#465: Lessons from running a $250M healthtech & biotech fund, with Steve Burnell from Tenmile

30 Sep 2026 · 1 h 18 min · 27 chapters

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In short

Steve Burnell discusses his path from marine ecology and documentary filmmaking to healthtech leadership, then explains Tenmile’s $250M Australian-focused healthtech/biotech investing thesis—especially “intersections” like tech + healthcare, and antimicrobial resistance + diagnostics + clinical workflow.

Guest background

Steve Burnell is an Australian PhD marine ecologist and former fisheries biologist; he produced underwater nature documentaries (including Antarctic research). He spent 26 years in the US, rising in strategy consulting and then joining Roche/Genentech after Ventana Medical Systems’ acquisition. At Roche he helped build clinical decision support and led digital pathology initiatives, including early FDA-approved breast panel algorithms. He later returned to Australia to lead health efforts for Andrew Forrest (cancer and COVID programs) and co-founded/led Tenmile.

Key claims

Adoption of digital pathology lags despite superior algorithmic performance; regulatory “gold standards” rely on inconsistent human pathologists. Tenmile targets seed/Series A (typically $3–8M checks) with an evergreen mandate, aiming for ~25% IRR while building Australia’s health commercialization ecosystem. Impact and commercial success are linked.

Notable examples

Right whale research helped drive new Australian marine parks; Roche deals included Foundation Medicine and Flatiron Health; Tenmile examples include an Eli Lilly acquisition (~20–25 months post-investment) of a Swiss antimicrobial vaccine company and Lumos Diagnostics (8-minute point-of-care viral vs bacterial testing).

Written by AI. May contain mistakes. Listen to the episode to check what was said.

Chapters

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Steve Burnell's Journey to Fund Management

0:45 to 4:12

Steve shares his eclectic background from marine biology to fund management.

“looking forward to getting into your background, because it sounds like the path to a managing director of a fund that now invests and is very successfully, I take it, with the exits you've got coming through.”

Transition to Healthcare and Biotech

4:12 to 7:30

Discussion of Steve's move to healthcare consulting and his role at Roche.

“putting satellite trackers on elephant seals and leg bands on wandering albatross, literally, to being in Roche, you know, a global farmer and running a couple of global businesses for them for over a decade.”

Intersections of Technology and Healthcare

7:30 to 11:00

Exploring how technology intersects with healthcare and conservation.

“What do you remember most fondly from that time?”

Documentary Making and Conservation Success

11:00 to 14:00

Steve reflects on his documentary work and conservation achievements.

“and stay very much from a pro bono and strategy point of view involved in that.”

Interconnected Health and Nature

14:00 to 14:40

Explore the relationship between human health and the environment.

“And I have a very deep sort of love and respect for people as well, not just nature.”

Leadership Insights and Career Growth

14:40 to 18:00

Discussion on leadership qualities and how to rise in one's career.

“If you're good and you're doing a good job, ultimately someone's going to recognize that, the owner of the business, the partner who's retiring in the case of the strategy firm, whatever it is.”

Building Business in Healthtech

18:00 to 20:20

Insights on transitioning from small to large companies while innovating.

“We'll probably get to that, but this is about as much about reading people and betting on people as it is about good science.”

The Evolution of Diagnostics at Roche

20:20 to 22:40

The role of Roche in advancing diagnostics and its impact on healthcare.

“And not many people know that Roche is the biggest IVD diagnostics company in the world.”

Challenges in Digital Pathology Adoption

22:40 to 26:30

Exploration of the barriers to digital pathology and AI integration.

“even though I was in a 90 ,000 person company.”

Regulatory Challenges in Pathology

26:30 to 28:04

Discussing the regulatory hurdles faced by new technologies in pathology.

“but then it's got to get two pathologists to agree with it in a blinded way.”
Show all 27 chapters

Challenges in Healthcare Economics

28:04 to 29:39

Explore the difficulties in healthcare budgeting and the role of AI in improving hospital management.

“down in the basement of the hospital, although it's critical to every, you know, most diagnoses and every cancer diagnosis.”

A Surreal Encounter: Meeting Andrew Forest

29:40 to 34:16

Hear the story of how Steve Burnell's unexpected meeting led to new opportunities in health and conservation.

“And so somehow I'd got on the radar, wasn't looking for a job.”

Founding Ten Mile: A Vision for Health Investment

34:17 to 39:41

Learn about the conception of Ten Mile and its focus on health innovation and ecosystem growth in Australia.

“I've got to do the health tech audience justice when I'm 35 minutes into the podcast.”

Investment Strategies and Thematic Focus

39:42 to 42:06

Understand Ten Mile's investment strategies, including a focus on healthcare diversity and specific thematic opportunities.

“You know, we're on various government policy working groups on things designed to improve, you know, policy, whether it's the R &D tax incentive or capital gains tax treatment for early stage companies.”

Investment Themes and Strategies

42:06 to 44:50

Explore the thematic investing approach in healthcare, focusing on commercial success and impact.

“We're a thematic investor, meaning we are across all of healthcare.”

Ten Mile's Fund Structure and Objectives

44:51 to 47:16

Understand the structure and objectives of the $250M evergreen fund by Ten Mile.

“And we don't know the effects and that's where it gets tricky.”

Evaluating Seed and Series A Investments

47:17 to 51:06

Learn how Ten Mile evaluates potential investments at the seed and Series A stages.

Successful Portfolio Investments and Exits

51:07 to 54:05

Discover insights from successful investments and the criteria for team evaluation.

“We've got to be talking to the founding team and ideally not one of them, you know, to the complementary team that's usually behind any good company where, you know, X has met Y back to the intersections.”

Addressing Antimicrobial Resistance in Healthcare

54:06 to 56:00

Discuss the pressing issue of antimicrobial resistance and its impact on health.

“But in this case, it was just over two years.”

Antimicrobial Funding Models and Global Health Needs

56:00 to 58:00

Learn about the funding models for antimicrobial development and the global health challenges driving investment.

“and not get deployed because people are worried about resistance.”

Navigating Investment in Health Tech

58:00 to 1:02:00

Understand the challenges and strategies in investing in health tech and the importance of business models.

“unless something changes and some new business models emerge.”

Success Stories and Lessons Learned in Digital Health

1:02:00 to 1:05:50

Explore successful digital health models and the lessons from missed investment opportunities.

“a good phase two efficacy result in a decent indication, someone else is going to take it to market and it's going to be a trade sale and a pharma acquisition.”

The Dynamics of Patient Capital in Venture Investment

1:05:50 to 1:10:01

Gain insights into how patient capital interacts with investment timelines and inflection points in health tech.

“and just proving what was possible from that perspective and almost deploying those people internally to go and figure it out.”

Understanding Patient Capital in Healthtech Investments

1:10:01 to 1:12:03

Learn about the importance of patient capital and inflection points in healthtech investments.

“If you're that early, you've got to have very clear line of sight to the first or second inflection point and what that is.”

Leveraging Australia's R&D Ecosystem

1:12:04 to 1:13:34

Explore how Australia's R&D benefits and clinical trial ecosystem attract global biotech investments.

“You mentioned you're 65 % Australian companies currently, but you're global.”

Investment Themes and Global Strategies

1:13:35 to 1:15:24

Discover how investment themes guide global healthtech strategies, regardless of location.

“There's a whole lot of things in our ecosystem that make this really sensible.”

Connecting with Tenmile and Investment Proposals

1:15:25 to 1:17:03

Find out how to connect with Tenmile for investment opportunities and proposals.

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Transcript

Automatic transcript. May contain errors.

0:21Dr James Somauroo:Steve Burnell, the Australian Fund. Steve, delighted to have you on the podcast. How are you doing? Yeah, good day, James. I'm thrilled to be here, mate. Thanks for having me. You're very welcome. You're very welcome. Yeah, looking forward to getting into this, because you've got a really interesting background. And actually, some of it I've literally only just learned before we hit recording and before we record. So I am really looking forward to getting into your background, because it sounds like the path to a managing director of a fund that now invests and is very successfully, I take it, with the exits you've got coming through.

0:59Dr James Somauroo:It's been a winding path. Some of it you'd expect, some of it you wouldn't. So I think that's probably all I'm going to say for now, not to ruin the story. But yeah, why don't you tell us a bit of your story, Steve? Where does this all start for you? Yeah, eclectic would be the word I'd use. Well, it starts with my dad. Both my parents were in healthcare dad was a gp um mom was a physio and actually my dad was just mad keen about the ocean and nature and and an amateur naturalist and and uh i think that did two things one it sort of steered me away from healthcare ironically because i obviously came back to it um and steered me towards towards um nature a lot deep love for the ocean and nature and the environment so i'm actually a PhD marine ecologist, James, if we go back to education and schooling.

1:52And so I had an interesting sort of first chapter, quite a long chapter of my career as a fisheries biologist, as a first job, and then worked in environmental consulting, had my own business actually. So I I think I was fairly entrepreneurial from early on. Then I made natural history documentaries as a producer and underwater camera operator. Wow. Several of those nature documentaries. Went to the Antarctic a couple of times as a research biologist.

2:29Dr James Somauroo:Wow. Yeah, so this was all through my sort of 20s and early 30s and really didn't settle down, as they say, until my early 30s when I had sold my little company in Australia, my environmental consulting company, and moved to the US. And that was a sliding door moment that was entirely related to meeting my wife. I had no real plans to go to the US from Australia, but in my early 30s, met my wife whilst traveling. She came here for a year and then we went back. And that resulted in 26 years in the US. Wow. Not necessarily planned, but fantastic time. Both my kids were born there. What part of the US were you in?

3:19Well, initially just out of New York City in Connecticut.

3:23Dr James Somauroo:Wow. And I got a job with a strategy consulting company. Because of my biology background, I ended up doing healthcare clients. and because it was the sort of New Jersey to Boston was the customer base, we had quite a lot of diagnostics and pharma customers. And, you know, long story short, four years later I was a partner and six years later I was the managing partner of that boutique strategy firm and then got hired into one of my clients. It was a public company in the U.S. and that company was acquired ultimately by Roche Genentech, the big Swiss biotech. And that was my kind of, you know, journey from being in the Antarctic, putting satellite trackers on elephant seals and leg bands on wandering albatross, literally, to being in Roche, you know, a global farmer and running a couple of global businesses for them for over a decade.

4:32So, you know, to finish that off, I was hired out of there back to Australia and the family was looking forward to coming back to Australia. So both my boys had been itching to spend some time here. So we moved back when Andrew Forrest, who is my sort of current chapter, Andrew Forrest is, at least in Australia, a very well-known philanthropist and he has built a very substantial company that's now a large public company and create a lot of personal wealth that he and his wife have have probably one of the southern hemisphere's biggest philanthropies and he hired me back to lead the health care efforts and at the time that was a big cancer program that we established and a big program in COVID as well and now international health but yeah it's um it was it was really dad and his you know i was diving scuba diving when i was 12 and and it was that that love of the ocean and i think how i how i at least remember it and and think that my life has happened is i look for these intersections and i love these intersections of tech which has always fascinated me you know what what we can do innovating in technologies my PhD was using satellite trackers on right whales and then identifying them through you know unique patterns and a digital database and a matching system and 20 years later I was running a digital pathology business for Roche that was using effectively a very advanced thing not for you know ocean conservation in this case but for human pathology and oncology so So these sort of intersections of technology with healthcare, technology with conservation and climate now are the things that really float my boat.

6:27Dr James Somauroo:Wow. That's an incredible story. I absolutely love what you said about intersections. I completely agree. I think the intersections of things are the most interesting place. I've said it many times in this podcast, but if computer scientists did ward rounds, we would have a better healthcare system without any shadow of a doubt, in my opinion. Absolutely. And it's that, it's this combining of people's skills, expertise, but actually the way they see problems and solutions that I think we can borrow, we can learn, we can integrate. and when and when those two you know in that example when there's two worlds that combine i just see that that's where the ideas live that's where the new information the new insights live and that's everything that i'm trying to do with the entire of somex with our events with our with this podcast with the newsletter with the clients with it's just everything i'm trying to do is just to smash as many of these relevant worlds that can help each other as possible together to just try and make things happen which is which are that that is just so close to my to my thesis um but i've got to ask because my my hobbies before even starting somax and and delighted that i get to combine these hobbies now but filmmaking like i've got you know my nephew's dop for you know he's hanging out the back of helicopters most of the time and filming various bits and bobs there's a lot in cars and supercars and formula one and it runs in the family i think the creativity the the documentary making, the videography, the cinematography, all of that stuff.

8:08Dr James Somauroo:What do you remember most fondly from that time? And I know you obviously had the, I guess, the motivation and the desire and the purpose from the conservation side of things, and that obviously being the goal in what you were doing. I also know that people that go into this world, it's not easy to find a solution. you're you're you know a drop in the ocean so to speak and trying to make things happen but that all said incredibly powerful things to be doing and actually just incredibly satisfying things to be doing I imagine as well what do you remember most most fondly and and and if you can a story from the documentary making I mean this is nothing to do with health tape but this is just to indulge me yeah yeah well I remember a lot of it fondly right it's still a passion that's as deep as my passion for the ocean and stuff doesn't go away.

9:01So I'm still, you know, finding every excuse to get in and on it. You know, there's a lot of things.

9:09Dr James Somauroo:I think right from the start I got, and this is perhaps unusual, as a young biologist at sort of 24, because I'd started the study on right whales and they were at the time endangered, they're now vulnerable and recovering thankfully. but they'd been whaled almost to extinction at the start of this last century. And we had a really good breeding population. We had started to demonstrate how important some of these areas on the Australian coastline were to their reproduction. And they have calves on the Australian coast and feed down in Antarctica in the summer. But that resulted, and the start of that whole study, resulted in essentially, and with a lot of effort, and me as a young biologist being put in meetings with, you know, angry fishermen but resulted in one of the biggest marine parks, new marine parks being declared in Australia.

10:03And so to protect the carbon ground of the whales. So I actually got to see that, you know, the work you can do in those fields can be put together with smart people in policy and stuff and you can actually make a difference that's a long-term, you know, a long-term difference. we were fortunate that it was quite a remote area so the impacts on you know fishermen and stuff weren't as huge so they were able to declare it quite quickly but there was still a lot of consultation is the right term consultation work but but that was an early win right and not

10:41Dr James Somauroo:everyone gets those even in an entire career so I was thrilled to have that and I think it's sort of made me remain optimistic and passionate about conservation efforts and continue to be involved today, you know, through Sharia Roo Foundation, which is Andrew and Nicola's foundation. You know, we do a lot of stuff in oceans and climate and I'm on the advisory board and stay very much from a pro bono and strategy point of view involved in that. So that scratches that itch. I think from the doco side, I was a photographer from a young age. my you know made a bit of money selling photographs actually um bird photographs and stuff when i was younger but then in the documentaries some of the most memorable things were you know chances to lie on the belly of a right whale you know like literally spread eagled on on the belly of a right whale underwater and um i had a male humpback singing underneath me to the extent that i was vibrating so much just i don't know if you've been to a rock concert and stood in front of those big bass speaker walls, a male humpback singing directly underneath you at full volume sends a wave that comes up through the bottom of the boat.

11:55And if you're in the water, it vibrates your whole body viscerally, like being at a concert like that. So those are pretty amazing experiences.

12:05Dr James Somauroo:Wow. How do you go from that to strategy consulting? Like, I get it. I get it, obviously. One pays the bills and one doesn't. What I was going to say is that the driver. That's probably the honest answer is, you know, family, responsibilities, kids come along. You can't just keep being a single, you know, field biologist in Antarctica and having those kind of amazing experiences. I mean, I guess you could, but what I've tried to do is just not lose my opportunities for those things. So actually the Right Wild project I started is in its 36th year now, the thing I started with my PhD. And it's been funded every year.

12:53And I'm now, you know, I joke that I get the boring job of being the principal investigator and, you know, being involved in trying to raise funding for it and things like that. but I don't get all the fun experiences of being out in the field all the time. But I haven't let go of a lot of that stuff. And I think if you can make a career and trust me, I don't go to work hating my job. I love my job and I love the strategy job and I love my time at Roche and I love my job now. But it doesn't mean you have to let go of your passions, right? Whether they're photography or filmmaking or storytelling or whatever.

13:30Dr James Somauroo:This is it. This is it. I love that. And you know what, moving into healthcare as well, I think what sounds like it still stayed with you is this respect and passion for the world. And yes, from an environmental conservation perspective, you were doing what you were doing then, being out in the field and doing those projects. But I guess that respect for the world can still manifest itself in antimicrobial resistance and in all these different things that actually your fund is incredibly focused on, right? It's hardly a million miles away. It's not. And I have a very deep sort of love and respect for people as well, not just nature.

14:15And it's very hard to exclude us from nature, particularly when you talk about global health. And I spent a huge effort on COVID, right, and these emergent pandemics and infectious diseases. There's a lot of this sort of One Health and global health that clearly shows that we're not isolated and, in fact, very dependent on the environments we live in and what we do to them. so yeah it's all it's all interconnected and to your earlier point about finding those intersections and so much of the energy and and what feels to me like the the innovation and the advancements

14:52Dr James Somauroo:happen at those at those intersections right definitely um in your career you've I mean you mentioned it when you went to the boutique strategy consultancy you've you've risen the ranks quickly and you've got to leadership positions and you've sought out leadership positions and even now when you talk about the things that you did in your in in your past you've gone back to to hold leadership positions as well do you as someone that's clearly seeking this out and passionate for leadership positions like what like what what would be what would be your advice to achieving that i think a lot of people will want to see this this sort of these leaps in career and wanting to impress and and finding their ways to move upwards in organizations what what do you think was what what do you think were the qualities and the and the practices that allowed you to do that yeah that's a great question um look i i don't think of myself as ambitious and seeking out leadership interesting but then but then in retrospect it's uh it's often found me and uh i don't know it's often the way to solve the problem that you want solved if you're passionate about solving the actual problem which it sounds like you are it's often that you have to be in those positions so you can be a reluctant leader almost yeah and i'm not i'm not a reluctant leader i actually enjoy it when i'm there i don't i never really find myself aspiring you know towards someone's job or a certain thing my career you know you've seen from the path of it it's mostly driven by interest and opportunity and i think one of the biggest things to leadership is not being afraid when the moment arises.

16:29If you're good and you're doing a good job, ultimately someone's going to recognize that, the owner of the business, the partner who's retiring in the case of the strategy firm, whatever it is. And you don't even necessarily have to put your hand up or aggressively go for that, but the opportunity will come to you and you have to see it when it does and not be afraid to take it. And probably that's the biggest advice. I've never felt unworthy. You know how people talk, and I shouldn't smile and laugh, people talk about imposter syndrome and I know full well, James, how real it is. I've got the opposite and I don't know what that is.

17:13Dr James Somauroo:I love that. I don't know what that is because I can be in almost any room and I probably should feel like an imposter because I don't have the background that everyone has but i will be putting forward my opinion and you know it's having feeling like i have a seat at the table and i i don't know where that comes from you know probably from childhood something or other um but yeah it might also just be a respect for how the world works i mean you've you spent enough time in nature to know that the forces of of creating individuals and creating organisms and creating ecosystems it's quite humbling i imagine when you view the world from that perspective so actually to see one human being as more worthy than another to be in any given position probably seems ludicrous when you're zoomed out to the extent that you can be observing nature I guess well I'm I'm a big picture guy that's why I found myself in strategy and that's the jobs I've had have been kind of usually strategy new business building new businesses like for Roche around clinical decision support and stuff areas that they were you know trying to explore or get into rather than just sort of an established business that you have to optimize sales I've always been at the other end of the spectrum in all my roles and I kind of see this early stage investment venture as being at that end of the spectrum as well right yeah it's really looking at a lot of different ideas and technologies but also people.

18:43We'll probably get to that, but this is about as much about reading people and betting on people as it is about good science.

18:51Dr James Somauroo:I want to talk to you about opportunity. I definitely want to talk to you about meeting the forests and Ten Mile and all that side of things. But before we do, I just want to touch on what you just said, actually. Being at Roche, undergoing an acquisition, joining a massive company, things can change, going from small to large companies, and yet again you're impressed. Yet again, you rose the ranks. And as you say, building an entire new business around clinical decision support. Can you talk about that? This actually turns into health tech now. So talk about that for me. Yeah. So Ventana Medical Systems was a public US company that was doing tissue diagnostics.

19:30Anyone in the pathology world would know who they are. Roche actually acquired them. And I was acquired into Roche through that acquisition. and Ventana had been a client of mine on the strategy side and I'd spent two years working with the management team talking them through tissue diagnostics and what the future of it was going to be and this was at the stage where companion diagnostics with drugs was really kind of a new thing and Roche and Genentech were leading the way in targeted therapies and with companion diagnostics and stuff. So that led to a whole sort of strategy and then business group in Ventana.

20:09And, you know, it probably, well, I know it did. It added substantively to the acquisition value when Roche bought them and the interest. And so they became Roche Tissue Diagnostics. And not many people know that Roche is the biggest IVD diagnostics company in the world. They're known for their pharma business with Genentech and Roche, but actually their in vitro diagnostics business is the biggest in the world. So it was an interesting onboarding. and I worked again at the interface. I found that from a strategy perspective, Ventana really had this touchpoint between pharma and diagnostics, and then clinical decision support was something that was super interesting to diagnostics who were going to ultimately deploy it and sell it into labs and practices and stuff.

20:59But it was also very interesting to pharma, who it obviously has a huge relevance to in terms of prescriptions and drugs and understanding how they're used and prescribed. And so it was at the interface and I ended up working across both organisations and that led to being involved in the deals, some of the most exciting deals back in that time which were, you know, Foundation Medicine and Flatiron Health which were really interesting and I think bold deals by Roche. we can look in retrospect 15 years later at stuff. But I think both of them were really interesting models that were trying to, in one case, really drive the whole genomics molecular revolution around profiling and understanding disease, but then bringing that into clinical relevance and drug relevance.

21:58And then the other one with Flatiron was really around, you know, putting nearly poor quality, qualitative oncology data sets, patient data sets, and structuring them into a way that they could be useful and computer read and stuff. And I think that remains a huge issue for healthcare more generally. It's very different from what it was back then. But, you know, the more we can structure data, the more we can get computers and AI to help us analyze it. It's got to be high quality. And that was the whole business model at the time of Flat on Hell. So it was an exciting time. I actually enjoy it.

22:38People call me the entrepreneur in Roche, you know, because I was doing those kind of exciting things that were at the interfaces. even though I was in a 90 ,000 person company.

22:52Dr James Somauroo:Yeah. And what a time to be doing it as well. Like what, five, 10 years ago, like really a time where these things were getting set out and you're absolutely right. We're in the world now that if you'd have got your data structure right 10 years ago, then with the models coming out now, then those people are going to be winning. And also for you as well, being part of figuring out the commercial models as well. I think that's, again, like it can be the hard yards, can't it? Like it's all well and good having an idea about how something should work and a model that should work for various reasons.

23:25Dr James Somauroo:But actually to create the incentives that then you see a flywheel actually then create something into the world. That's the thrill. That's the thrill of entrepreneurship. That's the thrill of entrepreneurship. That's the thrill of someone who creates. And you're a creative. You're a DOP. Like you filmed. You had an underwater camera. You want to create things into the world. You want to imagine things into the world. you are a creator so I think that is just such a such a joy and a privilege for for for creative entrepreneurs to yeah to imagine things into the world and I love finding a commercial model that starts to fly well it's just one of the joys of my life to be perfectly honest it is it is an absolute joy and companion diagnostics were like that right and um but then it can be equally for someone who sees a technology and a vision and gets excited about it.

24:18Look, I was in digital pathology and I don't know how much you know about the field of pathology and digital pathology. Even today, there's people saying that this is the most exciting thing and there's a whole lot of companies being funded, deploying AI into patent recognition on digital slides.

24:35Dr James Somauroo:Yeah, counting stuff. I was in this, James, I was in this 15 years ago when Phillips Roche General Electric was spending hundreds of millions of dollars on digital pathology companies and everyone was saying the same thing. And talk about, maybe 20 years ago, and talk about, you know, something that was visible. We had the first FDA, my team did the first breast panel algorithm. So the first five FDA approved algorithms for pathology were out of the Roche team that I ran. and we're talking, what are we talking, 2011 or something?

25:14And it's been that long still, now we're in 2026, and there are much of the world has not adopted digital pathology yet and everyone in 15, 18 years ago was saying, look at radiology, it went in a five-year period, it pretty much digitised. And pathology, just for the nature of the workflow, the nature of the clinical application, how good the age of a typical pathologist, the fact that they're really quick with their hands and their old microscopes and stuff, we still see a lack of adoption, frankly, that's hindering good science. Because even then, our breast panel algorithms circa 2011 were more consistent and much better, frankly, at detecting breast cancer than pathologists.

26:02and here's a really interesting fact for you because there's surely people still struggling with this is that part of a new technology's adoption and regulatory approval is you need something to assess it and assess whether it's right. And our assessment, gold standard, was human pathologists. So how often do you think you can get two human pathologists to agree on the diagnosis or the count of a cell membrane? The algorithm does it and you know it's doing it very well. but then it's got to get two pathologists to agree with it in a blinded way. And so the irony of having a gold standard that's actually determining whether you're right when you're getting those sort of submissions, and I know there's systems today that are going to be facing the same thing where they're essentially an automated or technology-driven solution that is far, far better than the human eye at counting how many disease cells are on a pathology slide or how much membrane staining there is, and yet they're being put up against the human eye as the gold standard.

27:11Dr James Somauroo:It's an interesting - Yeah, it is really interesting. I've had a couple of those companies on this podcast, actually, and the promise is huge. As you quite rightly say, the promise of what can be achieved, the delta between an analog system and a digital system or digital plus AI system, if you consider that an even newer category, is crazy, like what that can actually do, what that can actually achieve. I haven't quite appreciated it in the way that you'd explained it just then, though, the gold standard. Well, that's just a regulatory approval challenge. I mean, the market challenge of introducing cost, which is what these new systems are, their cost into a pathology lab that's frankly, you know, seen already as a cost center.

28:03It's down in the basement of the hospital, although it's critical to every, you know, most diagnoses and every cancer diagnosis. It doesn't, it's not visible in the healthcare economics system. So

28:16Dr James Somauroo:spending money in the pathology lab is a difficult thing to do. Those are all things you have to consider. So is this like a budget boundary issue of save money or pay for something here and save money elsewhere and no one actually zooming out and well not no one but it being difficult to then zoom out and see that system as a whole yes and that happens you know we've talked about value based care for the last 20 years as well and and until you know people really start to not just understand but be able to account for you know properly and i actually think some of the best uses of AI are not going to be in the sexiest areas of, you know, image analysis or, you know, drug target discovery.

29:01They're actually going to be in the picks and shovels of hospital risk management and process management. And how do you actually deploy these things into hospitals? So you can, you know, value-based care needs a really strong accounting across the whole patient journey and all their episodic care and everything else. And you need to be able to start looking at the economics like that to be able to make an investment in a pathology lab.

29:27Dr James Somauroo:Well, they say investors pick the world that we live in next, Steve. So I imagine you're doing a fair amount of work on this stuff, which we're going to come to. You talked about opportunity and you talked about seizing opportunity being one of the sort of hallmarks of how your careers panned out um meeting the forests talk to me talk to me about that and talk to me about how that links to the fund 10 mile yeah that that was sort of sort of surreal a good story about meeting into forest but you know i i picked up a call i was actually in switzerland um i had to go there every month because that's where i reported to even though i lived in california and uh picked up the phone and it was a recruiter who'd been someone had given them my name as an expat you know an Aussie who could potentially be enticed back to Perth and Andrew had had a global search going for someone and he has a very as an industry slash entrepreneur slash business guy he now has a PhD in science by the way as well in marine ecology but he didn't at the time And he was looking for someone who wasn't, you know, your typical academic in oncology sort of cancer background, but was actually a sort of interface of product and data, patient data in particular, and how that could be used.

30:50So more of a business person. And so somehow I'd got on the radar, wasn't looking for a job. We talked as a family about maybe spending some time back in Australia, but it was, again one of those things that was just a an opportunity he said can can you meet you know can you meet I was in Switzerland he said can you meet me in Oman or Dubai I think it was Dubai actually and uh I said well probably I've got to go home you know back to California and he's like yeah well we'll fly to Dubai from California and so I was on a plane to home and then a plane to Dubai and, uh, I met him in a hotel in Dubai, um, for an interview and, and to discuss this role.

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31:34And, uh, I, we spent about three hours together, honestly. And we probably talked for an hour about the role and cancer, uh, and, and that, and we spoke for two hours about, um, ocean conservation and he found out I had a PhD in marine ecology. He was in the middle of doing a PhD in marine ecology. And so it felt to me, and it's hard to describe, but it felt to me like finding someone who, up to that point, James, it's hard to explain, but I'd kind of had to partition my life. As much as we talk about it, giving you this diversity of background and experience that's really good, you don't sit in a meeting in Genentech and tell everyone your PhD is in marine ecology and you've studied whales, right?

32:19It's just that you have a PhD in biology. and uh and right and and so i had this whole life that was a passion life but it was largely sort of under wraps and happened in australia with various conservation initiatives and then i had my day job which was in health care and oncology in big pharma you know for for 14 years and now i'm talking to a billionaire in Dubai who's fascinated with both and actually deploying his considerable resources and assets and intellect into both. And all of a sudden I felt like I didn't have to switch clothes for the conversation because for the last 30 years I've been used to having either, you know, I was wearing my hat of being, you know, the whale biologist PhD in a conservation setting or I was wearing the hat of being the business guy in Roche, you know.

33:17And I never got to wear both hats at the same time or even really talk about both hats to the same audience. And that was the thing that I recall now, and this is seven years ago, as perhaps the most exciting. My wife sort of said I came home from Dubai buzzing and that she kind of knew we were probably going to Australia at that point.

33:37Dr James Somauroo:It was a family vote and both the kids could have been, Either of the kids could have vetoed it at the time, but everyone was up for it. And the funny thing was we moved in late 2019 and obviously COVID hit in 2020. So it was a sort of a family excursion for maybe three years, but it's turned into seven years and building a life here and everything else. But, yeah, I was thrilled to just have that intersection with Andrew, and that's led to a whole lot of super exciting things, 10 Mile obviously being one of them, but a bunch of ability to do conservation and climate things that I'm really interested in as well.

34:24Dr James Somauroo:The 10 Mile side of things, what was... Probably should be a 10 Mile. We should. We should. We've got to. I've got to do the health tech audience justice when I'm 35 minutes into the podcast. A health tech and biotech fund doing very well by all accounts. Really interesting, specific thesis about what you invest in. You're very particular about what you invest in. Well, I say that actually. I mean, I've noticed this with the investor conversations that I've had. There's always the space in between. I mean, we talked about intersections already, like loads here. A real theme of this conversation, actually.

35:06Dr James Somauroo:But those intersections still remain to be incredibly important. So I'm interested in, so was 10 Mile already, was it set up? Was it active? Did you start it? Tell me about the very beginning of 10 Mile. And was this an idea that, was this your idea of how a vision was executed? Or yeah, just talk me through that initial bit. Well, it was actually. I mean, it wasn't started and it was my idea. But about two years in, I benefited from being on the Tatarang Advisory Board. And by then I'd done a number of projects for Andrew and Nicolette Forest. So I'd set up the cancer initiative and we have huge programming, pediatric cancer, precision medicine, tumor boards.

35:50I leveraged a whole lot of stuff. We've set up a big cervical cancer Western Pacific program that is really, I think, just an amazing program in several countries across the Western Pacific adjacent to Australia. And, you know, those we did some brain cancer programs. So we've had collaborations all through Europe and the UK as well, by the way, in that initiative. But I also had done this large COVID response. we quadrupled Australia's IBD testing capacity for COVID during COVID. Oh, wow. You know, I was within two weeks, I pulled up a team of 50 people from across various organisations, a volunteer team, and then we worked for the next five months to really scale Australia's installed IBD lab, COVID lab testing, and not rat tests like the real tests that really underpinned a lot of Australia's strategy in that first six months of 2020.

36:51And so that was fascinating. I think it put me on the radar a little bit as someone who can, can I say, get shit done?

36:58Dr James Somauroo:Get shit done, yeah, no, 100%. Yeah, in Andrew's world, if you're someone who can get shit done and it doesn't need a whole lot of definition or there isn't much information to give you at the start, those are good things. And funnily enough, they rank pretty highly in my own assessment of people as well. I was on the advisory board for Tatarang, which is their commercial interest. So they have their foundation and then a very clear firewall, and then they have a bunch of commercial interests and made their wealth through iron ore mining. But they have massive interest in a diverse set of businesses from real estate to renewable energy.

37:41He's really focused on climate and renewable energy personally, personally. So he's investing heavily in those areas. And 10 Mile, in a way, was me tabling an area that I saw as a bit of an arbitrage post-COVID. This was late 22, early 23. Valuations had already recovered or pretty starting to recover in Europe and the US. Australia was really lagging. So there was an opportunity that was a bit differentiated by focusing on Australia. I knew they look, they really, not just in their philanthropy, but in their commercial assets, they seek to use their capital for good. So, you know, there are many places you can make money and I'm not knocking them, but the forests or Tatarang is never going to invest in gambling, for example.

38:30They look for capital for good, whether that's renewable energy and wind power or, in this case, early stage health innovation and health investing for technology. And so that's how Ten Mile formed. Ten Mile really formed with the forest saying, yep, like it, build a small team, focus on Australia, which was the sort of charter. It wasn't set up as a fund because, you know, they were able to self-fund it. So with a$250 million allocation, initial allocation, it's really about establishing, you know, an evergreen investment business that's focused on this area. And an almost equal part of our sort of mandate from the forest was to build the Australian ecosystem, you know.

39:22So yes, commercial returns. Yes, we're looking for an IRR of 25%, you know. But growing the Australian health commercialisation ecosystem is a key part of your mandate. So we actually do a bunch of stuff and all the team have goals in their plans each year for what they're doing for the ecosystem, whether that's mentorships, whether that's events that we hold. You know, we're on various government policy working groups on things designed to improve, you know, policy, whether it's the R &D tax incentive or capital gains tax treatment for early stage companies. You know, there's a bunch of stuff that 10 Mile does that's really focused on the ecosystem.

40:06um obviously we see that ultimately as benefiting investments but it's not directly tied and and there's no straight line you can draw between that work you're doing now and any one of our investments and and that's deliberate and to do that well as you know you need you need some depth in the team um you know private companies that are building new health technologies is not a space for you know average joe blow investor and i think a lot of people have lost lost money in the micro cap and small cap public markets because they, you know, pretend to understand healthcare and biology. And it's a difficult space as anyone who works in it knows.

40:50It's not easy to generalize. You have to understand clinical adoption workflows, payers, the economics of who's going to pay, all of these things as much as you have to understand the science or behind the thesis or behind the product idea so you know we built a small team i think we're only a small team we're seven people in 10 mile we have a focus on australia but not confined to australia and it's this kind of ability to be a bit flexible that allows you to be opportunistic and grab you know grab those intersection opportunities but But we have a couple, like most venture firms by mandate can't invest in listed stocks or in public markets.

41:36We actually have a couple of public market investments that we saw as misunderstood with good pipeline, very undervalued and stuff, and that fit with one of our thesis in the case of Lumos Diagnostics that fit with our antimicrobial resistance thesis. So we've had the flexibility to not just invest in Australia, but invest overseas. We're about 65-35, 65 % Australian, 35 % overseas at the moment. We're a thematic investor, meaning we are across all of healthcare. We're not just drug development and biotech. We have digital health investments. We have devices as well and diagnostics. And so we're across health technologies.

42:27And yeah, we're flexible enough that we can sort of take a theme, sometimes a slightly contrarian theme, like antimicrobial resistance, and really try to understand that field and understand where there might be opportunities to invest. And I want to be very clear, you know, anyone who knows Andrew Forrest knows that in his commercial activities, he has a foundation that gives away money. But in his commercial activities, we have really quite aggressive targets and objectives. So we have the same sort of pretty tough expectations on IRR for this capital and stuff.

43:11Dr James Somauroo:And I respect that because, by the way, you can't make impact if you're draining the well. Totally agree. And I don't want to dismiss philanthropy because I love it. I'm still involved in it. And I think in some areas, particularly, you know, rare diseases, pediatric cancer, some areas there's huge cervical cancer in developing countries for, you know, to do good and to really move the needle. But I think one of the reasons I pivoted and in the end both pitched and then went with Ten Mile is that at heart I do believe that, what you just said. I believe that it's intrinsically sort of linked commercial success and impact.

43:54And if you're really focused on the former, you'll get the latter. and there's something about making money and that really gets me out of bed in a different way than giving money away.

44:10Dr James Somauroo:Which, by the way, is capitalism working as it should? I mean, that's conscientious capitalism. It's just that when you do that, you have to just put in guardrails at the bottom end and the top end to make sure that it doesn't run away with itself and people end up extreme at the bottom end or extreme at the top end. And so that's the idea that then human wants and desires and needs then force innovation, that innovation, people trade the money, which is, you know, time or fun tokens for the thing. And then it's just that, unfortunately, as you quite rightly said, with things like gambling companies, we can use our money for things that are not actually in our interests that we might want immediately rather than not long term.

44:51Dr James Somauroo:And we don't know the effects and that's where it gets tricky. but um awesome loads of questions on 10 miles so um first of all 250 million dollars evergreen fund i say fund it's evergreen money in a bank account yeah um business you have business yeah um you have you can you can invest it wherever you like in healthcare you can invest it at whatever stage you like in healthcare you can well obviously yeah depending on a few things but talk me through that like what is the thesis what do you look for yes there are themes i'd be interested in what the big themes are there just talk me through the activity of the fund yeah so as i said a lot of flexibility but but not everywhere i think if we were a late stage We're not a growth company, late-stage fund.

45:46$250 million wouldn't go far in that. The thesis and what the forest really supported was this sort of Australia has a great ecosystem. We've got a great secondary STEM education system, public universities. We produce a lot of patents every year, far more than our per capita rate should suggest or our GDP. we don't do a great job of moving that through commercializing those ideas and getting products to patients. People come in and license from Australian universities. So a lot of US and European and now Asian companies will license IP early out of Australian universities. So part of our 10 mile charter was very much around the early stage and really making sure that the science got funding at this sort of critical preclinical and then clinical studies through to sort of phase two where you're starting to get efficacy data if you're a drug if you're a trial of some kind and and you've got interest then to other funding sources whether they be strategics and pharma or whether they be different sort of later stage funds so we tried to hit hit that sweet spot so we're really a seed series a you know investor um we're quite comfortable leading in in that space um a lot of our first checks are sort of three to eight million dollars um but we look at things knowing that you know we're there for the journey as we like to say not not that just the initial seed um so we're not an we're far from being an angel investor we're really looking at things and trying to understand how much they're going to take to get through to you know those inflection points and not the first inflection point that might be a you know clinical feasibility or a first in human trial but but really the inflection point that's going to change the value equation and bring another whole pool of capital that sits somewhere that's much larger frankly and and bring that into the into the mix so that's that's what we

47:53Dr James Somauroo:try to do and again it's opportunity isn't it you're looking for the biggest opportunity um so what do you what do you look for in you know seed series a people talk a lot about people don't they and i think um you can you can look at the idea of see particularly the series a end and and how they're looking to evolve that but the seed stage really it's a lot about people but again when you when you're having those initial meetings with people or even if you're just reviewing the deck that's dropped into your inbox what is it that you're looking for in fact take those two stages for example like let's let's take each so you know cold inbound what are you looking for first meeting what are you looking for if if we're honest in cold inbound and and stuff um it's usually the the thematic the idea the technology the science you know the science it's easier to put on paper it's easier for us to review and match up against our interests and stuff like that um very quickly you know with with a check there the moment you then have you know you dive into any sort of second or third meeting and meet it you're going to be looking very intently at the at the team and the people um and and that'll be at least equal to you know how they've thought about this idea that originally caught your attention but i would say in the cold inbound the science and not just the science, but you've got to make clear that you have an understanding of the commercialization of the science.

49:22Dr James Somauroo:Meaning even if it's, you don't have to have everything pre-baked and I'm not saying that because we're an early investor, but if you're a super bright academic who's worked on protein degraders for 20 years and if you come with just that. It'll be an interesting intellectual conversation for probably members of my team, not me. But if you come with that plus a real clear articulation of why this matters from a healthcare perspective or a druggable targets perspective or disease indication perspective, where it fits competitively and commercially, not yet done the full analysis, but just with an understanding of that and some examples of payer models or a similar class or whatever, if you can just put that together in a cold inbound deck, I think you'll get our interest.

50:23Now, if that's in one of our areas like delivery mechanisms, immunology, novel delivery mechanisms that are targeting tissues that are hard to reach, AMR, antimicrobial resistance, women's health, AI in drug development, you know, if it also touches on oncology, if it touches across one of those or multiple of those and does what I just sort of laid out, I think there's a fairly good chance we'll be in touch. The we'll be in touch matters, right, because you can get a lot of those, if we're honest, that meet that bar. And then the first meeting, it's really key that, you know, we're not talking to the banker who was trying to, you know, get a fund interested.

51:17We've got to be talking to the founding team and ideally not one of them, you know, to the complementary team that's usually behind any good company where, you know, X has met Y back to the intersections. You know, these two individuals have run into each other and and seeing that there's a there there potentially and and you want to hear their excitement and you want to see their complementarity live you know in in the real people um and uh and that's when it gets really exciting i mean there's still a journey from there to investment but that that's when it gets really exciting of course you talked earlier you mentioned

51:56Dr James Somauroo:earlier about reading people as well and again it not being an exact science at all but when you think about you know the investments in your portfolio they do particularly well I know there's an exit to talk about as well when you think about the first meeting with that team what was it that you read in them was it qualities was it things that they said was it things that they ever like what what did you what can you remember of that team in those initial meetings uh it's a Swiss company and and it was it they were impressive in in their sort of maturity and their prior experience in that case.

52:35And I want to say that, you know, it can be different things, right? Because sometimes you can meet very young founders who haven't had prior exits and done deals with strategics and pharma before. But in this case, that was part of it. So they had that sort of credibility and it's real. Super interesting science, you know, in this case, vaccines essentially raised against microbial toxins, so antimicrobial, antibacterial vaccines, against some really pernicious sort of diseases like Staph A and gonorrhea. And, you know, we don't have time to talk about the overriding sort of health theme of antimicrobial resistance, but it's a very genuine and real threat facing human health uh frankly and um it's going to be a bigger killer than cancer potentially anti antibiotic resistance in uh within a decade so you know there's a there's a lot of um reason to be focused on it and they were sort of quietly focused on it with some really good science they had in this case you know a big farmer already um interested on the register so you know that's always a pretty interesting signal.

53:58Interestingly, they weren't the one that acquired them two years later. And it was for us, that's pretty quick, right? We're an early stage funds and some of our journeys will be over a decade probably in terms of between first money in and any kind of exit. But in this case, it was just over two years. I think it was 20, 25 months or something from our investment and Eli Lilly actually acquired them. You know, Lilly's got a lot of cash flow, free cash at the moment and obviously are very acquisitive in a variety of areas to add on to their obesity franchise, but they have gone hard into infectious disease.

54:41And so for us, you know, vaccine approaches was just one complementary thread to an antimicrobial sort of thematic. We have a new brand new gram negative, you know, antimicrobial drug in the portfolio. We have Lumos Diagnostics, which is a point of care diagnostic. It's literally a diagnostic that lets someone at the point of care in a GP or some sort of, and it's clear wave now. So it can be done by someone who's not a GP. It can be done by a practitioner or someone in a GP setting and can actually tell you whether it's a viral or bacterial infection in eight minutes while you're in the GP's office.

55:25And as you know, overprescription and antibiotic stewardship is a huge problem and prescription of antibiotics when they have no potential to help. So that's directly related. So you can see we're sort of thematic and we like to put things together in a theme, assuming that that overall wave. But, you know, there's a huge, it is contrarian because it's been the place where capital goes to die, investing in antibiotics, right? But big pharma has gone away from it. You can build the best drug in the world and have it sit on a shelf and not get deployed because people are worried about resistance.

56:05And so there's been these kind of examples which terrify investors. and you've seen big pharma step away largely from trying to build new antimicrobials. That said, you know, there's this shift, and you never know whether you're too early or where you are in that, but we see it as a shift, a huge unmet need, only going to get worse with population level economic impacts and health impacts globally. And so, you know, that's kind of underlying why we're in. And then we look for ways that these companies can fund themselves and not rely on, you know, governments. It is nice that the UK actually has a great scheme.

56:56I forget what it's called. I wrote it down here. But it's essentially the APSM scheme, Antimicrobial Product Subscription Model. um they you know that that APMS SM sorry APSM scheme in the UK it's small but it actually provides a bit of a pool strategy in business uh from the government so they commit to essentially a new antibiotic or antimicrobial they'll commit a set amount of funding each year irrespective of whether one course gets sold or or 10 ,000 courses get sold it's it's really the concept of we need these on the shelf. We've got to pay the people who are spending money on R &D and building them for us.

57:43And for the sake of having them on the shelf, we'll make up this new subscription model. So the US has got a similar bill right now being considered called the Pasteur Act. So governments are starting to get the realisation that they're not going to get any innovation in this space unless something changes and some new business models emerge.

58:05Dr James Somauroo:talking of business models um sort of talking about where capital goes to die potentially that's probably a bit too pejorative um biotech's great like to like biotech can be great to you know quick exit two years clear buyer like biotech can biotech has a it has a formula to it digital health and and and health tech i guess doesn't fit neatly into that quite often so i'm interested in how you diligence those companies because we've talked about the importance and and the joy that can come from finding the commercial model and getting that to click and that's revenue great yeah you have to think about exits and you have to you have to think about returning that capital with some to your LP, the forest, et cetera.

58:58Dr James Somauroo:Tuttering. So I'm interested in, and there might not be a clear answer to this, to be honest, because health tech and the landscape changes and certainly the tech changes. But I'm interested, do you have a thesis? Do you like certain tech because it has a clear path to exit? Do you like a clear buyer particularly? And you're looking at the needs of that buyer. Do you look at it that way around? how do you how do you look at health tech investments and plot them to exit again i'm interested in this kind of selfishly almost yeah it's it's hard and you can be with this much gray hair you can and having worked in in the field for a long time you can be a bit skeptical and i'm i self-reflect sometimes and and some of the reasons i have some people in my team who are really passionate about digital health is because i've become a bit of a skeptic i was I was the digital health guy in 1998, you know, and sustainable business models took, some would argue, are still waiting to be found, you know, but they've taken this long.

1:00:06Having said that, and, you know, very aware that I can be a bit, because of so many hard-won scars and learnings along the way of, well, who's going to pay, right? It's super cool. It's super cool technology, whether it's determining everything from an image or whatever it's doing, finding new targets, but someone's got to pay. And I think I came somewhere to the realization that just as often the initial payer won't be who you think it is. It'll be, and for some of those technologies, it'll be in pharma and it'll be in R &D before it's actually in a clinical setting or commercial. and that goes for some of these digital health.

1:00:51So the patient clinical trial matching apps and stuff that people thought were all going to be hugely successful and their time had come a decade ago, I think they're only just now getting to that place where they're really finding a way to have a sustainable model. And honestly, it took pharma to sort of step in and nurse a few of them through for them to find that. So it is different. In some ways, and people laugh at me for saying this, biotech's simpler. Drug development, I feel like everyone knows it.

1:01:26Dr James Somauroo:I wrote this in an article like two weeks ago. I wrote this in an article about has venture capital worked in digital health broadly. Well, you've got to send it to me because I'd be fascinated. But I sometimes feel like you know where your risks are. You know that only 10 % of successful phase one drugs are ultimately going to make it. You can do all this sort of reconciliation in your head. You know when value will accrue if they're successful in a trial. To some extent, you don't have to worry about how to take it to market because if you get a good phase two efficacy result in a decent indication, someone else is going to take it to market and it's going to be a trade sale and a pharma acquisition.

1:02:11So I find it's both simpler to get your head around, I think. It's exciting because there is cool tech and there's the ability to make not just money, but actually big impact with new drug classes. And I would say AI is an exciting addition into this area as well in biotech and target discovery and stuff. um the rest i i think is and i've missed some opportunities heidi health's an amazing australian company that we didn't invest in right just to to call out some of the misses some of that's my skepticism about whether another you know clinical decision support tool that essentially helps the doctor in their office transcribe you know notes and and stuff like that was was going to have a commercial model and, you know, who looks like the idiot now.

1:03:09Dr James Somauroo:Well, that's fascinating. For the last 20 years before that, everyone I saw, you know, went to a doctor's office and died because it couldn't find anyone to pay for it. But congrats to them. And it's making me rethink some of those sort of tools and what they have to do and what they can do now that they couldn't do five years ago, what they can do now um you know those guys have solved some of those problems and they've obviously sold a recurring revenue problem and the business model so congrats to them but it gets to your point that in each of these and then devices are different again devices hugely expensive trials you want a strategic who will do the boots on the ground you know through the phase two and the phase three registrational trials you want them on the register already whereas in biotech and drug development, not necessarily if you're confident in the indication and the science.

1:04:09But you can get through a phase one device trial and you can sit there for five years struggling to raise capital or not ever getting through the big phase two or three because the deal's more likely to be done once it's got FDA approval, registrational approval and so it's it's just a different equation and and as investors have to treat it differently we think about it differently fair play for just talking about the Heidi thing

1:04:38Dr James Somauroo:as well because I I I understand I I understand because I I remember they invited a few people to a dinner in london a while ago and it was it was very early on um and they demoed it and it all looked great but there were people in the room that said the same thing you know we've seen this all before like we've seen versions of this like who's gonna pay like i'm the buyer but i've got all these questions there was a there was a lot of that i think what was really interesting about what Heidi did was the the marketing player they went bottom up they went all right you don't need to buy it right now watch me create all the demand and you're going to end up knocking on my door and so that's what they did they went pretty much b2c and just generated all the demand amongst doctors themselves and then those doctors were the ones that turn around and created the demand internally and actually that for me the way I look at it and my analysis obviously being very biased that I'm in the comms world.

1:05:43Dr James Somauroo:That's what I respect about what they did. And they blew competitors out the water with speed because of doing things that way round and just proving what was possible from that perspective and almost deploying those people internally to go and figure it out. Like, actually, if you want this, you're going to have to convince people. And then, of course, they ended up doing both and the success that they've had, et cetera. But there's an argument to say it would have been very falsely optimistic and actually you could label it a bad decision to have seen nine things go wrong previously that were similar and then be so optimistic you invested in the 10th.

1:06:21Dr James Somauroo:Like that's not a failure of using individual. That's just the order in which you've seen things. I think if it was the third one, you didn't seem to fail and thought, oh, this one's a bit different. I'll give that a go. That's perhaps a more defensible reason. But again, you can look at the team and say, well, actually I should have backed the team or whatever it is. many ways to skin that cap but you know i just like the fact that investors come on here and actually said here's one i missed i don't think we've had that before which is really nice appreciate we've all missed our fair share yeah trust me um look i think that's why i you know you really have to have a diverse a diverse team right and yeah and i'm i really value my team's excitement about things that i can can or have become cynical about yeah um because you know I'm like the old pathologist who doesn't want the new digital pathology thing.

1:07:11If I try to get too self-reflective, but I'm the venture capitalist who's seen so much money lost in digital health that they're not deploying in digital health. We are. We've got a couple of great investments in digital health that we're excited about. We've got Mindset Health, which is actually a really cool app that just got CMS approval in the US. Nice. that's doing more for irritable bowel disease and symptoms than any sort of other intervention, FODMAP and all of that. Yeah. And that's peer-reviewed and got evidence to back it up. So, you know, we're not out of the class. And if anything, I'm sort of starting to understand that there are very smart people who are doing these things that we tried to do 20 years ago, but they thought through, in the case of Heidi, like you say, they thought through the marketing and the pull and how to get their product to market and then get people to pay for it, and kudos to them.

1:08:18So there's going to be more opportunities in that space, and we are quite open to that.

1:08:22Dr James Somauroo:A couple of questions before I let you go. Actually about the structure of your fund and why I think it actually is likely to be very successful. I think the evergreen nature of it is very interesting. I'm wondering how do you reconcile patient capital, patient meaning I can wait a long time, versus the targets that you mentioned and commercial value? Because there comes a point where you might as well have just stuck it on the public market to 8 % if you wait long enough. So you need to beat that significantly enough to justify the risk. So I'm interested in how you reconcile those things. Is it because of the suite or the portfolio of companies that you bring on, taking bigger bets on the ones that might take longer and appreciating more risk but longer payout?

1:09:18Dr James Somauroo:Is it a different model than that? How do you reconcile those two things? Not always easily, right? And if you've met Andrew Forrest, you know he's the opposite of patience. The word, I don't love the word patient capital, but that phrase in Andrew Forrest should not be used in the same room because, you know, we laugh about it. He set up an early stage, you know, health technology venture fund, right? And off I go to run it. About six months later, he's back at my door. He's like, any of these chickens come home to roost? And we have a good laugh about it because, you know, that's the timeframe he's on.

1:10:01And, uh, so whether the, the term patient capital, you know, where we look for inflection points quite aggressively and, um, we, if, if it's an early inflection point and you're right there at the seeding or the, you know, even the founding, you know, venture formations, we've done a couple of where we've literally wrapped a new co around an academic or something. If you're that early, you've got to have very clear line of sight to the first or second inflection point and what that is. And you also have to have a very good sense of who's going to fund it with you at those early points, because a lot of the timeline to the ultimate exit or the return for the fund stretches out because of this, these huge delays in raising capital and and yeah and that causes a slowdown in pre-clinical programs that could probably be done in two or three years that are now done in seven and because they've just had to stall all the time waiting waiting for funds to come for to allow them to finish this set of experiments or whatever so if you've got you know part of why we focus on the ecosystem and and sort of sourcing more capital into the australian ecosystem we We focus a lot on international fund relationships and we've just brought a couple of US funds into Australian investments and stuff.

1:11:23This is what we have to do to change that, should change that dynamic. So we're as active on that kind of thing to try and mitigate this. We do look for these Series A syndicate opportunities where we often want to deploy capital that doesn't just get that company into the clinic, meaning into a clinical trial, it actually gets them to through that clinical trial to where they'll have some result, some data, because obviously that data in hand opens up a whole new world of potential financing. So I think if you're sort of milestone driven and inflection point aware, you know, we spend a lot of time talking about inflection points in the, once you're through the science and the excitement of good science and the excitement about a good team, you've got to jump straight to the development program and the inflection points, right, and think about the financing journey because being slow in your financing journey or interrupted

1:12:29Dr James Somauroo:in your financing journey can just make these timelines unbearable for investors, including my own. Final question. You mentioned you're 65 % Australian companies currently, but you're global. Now, I'm interested, your investments globally outside Australia, do they need to have considered Australia as a market? Does that need to be their primary market? What's the link to Australia with your global ambitions and aspirations? Or is this now? No, 10 Mile is a global fund. No, we look for a link, but not to the Australian market. It's just too small a market to try and put that albatross around an international company's neck.

1:13:16What we would look for often, though, is someone who could leverage Australia's unique, say, R &D benefits and our clinical trial ecosystem and stuff. And increasingly, we're seeing really good science and good companies not in Australia, not based in Australia, but are already thinking about running their phase one trial in Australia. And frankly, that's smart. uh right now with the government we've got an r &d tax incentive you know 43 cents on every dollar spent in r &d is money back into the company uh it's like having another investor on the register frankly and as an investor it's a huge thing um the australian sort of clinical trial ecosystem uh the quality of it the breadth of the investigators the institutions that are involved, our phase one, two sort of sites, state governments that support it.

1:14:14There's a whole lot of things in our ecosystem that make this really sensible. And US FDA in places value human data generated in Australia far more than they do, for example, human data from China, early human data from China right now. And so that provides a great benefit. And we're investing in that as a country. I think we're certainly, from our ecosystem point of view, trying to encourage it. And so Australian science, using the Australian R &D system in a way, you know, thoughtfully through their development program. And then critically, the third thing would be that they're on target with one of our themes, you know, our investment themes or areas of interest.

1:15:01you know we we ended up in their amr theme with a us-based biotech a swiss-based vaccine company and an australian-based uh diagnostic company so you know that that was thematic um they were complementary investments um and it didn't matter that the other two were

1:15:24Dr James Somauroo:outside of australia steve it's been absolute pleasure this has flown by i realize i've only got a couple of minutes left um if people want to if people what will thank you first of all this has been an education no it is it's been it's not not least in your background and and all your marine conservation efforts and and photography and videography it's uh it's amazing we can have some far more interesting conversations down the line after this one which is great um so if people want to learn more about about you if they want to learn more about the fund if they want to potentially get in touch regarding getting investment, what is the best way for them to do so?

1:16:01Well, the website is the best way. Honestly, 10mile.com is the website. If you navigate to the bottom and there's a get in touch with us button and then there's a, you know, do you have an investment proposal as a sort of separate link, that'll allow you to upload whatever, a non-con deck and just some information. that's a that's sort of cold inbound um like anyone the rest of the world works on introduction uh if if you know if you know know someone or um you know can get to to one of the team we do plenty of introductions we do uh we're at jp morgan and places like that uh rig you know every year and and uh bio and and things but i i would say the website honestly um we don't i don't give out an investments at 10mile.com we try and funnel everything through the website just because it's it allows us to manage and make sure we we uh respond and everything gets reviewed across the team yeah perfect triage is not allocated to a single individual perfect um thank you steve Thank you, James.

1:17:11It's been a real pleasure talking to you. Sorry I rambled about background. It's been fun. A bit too long. But it is fun, and it's certainly fun from my perspective. And thanks. Really enjoy your podcast. And, yeah, talk soon.

1:17:28Dr James Somauroo:Appreciate you, Steve. Thank you so much. See you, mate.

From the publisher

Steve Burnell is managing director of Tenmile, the health technology and biotech investment business Andrew and Nicola Forrest's Tattarang set up with a 250 million dollar allocation. He is also a PhD marine ecologist who spent his twenties putting satellite trackers on right whales and making natural history documentaries, then spent fourteen years in big pharma, latterly running digital pathology and clinical decision support businesses for Roche.

He and Dr James Somauroo spend a long stretch on antimicrobial resistance, which Steve calls contrarian, and for good reason. Antibiotics have been the place capital goes to die, and big pharma has largely walked away. He explains why Tenmile went in anyway, across a vaccine company, a gram negative antibiotic and a point of care test that tells a GP whether an infection is bacterial or viral.

The most useful part for founders is on money. Steve is candid that he became a digital health sceptic after being the digital health guy in 1998, and he names a miss, Heidi Health, an Australian company Tenmile passed on. His line on it is "who looks like the idiot now".

There is also his advice on leadership, which starts from never having felt unworthy, why he thinks the best uses of AI in hospitals are the unglamorous ones, the regulatory absurdity of proving an algorithm against two pathologists who cannot agree with each other, and what Australia's R and D tax incentive is worth to a company on the register.

Steve Burnell on LinkedIn: https://www.linkedin.com/in/steveburnell

Tenmile: https://www.tenmile.com

Apply to be a guest: https://thehealthtechpodcast.com

Produced by SomX

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#465: Lessons from running a $250M healthtech & biotech fund, with Steve Burnell from TenmileThe Healthtech Podcast · 1 h 18 min
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