Structuring and Funding Development Impact Bonds for Health: Nine Lessons from Cameroon and Beyond

Despite the considerable interest in Development Impact Bonds (DIBs), only a few have reached the implementation phase. The lack of publicly available information on DIBs that have failed to come to fruition, as well as the limited documentation on the negotiation processes underlying impact bonds more generally, limits the development community’s ability to address issues in the impact bond market. We use information from stakeholder interviews to describe the design of one DIB (“the cataract bond”) in-depth and use lessons from a range of impact bonds to develop recommendations for potential partners to future DIBs. Lessons from the set of impact bonds reveal a need to reset expectations, particularly around the time and effort needed to develop and market a DIB. In addition, interviewees stressed the need for better data on current investment practices and the importance of leveraging the flexibility of the DIB model.