Australia's health challenges: COVID, cancer, cardio and capital

By Mike Nicholls, Partner at Main Sequence
Monday, 07 June, 2021

Australia's health challenges: COVID, cancer, cardio and capital

Cancer, strokes and heart attacks didn’t stop for COVID, but screening and diagnosis ground to a halt. According to the Cancer Council, breast cancer screenings declined by 51% last year, which could mean 2500 missed cases. There are numerous similar examples in most countries across multiple disease types.

As a misdiagnosed Stage 3 cancer survivor, I can tell you that cancer doesn’t wait for anyone. Time is critical, progression can be swift, sometimes a matter of months, and late diagnosis results in low survival rates.

Strokes and heart attacks also benefit from early treatment to prevent more severe attacks from occurring. The longer these conditions remain undiagnosed, the more early deaths and severe cases we will see.

Australia needs a strong message from health authorities to encourage patients to visit their doctors and report symptoms before it's too late.

We must increase our sovereign capability

Delayed cancer and cardio diagnosis is not the only crisis we face. The COVID crisis made us realise we need to increase our sovereign medtech manufacturing capability. Shortages of critical items such as protective equipment, facilities and respirators were front-page news in the first few months of the crisis.

The speed at which the COVID vaccines were developed and approved is astounding and unprecedented, but none of this happened in a vacuum. The mRNA technology behind the vaccines was built on decades of scientific research and is arguably one of the most promising new technologies, with potential to provide vaccines and therapeutics for a whole range of diseases.

Australia has numerous mRNA expert researchers, but unfortunately we did not have the capability to deliver our own vaccine and are now dependent on foreign companies and governments.

Australian research is world-leading in many areas; however, our record of building great companies from that research is terrible. The underlying problem is not obvious to the casual observer. We have the scientific capability, but we simply do not have enough local venture capital (VC) to support our local medtech industry.

There is an invisible hard cap on the number of medtech companies that Australia can produce each year.

Australia has 2–3 active VC funds specialising in medtech and biotech, which invest in 5–10 companies each year. This is a rounding error compared with the US — our medtech investment ecosystem is a ghost town. Most government grants mandate matched funding, but without VC funding, many are unable to apply.

Each week I meet founders that are forced to consider a move to Silicon Valley or the US East Coast to commercialise their technology. Australia has the potential to create better health outcomes at scale, and help our economy by generating export revenue and providing high-paying skilled jobs, but medtech founders can’t do it alone.

Telehealth is a great example — it moved from the sidelines to a significant channel for health care during COVID and massively increased the efficiency of our health system. One of our investments, the telehealth platform Coviu, has seen a 4000% increase in appointments since December 2019.

The same goes for the use of AI and big data. It's now being harnessed for the early detection of diseases like prostate cancer by companies like Maxwell Plus, while others like Prospection are using data-driven medical insights to improve patient health outcomes for millions around the world.

The innovations are vast, impactful and happening right on our doorstep, but to deliver them we have to invest.

Driving investment in medtech innovations

When we talk about medtech companies in Australia, everyone holds up Resmed, Cochlear and CSL. They are fantastic companies, but they are 40 years old. Australia needs to launch dozens of medtech companies each year to compete with the rest of the world.

If we want to kickstart a burgeoning medtech industry there are a couple of easy ways to move forward:

  • Provide attractive incentives to form medtech-focused venture investment funds, including government funding to match private investor capital in new medtech funds; tax-free gains with no limits on size of ESVCLP [Early Stage Venture Capital Limited Partnership] funds or investment valuations; and removing fund ownership limitations for medtech-dedicated funds (currently no family/individual or affiliates can own more than 30% of a ESVCLP fund) — if high-net-worth investors want to invest in medtech we should encourage them, not restrict them.
  • Provide fast-track regulatory services to help new start-ups from day one to understand their regulatory pathway and responsibilities.
  • Create challenge-based competitions and funding for start-ups solving specific disease or health tech problems.
  • Create programs to provide easy and fast access to expensive and sophisticated equipment and lab facilities to start-up teams.
  • Allow researchers to take start-up sabbatical leave with the knowledge they have a position to return to.

2021 future investment directions

Main Sequence is focusing on solving the greatest causes of early death — including cancer, cardiovascular disease, brain ageing/disease, diabetes, and COVID and related diseases — including the use of big data and AI to solve challenges around early diagnosis and detection of population-scale health issues.

Mike Nicholls, Partner at Main Sequence.

Imagine if we could detect outbreaks in real time by analysing doctor visits and pharmacy purchases. Match this up with sewage testing and contact tracing and we’ll be on top of an outbreak before it even happens. Imagine cancer treatments that are as simple as a few injections as an outpatient or being able to treat terminal patients.

Main Sequence has just raised $250 million to invest in Australian research start-ups but, to be frank, we need 5–10 similar-sized funds to fully support the medtech ecosystem.

Australian researchers and entrepreneurs have the talent to drive amazing innovation, but they desperately need investment capital to support their growth.

Top image credit: ©

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