Last week, Nivi and MSD announced a global collaboration to expand HPV disease awareness and cervical cancer prevention beginning in India, Indonesia, and Thailand, delivered through Nivi’s goal-oriented, AI-routing chat platform.
The arrangement may look like a traditional development-sector initiative. The product, our askNivi chat platform, is free on WhatsApp and other popular messaging channels, and the money comes from an organizational payer, not individual end users.
In many of the markets where we work, charging consumers puts friction exactly where you don’t want it, so when we started Nivi almost ten years ago we built a B2B2C model instead. Yet from a user’s seat, it can resemble any donor-funded project.
Where it differs is in the incentives.
Aligning interests with a sustainable business model, affordable for local institutional buyers, is where we are betting more global health initiatives are headed.
What Pharma Manufacturers Are Buying
MSD is not donating to us. They are paying for outcomes delivered on a reusable technology stack that can re-engage our growing user base.
- MSD is aiming to expand awareness and access to cervical cancer prevention.
- We name no brands and run no advertising
The messaging is vetted content to spark awareness, strengthen motivation, and route to care, cost-efficiently converting latent demand. This is meeting individuals where they are, recognizing their motivations as well as their barriers and supporting them on their health priorities.
Those moments are where we see commercial value aligning with public health priorities.
Clearly priced outcomes give a signal that a payer can act on. This is not only a private sector dynamic; there is a well developed literature showing how and why governments use results-based contracting for the same reason.
What Nivi provides is one channel that carries many health journeys for the same people. Individualized health journeys at scale and scope.
One Relationship, Many Health Journeys
Across our markets we have engaged 2.5 million people, who opted in, and whom we can return to over time. Someone who first comes to us about contraception can later be reached about cervical cancer prevention or routine immunization or HIV PrEP.
We are not rebuilding the audience for each new payer or health area. This allows multiple buyers to use the same channel, which drives down cost. Market development for one buyer, public health reach for another, on the same standing relationship between Nivi and the populations we serve.
Aligning Incentives
Individuals are unique, with a range of motivations and abilities, and for some of them a public sector provider is the best fit. MSD values commercial demand for cervical cancer prevention, while that same demand also gives purpose to public services. The opportunity we see is to serve both the private and public sectors.
Kevin Starr argued in SSIR that Big Aid is over, and that anything built to scale with an African government as a buyer has to hit one number: the marginal cost per beneficiary if the government delivered it.
For solutions like Nivi, the same economics that led a commercial payer to buy outcomes are what will put the price within a ministry of health’s reach.
AI Makes It Effective
This also works because of how the AI behaves: mass personalization with hard guardrails.
We deployed scripted, goal-oriented journeys. But we encourage individuals to ask questions naturally, and then use AI to route the individual to the next conversational bubble or snippet of approved, vetted content. The person sees only information that has been reviewed before it reaches them.
We do this today for our customers, who want the reach and responsiveness of AI without the risk that comes with generative systems.
Routing handles most of what people ask.
For the harder, more open-ended questions, we are exploring retrieval-augmented generation (RAG), where the model draws only on an approved knowledge base and sits inside safety systems built to hold it there: clinical and expert review of the content, quality checks on what the system returns, and a way to set aside the questions it should not answer on its own.
The principle holds as we add capability. Nothing reaches a health consumer that has not been vetted.
That is why the same platform can sit with a pharma manufacturer, a ministry of health, and a regulator at once.
Serve at Scale and Scope
With global health funding stalled, the questions are no longer:
- Is a tool is donor-funded or commercial.
- Is it designed for the public or private sector?
- Does it serves PrEP-ready key populations or pregnant women?
The moment calls for general-purpose, multi-issue navigation infrastructure that serves broader swathes of the public. Build the channel once, earn the trust of the people on it, and bring every payer-at-scale on board at once.
Each brings their own priorities, and together they give the platform the scale and scope no single payer could fund alone.
By Ben Bellows, Co-Founder and CBO, Nivi.
