Testmate Health

As a teenager, Dr. Siew-Veena Sahi dreamed of being an obstetrician running field hospitals and delivering maternity care for Doctors Without Borders. What would eventually lead her to develop the world’s first urine-based at-home STI test was a mix of fate, luck and passion—of medicine, science, and women’s health. “I chose to focus on a degree in global public health, of which there are so many topics you can cover, like vaccines or water supply, but there was one class on women’s health,” she remembers. “It centered around a research project commissioned by the World Health Organization to analyze STI tests. Our goal was to find one, just one, that was sensitive, accurate, and low-cost.”

Four years later, after completing the project in parallel with her medical studies, it turned out that there wasn’t a cheap and accurate test for chlamydia or gonorrhea. There was, however, a new rapid DNA detection technology being developed by the University of Geneva to find salmonella in the food supply chain. “I thought, surely, we could create a similar test for STIs, which have DNA in them. So I tried it in the lab and it worked.”

Testmate Health combines DNA isothermal technology with cutting-edge Swiss microengineering techniques to create a discreet at-home urine test that fits on the palm of your hand. Results for the three most common STIs (chlamydia, gonorrhea, and trichomoniasis) are available within minutes and you can choose to share them with your doctor to get treatment via Testmate’s app. The Helm is thrilled to back founder and CEO Siew-Veena’s vision to revolutionize the future of STI testing and treatment, alongside other powerhouse women’s healthcare-focused funds, including RH Capital and Amboy Street Ventures. Read more in our interview with Siew-Veena below.

What is the 10-year vision for Testmate Health—both what this looks like for the company and the broader impact it will have?

For me, success is when Testmate is as ubiquitous with STI testing as Clear Blue is for pregnancy testing. From an impact perspective, at the end of the day, my passion and my heart always lie in public health. I’ll give you a good example: In 2017 I did an elective program in Tanzania’s largest national hospital, the Muhimbili National Hospital, where the maternity hospital is decrepit, yet the the oncology and cardiology buildings are very modern. At the antenatal clinics they would screen women for STIs, because if you have an undiagnosed STI this increases your risk of preterm birth and complications. Everyone was being screened, which is great, but no one was coming back for their results. Testmate can make such a tangible difference, because all of these women could get their antibiotic treatment before leaving the hospital. At that point, you’re not just doing an action—screening—for the sake of doing an action, you’re taking one step further and actually giving them the treatment that they need. For me, that was a really important moment in this journey. To this day, when the going gets tough and things get rough, I always think back to that moment and the huge impact that Testmate can have. I find it very motivating.

You have a PhD, not an MBA. Were there internal and practical hurdles you had to overcome to step into the role of founder and CEO of Testmate?

In 2017, after I proved the technology worked in the lab, I was sitting my finals to become a medical doctor when I entered a business plan competition run by Oxford University as a fluke—just to see what happened. I got accepted. I was juggling my final exams and their accelerator program, and while there, I met a VC partner who was also an MD; he told me to complete my foundation training, get real-life experience working for the NHS, and then come back to start the business. That was very difficult to hear at the time, because when you’re very excited about something, it’s all you want to do. But when I look back, it was really sound advice. 

So I completed three years of work in the NHS and in 2020, I saw the Switzerland-based accelerator program Mass Challenge had opened up their applications. It has a very low acceptance rate, so again, it was one of those things that I said, look, I’m going to apply and if I’m successful, I’ll take this as a sign from the universe to quit my job, move back to Switzerland and dedicate myself to Testmate full-time. My NHS contract was ending in August and this accelerator program started in June, so when I got accepted, I used my annual leave to start the six-month program. I treated it like mini business school. I attended every lecture and absorbed all the information on everything from regulations and business development to accounting, finance, legal, and IP. I started to integrate myself, met people in the ecosystem, and understand sources of non-diluted funding. 

One part of my story, which is important to say, is that before joining the accelerator, I approached the hospital where I was working as a doctor to see if they would be interested in co-developing the test; I needed a microbiology lab with access to chlamydia or gonorrhea to continue my research. I went to speak to the hospital’s innovation department and they said they would be happy to collaborate but they would take 90% of profits over $100K revenue. I remember sitting in the office asking her to repeat herself; did I really hear that correctly? I’m used to hospitals and universities taking royalties, but this was a very harsh contract. 

You met your co-founder during the accelerator, after you moved back to Switzerland. Finding a co-founder is a lot like dating—how did you decide you would build this company together?

I had no experience within this space, which is where meeting Didier, my co-founder,  at Mass Challenge was important because he had successfully taken products from the lab to market, which is a very different ballgame from academic research. Developing something in a lab is one thing, but developing it for a regulatory pathway is completely different. Didier was the entrepreneur in residence at the accelerator, giving advice to the MedTech startups.

We don’t have a very classical co-founder story like a lot of other companies. Didier is not an operational co-founder, he sits on our board, he’s what I call my wise owl. We worked together for about a year across different things from negotiating IP license agreements to understanding what the market looked like and what our value proposition was. We did a lot of this research together first before officially incorporating the company. In the UK and the U.S., you can create a company with a couple hundred bucks, but in Switzerland, taking the plunge to establish a company is a big financial commitment (they charge you 100,000 Swiss francs), so you need to really ensure your co-founder working relationship is solid.

The next step for us was to find the right engineering partners who could help us integrate our biochemistry into a device, then we applied for and won a 900,000 franc grant from the Swiss government. From there we raised $1M Pre-seed funding to match that grant and to take this vision of integrating these little technology sub-blocks into a device that can be actually used. This $4M Seed round is going to get us to a design freeze of the product—the final user ready product that consumers can receive in a package and perform at home, which sets us up for a clinical trial.

The majority of your investors are women, either from female-led funds or female GPs from male-owned funds. Why do you think that is? 

Being a female founder from a minority background talking about a taboo topic to investors who are typically Caucasian middle-aged men, it either goes one of two ways: they get it and the conversation is great or they just completely shut down. People either understood the problem, what we were building, and the unmet need, or they would just be like, I don’t get it. For a certain population of men, STIs are still so taboo that they don’t even want to engage with the topic, because they might see it as shameful, they don’t want to associate themselves with it. Whereas women, we’re used to getting tested for STIs openly. We go and get our routine checks at the gynecologist. We’re very aware of our reproductive health. And STIs are a leading cause of infertility. There’s something so tangible we can do about it, and I think that really resonates with women—or men who have had wives who have gone through an infertility journey. In a way it meant that I didn’t lose any time with investors, because the great leads all went somewhere and I knew not to pursue the ones which are not interested.

Women also used to talking about taboo topics: menstruation, menopause. We exist in taboo, so we’re comfortable with it at this point.

Exactly, and that taboo element is something that, for us as a company, we will not only have to confront when we eventually market to consumers, but also for subsequent rounds of financing. You never know people’s cultural beliefs, religious beliefs, or attitudes towards sex and their comfort or lack of comfort in having a company like Testmate in their portfolio. It’s not something to be totally ignored.

What was your fundraising process like? What did you came up against, and were there any learnings along the way? 

In some ways what I experienced is similar to what a lot of people experience: this $4M Seed round came together quickly when we had a clear lead, so for me, I really separate it into pre-term sheet and post-term sheet. Pre-term sheet it was slow, but as soon as the term sheet came in we closed a round in three months. 

Obviously, being a female founder in diagnostics comes with its hurdles in a post-Theranos world, which filters through in a few different ways. First, investors want to feel safe that the technology really works. In a way it’s great, because it means we get to put our technology through much more rigorous testing with a higher bar to prove, and I’m happy to demonstrate that we can do that. But on a broader scale, for example when I’m on a panel, I often wonder how much of the time that I’m speaking people are questioning the validity of our technology and thinking about Theranos, as opposed to actually listening to what I’m saying, and how I’m saying it.

I’ll give you an example. I pitched to a well-known conference in Switzerland that provided funding for early stage companies. I had an existing investor sitting on that panel and he told me afterwards that as a female founder in diagnostics, I shouldn’t have worn a black turtleneck. It was winter! Bernie Madoff wears suits; you don’t tell men in finance they can’t wear suits anymore. A black turtleneck is a basic item of clothing. It was very frustrating and it definitely made me feel self-conscious. I realized that despite being so excited to pitch my product, share my vision and the story, the person receiving it on the other end was just thinking, oh gosh, she’s wearing a black turtleneck, she must be like Theranos.

In terms of your fundraising process, were there any organizational strategies or platforms that helped you? 

I ran fundraising like a sales process. I had a sales CRM where I had a list of potential contacts and then under each one, whether or not I could get a warm introduction or if it was going to be a cold reach out. Then I pushed them through the pipeline: introduction made, pitch deck sent, first call scheduled, follow up, etc. 

If I look at the investors who came on board, it is a 50/50 split between cold outreach and warm introductions. There were times where I was sending out blurbs and submitting forms on investor websites wondering if anyone was ever going to read it, but I think it’s still a very solid way of doing it, and a lot of funds have very good way of tracking and processing cold inbounds. So my advice would be to not be disheartened by that, but the power of a warm introduction, for example, through our lead RH capital, can be very catalytic in bringing the round together.

What do you look for in an investor?

You can often tell a lot by an investor based on the businesses that they’ve invested in. For example, with The Helm, even though it’s not explicit, there’s a focus on businesses which have impact. That’s really important for me. I’ve had numerous conversations with VCs and the investors I connect with are those that understand how important the impact of Testmate Health is and how we can really change and solve a really big problem—improving access to STI testing. In order to have good partners on that journey, that, for me, is the number one connection between investors and founders that we need to have. 

We spoke earlier about your transition from doctor to CEO. How has this informed how you think about leadership? 

When I reflect back on my role as a doctor in the NHS and my role now, I’m not sure they’re that different; you show up for work every day and you have no idea what fires you’re going to need to put out. But an important thing I learned as a doctor is always know when to ask for help. If you don’t know what to do, always go to your seniors. That’s a philosophy I’ve tried to apply as I’ve transitioned into this founder/CEO role: I know that I have the vision, I know I have the energy, I know I have the ambition and the drive to execute the vision of what we want to achieve, but I might not have all the skills that are required in myself to do that.

I’ve been good at recognizing those gaps and trying to bring on the right expertise to fill those gaps with the right experience. I’m the conductor in some ways; I have a foot across every single aspect of the business, down to the minute technical details, and it’s my job to make sure that everyone is communicating with each other, that everyone has an overview of what the other is working on, and to promote a collaborative environment. I really pride myself on having a very diverse and inclusive team.

As you are building your team, how do you think about culture?

I have experienced very toxic work cultures. Doctors are pawns, constantly being traded off to different teams, you’re filling in rota gaps, you’re not really a person. You’re a number. It’s a very didactic kind of environment. From there, I’ve tried to foster openness, transparency, freedom to challenge and question and a passion to achieve. I sat down with the team at a very early stage to share and understand the important values of this company, and everybody came with different values. It’s interesting to see what different people say, but I think ultimately we hold those values very, very close to the heart of what we’re trying to do here. We’ve developed a close-knit team, and that really reflects those values.