Episode 33
Beyond Longevity at HLTH Europe Part Two: Microbiomes, Breath Diagnostics and the Future of Medical AI
Recorded at HLTH Europe in Amsterdam, Part Two of our special series looks at four very different ways technology could help healthcare move earlier, become more personalised and make better use of the growing amount of health data we are collecting.
Dr Marta Ciechonska, Co-Founder and CEO of Salient Bio, explores what the microbes living in our gut, mouth and vaginal microbiome can tell us about health. She explains how metagenomic testing and machine learning are being used to move microbiome science towards clinical diagnostics, including work in inflammatory bowel disease, as well as the links between oral health, systemic inflammation and changes associated with menopause.
Ilay Marom, Co-Founder and COO of NaNose Medical, introduces a very different approach to early detection: analysing biomarkers in our breath. He explains how nanosensors and AI can identify patterns associated with diseases including lung cancer and advanced liver fibrosis, what the technology is actually measuring, how accurate it could become and whether breath testing could eventually make large-scale screening more accessible and affordable.
Aad R. Liefveld, Chief Growth Officer at PACE Clinical, tackles a problem that has little to do with discovering new treatments and everything to do with whether patients actually follow them. We discuss why people struggle with adherence, how behavioural modelling can identify patients at risk of dropping out or deviating from treatment protocols, and why poor adherence can distort the results of clinical trials themselves.
Finally, Ruth Prieto of Nebius takes us behind the scenes of medical AI. We discuss the computing infrastructure required to power increasingly complex healthcare applications, from drug discovery to diagnostics, alongside the questions around privacy, security, regulation and what meaningful AI adoption in healthcare actually looks like.
Together, the conversations raise a broader question running through much of HLTH Europe: can we use technology not simply to collect more health data, but to detect problems earlier, intervene more intelligently and ultimately keep people healthier for longer?
Marta Ciechonska - Salient Bio
https://www.linkedin.com/in/marta-ciechonska/
Ilay Marom - Co-Founder & COO at Nanose Medical
https://www.linkedin.com/in/ilay-marom-846793218/
Nanose Medical - Nanose -Disease diagnosis - Official Website
Adriaan Rudolf (Aad) Liefveld -
https://www.linkedin.com/in/liefveld/
Ruth Prieto - Communications Manager and External Communications PR lead at Nebius
https://www.linkedin.com/in/ruth-prieto/
Find out about HLTH Europe https://hlth.com/events/europe/ See you there next year
Running order
00:00 Back at HLTH Europe
01:49 Microbiome Diagnostics
05:24 From Testing to Prevention
08:28 Breath Biomarkers for Earlier Detection
11:18 How Breath Sensing Works
15:50 Accuracy, Cost and Accessibility
18:05 Scaling Preventive Diagnostics
23:30 Why Patients Struggle With Adherence
28:50 The Behaviour Behind Non-Adherence
30:14 B-COMPASS and Proactive Support
31:08 The Clinical Trial Dropout Problem
32:03 How Protocol Deviations Distort Data
34:16 Rethinking Clinical Trials and R&D
37:56 Who Should Pay for Better Adherence?
40:46 Making Health Technology Accessible as We Age
42:37 The Infrastructure Behind Medical AI
46:37 How AI Is Changing Drug Discovery
47:41 Privacy, Security and Real-World AI
49:58 Breakthrough Projects and Recognition
55:33 Closing Reflections
Transcript
Foreign.
Speaker B:Welcome to Beyond Longevity and part two of our special from Health hlth Europe in Amsterdam.
Speaker B:Health Europe is one of the largest healthcare innovation events in Europe.
Speaker B:More than 5,000 people from over 70 countries came together there, including leaders from hospitals and healthcare systems, pharma and biotech, technology companies, investment and government.
Speaker B:It brings together many of the different people who are shaping what healthcare could look like in the future, which gave me the opportunity to explore a very broad range of ideas while I was there.
Speaker B:In part one, we looked at wearables, AI and rehabilitation.
Speaker B:This time we move into four very different areas.
Speaker B:We start with the microbiome and what the bacteria living in and on our bodies might be able to tell us about our health.
Speaker B:Then we look at something as simple as our breath and whether it could help identify the risk of serious diseases much earlier.
Speaker B:We also look at a problem that receives far less attention.
Speaker B:What happens when patients don't or simply can't follow the treatment they've been given.
Speaker B:And finally, we look at the enormous computing infrastructure behind AI and what it is making possible in medicine, from drug discovery to diagnostics.
Speaker B:Four very different conversations, but again all looking at how healthcare could become more preventative, more personalized and ultimately more effective.
Speaker B:So let's head back to Amsterdam in Health Europe, where the following conversations were recorded.
Speaker B:My first guest is Dr. Marta Chikhonska, CEO and co founder of Salient Bio.
Speaker B:Marta is a microbiologist by training with a PhD in microbiology and immunology and previous research experience at Imperial College London.
Speaker B:Today she's looking at how microbiome could be used not only to understand our health better, but but potentially to identify disease.
Speaker B:Earlier, SalientBio analyzes the communities of microorganisms living in different parts of our bodies, including the gut, mouth and vagina.
Speaker B:We talk about what those microbes can tell us, why changes in their microbiome can matter far beyond the place where they are found, and how this information could become part of more preventative healthcare.
Speaker B:Hi Marta, welcome to Health.
Speaker B:Nice to meet you here.
Speaker B:It's your first time here as you said.
Speaker B:Tell us a little bit about why you're here, what your company does and what you're hoping to achieve.
Speaker C:Thanks so much for having me on the podcast.
Speaker C:I'm really excited to be at Health.
Speaker C:Yeah, as you said, first time, but what a great conference.
Speaker C:Everyone's super friendly and there's so much knowledge milling around that really happy to learn from everyone.
Speaker C:I am one of the Co founders of SalientBio.
Speaker C:We are a diagnostics and wellness company so we mostly focus on metagenomic testing and microbiome analysis, and we have different products.
Speaker C:So we have oral, vaginal and gut microbiome wellness tests.
Speaker C:And then we've also now are applying lots of machine learning to these data sets to build diagnostics from microbiome data.
Speaker C:With the first product in inflammatory bowel disease, I would like to tell you a little bit about our wellness tests.
Speaker C:So in terms of how these fit into the, the wellness portfolio, or looking at wellness in general, it's really good to think about preventative health as we know.
Speaker C:And so with our microbiome tests, they're quite helpful for that.
Speaker C:And maybe I can tell you about our oral microbiome test.
Speaker C:That is a fabulous test in terms of looking at not only oral health, but also systemic inflammation.
Speaker C:So we've known for quite a while now that there are some pretty strong links between poor oral health and heart disease, or poor oral health and neurodegenerative disease.
Speaker C:And so within our test, we're able to identify the specific bacteria that are associated with those specific conditions.
Speaker C:So we very much encourage people to one, to floss for sure and keep their oral health really good, but also to analyze their oral microbiome to see if they have these specific microbes.
Speaker C:And if they do, we do also offer some actionable insights that they can have to be able to increase their chances of a healthy, healthy mouth and a healthy body.
Speaker C:Another really good example of preventative health in terms of our products is our vaginal microbiome test.
Speaker C:So that test is really important for women going through perimenopause and menopause because the pH and the vaginal environment changes, which then causes different bacteria to take over.
Speaker C:That is associated often with UTIs or with DV or different conditions where the microbiome is unbalanced.
Speaker C:So it's really good to know if that's happening because again, there are loads of things you can do to rebalance your vaginal microbiome, but without knowing that you may have some complications.
Speaker C:So those are two examples of how our products can be used in the longevity space.
Speaker B:What do you think are the most important changes that you expect in the healthcare market in the next couple of years?
Speaker C:That is such a great question and a great question for this conference.
Speaker C:I think more and more, at least from our perspective, we're seeing a really big shift towards preventative health and more people recognizing that it is worth really testing and trying to take care of your health much earlier so that the diseases that you may have, you may have a propensity for or you may develop, you basically catch them as early as possible and so you don't have all these complications.
Speaker C:So for example, in terms of our products, our IBD product is a test that catches IBD quite early.
Speaker C:So it's meant to be used by gps and diagnose people much earlier so that they don't develop complications that then lead to surgery.
Speaker C:So I think one is preventative health and another one is community health care.
Speaker C:Rather than having secondary care as your primary place where you get health care.
Speaker C:And also at home solutions, any kind of at home solutions that people can access without having to have multiple GP appointments, et cetera, telehealth as well.
Speaker C:So trying to get healthcare solutions in people's hands in their home I think is where we're all heading, I'm hoping.
Speaker B:So you at the moment, B2B lab, seeing what you're saying, do you think that you'll expand into, you know, direct to consumer or is that going to be too complicated for the consumer to administer the test themselves?
Speaker C:I would say that our company, we are very, very good at building the test, we're very good at the lab stuff, we're very good at all the bioinformatics, machine learning and that is our core strength.
Speaker C:I think being very good at educating consumers, at marketing to consumers is an entirely different proposition.
Speaker C:So I think where we can win is companies like us working with companies that are consumer facing and working together to offer the best kind of service or the best test.
Speaker C:Because I think everybody has limited resources and so if we really focus on the piece that we're really good at and find good partners, that is the best way, I think, to reach people in kind of the most comprehensive and easiest way.
Speaker B:And what do you hope to get out of attending health?
Speaker C:Well, I am constantly surprised at how amazing this conference is.
Speaker C:Everyone is super helpful and also the range of attendees is huge.
Speaker C:So I've met investors, I've met public healthcare administrators, I've met doctors and I'm just learning loads.
Speaker C:I'm also trying to meet people to set up some pilots with to test out our products.
Speaker C:But yeah, I've been really, really surprised at how fruitful all the conversations I've had so far have been.
Speaker C:So yeah, it's a really great conference.
Speaker B:Amazing.
Speaker B:Well, thank you so much Marta.
Speaker B:Next, I speak to Eli Marom, co founder and COO of Nanose Medical.
Speaker B:And this is one of those technologies that sounds almost futuristic.
Speaker B:Every time we breathe out, we release hundreds of chemical compounds that carry information about what is happening inside our bodies.
Speaker B:Nanose has developed a small device that uses sensors and AI to read the overall pattern of those compounds and look for signs associated with disease.
Speaker B:The idea is that a patient can simply breathe into the device and receive a risk assessment at the point of care without the sample having to be sent away to a lab.
Speaker B:Nanose is initially focusing on lung cancer and advanced liver fibrosis, two conditions where identifying people at risk earlier could make a huge difference.
Speaker B:Eli explains how the technology works, what their studies have shown so far, and why BREATH could become a completely new source of information for detecting disease earlier.
Speaker B:Hi Eli, thank you so much for joining me today to have a little talk about what you're up to at Health.
Speaker B:Tell us a little bit about your company Nanose and what you're trying to achieve at Health.
Speaker D:So thank you for inviting me to speak in your podcast, Daphne.
Speaker D:At Nanos, we came up with a sensing technology platform for recertification using breast biomarkers and AI.
Speaker D:We focus on early detection of lung cancer and also detection of advanced liver fibrosis risk using breast samples.
Speaker D:These are two of the most unmet critical need, I would say, in the healthcare space.
Speaker D:Whereas in lung cancer most of the cases are diagnosed too late for effective treatment, making it the most deadliest cancers in the world.
Speaker D:Again, not because there's no available treatment.
Speaker D:In fact, there is pretty good treatment for that simply because it is diagnosed too late for effective treatment.
Speaker D:For the liver fibrosis, it is very crucial to catch it when it's on the advanced stages.
Speaker D:Today the current tools are simply not good enough.
Speaker D:And it's a prognosis not only for liver cancer, but also for cardiovascular disease, chronic kidney disease, type 2 diabetes, obesity, those are highly associated with advanced cereal fibrosis.
Speaker D:So catching at the right time can help to reverse those diseases, reducing the symptoms and reducing risk dramatically.
Speaker B:So not only is your technology quite incredible, but also the way you're doing the testing is quite special because I saw the machine, it's very small and also the apparatus that you blow into to do the breath analysis is quite unique.
Speaker B:Can you tell us a little bit more about that?
Speaker D:I'll start with the basics that with every breath that we take there's enormous amount of information being released and most of it today is going to waste.
Speaker D:So the information is carried by the volatile ome, which is most of our volatile compound emit from our body.
Speaker D:So metabolic pathway constantly produced volatile byproduct, which is basically a real time chemical broadcast of what's happening in our body.
Speaker D:But until now, it was technically unreadable.
Speaker D: scale in our breath, there's: Speaker D:And on top of that, when you have a disease, it's not a single molecule change or a very small group of molecules, it's the entire composition that changes as a whole.
Speaker D:So traditional biomarker technologies, they identify specific molecule or a very small group of molecules, and their concentration could simply not work here.
Speaker D:So what we've been creating is a solution which correlates the sensing technology that interacts with those volatile organic compounds as a whole, generate an electric signal and correlate directly to disease.
Speaker D:Usually I like to give an example from the olfactory system.
Speaker D:For example, when you smell cinnamon for the first time, you don't know what molecules interacted with your olfactory system and what concentration.
Speaker D:What happens is that your nerve system generates an electric signal, your brain process it, and then you ask the next person next to you what is the smell?
Speaker D:And they tell you it's cinnamon.
Speaker D:And for the rest of your life you know that the electric signal is correlated to cinnamon without knowing what are the exact molecules in concentration.
Speaker D:So unlike traditional biomarker technologies, we're doing something very similar.
Speaker D:We expose our sensors to the VOCs, generate an electric signal like the nervous system, process it like the brain, and then providing an analysis by a learning system, in a sense, we provide a system with samples of patients that were diagnosed with lung cancer and samples of patients who were not diagnosed with lung cancer.
Speaker D:We create the two pattern of those groups and then the next patient that arrived, the system can evaluate how likely it is to be in each of these group, whether his unique breath print looks more like the lung cancer or the non lung cancer.
Speaker D:And by that we've been avoiding the burdensome of calculating each molecule in concentration by simply creating a correlation from the electric signal directly to the disease, bringing a very accessible and affordable device.
Speaker B:And who would use that Device?
Speaker B:Is it BigClinics?
Speaker B:Is it GP?
Speaker B:And how long does it take to get the results?
Speaker B:Tell us a little bit more about the technology, the way it works.
Speaker D:So thanks to the accessibility, ease of use and affordability, our target of course, would be a primary care, the GPs, the PCPs.
Speaker D:Obviously, starting with the PCPs could be quite challenging.
Speaker D:Usually adoption rates are pretty low.
Speaker D:That's why we want to start.
Speaker D:We have a detailed growth strategy.
Speaker D:Where you want to start with the secondary care clinics, for example, obesity centers, diabetes centers, where they see a lot of at risk patients and don't know how to test them and how to Manage those patients.
Speaker D:So our device could clearly support patient management.
Speaker D:In that sense, then we want of course to move forward to the PCPs.
Speaker D:And there is also the obvious longevity play here.
Speaker D:As longevity clinics, on one hand, we can support by risk stratifying patients.
Speaker D:It is known that aging population tend to develop both lung cancer and advanced cereal fibrosis.
Speaker D:So finding those who are at risk and treat them could help them a lot.
Speaker D:But on top of that, what we're essentially doing, we are creating a new layer of technology that can provide a lot of information for the longevity centers.
Speaker D:Translating the breast sample into a digitized data set could bring a lot of value in the future and how things are being shaped in the longevity aspect.
Speaker B:I really want you to blow your own trumpets here a little bit because I think what you've developed is pretty incredible.
Speaker B:If I understood it correctly, the way it works is you blow into this little tube device and the doctor literally immediately gets the results.
Speaker B:Is that correct?
Speaker D:So basically it's our advantage.
Speaker D:The core advantage of our solution is that you don't need to ship it to external lab.
Speaker D:When you breathe, there's the point of care device.
Speaker D:You ask the patient to excel, connect it immediately, sensor exposed to biomarkers, generate the result in real time.
Speaker D:And also on top of that, physicians today get a lot of information.
Speaker D:Some of the information is challenging to interpret.
Speaker D:They need different formulas, different metrics.
Speaker D:Our goal is to bring a clear answer whether the patient is at high risk, interdetermined or low risk.
Speaker D:In the future, we might add a numeric factor, but it will be just on a scale of 0 to 100 that indicates the risk with no complication of different formulas that they need to.
Speaker B:Calculate how high is your accuracy?
Speaker D:Today we are collecting data in eight medical centers.
Speaker D:Three sites in Israel, four in Europe, in Spain, Belgium and Latvia, and one site, the U.S. which is Jefferson Health in Philadelphia.
Speaker D:For the liver fibrosis staging, we currently sit in the accuracy of 77% and specificity of 81%.
Speaker D:This is something that again, just to emphasize it's not for diagnostics of muscled, it's finding within the muscle patients those who have higher risk for advanced liver fibrosis, which is crucial.
Speaker D:And we correlate our results to the gold standard, which is liver biopsy.
Speaker D:So we're now looking to expand in the next year the data set to at least 200.
Speaker D:To improve the classifier and validate it for the lung cancer, we are taking part of a European consortium called Lucia.
Speaker D:This consortium purpose is to identify lung cancer early.
Speaker D:They Started by testing existing data and then once they start technology, they approach and said, listen, we're trying to use existing data to improve the algorithm.
Speaker D:You have a new data layer.
Speaker D:Let's see if we can improve our results.
Speaker D:So we joined this study and we've been able to show really good results.
Speaker D:About 87% sensitivity on a cohort of over 800 subjects and 150 lung cancer patients.
Speaker D:The rest are healthy volunteers.
Speaker D:And more importantly, we have also high sensitivity in stages one and two, over 90%, which is a true game changer.
Speaker D:Because if we can prove that we can identify risk for lung cancer in earlier stages, that's a completely game changer.
Speaker B:A lot of tech that deals with preventative medicine and longevity is still quite expensive.
Speaker B:Your technology really isn't, is it one of our goals?
Speaker D:It would be affordable, so it has to be accessible and affordable.
Speaker D:Currently we don't have the right price tag, but it could definitely be on the range depends on the indication and the final results.
Speaker D:But it definitely could be in the range of 50 to $100 per test.
Speaker D:That's where we're targeting and it could definitely help to increased rates of population and not only in where the wealthiest live.
Speaker B:Even right now that's still cheaper than an MRI or CT scan which is the only other way or biopsy detect those cancers.
Speaker B:Where do you see a company expanding in the near future and in the.
Speaker D:Long term we are focusing on going to market with those two indications.
Speaker D:We are now raising our series A where we have.
Speaker D:We're raising $12 million.
Speaker D:Four out of the 12 were awarded by non dilutive grants from the Israel Innovation Authority that we're now working to match the $8 million with a few investors.
Speaker D:We want to use these funds in order to get to the market in less than two years as fast as possible to providing patients with value as early as possible in the future.
Speaker D:Basically for each indication we have a growth pipeline, how we want to expand starting from the secondary current, expanding to PCPs, pharmacies, etc.
Speaker D:And also potentially this technology came from the TECHN institution in Israel and they've shown on an academic research, an academic level proof of concept result for about 20 diseases.
Speaker D:So once we complete our studies with the two indications, it's a platform technology that could add more and more indications.
Speaker D:Of course we need to develop classifier for each one of the indications, but that's part of our pipeline.
Speaker B:So what are these 20 indications?
Speaker B:Are they mainly cancers or what are they?
Speaker D:It's mainly cancers and neurology.
Speaker D:There's also Parkinson's and Alzheimer.
Speaker D:And as a.
Speaker D:As a matter of fact there is a story about a woman from the UK that have been able to smell Parkinson's.
Speaker D:So she work in an elderly care and the house and she started to connect between smell of clothes to Parkinson's.
Speaker D:So she was invited to do a blind study test.
Speaker D:She was given 12 samples and she identified actually 11 out of 12.
Speaker D:But then what happens is that the one of the 12 that she was presumably incorrect, he was found with Parkinson later.
Speaker D:There is a strong correlation between VOCs which is what we smell to different diseases and the sky is the limit for that.
Speaker B:So you're here at Health.
Speaker B:How has it been?
Speaker B:What was your object of coming here and have you fulfilled your objective or even exceeded it?
Speaker D:It's always nice to connect with different stakeholders from the industry, pharma companies, diagnostics, health providers, potential customers to validate our value proposition.
Speaker D:When you want to work with the big players, you can't start when you're already validated.
Speaker D:You need to build a relationship.
Speaker D:So and that's what we are here to do.
Speaker D:It's been very successful.
Speaker D:A couple of days ago we won a startup pitching competition by Global Health Connector and it was a great experience which probably will lead that we'll be here again next year because we got a pre booth for next year so we're winning the competition.
Speaker D:So I really like the health conference here and also in the US we've been in last October, we did that in Vegas and looking forward to the next one.
Speaker B:Great.
Speaker B:And so where do you see the field as such expanding?
Speaker B:You know, the longevity fields especially, where do you see it heading?
Speaker D:I think it's a little bit of a cliche.
Speaker D:I still going to say it.
Speaker D:Healthcare is not healthcare today.
Speaker D:It's more likely sick care.
Speaker D:So we are waiting for people to get sick and then we treat them and we want to move to healthcare.
Speaker D:We need to start thinking longevity and thinking how we can prevent and maintain ourselves healthy instead of waiting to become sick and then treat ourselves.
Speaker D:Longevity clearly answers this gap.
Speaker D:And what we're doing, what we're building is also highly connected and correlated to this aspect where we want to find risk factors early and treat them before symptoms arrive and before it becomes a big issue.
Speaker D:So we can remain healthy and not wait to be sick and then be treated.
Speaker B:But what do you think the market as a whole does not really understand about the future of that healthcare system that is needed?
Speaker B:Or do you think everybody's on the same page and everybody understands what needs to be done.
Speaker D:I think that unfortunately we live in a world that's still a money talks.
Speaker D:And so there's a few policies that need to change in order to move forward.
Speaker D:I can give you the best example.
Speaker D:It's a conversation that I'll never forget.
Speaker D:I talked a couple of years ago with a senior manager from one of the biggest healthcare insurance companies in the us.
Speaker D:I'm not going to mention the name of the company, but I pitched him this idea and I told him, listen, if you can catch advanced air fibrosis, you can reduce risk for this and that.
Speaker D:And I thought it's a pure play for insurance because they can help their customers and reduce future burden.
Speaker D:And then he told me this.
Speaker D:We're not going to buy it because progressing from advanced afibrosis to all of these comorbidities takes on average three to five years.
Speaker D:Our average churn rate is two years.
Speaker D:So on average I know it can save lives.
Speaker D:That's how we said it.
Speaker D:I know it can save lives, but on average it's someone else's problem.
Speaker D:And until we deal with the roots of this and giving the right incentives, I think it's going to be very, very challenging.
Speaker D:But I'm very optimistic because I'm seeing all around the world that preventive health and value based care health is kind of like taking more, more of a place than pay for service system.
Speaker D:And in that sense I am very optimistic about the future.
Speaker B:What a positive note to finish this conversation on.
Speaker B:I like that.
Speaker B:Well, thank you so much and good luck.
Speaker B:My next guest is Ard Liefeld, Chief Growth Officer at Pace Clinical.
Speaker B:His starting point is a very human problem in healthcare.
Speaker B:A doctor can prescribe the right treatment, but that treatment can only work properly if the patient is actually able to follow it.
Speaker B:And that doesn't simply mean remembering to take a pill.
Speaker B:Treatment can involve changes to diet, exercise, appointments and everyday routines, all while somebody is trying to get on with the rest of their life.
Speaker B:Pace Clinical is looking at why people struggle to follow treatment and whether we can identify that risk earlier.
Speaker B:The aim is to give each patient the support they actually need, rather than waiting until the treatment has gone off track.
Speaker B:ARD also explains why this matters far beyond the individual patient, from clinical trials and drug development to healthcare costs and the wider economy.
Speaker B:I'm here with Art from Pace Clinical.
Speaker A:Hi Art.
Speaker B:Tell us a little bit about what you're doing at Health, why you're here, what your company does.
Speaker E:Well, my company, Pace Clinical, provides a platform that enables our customers to provide dynamic personalized patient support during clinical studies and during clinical care.
Speaker E:Nonadherence is a major issue.
Speaker E:It's usually seen as a healthcare issue.
Speaker E:But if you look at the numbers, in fact, it's a very societal and even economic issue.
Speaker E:If you look at what non adherence does on an EU level, we're talking about 2,200 thousand people dying before that time.
Speaker E:We call it preventable death simply because they were not able to do the therapy they're supposed to do.
Speaker E:That's not the end of it.
Speaker E:It also triggers 125 billion euro dollars of preventable health care costs.
Speaker E:Those are really great numbers, EU level.
Speaker E:But for each region in the world you see the same numbers.
Speaker E:So now we're talking about a million people.
Speaker E:Now we're talking about half a billion.
Speaker E:But think about this.
Speaker E:People that are sick are not as productive as they could have been.
Speaker E:People that are sick are usually taken care of not only by ACPs and doctors and nurses, but but also by informal caregivers, their family, their wife, their partner.
Speaker E:This takes us to a less productive level for caregivers.
Speaker E:That brings you into your gdp.
Speaker E:So it has an impact on gdp.
Speaker E:If you look at the numbers on that level, then billions turn into trillions.
Speaker E:If you think about that, your GDP pays for all of the bills of a nation.
Speaker E:Think about health care, think about defense, think about education.
Speaker E:All the budgets for all the departments are based on the taxes we can run on our gdp, meaning a less healthy population is a lower GDP is less budget for a nation, less budget for health care.
Speaker E:So it's extremely important for any nation to have a priority to keep their population healthy and healthy longer taken back to longevity.
Speaker E:And this is exactly what we are doing.
Speaker E:This is the business side, but we are also involved in a European project funded by the European Federation of Pharmaceutical Companies and my company, and backed up by EU funds.
Speaker E:And this project is called the BIMA Project.
Speaker E:And what we want to do and are doing is find a way to improve adherence during age therapy.
Speaker E:And we don't limit us to only medication adherence, because going back to the literature, when people talk about adherence, they actually are only looking at medication adherence, meaning taking your pills.
Speaker E:But that's just one side of the coin.
Speaker E:Because if you don't do all the other stuff you should do to support the efficacy of your therapy, then everything goes south.
Speaker E:Let's say have a cholesterol issue, you'll take your pills on a daily basis, be perfect medication adherence, and at the same time you buy yourself a slab of pork belly, shove it in the oven and eat it all up.
Speaker E:And you do that twice.
Speaker E:So this is 100% medication advance, looking at the overall zero results for your therapy.
Speaker E:Waste of money, waste of time and actually it will get you killed.
Speaker E:So, and this is what the project is about.
Speaker E:We have developed a model to understand in a simple, easy and fast way what type of support each individual patient needs at this moment.
Speaker E:Behavioral is dynamic, behavioral is influenced by factors and we are looking for the factors that actually impacts your adherence.
Speaker E:If we understand that, then we also understand the risk you may have to be non adherent.
Speaker E:And because of that we know how to counter that because we also know what subtype of support you need.
Speaker E:And this is a very easy and simple way.
Speaker E:So low level at the frontline, a doctor and a patient in a partnership to do the therapy initially you always say we're going to do this is acceptable to me.
Speaker E:And then you find out this is a lot harder than I expected.
Speaker E:I'm struggling with this and I'm struggling with that.
Speaker E:If only a doctor or a nurse had the time to really have a sit down with you and to talk about this, then they would probably provide you that support promise.
Speaker E:They're up to their eyeballs in work.
Speaker E:They have never been selected on their social skills.
Speaker E:They're fully focused on your condition and treating your condition.
Speaker E:They hoping assuming that health must be your top priority.
Speaker E:Meaning that you want to be cured.
Speaker E:Yes, you do.
Speaker E:But health is not on the top of your mind.
Speaker E:What is going out with your friends, is taking the kids to school, is having a really good life or a career and your condition and your therapy just gets in the way.
Speaker E:You do your best and you can't for whatever reason.
Speaker E:With the B Compass model, we now know when you are at risk and we also know what type of support you need.
Speaker E:This way, we are now proactive instead of reactive.
Speaker E:Today we only know that you were non adherent because of your biomedical data.
Speaker E:You were supposed to take these pills on a daily basis before breakfast based on your blood values.
Speaker E:Your doctor knows that didn't happen, so something went wrong.
Speaker E:Now we know that you're struggling.
Speaker E:Now we know how to help you, how to make things feasible for you again and help you simply live your life again.
Speaker E:And this is pretty much what not only the Bemer project is about, but also PACE and specifically for pace.
Speaker E:If you think about that from a pharmaceutical R and D perspective, what you always hear is that there's no adherence issue in a clinical study.
Speaker E:We have this perfect patient.
Speaker E:They will do everything as asked.
Speaker E:And at the same time we say, well, you have this early dropout thing.
Speaker E:We tend to lose patient 25 to 30% across the whole bandwidth.
Speaker E:No matter the type of drug, no matter the type of condition.
Speaker E:25 To 30%, four decades, it's a steady figure.
Speaker E:What is early dropout?
Speaker E:People leave your study.
Speaker E:That is in my mind a very extreme form of non adherence.
Speaker E:It's not, I'm not really sure if I'm going to do this actually I quit, I'm on my way to the exit.
Speaker E:That's precisely what is so early dropout is in fact null adherence.
Speaker E:And if you go to protocol deviations, which is a change is it's not as it, it didn't ran as it was supposed to be.
Speaker E:A protocol is pretty much your therapy.
Speaker E:It's the, the things you needed to do at a certain point in time, at a certain frequency.
Speaker E:If you look at the deviations, you were supposed to take the pill on Monday and Tuesday.
Speaker E:What you did is you took two pills on Tuesday, but which is on average one pill a day.
Speaker E:So you think, okay, I can get away with that.
Speaker E:But that impacts your clinical data.
Speaker E:You will have flawed data.
Speaker E:And that could go either way.
Speaker E:It could mean that the drug is less effective as we think it is, or it's even more effective.
Speaker E:Both are not really good.
Speaker E:So we see that we do have this issue and from a pharma perspective, until now we all said, okay, everything is perfect in clinical study.
Speaker E:And the minute we go to market and it gets into clinical care, primary care, suddenly it drops below 50, suddenly people are no longer capable of following this therapy.
Speaker E:And it is not my fault.
Speaker E:If I was a automotive company, if, let's say if I was BMW and would have developed a new model and I test driven this thing on the Nuremberg with a F1 driver at the wheel and I have perfect results.
Speaker E:This is the safest, the fastest, the most luxury car ever.
Speaker E:And I put it out on the market and you buy this model and within 10 minutes you kill yourself in this car.
Speaker E:You know what happens with BMW in the next five minutes?
Speaker E:They are dead.
Speaker E:Which that sounds acceptable.
Speaker E:This is, it cannot be that you say this is the perfect car.
Speaker E:And it shows in real life that actually it simply kills people, 50% of them.
Speaker E:So we do have this issue.
Speaker E:But think about this.
Speaker E:We spent 1 to 4 billion dollars to develop a new drug.
Speaker E:50% Of that goes into clinical studies.
Speaker E:So we're talking 500 million to 2 billion spending on clinical studies.
Speaker E:Most, if not all studies fail to be executed within the timelines and budgets.
Speaker E:So most of them will double, quadruple, triple more cost.
Speaker E:So that number, let's say 2 billion on clinical studies could have been 1 billion, leading to a lower cost in R and D, a lower cost in the real world.
Speaker E:If we could improve the situation, if we could make the data better, if we could make clinical studies better by simply providing patients in a clinical study the right support so they are able to follow the protocol as prescribed, then we have much better clinical studies, but even more much better performing drug from the get go.
Speaker E:Because think about this.
Speaker E:When I decide to develop a new product, I already know what my target population will be.
Speaker E:But at the same time, if I know that, then I also know how they will behave if I put a specific protocol to that.
Speaker E:So now I have the choice.
Speaker E:I can go for the perfect patient for the perfect dosing.
Speaker E:And I already know that only 1% of my population will be able to be that perfect patient.
Speaker E:From a data perspective, I have a perfect product.
Speaker E:Or I could accept the limitations of my population and say let's go for the 80% and have a simpler protocol.
Speaker E:So do the numbers and you will see that makes sense.
Speaker E:So this is where basis, if you support your patients through our platform, you will have better data, you have a better performing drug.
Speaker E:Actually your validated drug comes now with a validated patient support program.
Speaker E:If you move that into the market together, then you have another usp.
Speaker E:You can actually tell policymakers that your drug actually resolves a major issue, which overall health care cost.
Speaker E:It's not medication cost, it's the overall health cost.
Speaker E:Even more.
Speaker E:You can actually explain to them that these healthy people will help you to get a much better GDP, which will pay for in our times, for defense, for education, for global warming, whatever all the challenges we meet today.
Speaker E:So that's in not a nutshell, that's pretty much what PACE is about, what bima, the EU project is about.
Speaker E:This is actually about making our society better.
Speaker E:This is actually something to make each individual a member of our society better, as in a better life.
Speaker E:And be sure if you think today that you will never be a patient, it's not the question if you are or will be a patient, it's more a question of when will you be a patient.
Speaker E:And if it's not you, then it's one of your loved ones, then it's one of your parents.
Speaker E:So we are all in this.
Speaker B:So you here at Health, what's your ultimate goal?
Speaker B:To get out of health?
Speaker B:What are you Trying to achieve by being here who you're trying to meet, what are you trying to get done?
Speaker E:My primary goal, because we're talking about innovation, this has never been done before in a very conservative industry.
Speaker E:My goal is convince our partners in the project, the pharmaceutical companies, to be innovative.
Speaker E:Put your money where your mouth is.
Speaker E:You say you are patient centric.
Speaker E:Show it.
Speaker E:You invest in improving adherence.
Speaker E:Do what you tell others to do.
Speaker E:You want others to implement.
Speaker E:Use the model we have developed.
Speaker E:If we are not doing it, then no one else will do so.
Speaker E:This is the main question.
Speaker E:We need to change things.
Speaker E:We are reaching out to the European Parliament.
Speaker E:We want to make nations aware of the importance it's no longer a health care issue.
Speaker E:Yes, we are focused on providing support on in the front line, in the operational level, a patient and a doctor working together in a partnership to make the therapy happen, to get a better life.
Speaker E:But they are struggling and this simple tool can help them, but it comes at a cost.
Speaker E:It's in innovation, which means you need to invest.
Speaker E:A doctor needs to do a training for which they don't have the time.
Speaker E:Yes, we need to educate, but there's a better way.
Speaker E:We have technology, we can do this.
Speaker E:It needs support programs.
Speaker E:That is an investment.
Speaker E:You cannot ask a doctor to invest in patient support programs.
Speaker E:No time, no money, not trained to do that.
Speaker E:There's only a few parties that are actually able to do this payers and they benefit from that.
Speaker E:By simply providing this type of support to their subscribers.
Speaker E:They can limit the money they spend on healthcare, which means more profit or the opportunity to spend that profit on building even better services.
Speaker E:This is about pharma.
Speaker E:This is the opportunity to have a new USP in your negotiations with for instance Medicare.
Speaker E:This is a opportunity to show the world that you are truly patient centric.
Speaker E:This is an opportunity to deliver much better performing products into the real world.
Speaker E:So yes, there are many stakeholders involved.
Speaker E:Each of them will see value, but at the same time, someone needs to move.
Speaker E:So if you're talking about what I'm looking for, what is the impact on health?
Speaker E:It's actually more about making people happier, enabling people to live their life again.
Speaker E:We are in an aging society.
Speaker E:We will see that we all have more rare diseases, will see that population will need more care.
Speaker E:So it's really important to enable patients to get the right support, to get the right therapy.
Speaker E:And at the same time understanding the limitations of the people in healthcare, provide them the right support to deliver that care.
Speaker E:So we make healthcare professionals, docs more effective.
Speaker E:And more efficient.
Speaker E:You can now focus on the ones that really need your personal intervention.
Speaker E:The rest will be covered by yes, technology.
Speaker E:And no, this is not technology in the sense we truly believe in the wonderful world of AI and the wonderful world of apps.
Speaker E:Because think about that.
Speaker E:These apps are built by 20 somethings, four, guess who, 80 somethings.
Speaker E:We're talking about smartphones for people that are bit nearsighted.
Speaker E:So we need to understand that we need to provide them the technology in a level that is truly accessible to them.
Speaker E:We need to provide something that is easy to use for them.
Speaker E:We need to not to put another burden on them.
Speaker E:All of that can be enabled by using not only the model, the methodology and the platform.
Speaker E:And eventually we are the first.
Speaker E:Our journey on adherence started almost 10 years ago.
Speaker E:And yes, I actually am hoping that we all get competition.
Speaker E:I'm waiting to see the first competitor that actually understands that we're no longer talking about patience but people.
Speaker B:Well listener, this is super insightful.
Speaker B:Thank you so much for sharing your thoughts with us.
Speaker B:And finally, I spoke to Ruth Prieto, PR manager at Nebius.
Speaker B:We hear constantly about AI transforming healthcare, but every AI model used to discover a drug, analyze medical data, or develop a new diagnostic needs enormous computing power behind it.
Speaker B:That's where Nebius comes in.
Speaker B:Nabius provides specialized cloud infrastructure for AI, including companies working in healthcare and life sciences.
Speaker B:Ruth and I talk about what that infrastructure is already making possible in areas such as drug discovery and medical research, as well as the questions around privacy and sensitive health data.
Speaker B:And we look at where AI could genuinely improve healthcare over the next few years beyond simply putting the words AI powered on a product.
Speaker B:So I'm here at Health with Ruth from Nebias.
Speaker B:Hi Ruth, tell us a little bit about yourself and about Nubias.
Speaker A:Hi Vatna.
Speaker A:Nice meeting you.
Speaker A:It's great to be here at HLDH at Amsterdam.
Speaker A:My name is Ruth Brieto.
Speaker A:I am communications manager at a global level for Nevius here, representing the healthcare and life sciences vertical.
Speaker A:Excited to be talking to you today.
Speaker B:For people that are not too familiar with Nevios, tell us a little bit more about what the company actually does.
Speaker A:So Nevius is an AI cloud infrastructure company.
Speaker A:We sell specialized solutions for AI workloads, have a cloud solution and inference service.
Speaker B:Fantastic.
Speaker B:We're seeing AI transform biology, drug discovery and medical research.
Speaker B:Where do you think?
Speaker B:We're still underestimating what AI infrastructure can do at the moment and what will be possible in sort of the next five years.
Speaker A:AI is a new technology.
Speaker A:There's a lot of elements that people are coming across as new areas of knowledge, as new new areas of research.
Speaker A:And there's also a point of dissemination of knowledge.
Speaker A:There is a huge positive impact of AI in drug development, in research, in scientific breakthroughs.
Speaker A:You can use AI tools to actually implement time to market and decrease costs in research, in production and actually use in different areas such as diagnosis, that intake also implementation into applications for patients that are already diagnosed and they how do they take their medications, how do they go and visit a doctor, how the nurse or the doctor takes their data.
Speaker A:So there's a lot of ways of implementing AI tools at several different levels of that we are talking from patient everyday or day to day use, or even with rare diseases, detection, healthcare prevention, breast cancer, for example, detection or tools that come even before you get into a hospital.
Speaker A:Also we have the second layer, which is in the hospital or in the healthcare system.
Speaker A:There's also a number of applications that can positively impact.
Speaker A:So all of these are just examples.
Speaker A:In Nibius, we have different customer cases.
Speaker A:We support companies who are actively contributing to research, but also to development of products that will impact scientific breakthroughs.
Speaker A:In two weeks, we'll have the Discovery Awards, which is one of our flagship events where we will spotlight companies that are impacting the world through their use and their implementation of AI tools with solutions that can impact the world.
Speaker B:Yes, you've touched on quite a few topics that I want to delve in a little bit further.
Speaker B:You've mentioned drug discovery.
Speaker B:Drug discovery has traditionally been limited by time, cost and computing power, to name but a few.
Speaker B:Which of those constraints do you think is changing fastest and where do you think AI will have the biggest impact?
Speaker A:I think one of the biggest impact is in time to market, how fast you develop a molecule and you implemented into a solution that can eventually become treatment or a drug or an implementation or human use.
Speaker A:Time to market.
Speaker A:It has an implication in cost in human resources and also in investment.
Speaker A:So I think the impact is intertwined, but it impacts at the end around the accessibility.
Speaker A:So I think the most important part is access or the result that it will have in patient access to drugs.
Speaker B:Healthcare is one of the most sensitive industries when it comes to data.
Speaker B:How do you at Nubias balance giving researchers enormous computer capabilities while maintaining privacy and security?
Speaker A:So we are compliant with ISO and hipaa.
Speaker A:We of course follow the European frameworks and the regulations that are implemented in the country where our data centers are.
Speaker A:And yes, patient data and personal data as well are highly sensitive information.
Speaker A:And so we need to balance out the need of regulation, taking into account different stakeholders like industry, government, technology, hospitals and also patients.
Speaker A:So it should be something that we need to have everyone sitting down at the table to discuss and influence the implementation of it to have a fair and equitable access to AI and healthcare.
Speaker B:Many longevity companies are now what's been called AI powered.
Speaker B:From your perspective, what separates organizations in genuinely using AI?
Speaker B:Well, from those simply using it As.
Speaker A:A marketing term, I would say that it depends on how the company is building their product.
Speaker A:We have AI native companies where they take into account AI and all the implementations since the beginning.
Speaker A:So that those are the companies who are the ones that were our first target audience or our first customers.
Speaker A:But we are also going into a second enterprise target audience.
Speaker A:These enterprise and bigger companies are starting to implement AI from scratch and they need to hire the teams that are experts in the field to do a correct implementation of AI tools and actually get the results.
Speaker A:It's very important to approach experts and to have people that are also developing the tools helping in the implementation.
Speaker A:At Niveus, we have a specialized teams working with our customers in every step of the way.
Speaker B:What's the most exciting healthcare or life science project you've seen running on AI infrastructure?
Speaker A:That's a tricky question.
Speaker A:I think there's so many right now been receiving the applications for these career awards and we are going through so much exciting things that you could even not talk or think about.
Speaker A:For me there's two.
Speaker A:One is CRISPR GPT, the work that Dr. Kong from Stanford has been doing.
Speaker A:He used CRISPR GPT powered by Niveus to find cure for a rare disease and specifically it had an impact on a patient, on a three year old patient.
Speaker A:So in this case we can really see changing somebody's life at an early age, which I think is huge.
Speaker A:Also we have Primamente.
Speaker A:Primamente is developing a brain foundational model that will impact in us Alzheimer and detection and Parkinson's disease.
Speaker A:And then we have also breast cancer detection.
Speaker A:We've seen a lot of submissions that impact women health and historically we've seen that we need more knowledge about specifics of the female body.
Speaker A:So everything that is helping to that goal is also really important.
Speaker B:Can you give us some more examples of other companies that have been supported by Nubias and that are really sort of revolutionary?
Speaker A:Yes.
Speaker A:So we have Basecamp research, that's one of them.
Speaker A:We have SwartHealth who are also developing different tools, but the latest was one to support mental health and this is coming as a result of their previous product.
Speaker A:And then we also have Latent labs, Slingshot AI.
Speaker B:If you had to pick one area of medicine where AI will genuinely improve patient outcome over the next, let's say five years, what would it be and why?
Speaker A:That's a tough one.
Speaker A:I would say vaccines development, protein based and sim research has a huge impact on population.
Speaker A:As vaccines are something that forms part of primary care and needs to be done in the first stages of human life, I think that can have a huge impact in huge parts of the population and also in prevention of pandemics, in prevention of highly dense diseases.
Speaker B:Is there anything in AI or scientific computing that you are personally very excited about that not many people know about yet?
Speaker A:I think something that personally I find mind blending is the brain foundational model.
Speaker A:I feel super interested about anything that has to do with the brain.
Speaker A:So all the work from Primamente, I think we're heading there, right?
Speaker A:Everyone is aging, everyone is being impacted by how we eat and then developing different diseases due to the lifestyle that we have.
Speaker A:So there are some hypothesis of showing the lifestyle that we have and the stress, the levels of stress, how they impact the development of neurodegenerative diseases.
Speaker A:So that part is something that I'm really interested in.
Speaker A:Also because we are all getting older, the population is also living more years.
Speaker A:Like we're not dying at 50, right?
Speaker A:So, so that's good and bad maybe, but yeah, that's something that I personally find like very, very interesting.
Speaker B:And just to finish up, you've mentioned the, the Nebias Awards for startups that are coming up.
Speaker B:Can you give us a little bit of a sneak peek into some of the winners?
Speaker A:Well, unfortunately I cannot say the final winners, but what I can tell you is that we received 647 applications from all corners of the world in this time, which is the second time we do the awards we received also nominees and we are actually being very open to every stage of companies, not only startups, but also enterprises and also Latin American Africa.
Speaker A:We received applications from these locations.
Speaker A:So really this time it's every little corner of the world.
Speaker A:So we have people applying from Singapore, from Europe, North America, Latin America, Africa and almost every corner of the world.
Speaker A:So that's something really, really exciting.
Speaker A:And the Discovery Awards, we have invited a panel of leaders in the healthcare industry, technology industry, and also researchers and scientific community.
Speaker A:So the panel of judges itself, itself is really formed to actually have a fair and proper assessment.
Speaker A:After the 600 almost.
Speaker A:650 Almost applications that we went through.
Speaker A:We chose first and second and third place and honorable mentions.
Speaker A:And it was very difficult process because there are so much to see and it's so interesting.
Speaker A:But we did the evaluation on different criteria, use of AI, development, the product, also time to market, cost, et cetera.
Speaker A:So these criteria actually form part of the decision to go and choose the winners.
Speaker A:Even though I cannot say any names, what I can say is that all of them have something in common which is challenging the status quo and actually implementing AI solutions to products that can change people's life and can bring or close the gap to drug accessibility, to medicine and to healthcare.
Speaker B:Amazing.
Speaker B:Ruth, thank you so much.
Speaker A:Thank you as well, Daphne.
Speaker A:It was a pleasure.
Speaker B:Across these two episodes from Health Europe, we've heard from companies working on very different parts of healthcare.
Speaker B:Some are trying to give us new information about our bodies.
Speaker B:Others are trying to make sense of the information we already have, help people find, follow their treatment, or build technology that makes entirely new approaches possible.
Speaker B:But much of it comes down to the same thing.
Speaker B:Instead of waiting until somebody becomes ill and then reacting, can we identify risk earlier, understand the individual better, and intervene sooner?
Speaker B:Thank you to all my guests for joining me on Beyond Longevity.
Speaker B:You'll find more information about all of my guests and their companies in the show notes and if you've enjoyed these two special episodes, please follow Beyond Longevity Rate, review and subscribe.
Speaker B:Thank you.
Speaker E:Sa.
