The Healthcare sector, especially in India, poses unique challenges to startups, thanks to stringent regulations, pocket-friendly treatment expectations and consistent quality standards, pushing an entrepreneur to put on a scientist’s hat, in order to bring out innovations backed by scientific rigor, methodical approach and thorough analysis.
Sooraj Ratnakumar, our next pathbreaker, Scientist-Entrepreneur at Swagene, works with hospitals, NGOs and labs, recommending advanced yet affordable treatments to their patients based on the patient’s specific genetic variations.
Sooraj talks to Shyam Krishnamurthy from The Interview Portal about working in top-notch research labs at the University of Washington, Seattle, EPFL Switzerland, and Cambridge before setting up Swagene as a knowledge sharing lab to provide personalised/precision medicine to patients based on molecular diagnostics.
For students, research is not a degree, nor is entrepreneurship. They are both driven by a thought process to identify and solve problems that havent been solved before.
Sooraj, tell us about your initial years?
I was born in Africa, and raised both in Chennai and Kerala during school and college years.
Apart from living in four countries, USA, UK, Switzerland other than India, I have travelled to about 25 different countries, and love nature, animals, hiking and swimming.
What did you do for graduation/post graduation?
I did my BSc (with Distinction) in Microbiology from University of Madras, India. Driven by interest, I pursued a simultaneous second degree in BA Psychology, Annamalai University, India through distance education.
I then did my MSc (with Distinction) in Molecular Medical Microbiology from University of Nottingham, UK and PhD in Biotechnology from University of Cambridge, UK with full scholarship from Cambridge Trust.
What made you choose such an offbeat, unconventional and unusual career?
Ever since I was 5 years old, I’ve wanted to be a scientist. While I don’t remember much about what led to this fascination, I suppose I’ve always had a very deep interest in science. During high school, I developed a keen interest in Biology and then onwards, I was very driven to become a scientist in the Life Sciences.
How did you plan the steps to get into the career you wanted? Tell us about your career path
During my Bachelor’s, in the holidays, I always attempted to enhance my practical knowledge through industry experience by voluntarily pursuing projects in AIDS research, Cytogenetics, and Diagnostics in laboratories. This was instrumental in my applications for further studies.
Specialising in molecular medical microbiology in my Master’s was a natural progression. It carried a 6-month research project where I worked on the bacteria causing meningitis and worked on its signal transduction and identifying receptors involved in its internalisation into cells.
As a molecular biologist, I’d explored the two biggest avenues in my career-working in the industry briefly, as well as conducting academic research with freedom in the best institutes in the world. Throughout my work, I focused on molecular biology, mainly pertaining to cell signalling and regulation as these were my areas of interest. However, I decided to put an end to my academic journey and explore other opportunities. Then I briefly worked in the pharmaceutical industry and quickly decided that it was not where my passion lay. I have this huge thirst for knowledge and discovery and that’s the reason we set up Swagene as a knowledge sharing lab, spreading awareness on advanced yet affordable and actionable medical options to doctors and the public.
The academic medical community has been overwhelmingly supportive and even encouraging of Swagene accelerating the introduction of the latest clinical advances in the West to India. We are regularly invited to speak at conferences and seminars in Oncology, Reproductive Medicine and Pharma industry, where physicians get to challenge as well as understand the molecular aspects of modern medicine in clinical practice. We have also been invited to sit on Expert Committees and Panels on Oncology.
- IIT Kharagpur, Most Innovative Startup, Empresario, 2016
- IIM Ahmedabad, Masterplan Winner, 2015
- BITS Pilani, Conquest Winner, 2015
- FICCI DST-Lockheed Martin Gold Medal for Innovation, 2015
- CII Startup of the Year, healthcare, 2014
- NASSCOM 10K Startup, 2015
- Schlumberger Cambridge Research Limited UK, scholarship award, 2003
- Hinduja Foundation UK, scholarship award, 2003
- Cambridge Commonwealth Trust, scholarship, 2003
- St John’s College, University of Cambridge UK, scholarship, 2003
- University of Nottingham, Developing Solutions scholarship, 2002
- British Council UK, International student award, 2002
How did you get your first break?
During the later part of my PhD, I went to attend a conference at Princeton University in the USA. I wanted to find a good lab to do postdoctoral research and thought this will be the perfect venue to meet potential employers. There I met and spoke with a few different professors, and one of them said I should meet Prof Ted Young. I had a very good discussion with the Professor, and was immediately offered a position in his lab.
What were the challenges? How did you address them?
R&D is very finance-intensive and has a longer gestation period before seeing returns on investment. Although we work with a jugaad mentality, medical technology has to be foolproof when it gets out of the door; there is no opportunity for a beta version here. This means we’re running a tight ship when it comes to innovation. However, capital funding in India is very short-term and is geared towards growth. Growth can be sustainable only when it is backed by solid R&D, as it is this R&D that will build the moat protecting our growth. Patient and long term capital is non-existent in India, and sustainable growth without solid R&D is non-existent in biotechnology – bridging these is a serious challenge.
Can you explain your current work at Swagene?
There is absolutely no treatment modality in healthcare where 100% of the patients respond uniformly. This is the premise of Personalized medicine, a premise that is well-accepted by almost every medical professional. In other words, for the same condition, different patients respond differently ranging from cure without side-effects to emergency complications.
Genetic advances in science have now shown us that a majority of this diversity can be explained by miniscule genetic variations prevalent among us all. Precision or Personalized medicine is the approach that puts this into practice, whereby people are tested for specific genetic variations and stratified into response types in terms of both efficacy and risk of treatments. The appropriate therapy for that patient is then decided using this information along with other clinical factors. Personalized medicine is thus the culmination of evidence-based medicine.
Our biggest source of support and encouragement are the doctors and patients that use our services. There are numerous doctors that ardently back us because of what we do and how we do it. I’d say it’s their backing that keeps us going every day! For example, we are invited to Tumour Board Meetings to discuss management of cancer patients. We tremendously value our lab and hospital partners that include corporates, private hospitals, NGOs and public hospitals.
In oncology, several drugs, surgical and chemotherapeutic modalities are effective and indicated only in the presence or absence of certain mutations. It is therefore routine practice now to test for these specific mutations based on cancer type before initiating therapy. Our molecular diagnostics offer the highest sensitivity and accuracy enabling early stage detection in cancer leading to higher ‘cure’ rates for what were once thought to be incurable diseases.
How does your work benefit society?
Swagene is foremost a knowledge sharing lab, spreading awareness on advanced yet affordable molecular diagnostics and genetics to doctors and the public. India is a place with more commerce than science, affordability than quality, and therein lies a huge gap. We knew that we can bridge these differences by combining affordable business with quality science. For instance, about 50% of our tests are first-in-market to South Asia, borne out of extensive research into modern clinical trials. Only those biomarkers that have clinching evidence of dramatic improvement in treatment come out of our R&D into the market.
Interestingly, our biggest customers are NGOs and corporate hospitals – two extremes of the spectrum in healthcare. This is very interesting and has happened because top doctors in any setting are willing to recognize the importance and value of our offering and adopt them in their practice. Our customers also include private hospitals, hospital chains, big labs, as well as doctor clinics.
In cardiology and chronic diseases with a high disease burden in South Asia, people undergoing drug therapy or having undergone interventional treatment are still left with life-threatening complications. For instance, patients with hypertension are almost universally taking several drugs to control BP. In all likelihood, only some of those drugs are actually benefiting BP control in the patient, while others come with known long-term side-effects such as diabetes and other conditions. You definitely don’t want more diseases especially when you have a lifelong condition.
Based on your genes, we identify which medication will be most effective in treating your condition while at the same time causing the least side-effects. In other cases we determine which medications will cause severe side-effects to you, and thus advise how to avoid emergencies and hospitalization caused by them.
We have also expanded to numerous other medical specialties such as Diabetes and Obesity, Dermatology, Gastroenterology and Orthopedics.
Tell us an example of a specific memorable work you did that is very close!
A lot of our customers and doctors have shared tremendous success stories; I’ll share a couple of them with you. We got a lung cancer test where we gave the result within 24 hours, the doctor immediately started treatment and in three days the tumour had decreased in size. Compare this to the standard situation where a lab will take 7-14 days to provide results during which time the tumour will keep growing. I have not seen another lab in the world that can report a lung cancer test within 24 hours.
An example from fertility: a patient had undergone 12 different infertility procedures over three years that had all failed. Imagine having to waste years of your life, and tons of money on failed treatment, not to mention the stress and depression that surround wasted time and money. She came to our female fertility panel, and right after that her treatment worked leading to her pregnancy.
Your advice to students based on your experience?
Advice for further education and PhD: About 90% of the candidates we interview for laboratory positions mention that they want to go for PhD for higher education, and they usually say they want to end up in a research career. While I admire ambition, most of these candidates have had little exposure to laboratory work, leave alone research and therefore have a wrong perception. One does NOT need a PhD to do research or to succeed in science – in fact, quite like any other industry, we prefer people with work experience. We have had very capable Bachelor’s and Master’s candidates doing good research. On the other hand, if you’re determined to do a PhD, pick a good research-oriented institution or laboratory, as otherwise the experience itself is not useful.
Advice for Startups: India is a place with more commerce than science, focusing on affordability than quality, and therein lies a huge gap. We are bridging these differences by combining affordable business with quality science in molecular diagnostics. I think there’s a lot more potential in other areas too to adopt this strategy, without losing on quality. Lastly, focus on your customers and absolutely no one else.
To make molecular diagnostics rapid, easy and affordable. How will this be useful? Even for affordable cancer therapies, genetic tests are able to guide treatment regimens in terms of duration and drugs. But the majority of cancer patients in India lack access to these important tools for various reasons. We will make molecular diagnostics available, accessible and affordable for everyone.