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The Future of Precision Diagnostics | Aldatu Biosciences CEO Iain MacLeod
24 Plays6 months ago
In this episode of The Healthcare Theory, we’re joined by Iain MacLeod, co-founder of Aldatu Biosciences, to explore their groundbreaking work in diagnostics for HIV and emerging diseases.
Aldatu addresses the global challenge of affordable and accessible drug-resistance testing, focusing on resource-limited settings. Iain shares insights on the innovative Panda technology, which enables rapid and accurate detection of resistant strains even in the most variable viruses. We discuss the journey of developing diagnostics like COVID-19 tests, the role of public benefit corporations in social impact, and navigating global healthcare markets. Don’t miss this in-depth discussion on transforming healthcare through innovation in diagnostics.
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Transcript
Introduction to Future of Healthcare Podcast
00:00:00
Speaker
Welcome to the healthcare theory podcast. I'm your host Nikhil Reddy and every week we interview the entrepreneurs and thought leaders behind the future of healthcare care to see what's gone wrong with our system and how we can fix it.
State-of-the-Art Diagnostics at Aldaltu Biosciences
00:00:16
Speaker
On today's episode, we're speaking with Ian from Aldaltu Biosciences. Aldaltu uses state-of-the-art diagnostic technology to make testing kits for COVID-19 and other diseases that can easily be tested for. So thank you so much Ian for coming out today. Super excited to have you and to get into your story.
00:00:36
Speaker
Thanks for having me, Neil. Of course. And I'm super excited
Ian's Academic Journey and Focus on Diagnostics
00:00:39
Speaker
to get into this. And before we get into all Daltu Bio and Sciences and what you guys are doing at the firm, I know you studied biology in undergrad and then worked at Harvard as a researcher and professor. So um could you lead us to what this fascination of diagnostics was for you and what brought you to the space? I guess it was an unintentional journey. So as you said, I did my undergraduate in virology at the University of Glasgow.
00:01:06
Speaker
did my PhD in virology at Cambridge in England. And I wasn't entirely sure if I wanted to be a virologist. And my PhD was science for the sake of science. It didn't really have any health care benefits. And so I kind of fallen out of love with virology. But this one year post-doc became available at the Harvard School of Public Health. And that was to work on HIV drug resistance in Botswana. And so working primarily with clinicians um really at the interface of science and you know healthcare care delivery.
00:01:41
Speaker
um So that was back in 2008, came for that one year postdoc. Now 16 years later, I ended up staying for a second year. And then the third year my postdoc has been in Botswana, the Botswana Harvard East Institute chip there. um And while I was there, that's kind of when I started to fall in love with diagnostics, realizing that we were paying a lot of attention to treatment and prevention of HIV, but very limited attention to diagnostics, particularly around HIV drug resistance. Okay, that makes a lot of sense, yeah. And can you kind of, what was the experience like in Butzewand? I can imagine. It's a very different environment, you can work hands-on and see how you're making an impact and what kind of happened there.
00:02:27
Speaker
Yeah, it was really the first time that I got to experience where, you know, my work in the lab had direct clinical benefits and kind of health care policy benefits, as well as working on HIV drug resistance. I was working on human human papillomavirus, which is the cause of cervical cancer in women. And this is in 2010 when the Botswana Ministry of Health that were trying to determine whether or not The HPV vaccine, at the type called Gardasil, should be implemented in the country. So myself, along with a summer student from from Harvard, we worked to look at the the prevalence of HPV in HIV-infected women in Botswana. We found it was highly prevalent. We found that the types of HPV you get in Botswana would be covered by the vaccine. And you know it really helped the the government inform the decision about you know when and how to implement.
Inspiration Behind Panda Diagnostic Technology
00:03:23
Speaker
garous so So yeah, for me, that was kind of like when I fell in love with virology all over again. Yeah, it must have been nice they actually seeing the impact in real time. And virology is kind of a nuanced space, right? you have like And then diagnostics, of course, too. I mean, what kind of led to that? like What kind of led to like a starting Aldal, too? Was it the work you saw in Botswana, or was it kind of later on, this later years, more recently?
00:03:48
Speaker
Yeah, so while I was working in Botswana, I was working with a physician called Christopher Rowley, who's at the Beth Israel here in Boston. And he had a study on transmitting drug resistance. And what that is, is when someone becomes infected with HIV, they can become infected with a drug resistant strain. So HIV drug resistance is a lot like antibiotic resistance. It makes the drugs that they're receiving effective.
00:04:15
Speaker
And the population you look at for transmitted drug resistance is young pregnant women, as they are the population most likely to be recently infected with HIV. And so one of the great um successes of HIV treatment and prevention in the last but over a decade now was something we call PMTCT, the Prevention of Mother to Child Transmission.
00:04:42
Speaker
And what that is, is if you put a woman on antiretroviral drugs to treat her HIV, she will completely suppress her viral load and she won't pass on HIV to her newborn infant. And so that dramatically decreased the rate of new infections in newly born infants. But what we found in her study was that some of the women actually had resistance to the drugs that they were being given to prevent transmission to their baby.
00:05:10
Speaker
And so only because they were part of our study were these women given different antiretroviral drugs. They suppressed their HIV, they didn't transmit. And you know that made us realize you know there has to be a way to do HIV drug resistance testing better because it wasn't something or it still isn't something that's widely available. um It's not something they do as kind of standard of care.
00:05:34
Speaker
And it was very clear that if these women hadn't been on our study, they would have transmitted to their meatball infants. And so that was kind of the the impetus for coming up with the Panda technology. um Resistance testing uses signer sequencing, you know, the kind of sequencing that happens when you send off a swap to 23RME or anything like that. It's a very antiquated technology. um It takes two to three days to use. It's labor intensive, requires a lot of hands-on time, a lot of specialized training.
00:06:07
Speaker
And that was one of the, uh, and it's expensive. And that was, those are the auto-necks for HIV drug resistance testing. So we wanted something that was quicker, easier to use, more cost-effective. Um, and then, you know, that's when myself and Chris started working on the time to technology. Okay. That makes a lot of sense. And just to clarify for the problem is basically for an HIV treatment, there's some people that may not, it may not work for. So I guess I'll dial two goals to identify who are those people.
00:06:36
Speaker
And of course, I can't provide the framework for a solution. Yeah, so in countries like the US or in in Europe and the UK, if someone's recently diagnosed with HIV, they'll get a resistance test immediately and they'll get personalized tailored treatment based on the resistance profile. In resource imitates countries, particularly in sub-Saharan Africa, there's no there's no personalization of the treatment. there's ah There's a standardized generic first line treatment regimen that everyone goes on.
00:07:08
Speaker
And if that fails, then after a couple of years, they go on a standardized second line regimen. And so everyone kind of cycles through these standardized approaches because that's the most cost effective for the government. They buy the generics on bulk. um And so that's the way we can we can you know really scale up drug treatment for HIV.
00:07:28
Speaker
And so you're looking at 30, $40 per person per year in a country like South Africa, which is great. But before Panda, a resistance test would cost $200. So there was never the cost effectiveness of trying to identify the best treatment for someone. And so it was a hit and miss approach. Let's put people on the same first line regimen.
00:07:52
Speaker
We'll wait to see if they get better, if the viral load goes down, if it doesn't. And this is over the space of a couple of years. We'll put them on a second regimen. That kind of pattern, you know, goes on until someone's, you know, the right treatment regimen is identified for someone. But what that means is that people are, you know, sick for a long time.
00:08:11
Speaker
They have an increased risk of transmitting HIV to others because they're not on a suppressive treatment regimen.
Aldaltu's Social Impact and Public Benefit Corporation Status
00:08:16
Speaker
And so even though we know in resource rich countries like Ireland that doing resistance testing is the best treatment option for an individual and resource limited to countries resistance testing was was out of reach. It was too inaccessible and unaffordable.
00:08:33
Speaker
Okay. And did the U.S. like say back before drug resistant like HIV and these type of issues were like as prevalent or as well known. Did the U.S. also have this issue where like there wasn't as much identification of drug resistant HIV or there was the funding in the U.S. enough to kind of overcome this issue and they've always had a good system in place.
00:08:54
Speaker
the The funding has been enough and that's because the the the drugs are so expensive in the US and you know usually covered in the most part by insurance or by the government in some way, shape or form. The resistance test here is still only $200 or $300.
00:09:10
Speaker
You're talking thousands upon thousands upon thousands per year in treatment that insurance companies have to cover. so The cost incentive is there for them to do a resistance test first because they don't want to waste thousands of dollars on the on the wrong drugs.
00:09:23
Speaker
and um We've known from you know very, very early days in the HIV epidemic that drug resistance arises very quickly with HIV. And that's why HIV treatment is usually a cocktail of three drugs. um Any fear and the virus can break through with resistance. And so we know from the early days, if you put someone on one drug or two drugs, resistance develops quite quickly, but three drugs is enough to keep someone suppressed.
00:09:52
Speaker
Okay, that makes sense. Yeah, I guess like insurers love the ROI, seeing that they can save money. And I know you guys. Exactly. Yeah, right. So I guess that's that makes sense. And now you guys like, you guys, ah I mean, one thing I was talking on the show is being mission driven is great. I think a lot of people in health care like health care is a hard space to be in. So I know you guys like a public benefit company or corporation. And can you kind of like explain like what that is? And why you guys decided to move that route? And I mean, how's that affected your operation so far?
00:10:19
Speaker
Yeah, so we were founded in 2014 to commercialize the Panda technology. And so we were, myself and my co-founder, David Reiser, we were initially a standards for profit, C-corporation. um And we are almost exclusively funded by grants from the NIH to do our work. um But in the you know early years of all data, we were looking for investment. And and David and I went to we We did the rounds of the VC circuits, particularly out of the West Coast, actually. And you know one one comment that kind of has burned in my brain is we had our presentation, we're pitching. you know There's this massive population of people living with HIV in sub-Saharan Africa. They're not getting the the treatment they need, the testing they need. Even though our testing is affordable, at scale, it's massively profitable for a company like ourselves. And the comment we got from someone at the end of the presentation was,
00:11:19
Speaker
HIV is still a problem. you know I thought we dealt with that. you know A lot of people we were speaking to were so US-centric. um and you know As soon as you open your mouth and you mention global health, you know people who are looking for that large return on their investment, they turn off. and so we We got a program el related investment from the Charles Hood Foundation, which is based in Massachusetts. They're primarily a choke children's health foundation.
00:11:48
Speaker
um And they were looking for a social impact investment. And we're working with John Parker at the Hood Foundation. um And what we realized was that by becoming a public benefit corporation, that would be a kind of signal to social impact investors that we are, you know, dedicated to the work that we do. And so when we became a public benefit corporation, we changed our charter.
00:12:15
Speaker
And so the company charter states that as well as, you know, the the priority isn't just to maximize shareholder returns, it's also to ensure that diagnostics are available to everyone who needs them. And so moving forward, if our data is ever acquired, you know, people are held by that same standard. um Shareholder profits aren't the number one priority, they're on parity with ensuring that everyone receives access to the diagnostics that they need.
NIH Funding and Early COVID-19 Testing Success
00:12:45
Speaker
And so that was you know really the the driver for becoming a public benefit corporation, kind of sending the right signal to the people we wanted to attract. Okay. And that's great because I think it's good to hear that important technology like this isn't it behind like a paywall of like being cashflow positive and like not having too much cash for it and all that kind of VC stuff. um Has it kind of impacted your growth so far? Or do you think like being like having these social impact investors
00:13:11
Speaker
has enabled you to go and still develop the Panda technology and take it to where you want to go? Yeah, so we've we've been very fortunate on a number of fronts. The first is the the amount of money that we've received from the National Institute of Health, through the National Institute of Allergy and Infectious Disease. That's a number of grants and contracts to develop HIV drug resistance testing for different treatment treatment regimens in sub-Saharan Africa.
00:13:39
Speaker
After that, we got funding for Lassa fever, which is a viral hemorrhagic fever, much like Ebola. In fact, it was just in the news yesterday. Someone died from Lassa fever in Iowa. It was an important case. And then we moved on to another viral hemorrhagic fever, finally in Congo, hemorrhagic fever. And then we're recently Ebola and Marburg. So we focus very heavily on you know, diagnostics that are needed in resource 70 countries, but also very specialized diagnostics for your something that you're not likely to get in the US. And so that's been able, that's allowed us to attract a lot of funding from the NIH. And thankfully, the NIH
00:14:21
Speaker
They have this mechanism called SDIRs, small business and innovation and research grants, specifically for small businesses. and The and NIH will fund our research, but they'll also fund the commercial development. So, having you know looking into um our marketing strategy, scale-up or manufacturing. That's allowed us to kind of not have to worry too much about going looking for external funding for a number of years. um And then you mentioned at the beginning of the show, we had developed a COVID test. And on that too, developed one of the first COVID tests in March 18th of 2020. It was the first test that was available in Massachusetts. And so we partnered with the Beth Israel Hospital. We launched it there. And our test was
00:15:13
Speaker
the the only tester, the most frequently used test in the state for the first two or three months of the pandemic. And so that allowed Eldar to actually become profit ah generating for the first time. And so we were able to take those profits and reinvest them back into the company, rather than having to go looking for more private investment.
Panda's Innovative PCR Approach
00:15:33
Speaker
um So that that that's kept us afloat and on track for a number of years. um We are getting to the point now where we've commercialized a number of our diagnostics. And so we're going to have to go out looking for some more private investment to move the company forward. Okay. That makes a lot of sense. And I know, I mean,
00:15:55
Speaker
Before we get into like the kind of commercialization of Panda and and on your technology and the applications, i can you explain to the audience that like like like me has a business background like Panda like simple terms and why it's so effective and like like detecting drug resistance strains?
00:16:11
Speaker
Sure. um and This used to be a lot more difficult than it was, but i one of the silver linings of the pandemic so for for our story is that people would become um familiar with the word PCR, you know, everyone, you know, getting their COVID test, they got a PCR test, and then everyone was hearing a lot about COVID variants in the news, like the Omicron variant and the Delta variant.
00:16:37
Speaker
So Panda is based on a technology which is called real-time PCR.
00:16:45
Speaker
And real-time PCR is very good at very sensitive to the detect you know the virus that you're looking for, be it COVID or bacteria. It's not very good at detecting viruses that change a lot, that mutate a lot. So HIV is you know the perfect example of that. One of the reasons we don't have a vaccine for HIV is that its genetic makeup changes very quickly and mutates a lot. And that's what we saw with COVID. That's what these variants were. They were mutations of the virus.
00:17:21
Speaker
And when the virus mutates and its you know genetic sequence changes, um that can lead to a diagnostic test failing because it can no longer detect that part of the virus genetic sequence that it was looking for because the sequence has changed. um And so real-time PCR up until Panda It was never possible to use for HIV drug resistance testing because HIV is so variable. So before Panda, if you try to use real-time PCR, you get a false negative result 30% of the time. So resistance would be present, but the test would say it's not there. And for a clinical diagnostic, you can't have one in three tests giving the wrong result.
00:18:05
Speaker
So um Panda is um when we published the paper, we called it intentional violations of real time PCR. People have been designing real time PCR tests the exact same way for 30 years. But um molecular biology has changed a lot in 30 years. And with Panda,
00:18:26
Speaker
um We kind of broke all the existing rules and we came up with a way to compensate for mutations that you get in these viruses. So our Panda technology can strip out or change or adapt um the new mutations that have appeared. It can change the virus back to its old sequence and then the test can detect it.
00:18:53
Speaker
um so So with our Lassa fever test, all of our viral hemorrhagic fever tests, Ebola, Marburg, um all of the existing tests for those diseases as well have a high false negative rate because these are viruses that change a lot. There's a lot of variance. So Panda is the only technology is able to detect all variants of a virus that you're looking for. So maybe a little more science heavy thing than you expected, but yeah at the end of the day, it's a new way of doing an old an old type of testing.
00:19:32
Speaker
That makes a lot of sense. I think COVID definitely introduced like this idea of different strands, which I guess was, to me, at least confusing at first. And can you talk about it? We know you guys work with, or started with HIV, and now you guys are in different areas, even COVID now. I mean, what is like the iteration? How much time does it take to like kind of tailor the pandemic technology to a different disease or issue? Because I can imagine years, months, maybe weeks. I have no idea, but that sounds interesting.
00:20:00
Speaker
It's a very good question. and um so It really depends on the complexity of the virus.
Adapting to New Viruses with Flexibility
00:20:07
Speaker
With HIV, if we're looking for a new drug resistance mutation, we can design those testing regions within six to eight weeks. We have that down to a fine hour.
00:20:20
Speaker
um For a new virus that we're working on, like I have worked on like LASA or Ebola, you're looking about six to nine months to do the, well, I mean, it only takes a few weeks to do the design, but it's a lot of lab work um to to validate the design.
00:20:39
Speaker
And then after that, we have to go through very rigorous analytical testing to show um you know for regulatory bodies like the the FDA or regulatory bodies in African countries that our test is very sensitive, very specific.
00:20:56
Speaker
Um, our COVID test was somewhat of an outlier. We were able to design it and validate it within 18 days. Um, yeah, so we, we, it was kind of a test for the company. We're a small company and there's only 12 of us and it was, uh,
00:21:14
Speaker
kind of like, okay, this this virus has appeared. um There was very limited information on the genetic sequences of the viruses. you know For example, I think with HIV, I have access to about 1.3 million sequences from across decades. For COVID, when we did the design in March, well, February 2020, we had access to 126 sequences. So um COVID back then wasn't There was a lot of variability. There wasn't a lot of difficulty in designing it. So with very new viruses, and by that, I mean, like we've never heard of them before. We've designed a test within three to four weeks. um For those with a lot of genetic information, ah you know, three to four months.
00:22:05
Speaker
Okay, that makes sense. When I said weeks there, I didn't expect it to actually be weeks. So that's a pretty great thing. I can imagine, I mean, COVID changed a lot of things for you guys, because there's this huge demand in the US, looks like high paying consumers, and even especially abroad too. I mean, can you kind of walk us through what kind of happened there? And, and now that COVID's kind of, I know there's still a need for tests, but it's kind of trailed off a bit. Like, how's it impacted you guys since then?
00:22:32
Speaker
it was It was an interesting journey for for sure. um And kind of like my work in Botswana, it was it was great to be able to see our work translated so quickly to help you know the local community. Azaldatu had always been a company that focused on diagnostics outside of the US. This was our first time working in the US. And we were very lucky and grateful that the Death Israel Hospital were looking to take a chance on us. estate be had Several staff members off sick with, you know, unknown respiratory illnesses, every single isolation room they had in the hospital was in use because again, people were sick with unknown respiratory illnesses and they needed a test very quickly.
Pivoting for COVID-19 Testing in the US and Africa
00:23:19
Speaker
And they had the equipment in place for testing from Abbott. But as a you of big global manufacturer, Abbott intended to release their COVID test to all of their customers at once, you know kind of en masse. They couldn't really favor anyone because everyone needed it. And they weren't looking to make they weren't able to make their test available until April of 2020.
00:23:47
Speaker
um So, through Chris Riley, who was the co-inventor of the Panda Technology that I worked with at the Harvard School of Public Health, he's an infectious disease clinician at the Beth Israel and, you know, they they took a chance on us and we're very grateful and it worked out very well because Within you know two days of validating it in their lab, they were able to clear their backlog, and they were doing thousands of tests per week. um And so that was, we were able to help them for the first couple of months until Abbott came along. And what we found was that you know every time we decreased the price of our test, Abbott would decrease theirs further. And we very quickly got pushed out by the big guys, which we knew was going to happen.
00:24:34
Speaker
no Hospitals have these contracts in places with companies like Abbott, with Roche. um And so what we ended up pivoting to was working with smaller testing labs that weren't really getting the attention from the big biotech companies that did have the testing volume. So we worked with a pathology lab down in Virginia to get them set up with our COVID test.
00:25:00
Speaker
um
00:25:02
Speaker
a lab testing firm out in California, who were actually doing testing for the UC system, UC colleges, yep. And then we ended up sending our tests to six different countries in Africa because, you know, as a kind of tale as old as time, you know, Africa was the last place that these diagnostic companies, these big diagnostic companies were we're going to be looking. So we were able to get a testing set up and Cote d'Ivoire, Uganda, Nigeria, Botswana, Senegal, and another country that I've forgotten. um you know but that that was that was That was great for us. you know we We started with the big hospital systems here. We were able to help the local community um and then kind of go back to our roots almost and and help those more um neglected resource-limited countries.
00:25:56
Speaker
Okay, that's a really interesting story, kind of like ah a circle there. I guess those pros and cons, because I mean, I know with you guys, like being a smaller team, and you guys are more nimble, I assume like, yeah, I'd be would not be to like shift their model that quickly and work with different labs like that. But on the flip side, of course, like you kind of have less resources just because of the nature of being smaller and having less like,
00:26:17
Speaker
ah pricing power? I mean, how do you guys compete with these larger diagnostic companies or medical companies that have like billions of dollars to kind of do whatever they want to do? Yeah, it was, it was, you know, like you said, it was great. We were able to pivot it so quickly because at the time, well towards the end of 2019, we had just finished our first e clinical evaluation of a drug resistance test.
00:26:42
Speaker
with the South African government. So we've actually gone all the way from R and&D to product development. um And so we actually had everything in house to enable us to put together kits, instructions for use. We actually had that experience.
00:26:56
Speaker
um And by that point, the company had been operationable operations operational for almost five years. um And so like you said, we could pivot very, very quickly. you know A small team, we could have someone dedicated to putting together the instruction manual, someone you know ah doing the kitting and so forth. And it was great to see the team adapt so quickly.
00:27:20
Speaker
In terms of pricing, yeah, we we saw that are having to push down our pricing quite quickly because we didn't have the volume. But from our perspective, you know any kit sales, any testing was a win for us because like you know for being a a public benefit corporation, we we balance both profit and access to diagnostics. And in order to do that, um All of our diagnostic products are designed so that most of the components within the each diagnostic product is the same. So all that changes really is the the Panda, which is the detection regions. All of the other components that you need for a Panda test remain the same. So we can if we find that we need more LASA tests this quarter, then we do Ebola tests.
00:28:14
Speaker
we can just shift to creating different products with the same material. So we minimize are our waste. So even over even though we're making all of these COVID kits, if we weren't able to sell them, we could reuse a lot of the product components and
Navigating Regulatory Challenges with Market Access Africa
00:28:32
Speaker
other kits. So are um because we're and focusing on affordable diagnostics,
00:28:39
Speaker
our cost of goods are very low. And so we were able to continue to decrease the price of our COVID test. But it is hard to compete with like the big diagnostic companies. Yeah, that makes sense. It's good to hear that the reagents have like some at least fluidity and flexibility because it does save money so you don't have to worry about like managing inventory as much. And I can imagine like going abroad, like you have so many different like challenges with like selling these goods abroad because they're like regulatory challenges, like set like ah implementation of working with these governments. like how What was that journey like working with these rural, not rural, sorry, ah foreign governments? And also, like did you guys have any partners or organizations that helped you along the way? Yeah, so the HIV drug resistance, because I started in that field as an academic, I had a lot of connections with people doing resistance testing in Botswana, in South Africa, and South Africa is our largest market.
00:29:35
Speaker
um And so working with the government labs there, to to an extent, they're kind of staffed by academics as well. There's a lot of overlap in that community. um And so before we even started the company, we had the the connections there to work with the National Health Lab services in South Africa.
00:29:53
Speaker
um Outside of Southern Africa, so for a LASA test, for example, Nigeria is our biggest market. um And LASA fever is seasonal um and it's endemic to Western Africa. So there are outbreaks um the first kind of quarter of each year. But I had no experience working in Nigeria. So we partnered with an organization based in Geneva called Market Access Africa.
00:30:21
Speaker
And this is a consulting firm that is staffed by um primarily African people who have worked in the past with the WHO, the Clinton Foundation, the Global Fund. um And their goal is to enable small companies like El Datu to get market access in the the markets they need. So working with Market Access Africa in Nigeria, they facilitated facilitat are clinical evaluation of our test in Nigeria.
00:30:54
Speaker
And so certainly in Nigeria, we've never actually had to directly interact with the government. They do it on our behalf. They have someone in country. They have the connections, the experience. And that's kind of ideal because Market Access Africa in you know in the space of six months last year achieved more than we could have done within you know three years, just being abroad, being an American company.
00:31:18
Speaker
um It comes with you know some downsides, particularly when you're trying to get the message across to people that you're you're making affordable diagnostics, you're trying to help. But sometimes people just see you as a for-profit company with only one goal in mind. So Market Access Africa, you know we've now worked with them in Ghana, Sierra Leone, um Liberia, and so they've been instrumental in helping us push it along.
00:31:47
Speaker
Okay. So they kind of that's ah that's awesome. Because I can imagine, like even if you have a great product and a great mission, that doesn't always translate very easily. I mean, especially if you have like don't have the huge resources these larger corporations have. Are you guys planning to go into any other countries in Africa or even Asia or just trying to stay within that realm for now and grow there? Yeah. So lastly, a few verbals, certainly. um be limited to to West Africa at the moment. And perhaps um there is the hope that we can use our LASA fever test in the US s with the CDC and perhaps also the UK government because they also do LASA testing. If someone is traveling, just like we saw in Iowa, if someone travels back from Africa and they have what they call undifferentiated febrile illness, then what that means is someone shows up, we have a fever, they're very ill, but it could be
00:32:40
Speaker
It could be anything, you know, it could be COVID, it could be malaria, it could be TB, it could be HIV, it could be Ebola.
Expansion Plans for Tailored Diagnostics
00:32:45
Speaker
So they do a whole panel of tests. So there is lots of testing in the US, there is lots of testing in Europe. um And so we do hope to work with the governments and in those countries. um For our Crimean Congo hemorrhagic fever, which is probably something no one's ever heard of, it's actually the most geographically widespread tick-borne virus in the world.
00:33:09
Speaker
And so as the name kind of suggests, it starts in the the Congo and moves all the way through the Middle East um into into the Crimea. But because of climate change, um it's actually moving further north. So it's now being detected in southern Spain and parts of France. So it has a fatality rate of anywhere between 30 and 50%.
00:33:35
Speaker
um and some of the places that have it the most prevalent are Turkey and the Middle East. And so you'll actually find large outbreaks of Crimean Congo hemorrhagic fever because the ticks live on cattle. And when cattle is slaughtered for particular religious events, there's a lot of blood exposure. And then there's these very large outbreaks. um So with Crimean Congo, um or shift our focus will shift a little. and We'll actually be looking at the Middle East and Turkey a lot more.
00:34:09
Speaker
and perhaps, you know, some of those Mediterranean countries as well. So there's a kind of different region for each of our tests. Ebola and Marburg is going to be more Eastern Africa. And then as we develop more such for like, dengue, we'll start to move into into Asia as well.
00:34:27
Speaker
Okay, that makes sense. It's interesting though to see like these diseases and like viruses change over time. But of course, like all deltoid and the industries as a whole is also like innovating very quickly. I'm just like, I guess, a decade ago, like this is like just starting to commercialize. And I'm just curious, like within like all deltoid or diagnostics as a whole, is there anything like trend trends or changes that you're excited for, or kind of like working on or looking to see?
00:34:54
Speaker
Yeah, that's a good question. You know, I will say that I have been surprised by how slow progress could b And you know if anyone listening to your podcast is thinking about starting a company, my my advice would be start now because it's going to take much longer than you expect. um you know Progress is surprisingly slow. I thought 10 years after we launched the company that Panda might be obsolete by by a new technology. um But there doesn't seem to be anything that's kind of in development pipelines that I know of.
00:35:31
Speaker
that's able to deal with these variable viruses the same way that Panda can. you know There's CRISPR-based diagnostics that are you know it can be put on paper and deployed very rapidly and in very resource-limited, very resource-constrained labs, but they still have the same issue of not being able to detect all strains of a virus. But we're trying to work on new new iterations of Panda. um Because right now, when people do testing with Panda in African labs, they do them in a centralized lab. There's usually only one or two labs in the country that will do the testing because you need high level containment areas to handle blood samples that have Lassa fever or Ebola. But there's ah a real hope and a push to decentralize that.
00:36:26
Speaker
bring testing closer to point of care so that as soon as someone shows up at a rural clinic or a rural hospital, they can get tested very quickly for these thyroid hemorrhoid
Motivation and Industry Progress Despite Challenges
00:36:36
Speaker
fevers. So it is our long-term goal to get a point of care version of Panda developed, but we need to get the current version fully deployed first. Okay. That makes sense. That's going to be exciting though. And I'm surprised though, because I think so some of the guests we've had on I'm pretty varied across the board. We've had like guests and like consumer, like med tech. We've had an BCI, brain computer interface. Like the innov like the product cycles are so quick, it innovates so quick. And then biotech is kind of in the middle, but it's interesting. yeah I guess virology and like vaccine drug development or that sorry, um diagnostics is a bit slower. i For some reason thought it kind of be at that same pace.
00:37:16
Speaker
Yeah, certainly in the U.S., it moves quickly. We saw that from the COVID pandemic. I lost count of how many COVID tests there were. When we had the MPOCs outbreak in the summer of 2023. Yeah. Um, Audato developed an MPOCs test and I looked it up online and I think there were over a hundred, or maybe over 150 tests available in the U.S. within a few weeks for MPOCs. Yeah. Um,
00:37:42
Speaker
But again, those tests are just not made available in resource-limited countries. um And so that's, you know, I was just in Botswana a few weeks ago, and there's been the large MPOCs or continued MPOCs outbreak in Central Africa that's, you know, spreading to children and actually working its way down the continent. And in Botswana, they were looking, you know, asked us if we had an MPOC test available because they wanted to be ready for testing. They wanted to be proactive about having having something in place But um I found that people can be resistant to change. HIV drug resistance testing. um People have it available in countries like South Africa. And even though it's expensive and cumbersome, and people are excited about Panda, it's been a bit of an arduous process to really get
00:38:38
Speaker
people to to implement it, um which is which is surprising. um was just you know Some people can be yeah resistant to changing even though they ask for something better, they know it's better, they know it's less expensive. um there's ah The Hurdo, I guess, is like a policy and politics Hurdo. Once you do all your diagnostic development and you get to the end and you want to sell it to these these governments,
00:39:02
Speaker
you know, you need to take that final step and convince the policymakers um that this is this is the best, best thing for them. Yeah, it's something a complex problem, a difficult one. And I'm just kind of the last question we have for today is like, what kind of keeps you motivated in that space? I kind of keep talking to this problem. There's like so many different things I have to deal with and like solve. I mean, what what kind of makes you want to stay here?
00:39:28
Speaker
I would say it's You know, knowing at the end of the day, no matter how long it's going to take, that we will help people and we have helped people. um And that, you know, i've if we were ever to stop doing what we're doing, no one's going to step in to to fill the vacuum, you know. um And I'd love it if there were more people if we had, you know, more competitors in HIV drug resistance.
00:39:53
Speaker
if we had competitors and of all of our viral hemorrhagic fevers, because it would push us forward, it would push them, it'd probably get us deployed even faster, but it's just an area that continues to be overlooked. And so I think that's what keeps the company going. and Our company mission, our determination to ensure that everyone does have access to affordable and accurate diagnostics, no matter where they are in the world.
00:40:20
Speaker
Yeah, I think that's great. I've definitely never heard like, I love it if you had more competitors, but it's said it's like what I thought his mission is. Yeah. Yeah, it's you know, the WHO have a target product profile for HIV drug resistance testing. And um they have this weird um They're not so much of a policy, maybe of an attitude at the WHO where they don't want to engage with all data because they'll say that, you know, if we engage with all data to help develop this target product profile, we'll need to engage with other HIV drug resistance testing or manufacturers. And I'm like, I would love that because if you can find other testing manufacturers, then we can all have this conversation together because, you know, it it really should be a conversation between
00:41:12
Speaker
the policy makers and what they want to see in a test and what we believe is capable in a test. Bringing that together is a group, but and they just have this attitude, you're a for-profit company, we we can't engage with you. That's kind of where my comment about wanting more competitors comes from. you know so we can We can have these conversations so that know we're not and say where there's There's a lot of guidance from international organizations about about what they want. We want to design the best test possible. And you know that only comes from having conversations with the people who are going to implement them and other
Conclusion and Where to Find More Content
00:41:49
Speaker
people in the field. So the more conversations we can have with competitors, with international organizations, the better our tests are going to be.
00:41:58
Speaker
Yeah, that makes sense. That's interesting. and i think like as I know it's definitely complicated to kind of like deal with all this in WHO, but it's as long as you're making a difference every day, which you guys are, and I think it's awesome the work you guys have done.
00:42:11
Speaker
And um I mean, I just wanted to say, I mean, this kind of, I mean, this will probably wrap up our episode. And I want to thank you so much for coming on today, Ian. I think this was great. And I think it's awesome to see you guys are like really actually represent that mission driven thing. I mean, approach you find in healthcare, care but super excited to see where things would go with all Delta, but thanks for coming in today. Thank you very much. migu I appreciate it.
00:42:33
Speaker
Thanks for listening to The Healthcare Theory. Every Tuesday, expect a new episode on the platform of your choice. You can find us on Spotify, Apple Music, YouTube, any streaming platform you can imagine. We'll also be posting more short-form educational content on Instagram and TikTok. And if you really want to learn more about what's gone wrong with healthcare care and how you can help, check out our blog at thehealthcaretheory.org. Repeat thehealthcaretheory.org.
00:43:00
Speaker
Again, I appreciate you tuning in and I hope to see you again soon.