At Iterative, we have invested in 15 healthcare companies over the past 4 years, and we continue to actively seek out more innovative opportunities. With the growing aging population, limited doctor-to-patient ratio, and significant gaps in access to quality care across much of Southeast Asia (SEA), we believe there are numerous untapped opportunities for healthcare founders in the region.

Jessica Chao, Iterative’s Visiting Partner who leads our healthcare investments, works closely with all of our healthcare portfolio companies. In addition to her role at Iterative, Jessica has mentored over 100+ biotech startups at UCSF’s Clinical Innovation Center and UC Berkeley’s SkyDeck accelerator. She was also a Co-Founder of Healtho, a consumer health information company.

Below, Jessica shares her “Request for Startups” in the healthcare sector, outlining emerging trends and pressing needs within the industry. While these are areas we are interested in funding, we view this list as a starting point and an inspiration for the kinds of impactful healthcare solutions we hope to support. We encourage you to bring forward ideas you are already working on that can make a meaningful difference in Southeast Asia.

#1 Unlocking Clinical Trials in SEA

Iterative is looking for companies that can enable more clinical trials to be conducted in Southeast Asia. While the Asia-Pacific (APAC) region has experienced nearly double-digital growth in clinical trials over the past five years, the Southeast Asia region itself still lags behind in terms of clinical trial participation. Clinical trials are one of the last mile validation required for government approval, yet one of the slowest steps in the entire drug development process. Everyday, pharmaceutical companies large and small are looking at clinical trial sites for various stages of their drug development. While developed countries in the US and EU have the ideal infrastructure for engagement in these partnerships, the cost and time to conduct these trials have become exorbitant, leaving them exploring outside options.

We are looking for tech companies that are leveraging software to enhance, augment or overhaul the clinical trial lifecycle, either by bringing differentiated data, automating workflows or enabling new functionalities:

• ability to identify and screen a population based on a set of eligibility criteria
• ability to explain how a clinical trial works to a population that is not used to being part of a trial
• ability to develop the infrastructure for the principal investigator (PIs), investigational sites and the trial enrollee to adhere to trial standards and parameters
• ability to synthesize and summarize clinical data

SEA is a gold mine for conducting clinical trials as the population is diverse while relatively treatment naive; cost of trial is also cheaper with savings of up to 40% compared to developed countries, and the region have seen tremendous growth in terms of regulatory standards and healthcare infrastructure.  There is no shortage of CROs (contract research organization) in the world, but there is a shortage of CROs that’s developed specifically for the region with localization and cultural aspect in mind. We are looking for localized enablers for clinical trials in SEA.

#2 Unlocking rate limiting steps in clinical care delivery with AI

There are 5 times less doctors in Southeast Asia than in regions like Europe (117 per 10,000) and the Americas (113 per 10,000). This means that access to quality care is extremely scarce in the region. In the era of AI agents, augmentation of primary and specialist care will be crucial in order to close these care gaps. We are looking for companies that can make a big impact in the following using AI to reduce time to diagnose and treatment:

For example:

• By using AI to triage patients who truly require surgical intervention, you can increase something called the surgical yield for medical specialists. When a surgeon sees a patient that does not end up getting a surgery, it’s not only a waste of the patient’s but also the surgeon’s time.
• What if instead of seeing the doctor and then receiving a set of instructions to get tested and medications, now flip this model by using AI to recommend diagnostic tests based on the patient’s risk factors and symptoms prior to seeing a doctor so that the doctors are armed with better information to make a diagnosis.

#3 Balancing supply and demand…and the quality of care

In a region where insurance penetration is less than a single digit, healthcare becomes a capitalistic marketplace where consumer goods and services are priced based on supply and demand. This is generally a good thing in the non-healthcare setting, but in healthcare, there is an imbalance of knowledge where service providers have a deeper understanding of the treatment options than the average consumer. We are looking for companies that can tip the scale by helping consumers make better healthcare choices.

Examples include:

• Treatment based monitoring especially for high cost medication or serious illness progression
  • If you are on a specialty drug that you pay a lot for, wouldn’t you want to know that it is working by monitoring certain labs or symptoms? And if it’s not working, wouldn’t you want to know why? perhaps is because of some predetermined risk factors like genetics or biological factors that should be taken into account.
• A company that can implement a value-based model where care is paid based on outcomes such as a drop in blood pressure or glucose A1C rather than services or goods provided. This type of model generally requires someone to subsidize care such as a regulated entity or an employer.
  • Cityblock Health in the US is an example of value based care for the vulnerable population where insurance company pays them to take care of a cohort of population.

#4 Connecting decentralized healthcare system with interoperability (OS for healthcare)

We are looking for companies that can develop the operating system for private medical practices to help them instantly connect to the vast healthcare network like pharmacies, labs, and other ancillary care so that the average patient in SEA can shift from getting episodic care to comprehensive care.

In SEA, private practices are actually not only on the rise, they are often more affordable than managed organizations and public options. However, much of these practices are still operating in analog and fragmented from the rest of the healthcare system; making it difficult to look at disease and treatment progression in a more holistic way.

For example:

• Just like Zi.Care (S21) that develops an operating system (electronic medical record) for hospital systems that connects them to each other as well as ancillary services like labs, imaging, and making appointment; we need an operating system that connects private medical practices.
• Medpiper (S23) is another example that connects insurers with labs for medical checkups across India.

#5 Saving our hearts

Cardiovascular (CV) diseases remains the number one cause of death in the world; with cancer coming in second. Yet research funding for cardiovascular diseases remains dismal compared to cancer research. This is a global epidemic that requires innovation from all aspects, from understanding genetic factors to diagnostics to treatment. Iterative is looking for companies that can significantly impact the way to diagnose, treat, and monitor CV diseases for all.

For example:

• Non-invasive screen for presence and severity of cardiovascular disease
• regenerative genetic and cell therapy to repair damage cardiac tissue and restoring cardiac function

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