Maybe Health Tech Was Never Supposed to Look Like Fintech

Since around 2022, I’ve heard some version of the same line at nearly every health-tech gathering: health is the next fintech.

It surfaced again this year at the Africa HealthTech Summit, where organizers put a hard number next to the optimism. Africa has ten technology unicorns. Nine are in fintech. Health has none.

Four years is long enough to ask a harder question than “When?”

Does the absence of an African health-tech unicorn suggest that there should not be one, that the sector’s economics simply do not produce billion-dollar outcomes in the way payments and lending do? Or is the problem structural? Perhaps health tech never developed the deal flow that fintech did: the volume and consistency of transactions that help investors learn how to price a sector.

The global data suggests that neither explanation is entirely right. Health tech can produce unicorns. It simply does not produce them the way fintech does, and the difference between the two sectors is more instructive than either easy answer.

What the Global Numbers Actually Show

In 2025, digital health funding reached $14.2 billion, a 35% increase from 2024. The year also produced 15 new unicorns, up from six the year before. On paper, the sector appeared to be moving again.

But underneath those figures, Rock Health described “a tale of two markets.” Twenty-six mega-deals absorbed 42% of all capital. Everyone else divided what remained. Meanwhile, more than 600 companies that last raised funding in 2021 or 2022 remained unfunded and unexited, a holding pattern that rarely ends well.

raised in 2025, up 35%

$14.2B

new unicorns, up from six

15

of capital went to 26 mega-deals

42%

companies stuck since their 2021 or 2022 round

600+

By the first quarter of 2026, the pattern had become even sharper. The number of deals fell year over year even as total investment rose, concentrating capital in fewer, larger, later-stage rounds.

Even companies that make it through the funding cycle often struggle when the market tests their ability to commercialize.

Hinge Health went public in 2025 at a valuation of roughly $3 billion, about half its $6.2 billion private valuation in 2021. Thirty Madison was acquired at around half its previous billion-dollar valuation.

These are not failed companies. They are funded, operational, revenue-generating businesses. Yet their valuations fell when public markets or acquirers examined their commercial performance more closely.

That is the pattern worth naming. Health tech’s hardest proof point is not building a product or even raising capital. It is demonstrating that real revenue can justify the valuation. A meaningful share of well-capitalized companies are stumbling at that stage, not at the earlier ones.

The hardest proof point is not building a product or even raising capital. It is demonstrating that real revenue can justify the valuation.

Why Fintech Cleared the Bar Faster

Fintech unicorns did not avoid the commercialization test. They often passed it faster because the test itself was simpler.

A payments or lending company typically has a take rate that scales cleanly with transaction volume, one or two primary regulators, and a revenue model that an investor can map in an afternoon.

Health-tech revenue, by contrast, usually flows through an insurer, a government payer, an employer benefits plan, or some combination of the three. Each has its own procurement cycle and requires a different kind of evidence before money moves.

Commercialization is not optional friction that health-tech companies can engineer around. It is the business itself, and proving it takes longer than validating the unit economics of a payments company.

What This Means for Africa’s Ecosystem

In my work at Daya, and across Tuliz and AfyaRekod, this is the distinction I return to whenever a founder or co-investor raises the unicorn question.

The absence of an African health-tech unicorn is not evidence that the continent should stop trying to build one. The global data shows that health-tech unicorns are possible. It also shows that reaching a billion-dollar valuation does not exempt a company from the commercialization test. It may simply postpone that test until an IPO or acquisition.

What Africa lacks is not proof that health tech can scale. It lacks deal volume: enough transactions across enough health-tech categories for investors to develop the pattern recognition they built in fintech over the past decade.

Globally, that pattern recognition exists in an uneven, hard-won form. Investors can now see a bifurcated market, a long tail of stalled companies, and unicorns whose valuations fall when commercial reality catches up with investor expectations.

Africa does not yet have enough health-tech deal flow for a comparable pattern to emerge.

That is the work ahead. It is not about deciding whether health tech deserves a unicorn. It is about creating enough serious attempts at commercialization (funded, operational, and tested against real payers) for the ecosystem to learn what a credible health-tech business looks like before trying to crown one.