traditional sources of capital, such as banks. VC steps in with funding in exchange for equity in the company, betting on companies sometimes with only an idea before they have revenue or clinical data. Cyriac breaks the continuum down like this:
| Stage | Typical Check Size | What Exists | Who Writes It |
|---|---|---|---|
| Angel | $50k–$250k | A big idea & a prototype | Friends, wealthy family members |
| Series A (Canada-style) | $1–5 M | Proof-of-concept + first regulatory talks | Niche VCs, family offices |
| Series B/C (CBIV zone) | $3–10 M | Near-commercial product & traction | Professional VCs |
In other words, VCs help innovators turn science projects into products that improve your health and quality of life.
How CBIV Picks Winners
Cyriac and the CBIV team runs every deal through their due diligence gauntlet:
- Dual-market fit: Can the tech sell in both Canada and India? (developed country and developing country)
- Technology vetting: Show me the data! (e.g. clinical studies)
- Exit math: Delivering 3 – 5x cash return and ~30% internal rate of return within 4 – 7 years.
CBIV also insists on a board or observer seat to make sure that the global-impact promise is alive post-investment.
Geopolitical headwinds for Foreign Aid
Global-health dollars are shifting. U.S. programs like PEPFAR still supply ~53 % of America’s international health spend, the world’s largest single-disease commitment, but future aid looks less certain.1
Result?
Market-driven solutions become even more critical.
CBIV’s thesis: if startups can produce products with lower cost-of-goods sold (COGS) and keep margins, developing nations and their populations can buy rather than beg.
How Success Will Be Measured
Cyriac’s litmus test isn’t just CBIV’s own exit multiples; it’s competition.
“When 20–30 other funds do what we do, global-health VC will have reached its inflection point.”
Cyriac’s call to action is “bring it on”.
Key Takeaways for Founders
- Come with proof, not promises. A Kenyan pilot trumps a PowerPoint map.
- Know your COGS. If your product costs more to build than to sell, investors say “NO”.
- Expect tough term sheet questions. In an exit, how does the VC make money?
- Board chemistry matters. Seasoned directors can save you (or sink you) when clinical trials fail.
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