NEWSLETTER DECEMBER 2021
Introduction by the founder of Snedden Campbell
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nedden Campbell (SC) is a Callendar-based recruitment firm for the global medical technology sector. It was founded by me and my wife, Jennifer Snedden, in 2001 as a recruitment partner for medtech firms in Europe and beyond. We find senior, skilled people and we make board placements in companies that are involved in a range of areas, including life sciences, biomedical, diagnostics and medical devices. Working directly with company management or engaged by external investors, we have placed skilled staff in companies in the UK, Spain, France and Denmark and we have attended meetings in Germany, the Netherlands, the Czech Republic and Dubai. As a small company with a global audience, we are one of only a small number of recruiters with more than two decaces of experience in medtech recruitment and we have an enviable and hard won reputation for quality, effectiveness and dependability, which benefits from a large amount of repeat business. We bring a specialist understanding of the medical technology industry to the business, plus a mix of experience, curiosity and creativity to help find the best possible candidates available for your company. We’ve also been told on many occasions that working with us is an enjoyable experience. I have been in candidate search for more than 30 years. Prior to launching Snedden Campbell, I held senior roles for some of the UK’s biggest recruitment companies. Fed up with men in grey suits, pointless KPIs and sharp practice, I decided to launch a new kind of retained medical technology search consultancy that would bring
approachability to headhunting, where clients and candidates would be treated equally and where nobody ever said ‘touching base’. I now spend my time meeting clients and delivering on projects around the UK, Europe and worldwide. Regular business trips always include a visit to the nearest art gallery or cathedral. Outside of work, I love exploring Scotland on foot and usually in the company of Ziggy, the office wonder dog. If the weather is bad, I’ll head to my bench where I’m making a 1:48 scale, air force in plastic. Jennifer leads our market analysis and candidate search function, as well as providing operational support for Snedden Campbell. She has played an important role in making the company what it is today, primarily by not putting up with my madder ideas. Away from the office, Jennifer relaxes, by designing and making soft furnishings, especially lampshades.
Ivor Campbell CEO of Snedden Campbell
Early cancer detection will take blood sweat and tears Why is the NHS partnering a US firm to establish a breakthrough technology? By Ivor Campbell
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he announcement in the autumn that the NHS is taking part in a major new clinical trial for a blood test that could detect more than 50 cancers early, was welcomed as a potential, once-in-a-generation breakthrough. The health service is partnering with Silicon Valley-based healthcare company Grail Inc in a randomised control trial involving up to 140,000 volunteers. The Galleri test will look at the DNA in each patient’s blood to determine if any comes from tumours, which shed cell-free nucleic acids (cfDNA), carrying signals specific to cancer. If successful it could lead to earlier diagnoses of cancers, with dramatically increased survival rates. But before we hang out the bunting, it’s worth noting that nothing in this field is straightforward and we have been here before. Knowledge about the potential of blood testing for cancers has been around for a long time and there remain some major complications to overcome. One of the first questions worth asking is why the UK health service is working with an American company on a potential diagnosis that could play such a significant role in the future of healthcare, particularly when there are several British firms working in the same field? Glasgow-based Dxcover, has already developed a blood test which, combined with artificial intelligence, aims to fast-track patients suspected to have a brain tumour for further treatment. The University of Strathclyde spin-out company has raised £5.1m in funding to progress its multi-cancer development program, based on world leading research and fronted by an award-winning team dedicated to translating this technology into the clinic. The answer lies, inevitably, with expense. The cost of obtaining and processing a single blood sample is around £500, and clinical trials will require hundreds of thousands of samples to be collected. Anyone familiar with this area of research will be aware of Biosignatures, a UK company which spent 12 years working on a similar test, which raised more than £10million in equity funding before investors got cold feet. In comparison, Grail has raised $2billion in the US to get to the same stage, but there’s no guarantee even that
will be enough to get a product to market. Biosignatures co-founder Will Dracup, who invested £3million of his own money in the venture, said: “We didn’t make as fast progress as we’d have liked because we couldn’t afford to. We got the first test to the point of a clinical trial and it worked, at which point we thought we would walk into funding, and so did the big four accountancy company who were our advisers, but we didn’t. “A lot of investors didn’t like the fact that it was a long-term play. After five years of clinical trials, you might just about have some products, but you won’t have broken into the market.” In an ideal world, the NHS would own the technology needed to solve its biggest public health problem, while also being able
to license a successful blood test for cancers to health services around the world, generating additional revenues that could be invested back into improving UK healthcare. However, the NHS is not geared towards investing in, as yet untested treatments, and health trust managers tend to shy away from any opportunities to generate additional revenues, for fear that the equivalent amount will be removed from their budgets by the Treasury. As a result, we have a perverse situation in which the NHS willingly partners an overseas company to help it develop a technology for which it will have the privilege of paying future licensing costs in perpetuity. Even if Grail Inc is successful, the ability to extend the lives of the general population through early diagnoses carries other, associated problems, with co-morbidities. Blood tests are already being developed to identify
debilitating diseases such as Alzheimer’s Disease or rheumatoid arthritis. While there is currently no cure for Alzheimer’s, some companies, including Roche, are seeking to develop develop drugs that can slow the development of the disease. However, even if we can spot the symptoms early, there different forms of dementia that will need different approaches to treat them. We still require to do the trials to identify which ones respond best and where there’s the greatest clinical need. In the US, 40% of cancers are lifestyle related which means identifying and treating tumours earlier will, inevitably lead to the survival of many people who will continue to suffer other, associated effects of obesity, cardiovascular and renal problems, among others. According to David Bramwell, (pictured left inset) the other co-founder of Biosignatures, the term ‘life expectancy’ will become less relevant to future generations who will be taught to focus instead on their ‘healthy life expectancy.’ He said: “Life expectancy in the UK is about 82 years-old but healthy life expectancy, which people are going to hear a lot more about, is about 20 years behind that.
“So, the data is effectively saying that for the last 20 years of your life, you’re not going to be in ideal or good health, you are going to have co-morbidities. As the population gets older, a lot of the focus is going to move to looking at how we can give people a longer healthy life expectancy, rather than a longer life
expectancy, and a lot of that has to do with lifestyle.” Bramwell believes that, with earlier diagnoses, GPs and consultants will require to be more subjective – even judgmental – in their approach to
patients with co-morbidities. He said: “That could mean telling them, ‘if you don’t change your path quite soon, you’re going to have these conditions’, but also managing people changing through weight control, smoking cessation, etc. Most people still think of healthcare in terms of being diagnosed and there being a pill or surgery without them having to do anything to change their lifestyle – but that nettle is going to have to be grasped quite soon. “If you tell a smoker that they have a one in three chance of dying of a smoking-related illness, and their life expectancy is 12 years less than a non-smoker, many will be surprised by this. “How are we still in a position where people don’t know the risks of smoking? These are the sort of things that need to be tackled going forward – the big issues are heart disease, cancers and dementia and Alzheimer’s which are going to cost trillions and we still don’t know what to do about them.” Ivor Campbell is Managing Director of Stirlingshire-based Snedden Campbell, a search company for the medical technology industry.
into the blood. We think that we can detect these before you notice that you have a problem, which means that we should be able to catch it early enough to do something about it.”
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We need to get away from the idea that the only revenue the NHS can spend should come from direct government funding “It’s a high-tech blood test, so what we do is to measure thousands of these proteins in the blood and what we are looking for are signatures of proteins that would say, ‘if you have more of this modified protein and less of that one, that might mean prostate cancer’, while changes to the modifications of other proteins could mean you have got another kind of cancer. So, you can do multiple tests in one blood sample.” Despite attracting £7million in venture capital funding, and £3m
HEAD AND HEART: Biosignatures co-founder Will Dracup (inset) has proposed the creation of an Early Diagnostics Institute
Health benefits Giving the NHS proprietory ownership of technology that can achieve early diagnoses of cancers and dementia makes medical and financial sense, says IVOR CAMPBELL
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ne of the most interesting developments in the past quarter was the news that a leading authority on human proteomics is seeking to establish a publicly owned foundation that will make the National Health Service a world leader in the development of blood tests to detect cancers. Will Dracup, co-founder of Biosignatures Ltd, proposed the creation of an Early Diagnostics Institute (EDI) that, he hopes, can build upon years of research and data collected by his former company. As well as having the potential to detect cancers earlier than is currently possible, he believes the proprietary technology could also achieve early diagnoses of a range of neurological conditions, including Alzheimer’s and other
forms of dementia. As mentioned elsewhere, in the autumn the NHS announced its participation in a major new clinical trial for a blood test that promises to detect more than fifty cancers early. The health service is partnering with Silicon Valley-based healthcare company Grail Inc in a randomised control trial involving up to 140,000 volunteers. The Galleri test will look at the DNA in each patient’s blood to determine if any comes from tumours, which shed cell-free nucleic acids (cfDNA), carrying signals specific to cancer. If successful it could lead to earlier diagnoses of cancers, with dramatically increased survival rates. Biosignatures Ltd was forced to halt its 12-year research programme, doing similar work, in 2020 due to a lack of private
investment in the UK. However, Will believes that its work can continue under the the auspices of an independent foundation, with input from private and public sectors, and with ownership of the intellectual property for its blood tests reverting to the NHS. He said: “The organisation is called the Early Diagnostics Institute, and it’s goal is to develop tests that tell you are developing a cancer before you realise you are. “Many cancers are much easier to treat if you can catch them early. This is why early diagnosis is our most pressing public health challenge. We have reason to believe we might be able to help with some dementias as well.” He added: “The idea of the EDI is to have it owned by the NHS. Because it will need public money to develop the technology, then the NHS should be the main beneficiary. “It therefore seems strange that the government and the NHS are assisting an American company (Grail) to develop the technology for our most pressing public health challenge, then having to pay the licensing costs of using that technology in perpetuity, when we could develop the capability ourselves, here in the UK.” My view is that, from a public
health perspective, it’s an absolute no brainer, and I don’t say that because Snedden Campbell will be sourcing scientists for the institute. If it is to happen, it will require a change in the mindset of central government and people who run NHS Trusts. We need to get away from the idea that the only revenue the NHS can spend should come from direct government funding. Will told me that there are 21 conditions where there are currently enough samples for his approach to work in the UK Biobank – so his goal of developing five novel tests is reasonably conservative. He said: “The idea is that we will try to find modified proteins that the cancers use that have leaked out
from its founders, Biosignatures Ltd was unable to continue because of the ongoing need for more investment. To date, Grail has raised $2billion in the US. Will said: “One of the things driving this research is having enough samples for a particular disease. we worked on a fairly conservative assumption that, for various technical reasons, they won’t all be tests that we would want to take to market. Some people say that may be the case for Alzheimer’s because at the moment there isn’t a cure for Alzheimer’s. The next issue is cost. You have to process the samples using complex laboratory equipment. That currently costs around £500 a sample including acquisition cost, and you need to do it with hundreds of thousands of people for it to work.”
Testing our patience The UK Government was quick off the mark with the Covid vaccine rollout. But did it jump the gun?
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mid all the ongoing media chatter about the omicron variant and booster jabs, a little read article in Nature recently carried the most important news about the future of the Covid trajectory. While societies across the world continue steadily on a path towards pre-pandemic normality, and lockdown now seems like a distant memory, the science magazine reported that immunity to the virus is declining. Despite the self-congratulatory tone of politicians about the success of the vaccine rollout, people immunized against Covid are losing half of their defensive antibodies every 108 days or so. As a result, those who received their first jab six months ago – offering, at best, 90% protection against mild infection – now have only around 70% immunity. As it was also reported that uptake of booster shots among the UK population is proving sluggish, should we be concerned about a resurgence of cases and even the spectre of further lockdowns in the future? As far as anyone can tell, we’ll be living with Covid for some time to come, with all signs pointing to it becoming endemic, similar to
the cold, flu, or measles. So, if the virus is going to be around forever what will it look like, what impact will it have on our lives and what, if anything, is being done to prepare for that future? The good news is that, to date, existing vaccines have proved effective in dealing with variants of the SARS-CoV-2 strain first detected in Wuhan, China in December 2019. But that may not always be the case and the three main players in the field – Pfizer, Moderna and AstraZeneca – have spent the past few months war gaming for future strains that may be resistant to current vaccines. By practising on known variants such as Beta and Delta, and learning from dress-rehearsal trials, scientists have been able to fine-tune their processes, so that they can hit the ground running if and when, a genuine ‘escape variant’ emerges. Pfizer’s chief executive, Albert Bourla boldly predicted that should the need arise, his company could produce a new, clinically tested vaccine within one hundred days. If experience of the pandemic has taught us anything, it’s that testing is as important as the rollout of vaccines and the quicker our future
ability to test large groups of people, the better it will be for the normal functioning of the economy, education, and travel. Central to the normal functioning of society will be to continue allowing groups to meet in numbers, in offices and classrooms up to larger gatherings at music concerts and sports events. The Technology Partnership, a Cambridge-based diagnostics company, has developed a pioneering method of significantly speeding-up the screening of large groups of people, using a simple saliva test. It believes the technology will be particularly useful in helping to keep schools and offices safe and open by identifying asymptomatic, Covid positive pupils early. Consultant Giles Sanders said: “We know from our own experience that we can collect the majority of viral RNA from a large volume samples – up to 50ml. We can work with up to 50 samples of saliva typically 0.5-1ml per person, using commercial chewing swabs, which are dropped into a cartridge. “In schools there would be a point every day when the teacher comes round with a cartridge and the pupils drop in a chew swab. “The samples can be processed as a whole and, if there is any viral RNA
present, it can be collected and amplified within 30 minutes. He added: “If something is detected in a classroom cohort, you can then proceed to do individual testing or smaller cohort to identify which pupil or pupils are Covid positive.” Yet in many areas of our future lives, particularly travel, what will be as important as our testing negative, will be our level of immunity, according to
Brendan Farrell, CEO of Guilford-based Luas Diagnostics. The World Health Organisation has produced a safe standard of immunity which could soon be adopted by countries as a requirement of entry, according to Mr Farrell. His company is the distributor of a US-manufactured test to determine a person’s level of Covid antibodies, post infection or vaccination. He said: “That’s going to become increasingly important with vaccination roll out. Those people who have had their vaccination completed are merrily going around feeling warm and fuzzy, but the reality is that up to 15% of people vaccinated will not be protected because they didn’t produce antibodies. “And to take that further, people who have produced antibodies, those antibodies can decline quite quickly.” More concerning is his contention, supported by data from the REACT-2 Study of Antibody Prevalence in England, published by the University of Cambridge, that the AstraZeneca vaccine, used most widely in the UK, is less effective at producing antibodies, than either the Moderna or the Pfizer vaccines. Mr Farrell said: “Regretfully for the United Kingdom, the AstraZeneca is certainly less effective than the other vaccines. There’s no doubt about that. “It’s definitely not as effective at all, so Boris and his fellow politicians were flying a very strong flag that they had done a great job in rolling out the vaccine programme, which they did, but their dependence on AstraZeneca is problematic because it definitely does not produce antibodies in the way the Moderna and Pfizer vaccines do.” Guinea pig: Boris Johnson receiving the AstraZenica jab, above, and, left, Pfizer boss Albert Bourla
ONLY LIMIT IS IMAGINATION Covid was the spur that has taken the diagnostic testing industry in new directions and to new heights of achievement, says IVOR CAMPBELL
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ntil recently the only group of people likely to routinely come across a lateral flow test were women who wanted to know if they were pregnant in a hurry. Since Covid, such tests have become part of our everyday lives and the fabled passenger on the Clapham omnibus has suddenly become an expert in everything from antibodies and sandwich assays to dipstick formats. Despite concerns about the reliability of some tests, results have improved and the ease and speed with which self-testing is now routinely done has given diagnostics companies a valuable insight into the future market potential of rapid, point-of-care testing. The popularisation of testing has shone an unprecedented spotlight on the diagnostics industry as well as gaining the attention of investors. Forward planning groups have been hastily assembled to anticipate future demand and to develop
advanced stage technologies that are ripe for commercialisation. The benefit of lateral flow assays (LFAs) is in their speed, simplicity, low cost and robustness. Stored at room temperature, they can have a shelf life of several years. Billions of test strips are manufactured globally every year for point of care testing to diagnose a range of diseases and conditions, including sexually transmitted infections (STIs), malaria, tuberculosis and hepatitis. They are also used to test for pregnancy and fertility, cardiac markers, cholesterol/lipids, drug abuse, food safety drug abuse and veterinary diagnostics, among others. However, they can stop short when it comes to reliability, as any woman who has had to do multiple pregnancy tests before arriving at a definitive result, will testify. Birmingham-based Linear Diagnostics is pioneering a new process that promises to combine the speed of lateral flow technology with a high level or reliability in the diagnosis of STIs,
particularly chlamydia and Gonorrhoea. Co-founders Professors Tim Dafforn and Professor Matthew Hicks (pictured inset) developed the method – known as linear dichroism – which works by detecting a shift in the plane of polarised light focused on detector molecules of bacteria. Different molecular recognition methods can be used on detector molecules to measure target analytes and antibodies and detect antigens or oligonucleotides to capture complementary target DNA sequences. Brendan Farrell, chairman of Linear Diagnostics – a spinout company from the University of Birmingham – said: “Current testing for STIs takes days and uses molecular technology which detects the genetic material of whatever it is you’re looking for. “It detects a specific genetic
sequence that is unique to that organism, whether it is chlamydia and Gonorrhoea. “We are using a process which is a very simple way of detecting various molecules floating around in a solution. It shines polarised light on a solution that contains certain bacteria molecules and, if they bind to a target, the flow gets disrupted.” The point-of-care test can be done in a hospital or clinic within 15 minutes using a portable, single-use disposable cassette and electronic reader, both developed by partner company, Cambridge-based Sagentia Innovation. Farrell said: “We decided to focus on sexually transmitted infections, which is a large and growing market and not very well served with rapid testing at the moment. “The spread of some of the STIs is quite rapid. People don’t take
precautions and there is a significant spread of the diseases. “We detect chlamydia and Gonorrhoea in a single sample of urine or a swab sample. Some people will go to the doctor and get a sample taken and then get nervous and they don’t come back for the result. They don’t get treated, because they don’t know the result. “With this test within 15 minutes, which is a reasonable waiting time for someone sitting in a waiting room, they will be called back and, if they are positive, they can be given a prescription on the spot.” Among the most ambitious advances in testing has been done done by the global health arm of Omega Diagnostics, based in Alva, Clackmannanshire. Its point-of-care Visitect CD4 Advanced Disease technology is a
rapid, semi-quantitative lateral flow assay that can diagnose HIV within minutes. It does so by detecting relevant proteins on the surface of patients’ CD4 cells – also known as T cells – which are the white blood cells that fight infection and play an important role in the immune system. The company hopes that faster, point -ofcare diagnosis of HIV can slow the spread of the disease in low to middle income countries, particularly in Africa Chief Executive Colin King said: “The World Health Organisation (WHO) has identified that there are
still around 1million people around the world dying of HIV every year. For the past few years, if you have tested positive for HIV you have been given anti-retroviral drugs. The WHO did a deal with several companies to try to drive down and eradicate HIV in those countries. “It has been successful in reducing deaths but what they have found is that casualty rate has plateaued and hasn’t dropped any lower than 1million deaths a year.”. He added: “A substantial proportion
of people dying are in the advanced stages of HIV disease. “Because their CD4 count is below 200, they are more likely to die from other diseases because their immune system is so compromised. “We are putting in place a programme that will screen high risk patients in these countries. “If their CD4 count is below 200, then they will be tested for other diseases, such as tuberculosis, cryptococcal, meningitis and Aspergillosis. There’s about half a dozen other tests that sit around this that are potentially fatal and most are easy to treat.” Ivor Campbell is Managing Director of Stirlingshire-based Snedden Campbell, a search company for the medical technology industry.
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