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May 26, 2019
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Biofourmis raises $35M to develop smarter treatments for chronic diseases

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Biofourmis, a Singapore-based startup pioneering a distinctly tech-based approach to the treatment of chronic conditions, has raised a $35 million Series B round for expansion.

The round was led by Sequoia India and MassMutual Ventures, the VC fund from Massachusetts Mutual Life Insurance Company. Other investors who put in include EDBI, the corporate investment arm of Singapore’s Economic Development Board, China-based healthcare platform Jianke and existing investors Openspace Ventures, Aviva Ventures and SGInnovate, a Singapore government initiative for deep tech startups. The round takes Biofourmis to $41.6 million raised to date, according to Crunchbase.

This isn’t your typical TechCrunch funding story.

Biofourmis CEO Kuldeep Singh Rajput moved to Singapore to start a PhD, but he dropped out to start the business with co-founder Wendou Niu in 2015 because he saw the potential to “predict disease before it happens,” he told TechCrunch in an interview.

AI-powered specialist post-discharge care

There are a number of layers to Biofourmis’ work, but essentially it uses a combination of data collected from patients and an AI-based system to customize treatments for post-discharge patients. The company is focused on a range of therapeutics, but its most advanced is cardiac, so patients who have been discharged after heart failure or other heart-related conditions.

With that segment of patients, the Biofourmis platform uses a combination of data from sensors — medical sensors rather than consumer wearables, which are worn 24/7 — and its tech to monitor patient health, detect problems ahead of time and prescribe an optimum treatment course. That information is disseminated through companion mobile apps for patients and caregivers.

Bioformis uses a mobile app as a touch point to give patients tailored care and drug prescriptions after they are discharged from hospital

That’s to say that medicine works differently on different people, so by collecting and monitoring data and crunching numbers, Biofourmis can provide the best drug to help optimize a patient’s health through what it calls a ‘digital pill.’ That’s not Matrix-style futurology, it’s more like a digital prescription that evolves based on the needs of a patient in real-time. It plans to use a network of medical delivery platforms, including Amazon-owned PillPack, to get the drugs to patients within hours.

Yes, that’s future tense because Biofourmis is waiting on FDA approval to commercialize its service. That’s expected to come by the end of this year, Singh Rajput told TechCrunch. But he’s optimistic given clinical trials, which have covered some 5,000 patients across 20 different sites.

On the tech side, Singh Rajput said Biofourmis has seen impressive results with its predictions. He cited tests in the U.S. which enabled the company to “predict heart failure 14 days in advance” with around 90 percent sensitivity. That was achieved using standard medical wearables at the cost of hundreds of dollars, rather than thousands with advanced kit such as Heartlogic from Boston Scientific — although the latter has a longer window for predictions.

The type of disruption that Biofourmis might appear to upset the applecart for pharma companies, but Singh Rajput maintains that the industry is moving towards a more qualitative approach to healthcare because it has been hard to evaluate the performance of drugs and price them accordingly.

“Today, insurance companies are blinded not having transparency on how to price drugs,” he said. “But there are already 50 drugs in the market paying based on outcomes so the market is moving in that direction.”

Outcome-based payments mean insurance firms reimburse all outcomes based on the performance of the drugs, in other words how well patients recover. The rates vary, but a lack of reduction in remission rates can see insurers lower their payouts because drugs aren’t working as well as expected.

Singh Rajput believes Biofourmis can level the playing field and added more granular transparency in terms of drug performance. He believes pharma companies are keen to show their products perform better than others, so over the long-term that’s the model Biofourmis wants to encourage.

Indeed, the confidence is such that Biofourmis intends to initially go to market via pharma companies, who will sell the package into clinics bundled with their drugs, before moving to work with insurance firms once traction is gained. While the Biofourmis is likely to be bundled with initial medication, the company will take a commission of 5-10 percent on the recommended drugs sold through its digital pill.

Biofourmis CEO and co-founder Kuldeep Singh Rajput dropped out of his PhD course to start the company in 2015

Doubling down on the US

With its new money, Biofourmis is doubling down on that imminent commercialization by relocating its headquarters to Boston. It will retain its presence in Singapore, where it has 45 people who handle software and product development, but the new U.S. office is slated to grow from 14 staff right now to up to 120 by the end of the year.

“The U.S. has been a major market focus since day one,” Singh Rajput said. “Being closer to customers and attracting the clinical data science pool is critical.”

While he praised Singapore and said the company remains committed to the country — adding EDBI to its investors is certainly a sign — he admitted that Boston, where he once studied, is a key market for finding “data scientists with core clinical capabilities.”

That expansion is not only to bring the cardio product to market, but also to prepare products to cover other therapeutics. Right now, it has six trials in place that cover pain, orthopedics and oncology. There are also plans to expand in other markets outside of the U.S, and in particular Singapore and China, where Biofourmis plans to lead on Jianke.

Not lacking in confidence, Singh Rajput told TechCrunch that the company is on course to reach a $1 billion valuation when it next raises funding, that’s estimated as 18 months away and the company isn’t saying how much it is worth today.

Singh Rajput did confirm, however, that the round was heavily oversubscribed, and that the startup rebuffed investment offers from pharma companies in order to “avoid a conflict of interest and stay neutral.”

He is also eying a future IPO, which is tentatively set for 2023 — although by then, Singh Rajput said, Biofourmis would need at least two products in the market.

There’s a long way to go before then, but this round has certainly put Biofourmis and its digital pill approach on the map within the tech industry.

These Johns Hopkins students are slashing breast cancer biopsy costs

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Over 2 million women were diagnosed with breast cancer in 2018. And while the diagnosis doesn’t have to be a death sentence for women in countries like the United States, in developing countries three times as many women die from the disease.

Breast cancer survival rates range from 80% or over in North America, Sweden and Japan to around 60% in middle-income countries and below 40% in low-income countries, according to data provided the World Health Organization.

And the WHO blames these low survival rates in less developed countries on the lack of early detection programs, which result in a higher proporation of women presenting with late-stage disease. The problem is exacerbated by a lack of adequate diagnostic technologies and treatment facilities, according to the WHO.

A group of Johns Hopkins University undergraduates believe they have found a solution. The four women, none of whom are over 21-years-old, have developed a new, low-cost, disposable core needle biopsy technology for physicians and nurses that could dramatically reduce cost and waste, thereby increasing the availability of screening technologies in emerging markets.

They’ve taken the technology they developed at Johns Hopkins University and created a new startup called Ithemba, which means “hope” in Swahili, to commercialize their device. While the company is still in its early days, the women recently won the undergraduate Lemelson-MIT Student Prize competition, and has received $60,000 in non-dilutive grant funding and a $10,000 prize associated with the Lemelson award.

Students at Johns Hopkins had been working through the problem of developing low-cost diagnostic tools for breast cancer for the past three years, spurred on by Dr. Susan Harvey, the head of Johns Hopkins Section of Breast Imaging.

While Dr. Harvey presented the problem, and several students tried to tackle it, Ithemba’s co-founders — the biomedical engineering undergrads Laura Hinson, Madeline Lee, Sophia Triantis, and Valerie Zawicki — were the first to bring a solution to market.

Ithemba co-founders Laura Hinson, Madeline Lee, Valerie Zawicki and Sophia Triantis

The 21-year-old Zawicki, who grew up in Long Beach, Calif., has a personal connection to the work the team is doing. When she was just five years old her mother was diagnosed with breast cancer, and the cost of treatment and toll it took on the family forced the family to separate. “My sister moved in with my grandparents,” Zawicki says, while her mother underwent treatment. “When I came to college I was looking for a way to make an impact in the healthcare space and was really inspired by the care my mom received.”

The same is true for Zawicki’s co-founder, Triantis.

“We have an opportunity to  solve problems that really need solving,” says Triantis, a 20-year-old undergraduate. “Breast cancer has affected so many people close to me… It is the most common cancer among women [and] the fact that women in low resource settings do not have the same standard of diagnostic care really inspired me to work on a solution.”

What the four women have made is a version of a core-needled biopsy that has a lower risk of contamination than the reusable devices that are currently on the market and is cheaper than the expensive disposable needles that are the only other option, the founders say.

We’ve designed a novel, disposable portion that attaches to the reusable device and the disposable portion has an ability to trap contaminants that would come back through the needle into the device,” says Triantis. “What we’ve created is a way to trap that and have that full portion be disposable and making the device as easy to clean as possible… with a bleach wipe.”

Ithemba’s low-cost reusable core-needle biopsy device

The company is currently in the process of doing benchtop tests on the device, and will look to file a 510K to be certified as a Class 2 medical device. Already a clinic in South Africa and a hospital in Peru are on board as early customers for the new biopsy tool.

At the heart of the new tool is a mechanism which prevents blood from being drawn back into a needle. The team argues it makes reusable needles much less susceptible to contamination and can replace the disposable needles that are too expensive for many emerging market clinics and hospitals.

Zawicki had been working on the problem for a while when Hinson, Lee, and Triantis joined up. “I joined the team when the problem was presented,” says Zawicki. “The project began with this problem that was pitched three years ago, but the four of us are really those that have brought this to life in terms of a device.”

Crucially for the team, Johns Hopkins was fully supportive of the women taking their intellectual property and owning it themselves. “We received written approval from the tech transfer office to file independently,” says Zawicki. “That is really unique.” 

Coupled with the Lemelson award, Ithemba sees a clear path to ownership of the intellectual property and is filing patents on its device.

Zawicki says that it could be anywhere from three to five years before the device makes it on to the market, but there’s the potential for partnerships with big companies in the biopsy space that could accelerate that time to market.

“Once we get that process solidified and finalize our design we will wrap up our benchtop testing so we can move toward clinical trials by next summer, in 2020,” Zawicki says.

‘Crypto exchange’ Goxtrade caught using other people’s photos on its staff page

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Alleged cryptocurrency exchange Goxtrade bills itself as a “trusted platform for trading bitcoins,” but its staff page is filled with photos of people of pulled seemingly at random from the internet.

The alleged exchange, which claimed to debut in 2017 yet its website is only a little more than a week old, used photos taken from social media profiles and other company websites not associated with the company.

Bizarrely, the alleged exchange didn’t bother to change all of the names of the people whose photos it used.

Amber Baldet, co-founder of Clovyr, a prominent figure in the blockchain community, and listed in Fortune’s ’40 Under 40′, was one of the people whose name and photos appeared on the site.

“Fraud alert: I am not a developer at Goxtrade and probably their entire business is a lie,” she tweeted Friday.

Nearly all of the names are accurate but have no connection to the site. (Image: TechCrunch)

Goxtrade claims to be an exchange that lets users “receive, send and trade cryptocurrency.” After we created an account and signed in, it’s not clear if the site even works. But the online chat room has hundreds of messages of users trying to trade their cryptocurrencies. The site’s name appears to associate closely with Mt. Gox, a failed cryptocurrency exchange that collapsed after it was hacked. At its 2014 peak, the exchange handled more than 70 percent of all bitcoin transactions. More than $450 million in bitcoins were stolen in the apparent breach.

Baldet isn’t the only person wrongly associated with the suspect site.

TechCrunch has confirmed the other photos on the site belong to other people seemingly chosen at random — including a claims specialist in Illinois, a lawyer in Germany, and an operations manager in Melbourne.

Another person whose photo was used without permission is Tom Blomfield, chief executive of digital bank Monzo. In a tweet, Blomfield — who was listed on the alleged exchange as “Arnold Blomfield” — said his legal team has filed complaints with the site’s hosts.

But things get weirder than just stolen staff photos.

Hours after the site was first flagged, Cloudflare now warns users that the alleged exchange is a suspected phishing site. (Image: TechCrunch)

GoxTrade lists its registered address as Heron Tower, one of the new skyscrapers in London. We checked the listings and there’s no company listed in the building of the same name. There’s also no mention of Goxtrade in the U.K.’s registry of companies and businesses. When we checked its listed registered number per its terms and conditions page, the listing points to an entirely unrelated clothing company in Birmingham that dissolved two years ago.

Later in the day, networking giant Cloudflare, which provides its service, flagged the site as a phishing site.

We reached out to Goxtrade by email prior to publication but did not hear back. When we checked, Goxtrade’s mail records was pointing to an email address run by Yandex, a Russian internet company.

It’s not the first time a cryptocurrency startup has been called into question for using other people’s photos on their staff pages. After raising more than $830,000, Miroskii was caught listing actor Ryan Gosling as one of its graphic designers. Almost every photo later transpired to have been lifted from another source. The company later claimed it was hacked.

Cryptocurrency-related scams are not rare. Many have taken what they’ve raised and gone dark, never to be seen again. We’ve covered a fair number here on TechCrunch, including a massive $660 million scam from 2018.

A fair warning with Goxtrade: all signs seem to point to yet another scam.

Read more:

YouTrip, a challenger bank in Southeast Asia, raises $25M for expansion

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Singapore-based startup YouTrip thinks consumers of Southeast Asia deserve a taste of the challenger bank revolution happening in the U.S. and Europe, and it has raised $25 million in new funding to bring its app-and-debit-card service to more parts in the region.

Challenger banks have sprung up in Europe in recent years. Unicorns Monzo, Revolut and N26 are among those that offer their customers a debit card linked to an app and various levels of banking services, including savings and overdrafts. Brex — another billion-dollar-valued startup — is bringing that approach across the pond to the U.S. market.

But what about Southeast Asia?

All the signs indicate this is a region where digital services can thrive. The number of internet users across its six main countries is larger the entire U.S. population, and online spending is tipped to triple to $240 billion by 2025. Already, the region has mega startups including Grab ($14 billion valuation), Tokopedia ($7 billion) and Go-Jek ($9.5 billion) whose investors are betting that these growth signals will translate into reality.

At the more modest end, YouTrip has pulled in this new money to take its model beyond Singapore and into larger countries in Southeast Asia.

YouTrip CEO Caecilia Chu counts Citibank, McKinsey and Chinese fintech giant Lufax among her past employers

Since its commercial launch in August 2018, YouTrip has clocked over 200,000 app downloads and completed over one million transactions for its customers, according to CEO and co-founder Caecilia Chu.

It covers 150 currencies in the app, but the card itself is limited to 10 currencies (including Singapore dollars) with plans to add local options for Southeast Asia.

Chu — who went to Havard with Grab founders Anthony Tan and Hooi Ling Tan, as well as Go-Jek CEO Nadiem Makarim — started the business with co-founder Arthur Mak in 2016 for frequent travelers who are sick of being short-changed when exchanging money for trips, or using overseas ATMs. Over the longer term, she wants to turn the product into a more modern take on banking for Southeast Asian consumers in the style of the aforementioned European flagbearers.

“The objective is to build a trustworthy financial product for the mass consumer with exchange rates that are competitive,” Chu explained in an interview with TechCrunch. “Right now, we’re incredibly focused on travelers.”

“The success [of European challenger banks] has certainly helped in this part of the world where we are the first mover,” she added.

Like Monzo and its ilk, YouTrip offers zero percent transaction fees and no cross-border fees, but there are “competitive” exchange rates and a “small” fee to cover up to SG$2,000 ($1,460) in ATM withdraws per day. (Because, in much of Southeast Asia, cash remains king.)

The plan, further down the line, is to introduce financial products in the future to draw revenue and provide access to services for users, Chu explained. That’s, again, straight out of the European playbook… but there’s nothing wrong with that.

In Singapore, the card — and app — is backed by Mastercard and it includes integration with EZ-Link, the contactless payment option that covers public transport and more in Singapore. Those are the kind of local integrations that the company is eying with its market expansions.

The YouTrip service in Singapore is integrated with Singapore’s EZ-Tap payment system

On that note, Chu, a former banker, is keeping coy on which countries the service will expand to, but she does anticipate that YouTrip will reach one or two new markets over the next six to twelve months. It already has a regional footprint, though. Its team of 70 is located across HQ in Singapore and an engineering office in Hong Kong.

“We’re certainly looking to expand regionally,” she said. “We will hire a local team for each country because the future of fintech is regional and we believe in a localized strategy.”

That’s where this new money will come into play for YouTrip. The $25 million round included Insignia Ventures Partners — the Singapore firm from Yinglan Tan, formerly with Sequoia India and Southeast Asia — with undisclosed family offices and angels providing the remainder.

That’s somewhat unconventional, but Chu said the family offices “have deep roots in Asia, are really motivated and want to invest in our kind of business.” Likely, they understand the frustration of moving money between borders, or for travel purposes, in Southeast Asia and beyond.

With Revolut continuing to stall on its planned entry to Singapore — which was first announced last November — YouTrip will want to seize the initiative on establishing challenger banking in Southeast Asia.

Kargo is disrupting logistics in Myanmar, one of the world’s most challenging countries

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Founders in Seattle recently bemoaned a lack of capital and support when compared to Silicon Valley — what about those building startups in more remote markets?

Kargo, a company that takes the spirit of Uber and brings it to the disorganized world of trucking, has raised a SG$800,000 (US$580,000) round of funding, giving TechCrunch an excuse to delve into the world of startup development in Myanmar, one of the world’s most curious countries.

Ostracized from the world until its first free general election in 2015, Myanmar — which was previously known as Burma — has seen the world’s most radical digitization. Ruled by the military from 1962 until 2011, the price of a SIM card in the country was $250 as recently as 2013 (a big jump on $3,000-odd in the early 2000s) but that all change around the elections in 2015 when the country opened its doors to outside investment and global companies. Telecom companies rushed in, reducing the price of a SIM card to mere dollars, in U.S. terms, and giving those who bought them gigabits of data to use each month.

That rush saw services like Facebook go from non-existent to the key digital space overnight as Myanmar’s 55 million people poured online — the U.S. social network has failed to cope with that crazy growth. Today, some 46 million people are estimated to be online in the country, with mobile the dominant platform and Facebook the top browser — yep, the social network is that big.

Myanmar is getting its first 4G rollouts and the seeds have been sown for internet businesses and startups.

Simplifying logistics

Kargo — which is not to be confused by the Indonesia company of the same name that’s backed by Uber co-founder Travis Kalanick — was started in 2016 by Alexander Wicks, an Australian expat who had previously run digital marketing businesses.

The young company initially joined Phandeeyar, a tech accelerator in major city Yangon, before dropping out due to a disagreement on terms, CEO and founder Wicks said. He told TechCrunch that he valued the organization, but decided to “fly solo” with the business.

That is a bet that appeared to pay off, so far at least. Kargo won a grant from the GSM Association Ecosystem Accelerator Fund, a unit associated with the GSMA, and it represented Myanmar at the world Seedstars Summit last year. Now, it has secured this new funding led by Singapore-based early-stage specialist Cocoon Capital.

Wicks said the round is a pre-Series A deal and he hopes that Kargo can go on to raise a Series A to fuel overseas growth within the next year or 18 months.

Alexander Wicks started Kargo in 2016

Kargo works with multinational companies, including Coke and Nestle, to help them navigate the complicated world of logistics in Myanmar. By aggregating multiple fleets through its platform, Kargo becomes a single point of contact for companies moving product, thus simplifying the process massively. In the past, they’d deal with copious numbers of middlemen, who would liaise with truck fleets to add unnecessary levels of complication and cost.

“The market is very big, its a core part of how the whole country runs,” he explained, adding that Myanmar’s freight industry is expected to triple in the coming years.

Wicks said Kargo works with some 2,000-odd drivers mostly via fleet owners, who typically operate 5-50 trucks through their business. It disintermediates the aforementioned brokers and middlemen, to help drivers and fleet owners recoup a higher portion of each order and gain access to potential new clients. A partnership with Yoma Bank will also give the startup access to an SME loan that’ll enable it to make daily payouts to drivers that need more immediate cash flow than its regularly weekly deposits.

Kargo is currently close to $200,000 in monthly order volume, with 20-30 percent growth month-to-month during 2019, Wicks shared.

It is now exploring its first steps outside of Myanmar by covering ‘logistics corridors’ into Thailand. Wicks said the company has seen a high level of requests to move overseas from existing clients, and he intends to use those relationships to begin to step into new markets tentatively, starting with Thailand.

The new funding will also go towards developing Kargo’s new — and particularly improving the web app used by drivers — as well as increased education and training for truck operators and drivers.

“It’s very much a product for Myanmar,” Wicks said in an interview. “It’s an old industry being built with a new mindset.”

Finally, hiring is a key focus for the capital, too.

Kargo currently has a team of 32, most of whom are located in Yangon, and that headcount is forecast to rise to as many as 60 this year. Business development, fleet management and operations are the core areas where the startup plans to hire, and that will include beefing up its new office in Mandalay.

Wicks — center in a cap — with the members of the Kargo team

Building a startup in Myanmar

When asked what the hardest part of operating a startup in Myanmar is, Wicks claimed that dealing with the government is just ahead of raising investment money.

“Bureaucracy… there are no stats or systems here,” he said. “We have to deal with a lot of government issues.”

Still, he said, the arrival of Uber and its regional competitor Grab — which ultimately acquired the U.S. firm’s regional business — in Myanmar in 2017 gave Kargo and other on-demand startups in the country a real foothold in working with governments by educating them on new business models.

“They made it clear what a platform is for the government,” Wicks said.

He believes that their arrival, coupled with growing internet usage and increased speed, have also helped get investors comfortable with the idea of investing in tech in Myanmar, although he insisted that they must still be “patient” over growth.

“It’s certainly a much more positive landscape for founders today,” Wicks said. “That trust has changed for investors, there are a few of us building companies across the country.”

Educating and training drivers is a major focus for Kargo following its fundraising

That’s certainly true for Cocoon Capital — which is currently raising for a $20 million fund having completed a first close last year.

Managing partner Michael Blakey told TechCrunch that Kargo is the firm’s second investment from that new fund. He’s equally bullish that Kargo is well placed to take advantage of both digital growth and the development of logistics as Myanmar continues to appeal to overseas businesses.

“Myanmar is the fastest growing economy in Southeast Asia and logistics is a key industry to support this growth,” Blakey said in a statement. “We believe the Kargo platform has the potential to disrupt the trucking industry, not only in Myanmar, but in the region.”

If ‘Myanmar 1.0’ was the establishment of credible startups, then the second chapter will be the cream of that crop venturing overseas. Kargo is one of the early contenders that is intent on making that move.

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