Racing to save lives

Health care innovations are stuck in the labs some of India’s brightest inventors

Unitus Seed Fund
Published: 28, Sep 2015



Image: Shutterstock

Every day in India, people are going blind, not getting tumours detected, living with treatable chronic pain, not developing their brain cells, losing limbs, and dying while the solutions are stuck in the labs of some of India’s brightest inventors. These challenges are not unique to India, but the magnitude of potential lives to improve or save is. Innovation needs to accelerate, and the pathway from labs to patients needs to be shorter and easier.

Are there really promising innovations in the labs? Yes. As an early-stage venture capital investor in health care, we have had the first-hand opportunity to talk with hundreds of entrepreneurs over the past two years who are working on developing many break-through health care products and services designed to meet the needs of the underserved masses in India. These include better ways of delivering life-saving, life-extending and life-enhancing services in low-resource medical environments such as: Eye-disease screening, anaemia screening, foetal monitoring, diabetes management, cardiac event interventions, early detection of cancer, detecting internal bleeding, detecting untreated STDs, and preventing misdiagnoses galore.

Why are health care innovations stuck in the labs?
Here’s the typical cycle for a health care inventor/entrepreneur. First, they see a need and they identify a promising conceptual solution. They then do some hard science and ultimately work on taking the concept into a prototype. And usually the prototype doesn’t fully work so they have to rework it multiple times. And then they try it with a few patients and find out that it needs further refinement, so it’s back to the lab. And so on. It’s an iterative process.

Iteration requires money (to keep the bills paid for entrepreneur and their support team, patent fees, etc), access to resources (such as equipment for testing, prototyping), access to patients and medical experts, and more. Health care innovation is not cheap.

Where do these resources come from? Savings of the entrepreneur along with generous friends and family only get them so far. They usually need to apply for grants and prizes (long cycles and lots of paperwork). And if they’re lucky, they find a friendly angel investor who will throw in a few lakhs. They may also try to pitch some venture investors, but very few will invest at this formative stage. And then there’s the begging for access to facilities and patients and experts which are all in high demand and are concerned about whether this company is going anywhere. Finally, there is often regulation and certification before things can be sold.

The result is that the entrepreneur can spend 50 percent or even 75 percent of their time pitching multiple people and organisations to provide resources. This delays progress which then requires more money to keep the lights on. A challenging cycle. The result is that many promising innovations get stuck in the lab.

How an innovative cardiac screening solution is emerging from the labs
India has the highest incidence of coronary heart diseases and the lowest number of cardiologists per capita (1 for ~250,000 people). Even if the country’s already-stressed medical schools doubled the number of cardiologists starting to practice in India each year, it would take a very long time to catch up with the per capita ratio in the US which is 25 times that of India.

While running a hospital in Tamil Nadu, successful businessman and entrepreneur Manick Rajendran got an inside view of how many people having chest pains were not getting a cardiac assessment within an hour (the golden hour). There were various social, economic, and cultural issues arising out of a lower trust of the system, expensive screening tests, and conservative attitudes that created barriers to seeking immediate assistance. The result is that the average time to getting to a hospital after a potential heart attack in India is a staggering five hours (if they get there at all!).

Out of this experience, Manick decided to start a new company, iMMi Life, to bring golden hour heart screenings to the masses in India. Today, you don’t purchase an ECG machine unless you have someone who can diagnose the results. With most doctors not trained to expertly read ECGs, this means that you must either have a resident cardiologist or one who visits regularly. The most productive place for cardiologists though is to be situated in tertiary care facilities, not on the front lines of primary health care near the patients. So, ECGs are generally not available near patients, creating a major access barrier to the average India, especially outside major metros.

iMMi Life solves this problem by enabling a technician to capture an ECG reading which is then shared via mobile networks with cardiologists. Cardiologists bring up the ECG images and patient data on their mobile phone/tablet and can often diagnose whether a heart attack has occurred or not within a minute. This information is conveyed to the local clinic and an intervention can take place as needed to stabilise the patient until they can get to a tertiary hospital.

How an innovative partnership helped break the logjam
A diverse group of players, including my firm, have recently set up a collaborative partnership called “StartHealth” to help entrepreneurs like Manick get their promising innovations out of the labs and serve the masses in India. Our early-stage India venture capital firm, Unitus Seed Fund, has partnered with PATH (global leader in commercialising public health solutions in emerging markets), Pfizer (global pharmaceutical firm), Manipal Hospitals (global health care education and operator), and Narayana Health (leading India health care operator). Together, we have brought together pre-investment funding, hands-on access to health care experts, access to leading medical facilities, and high-risk venture capital to help “accelerate” the development and commercialisation of some of the most promising health care technology ideas in India. This “jumpstart” package provides two-plus years of funding and support so that the startup can focus on development and go-to-market operations, rather than on tin-cupping for funds.

This funding and support enables Manick and his team to focus on business execution rather than having to spend lots of time fundraising and securing access to experts and other resources. And the faster Manick can innovate, the faster he and his customers can start saving lives.

More collaborations needed to bring health care innovations out of the labs
There are many more Manicks out there with promising health care innovations that need high risk capital plus expert and specialised support to help them navigate the path towards commercialisation and scaling up.

We need more creative partnerships like the StartHealth collaboration we’re involved in. Collaborations that bring together corporates, academics, investors, governments, philanthropists, scientists, and entrepreneurs are required to bring the health care for all future we envision for India.

-By Dave Richards, Co-Founder and Managing Partner, Unitus Seed Fund

  • B T Maran

    As the risks for life are growing due to logistics issues, work place stress and delay in diagnosis and treatment, Manik's innovations coupled with technology shall reach all with minimal investment in time and money! Best wishes to his team! Prof B T Maran

    on Oct 15, 2015
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