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Credence Genomics’ pioneering journey in clinical genomics diagnostics


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  • Founder Dr. Vaz Gnanam shares key insights to its origin, success so far and what is in store for the future 

Dr. Vaz Gnanam conceived Credence Genomics

Dr. Vaz Gnanam conceived Credence Genomics Ltd. in 2011. He grew up in Sri Lanka and was sent to be educated in India in 1989. Qualifying in India as a medical doctor Dr. Vaz headed to the United Kingdom to work in the NHS. He has an ingrained passion for computers and parallely taught himself to code and work on distributed systems. Further to his return to Sri Lanka Dr. Vaz started a series of companies which specialised in software development. As an entrepreneur Dr. Vaz conceived Credence and worked towards establishing a NGS (next generation sequencing) facility in Sri Lanka. The company launched its first set of products in 2015. Following are excerpts of the interview with Dr. Vaz Gnanam:



Q: Can you tell us about Credence Genomics and what you do?

A: Credence Genomics is a clinical genomics diagnostics company that has built its diagnostic tests and applications, all on the next generation sequencing platform. Credence Genomics was one of the earliest adopters of the next generation sequencing platform. This allowed for the creation of unique applications which were accurate, fast and cost effective. The mission of the company is to build low cost, highly accurate, cutting edge diagnostic products more specifically focused on the lower and middle income groups. 

The tests span 3 main clinical areas – infectious diseases, cancer and fertility. The reason for choosing these areas considering our present global scenario of active intervention with diagnostics, screening, and physician assisted precision medicine treatment. This focus has brought a real world impact and better measurable patient outcomes. 

In short our applications assist physicians, patients, and administrators to reap the benefits of the latest technology at the most cost effective price. Hence we can say that Credence has a positive impact on society which makes our field of work very rewarding. 

Q: Can you describe your journey and what it took to be one of the foremost biotechnology companies not only in Sri Lanka but also the region?

A: Credence made a few fundamental decisions which included leapfrogging conventional technology that was out there. When investing in our first platform we had acquired one of the first batch of Ion Torrent PGM machines. At that time many wondered how a Sri Lankan company would be able to dive into the latest realms of biotechnology. We had a dynamic team of young scientists, computer engineers and clinicians. Most importantly the Grace of God, hard work and persistence to build the very best has paid off. We did have our struggles not only on the technology aspects, but other areas which were regulatory, training, infrastructure, acceptance from various sectors and lack of funding. I would not say we have overcome all our challenges but we have been able to adapt to the many challenges. With our past strengthening us, we continue to operate on the bleeding edge and churn out world class competitive products. We are preparing ourselves now to face bigger challenges that may be in the making.

Q: Can you explain a little about the principle science behind it?

A: The simplest way to put it is that our tests are based on analysis of DNA (deoxyribose nucleic acids) which is the basic building block of any life forms. The basic building blocks of life are four – adenine, guanine, cytosine and thymine. Based on the arrangement of these basic blocks we are able to identify organisms, identify disease, predict cancer and evaluate response to medication – to name a few applications. With the NGS technology based equipment and sophisticated IT database analytics/platforms, we can now do this accurately, quickly and evaluate data with extreme precision. 

As a singular impact technology Next Generation Sequencing (NGS) has had a massive impact in changing the way we work especially in relation to genetic and genomic data. New areas such as epigenomics, metabolomics, etc. have surfaced and co-related studies show that with NGS and supporting technologies we will be able to not only predict and respond to disease, but be able to flag very early changes in our body. Application of this technology is not only limited to the areas of medicine but in related fields such as agriculture, animal husbandry, and other life sciences

Q: Would you say the availability of next generation sequencing has changed the way diagnostics based on DNA is being done? Can NGS affect other fields/industries too?

A: As a singular impact technology next generation sequencing has had a massive impact in changing the way we work especially in relation to genetic and genomic data. Not only does all this data have a huge impact on the outcome of diagnostics, but in research new discoveries are made regularly. Along with all these findings, scientists are discovering new areas of specialised studies backed by large quanta of data. New areas such as epigenomics, metabolomics, etc have surfaced and co-related studies show that with NGS and supporting technologies we will be able to not only predict and respond to disease, but be able to flag very early changes in our body. Application of this technology is not only limited to the areas of medicine but in related fields such as agriculture, animal husbandry, and other life sciences. 

Q: How has the field of genetics and genomics changed since the advent of this technology? 

A: In 2003, the human genome project completed sequencing human DNA. Further to that during the human genome project there was a technology shift which brought on next generation sequencing allowing organisations to put this data together cost effectively. Hence the human genome project was one of the few projects completed before budget and at a lower cost. 

In the meantime, many other facilities were using this new technology to build references to various organisms, such as bacteria, viruses, plants, etc. 

More importantly with the ability to have the exact sequences of a life form, this also allowed discovery of various new organisms, species and identification of new diseases. Now with the development of complementary therapies the knowledge of one’s genetic makeup can not only affect an individual’s diet, but also the medication they take. 

The current understanding is limited in reaching the full potential of applications. We believe the next 10 years will see many new findings which will benefit the life sciences especially around the area of genomics. 

Q: Can you speak about your products and how they serve both your local and international markets?

A: We focus on 3 separate areas namely – infectious diseases, infertility and cancer. Our infectious products Rapid Infection Detection (RID), Bactfast and Fungifast are able to identify the presence of bacteria, fungi in any sample with over 92% published accuracy. Furthermore, the technology allows one to do this very quickly. We have also seen that in conditions where there is more than one infective organism our relative abundance report allows us to give a complete view of the all positive infective organisms. 

Our cancer panels cover the most common mutations in breast and colorectal cancer which are inherited. We also have a product that looks at 50 genes to help identify the exact chemotherapy the genes are resistant or sensitive too. 

In fertility we deliver NIPT (non-invasive pre-natal testing) and IVF-G scan, both of which play a contributory and assistive role in increasing the success of IVF and conception. 

Locally we work in both the public sector and the private sector as an independent lab. Internationally we do get inquiries from overseas patients and healthcare institutions. We also draw international patients to our facility. Most importantly is our symbiotic partnership with Apollo Healthcare Enterprises where we are establishing core facilities in Chennai, India to cater to patients not only in Apollo but throughout India. This is a significant partnership and shows confidence in not only our tests but also our technology capabilities. 

We expect that in the next five years we will be able to expand our services and technology foot print to other regional countries through healthcare partnerships or franchising agreements. 

Our core areas of focus will continue to be in diagnostic operation and delivery, apart from the research and development to launch a series of new products. 

Q: Could you give us insight into some of the new products you have in the pipeline?

A: Continuing with our focus in pan infection we will be launching an increased coverage of other infective category identification along with our present spectrum and value added information. We would target the first stage to be within a period of 12 hours to report generation and 24 hours to organism identification and treatment. 

We are also initiating a series of lifestyle products but keeping in mind costs, we would release this for wellness considering the benefits to a larger population in mind. 

Another area we will be developing is our existing series of cancer related tests by augmenting this with liquid biopsy which is non-invasive. 

Also with integrated machine learning capabilities our informatics would deliver not only faster turnaround but higher rate of qualitative analysis. 

Q: In terms of the medical industry and the biotechnology space this is a first for the country as we understand. How will this position Sri Lanka?

A: Yes, it is truly a first for Sri Lanka where medical products and expertise are now exportable and this highlights the country as one with high tech export capabilities. Not only with Credence Genomics but the ability for biotechnology as a sector to grow locally and internationally there is a lot of potential. Export of products and technical know-how in this space will be a large forex earner for the nation. 

Many developed countries and developing countries are now focusing on being research destinations for larger technology companies. Conventionally the service aspect is one area which has been explored where services such as IT services, or manufacturing services can be offshored at a fractionalised cost. Of course Sri Lanka’s intrinsic problem will be to scale to cater to these ever-growing requirements in the international market due to the mass availability of skillsets and infrastructure. 

Development of products or specific niche technology in the medical industry, biotechnology or even in other sectors, will highlight specific skillsets. This not only gives confidence to an international customer utilising the product along with benefits of foreign exchange but also then entertains discussions along the lines of foreign direct investments for further scaling of existing products and even new initiatives. 

Credence Genomics has truly highlighted Sri Lanka’s capacity for science, medicine, information technology and innovation. We are a 100% Sri Lankan team and we are happy to be able to highlight our capabilities along with our representation of the country. 

Our vision is to build cost effective, rapid and accurate clinical genomic tests based on the NGS platform. We will continue to develop intellectual property in relation to our products and related collaborations that we work on

 

Q: What are your thoughts on medical tourism and how will organisations like yours play an important part in this space?

A: Medical costs are quite prohibitive in the western hemisphere and there are long wait times even in nationalised services. Medical tourism is seen as a promising area of specialisation. To be able to offer such services is not only about infrastructure, specialisations and availability of advanced services but a cohesive approach to care. Organisations like ourselves can link with other providers of medical tourism to provide specialised integrated services. This can extend into the areas of diagnostics, treatment and general wellness. As Ayurvedic treatment is one of the larger areas of specialised treatment in Sri Lanka, organisations like Credence can even design specific holistic treatments based on patient profiling. As a country, developing this sector of tourism would benefit not only job creation but tourism of this nature would be a niche offering. 

Q: You had said earlier that there were some regulatory challenges, are we geared now to cater to high tech export?

A: Considering our pioneering status, we were expecting challenges but were not ready for their magnitude. As we worked through various problems we were able to find unique solutions but we never wavered from our end goal. Working with regulators, academia, medical personal and logistic organisations, we kept fine tuning our process. We developed the most unique solutions to cater to our challenges and it was a process of educating ourselves and other stake holders to achieve a symbiotic goal. The process is still not over. As we enlarge our footprint to other regions and into other products we will have to repeat the process. Adaptability is key. 

Q: A partnership with Apollo – can you expand on this?

A: Apollo had evaluated us in respect to our infectious disease product range. On evaluating us in respect to RID, Bactfast and Fungifast, Apollo sees an advantage in applying our products to its portfolio of tests. The partnership allows Apollo to offer cutting edge infectious disease diagnostics across its network of hospitals and to other healthcare institutions. The collaboration will see an initial facility in Chennai catering to the city and surrounding region. We believe both our organisations will see mutual benefits in our collaboration. 

The ability for biotechnology as a sector to grow locally and internationally there is a lot of potential. Export of products and technical know-how in this space will be a large forex earner for the nation

 

Q: What is your vision and what do you see in the future for Credence?

A: Our vision is to build cost effective, rapid and accurate clinical genomic tests based on the NGS platform. We will continue to develop intellectual property in relation to our products and related collaborations that we work on. The future of Credence in the short term will be to continue to expand our portfolio of products, along with our local and international footprints. In parallel we will seek partnerships to fuel our growth through monetary and synergistic gains. Credence is committed to ensuring all stakeholders will continue to be at the bleeding edge and Beyond Biotech 2018 is our primary initiative to deliver on this promise.


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