In 2013 private equity investment in Africa rose 130% to $3.3bn, yet African healthcare service operators tell us that finding serious investors is all but impossible. That is reflected in the coupon on a recent bond issue and in the failure of Hygeia, the largest Nigerian private operator and HMO to find a buyer. Why, given that cash payments make up 80% of sales in many countries and many governments are ready to welcome private operators. We spoke to experts at the Africa Healthcare Summit in London.