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The Broken Ecosystem: What It Will Actually Take to Change Women's Health

45m 53s

The Broken Ecosystem: What It Will Actually Take to Change Women's Health

Dr. Chrissy, founder of XX Innovation, discusses the systemic challenges in women's health, drawing from her government experience at the UK medicines regulator. She highlights that the ecosystem is fragmented, with misaligned incentives and a lack of patient involvement, often misusing the term "ecosystem" to focus only on startups and investors. A key issue is the misperception of regulation; regulators are supportive and offer free advice, but startups avoid engagement due to fear. Another barrier is the misalignment of investment, where investors push companies toward wellness routes instead of clinical pathways, hindering long-term solutions. Dr. Chrissy stresses the need for early collaboration across all stakeholders—regulators, investors, healthcare systems, and patients—to break silos and accelerate innovation. Her organization, XX Innovation, aims to act as a connecting tissue, providing guidance on regulatory pathways and funding strategies. She advocates for patient-centered approaches and systemic action to overcome these challenges, ensuring that evidence-based solutions reach patients faster. The conversation underscores the importance of community and shared learning to drive tangible outcomes in women's health.

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Dr. Chrissy is the founder of XX Innovation. While alongside the team, they focus on turning evidence into outcomes for women's health. She brings years of real-world experience across policy, regulation, fort leadership, research, innovation and investment, focusing on applying to solve complex and systemic problems. There's honestly no one better to discuss the current state of the ecosystem of what needs to change, as well as what we can do to move forward as founders and community leaders. I hope you love this episode as much as I did, and as always, if you've got any questions or feedback, please feel free to reach out. Our podcast today is sponsored by Progyny Global, providing best-in-class fertility, pregnancy, postpartum and menopause benefits for the modern global workforce. Check out the show notes for more information. Chrissy, thank you so so much for being here this afternoon. You have such incredible experience, such amazing deep-domain expertise, but also visibility over the whole landscape, which is why I'm so excited to learn from you. You're someone that I've got so much value from in terms of conversations that we've had before, and I've always thought, wow, I just wish I could share so many of these lessons with other people, so I'm really excited for you coming in today. Thank you for being here. No, thank you, Leo. I mean, I have been following you for quite some time now. I have learned a lot from the community. You have built some, I'm very excited to be in this podcast. Oh, amazing. I love that. That's the goal of community, right? Everyone learns from each other and will get onto that in terms of the ecosystem. But before we do, please feel free to share with everyone a little bit about your backstory and what you're working on now. Of course. So, I'm Chrissy Sergaki, I'm the founder of CEO of XX Innovation, which is a non-for-profit organisation that drives systems chains in women's health. And that whole idea came from my previous job, which was within the government. I come from the government. I was working for seven years, seven years of the medicines, a health care products regulatory agency, so the medicine circulator. And there I was working on the intersection of academia, industry, government, policy, and healthcare and the intersection of those trying to align them, bring them together to drive chains. And then at some point, I wrote a paper about the antapotential of the Zalent Macro-Bermed Agnostics, and I realised the huge gap on something like it's so simple to solve. There is so much evidence there. I now know that it's one trillion opportunity, one trillion dollars opportunity, yet completely realised. And as I started digging, I realised that, oh my God, it's exactly the same thing I have come across before, which is people don't talk to each other, don't understand each other. The ecosystem just has never come together. And specifically for women's health, it's just never was never designed with women as a reference point. And I thought that this is going to be my next adventure, bringing all that experience, the governmental insight, understanding how to align, kick-stayholders from different perspectives, different centres, understand what blocks them, and bring them all together to actually drive chains. So, I think sex is not focusing on advocacy, it's focusing on action, really driving action to make things to obtain women's health. I love it, I love the action part. I've, you know, as you know, and as hopefully most of the listeners know, having done 60+ events now, I'm very conscious of always thinking I could do more, and have more focus on tangible outcomes and actions. So, yeah, really, really excited to learn from you today and the rest of your work. What year did you do that paper on the giant microbein? It came out last summer, summer 2025, I have been working with it for a year before that. So, it's rather fresh in the field, and I already know that we have a few companies picking that up, which is exciting. I love that. Yeah, I had Malta on a couple of days ago, who I know your friends with. So, if you are saying that when you first started the research for that paper, I was when you maybe first started really seeing how much of a gap there was in women's health, that was actually only a couple years ago. Is that kind of fair to say that before that maybe the size of the gap wasn't us, kind of, yeah, prevalent to you, haven't noticed that? Yes, and actually this is, I mean, I knew it, but it's just, as most women, perhaps, we're just accustomed to it. We're just part of, if you're one of the problem, we're just, I was always told that my pain is part of being an woman. Anything that was going wrong was just a simple take a person to move or we don't know, or don't stress, or take the pill. And I questioned it, but I just never had an answer, and I thought that, I don't know, that's what it is. So, I was aware, I would just never figure that there were so many solutions. That's what struck me when I did the paper. That's what struck me, that there are solutions, and they're actually simple. It's just that people have, like, I saw studies with 10 patients. I mean, how do you do a study like that? And then I started digging deeper and realized that there are so many problems in pockets. It's not one problem in one solution. It's a lot of different pockets of problems that just is too big of a challenge for anyone to tackle them all, but actually there are solutions. And I see now there are so many innovations. It's not that we don't have sources for everything, but there are a lot of innovations. It's just never making it to patients. And that's exactly what I want to work on, just making sure we get them to patients, and as fast as possible. I love where this is going, but I just want to, the reason why I just asked you that question, and I love that answer, thank you for sharing, is I guess we're more of a lived experience, advocacy standpoint, so many women that I chat to feel like that they are the problem, if they don't fully understand their experience, or if they weren't aware what solutions were available, or something that's come up time and time again from our events, is that it's really reassuring, really affirming and comforting to see these women who are working in and around relevant sectors, who obviously are very educated, also sometimes maybe not be fully aware of the full problem, or also have their own symptoms. I hear a lot of them ask really reassuring for women to hear that it's not necessarily just them and their problem about them lack of potential understanding around their experiences, so thank you for sharing that bit. But in terms of moving forwards and looking at the work that you're about to be doing, and how do you see the current ecosystem and landscape? That is a big broad-fade question on doing that on purpose, so I know you have lots of thoughts, and I want you to jump into the current state of women's health. So first of all, one of the things that I started realising is that we have been overusing and misusing the world's ecosystem, because for me, ecosystem is everything, everyone influencing the pathway from moment zero for conception of the problem and creating a solution to having the actual health care outcome. And everyone involved in that journey is part of ecosystem. The way I hear the word ecosystem be used is usually for two or three actors of the ecosystem, so usually it's startups and investors. That's not the ecosystem, and by focusing just on two of the so many actors of ecosystem, we will not change women's health. No matter how much money, how many innovations we have within the startup's environment, or how much money this is dropped on those, we will not see the change. We want to see the change. We have to really understand where are the silos within the ecosystem? Where does the ecosystem break down? Because it breaks down in so many different places, and each of the places that it breaks down, we have to focus and solve the problem, understand the blockades, and solve the problem, and solve the problem with the specific stakeholders that are involved in that point of the journey. And that's exactly what we want to do with XX, and having that background of really working in the intersection of all the actors, that's what I have been doing for a set of years, from the point of view of the government, I really understand all these different incentives, and perspectives, and so on. And I think this is quite fundamental because what I see time and again is people that cannot communicate with each other within that ecosystem. So I see that the biggest problem is the fragmented ecosystem across the whole journey, the misaligned incentives, and the gap in knowledge across, again, across the whole ecosystem. These are the main, main problems I see, and the problems we're going to focus on tackling with XX. I'm so excited to get into all three of those because I am not the expert on any of those three, but the last few months since losing my own text startup and trying to do more research on this space, that is the exact conclusion that I've came to. So I mean, let's start with the fragmentation, if that's OK, I've faced the start. I completely agree. I feel like there isn't enough collaboration, a lot of people are keeping their cards close to their chest. There isn't maybe that clear channels with Simon. posting. On the never I have a bit of a high-profises, I like to try and find other areas, I then like speak to people in those areas and see if they have the same experience. And I actually mean that in this instance a bit geographically, so I literally when I speak to some people in Oxford and Cambridge, they don't seem to have that same fragmented experience. Or a bit like a micro example in a macro, a macro landscape. But yeah, the fragmented bit is really, really interesting, so please feel free to elaborate on that. So you're speaking about fermented, the pregmentation that we feel here in comparison to Oxford or Cambridge, right? But that's still within the startup environment because we haven't solved women's health in Cambridge or Oxford, right? Yeah. So that's one problem that you have experienced up within London perhaps. But when I'm talking about the fragmentation, I'm looking at it across the whole ecosystem. For example, I am so surprised that people still come to me and ask me, "Oh, why is regulation so difficult for women's health?" It's known. Women's health doesn't have any special requirements for regulation. Regulators don't have to create a new legislation or a new regulation for women's health. Women's health products can't actually go through. Regulation quite simply and straightforward. It's just a perception of how regulation is problematic. That's one problem. Second problem is the pathway to healthcare. So they think I hear very often whether or because of the regulator, we cannot get it to the NHS, but the regulator has nothing to do with your ability to get it to NHS. It's actually other actors within the ecosystem that you have to engage with and quite early on to get your technology through to to NHS. And then there are the investment in certain other quite misaligned with where the money is needed, the capital is needed. So we see, and the biggest thing for me, which I cannot believe we have that problem in women's health, is the patient involvement. Where's the patient? I don't understand how patients are not the center of everything, particularly in this field. Which I have heard the voices through some events that you have been doing, but they're not part of the ecosystem conversation. And for me, that's just wrong. So that's what they mean about fragmented, the whole ecosystem is fragmented, and that's what they mean by ecosystem, really all the actors across. Let's touch on the first one, maybe not to get into regulation fully because we'll get to that, but in terms of it being an example of where there's maybe the wrong perception. Where has that stem from? Who is kind of starting this? I don't fear the fear of regulation because it's being seen. This is not the problem of women's health whatsoever, and that's surprised because I was working on a very innovative space before where regulation wasn't there yet. But coming into that is, I realize that it's just not unique to, it's just startups in general have that fear of the regulatory process because the language is very different and because you invest a lot of money on this process that might actually lead you to nowhere. I think that's the fear and the perception that exists. And the fact that I have heard from many people, they feel like regulators are against them, whereas it's like they're trying to find problems to reject the applications, but actually the regulator wants exactly the same thing as the startups to get very innovative products, two patients as fast as possible, but as safely as possible. So and they're creating a lot of incentives for startups to go faster. There are a lot of examples like in March, they're doing advice for free for startups. So they are doing things to demonstrate that, but it's just that perception and people avoid speaking to them, but those are half spoken to them. I get very good feedback that they actually was very helpful. So it's that perception that hold people back for even trying to get through that process and not that it's using the easier way, which is the wellness route, but actually we need a lot more on the medicinal side of things diagnostics. Ownership should it be on for that then because whenever we have a perception communication problem, for me, I'm like, okay, well said person or institution needs to get in front of those people, but is it the regulators, is it their obligation to basically get in front of people and try and change that perception or the founders need to change that? They're doing that. They are trying to be as closely as they can. I mean, now I'm an example. I was going to conferences, having these conversations and breaking these perceptions while I was within the regulator. And they have the front door, which is the innovation office. They have these programs that just people don't know about. And so for me, it's, I think you need an actor like what XX can be for the field where it can breed that gap, that distance that feels, people feel exists within the between the regulator and the startups, but actually what the step is now, the bullies on the startups court, I would say, because it's just for them to engage and have a conversation because you can just go and have a conversation. And if you do that, you're going to see that events are raised by your side. Love that. I obviously don't have that experience with them, but the one I had with any of that UK comes to mind. So I remember thinking, oh, we're too early for an event UK, like on a waste their time. And then someone came up to me and event and was like, you know, the delay of your events, I'd have to straight you to jump on a call and I was like, I'm sure you got a lot on. I'd probably waste your time, like, you know, I'm still flashing some things out. No, no, no, that's the perfect time to jump on a call. And I was like, okay, sure. So yeah, I think it just comes down to that like awareness piece, doesn't it? If that's an option. And you're absolutely right. That thing, that presentation on Oh, it's too early. Oh, no, no, no, no, it's never too early. Never too early to engage with the regulator. Never too early to engage with all these steps on how do I get to an interest? It's something that you have to do as early as possible because that's going to be part of your fundraising, right? If you have to to to to account for the fact of doing regulation, you need to know what you're going to be doing early on. And I want for execs to be that that connecting tissue that will be there to have exactly these conversations early on. You don't know what to do. You don't know how to think come to us and we can help break these silos between the different organization different actors because I think that can help move a lot of things faster and break the perceptions. I'm going to be saying the same things again, again, until we break all these perceptions in the field and allow to accelerate innovation and pass to access. I love it. Let's talk about the alignment piece of outcomes. Yes, so this is a little bit more difficult again because you see for example, I'll take the investment for example, we see that there's lack of investment within women's health, right? So startups I know they are struggling currently to raise money and a lot of them end up taking the wellness route because they investors that are here to invest for women's health are more comfortable with the faster route to revenue and they want to see that's what I hear from a lot of companies. They want to see revenue. How's exactly my experience? Exactly. And this is because anyone who will actually invest for a set up, a diagnostic that will be at the point of care within a night says, wants to see what is the pathway to return. It may be in 10 years, but what is the pathway? And one that when the pathway is non-set up is not that simple, is not a straightforward, when we don't have the experiences of innovators making it through their having that return, it's a far too big of a risk for these type of investors to invest in women's health and that means that a lot of amazing ideas could actually change women's lives, have to survive, they have to go find a way to go the wellness route in order to get into access to some capital and survive, but that also means that they get into a loop that is very difficult to get out because you need a lot of money to go to the regulatory process, the proper clinical trial routes and then the implementation to healthcare that not many of those investors at that into the one space would accommodate. And this is what I mean that is quite white misaligned. And then not enough, there's not the no incentives from a farmer, for example, for these products to have a root to get through to this exit. And that's one layer of the misaligned in incentives that I see. If I think about my own experience and what you've just said a few on asex to be from like a, you know, an entry point signposting, etc. support, which is amazing. I had no one that could give, I didn't really feel like I'd find anyone that I could speak to about it in general, but the people that I did have around me to chat to about this, and didn't really have any, have any answers. And I was like, do we wait to become a category one medical device before going to market? And obviously, if we do agree that that is the right approach, then there's downstream things that I need to, you know, align in order to survive that long and to pay that money, etc. But at least then there's a strategy and a narrative off the back of it. Or the only VCs that really seem to be interested are consumer VCs, because even a category one medical, again, this might be like a hyper specific example. But for us, even the med tech funds were like, we're not interested in chatting with you until you've got it. And I was kind of like, well, I don't know if I want to prioritize it upon launch, if that still isn't med tech enough for you. Because the consumer VCs are kind of saying that it's, you know, something that might be called Fensibility later, but you don't obviously need it at the start. So I kind of went for that option of go to market consumer with a guy that becoming a category one medical device later. But really, that was just the best, the best guess like, I had no one to like flush that flush that out with. So it definitely would be cool for there to be more people that you can access to be like, okay, here are my like pathway options. One is definitely to have this conversation and to understand how to even think about that. But the second is that we have to build, in my opinion, we have to build the case studies, this success stories within the field. The pathways to market access through a n a test for the field to see for investors to see that there is way to get through the reason why in the pipeline to get to have that return on investment. And so there are two sides of it. One is to support startups with that. And the second is definitely to identify ways to unblock because that's where a fragmentation of the ecosystem, what do we have to tackle as XX? The next part of this then is knowledge. And I'm really curious to hear your thoughts on this and we may be touching it a couple of times already. But as someone that was coming into this without a clinical or a technical or a regulatory background, I really did feel like I was starting from your final background. I really felt like I was starting from absolutely zero. I feel like there was actually a couple of advantages to that in a way. I feel like I viewed the problem a little bit differently. I viewed the landscape a little bit differently, like there can be some advantages to that. But ultimately for the most part, it was, you know, it was a drawback because there was so much that you were trying to learn simultaneously. So yeah, I'm really clear to hear your thoughts on the knowledge part of the fragmentation. So the knowledge, but the knowledge part that I mentioned is rather on the how little we know about the windows physiology. And that is a block it's to implementing change actually, whether that's within a net test or with innovation itself. So there's a lot we still don't know, even if we try and get one of the stakeholders to change some things, if the knowledge is not there, how can the reliable make that terribly make that change? For example, how different drugs affect the or work within the female body? If you don't know enough, but there's not enough data on that, how can we fix that? And that's where that's what the knowledge fits in that we still have to build a lot. A lot of the fundamental understanding of how hormones work. We still don't know how they work, how they change, how they interact with in different stages of life or health of disease. And let's have that information, how can we meaningfully change women's health and quantify that change? So we see because I think women can feel it, can see it, we can see what it will mean not to feel like that, but we cannot actually scientifically or even economically measure that impact and that change. Cool. So as moves of the solutions, what do we do about all about? And I guess if we start from like a founder perspective, of course, the whole ecosystem is not going to change in the next week or two, but you are going to want to drive your start up forwards. So you're a founder, you know, early stage, something to do with women's health. What advice would you give them in terms of the blind spots that there are in the ecosystem at the moment? Oh, nice. Definitely decide who you are, who you want to be, what problem do you want to solve? If you decide that you want to change women's health and the point of care, please do that. We need we need more of that. And if that's what you want to do, engage as early as possible with the regulator, start thinking about it, asking these questions, ask, well, ask us, ask like sex, but ask as many people, you need to ask for you to understand what you need to think about that, think about your evidence, think about your clinical validation, think about, think about everything that will determine how you will get to the patient. Think about the patients and what do they need and how to different types of patients from different communities may need for your idea to reach them and improve their lives. And that's what practically start-ups can do to begin with. And then there is a lot of work that an organization like a sex who is neutral, you know, who is independent, not for profit, so they're not in center, it's monitoring, said it can do to start breaking blockages because I don't think this is a job of the start-up to go on that has a product that go to go on and break those blockages in the system. And we need an organization that will actually act on those different bits that the barriers to break them and allow for this pathway, pave that pathway for start-ups to go through. And ultimately as a community, I think we need to, I mean, I'm proud of all the people that do the advocacy because that's how what Brut has all here, right? But I would like us to move beyond the advocacy and start actually implementing change, which is exactly what XXKing to do in the field. How do we do, yeah, I guess maybe moving on from founders then, ask anyone that wants to facilitate community, whether that's, you know, events or chats or programs, like what would you like them to take away from this? What can we do better? What can I do better? This is just me trying to try to learn from you now. As I said at the beginning, I love the community side of this field. I think I would like to see us talking a lot more about action. Practical, not saying, let's say, in legislation, because that's not practical. Practical things that we can start doing tomorrow, practical solutions. And then having some sort of accountability, which again, how I like to work is holding people, organizations, stakeholders, actors accountable to drive that change. And it has to be broken down to steps, it has to be broken down to examples to case studies to demonstrate how practically we can move forward. That's my, maybe you have refueled. I love it. I, yeah, I'm really excited to see, to see where we go with this. You mentioned around being a non-profit, was that choice because of the potential alignment of outcomes? I thought a lot about this and what it should be. It was very important to me, the ecosystem, to be able to build that ecosystem, to be able to engage with all the stakeholders, with all the actors of the ecosystem. It is very important to be neutral, to be objective, and to bring everyone together, you have to be, you shouldn't have any strings attached. And when there is some sort of monetary exchange, there are certain strings attached. I didn't want to have that because I know that being non-profit, neutral objective that will allow me to align with stakeholders and bring everyone together. And did that voice that anyone within the ecosystem will know? know that we call that neutrality and objectivity and that the incentive is clearly to change women's health. I love that. I have a lot of people who are to test this. Whenever someone asks me for introductions to angel investors or partners or sponsors and they'll, but I'll give you a commission on just like absolutely not. Because if I think I'll even make the introduction because I think it's in everyone's best interests or a way, but offering me a car will not change if I think that is the right approach, which I really believe in and stand by. Slightly, I guess, contradicted by the fact that I'm not a non-profit in terms of the events and community and I completely agree with what you just said there. So I'm now thinking like, you know, how do I go about that? Basically, like, do I have to become, how I'm curious to hear your thoughts, like, do I have to become a non-profit? I'm kind of answering my own question because like, the answer, I guess, really is yes. But if I don't want to do that, how can I ensure that I still have everyone's best interests at heart with aligned outcomes, I suppose, to needing to monetize certain partners? This is a tough one. I think speaking to me, you will know why I'm doing this. It's very clear I believe why I'm doing this. But coming from the government and knowing how the view conflins of the internet is how they're very careful about the engagements and understanding the incentives of people that approach them because the digital approach by a lot of different people. Knowing how governmental organizations with that, with a very, very important stakeholders in bringing change, for me, it was very important that they will feel comforted up engaging with me and being with me, with sex, and being part of this initiative. That wouldn't be possible if I was for profit. I know that for sure. This is to make sure that they maintain their objectivity and the lack of conflict of interest. That was very clear to me. That comes from the insight. That part of the insight knowledge that I have on how governmental organizations, public organizations, be prepared to work and can't work with others to bring change. Because they want to, what gave me confidence is that I engage with them and I know they see what I see, they want to see that change. But it's creating the conditions for them to engage and support them to bring that change in the ecosystem. That's got me thinking. Because it's obviously a very smaller, light touch example, but I've had a non-profit narrative as part of the events and community, right? I don't mean that disrespectfully taught it actually takes a means to be a non-profit, but everyone that I've worked with, whether that's the speaker or partner, has known that I've not made money on it if anything, it's cost me my money. Which therefore just has a different dynamic to the relationship and the trust and wanting to support. I think once you've identified that that's a core part of what's been successful so far, it then makes you question how you're going to go about that moving forwards, but that's some thinking that I need to do. I mean that our bros and cons, right? Because it's a different route of funding when you're not for profit and it's not necessarily easier or harder, right? But for me, the level of the world that needs to be done to bring the chains across the ecosystem, it was an obrater basically. Yes. I love it. You mentioned about accountability and before we started reporting, we were chatting about a few, well, I feel like a really tiny little idea is that I can do it for the community to just try to help and we talked from what a few of them were. Another one was an accountability system. That is not new. I'm completely aware that people have used those systems. But yeah, accountability is I think something that is really interesting because essentially a lot of founders or cell founders or even maybe when you have a co-founder, sometimes that, it's a dynamic relationship. Of course, it should be very open, but sometimes maybe you don't just chat to your co-founder about funding. Maybe you would chat to someone else or maybe you need different expertise that you and your co-founder have. I hope the accountability bit is something I've been really thinking about recently. I'd love you to delve into now and what could some potential solutions be? In what way, holding people accountable? A more of a founder level, like founders just trying to build their own accountability network, community systems. Oh. Yeah, that's a tough one. Particularly, I don't know if that was on controversial, but I do say some noise in this space. It's very, particularly when there is enthusiasm, right? I'm pretty sure you experience the same. There is enthusiasm, but there's no follow-up. So, yes. So for me, I like to understand very quickly, to put actions very early on and understand very quickly who is going to be the right point of conduct or not. That's how I work. I'm going to talk about the same thing to us, but not the third time. That's how I like to put actions early on and follow up to see if that's a right point of conduct to see things through or I have to look for a different point of conduct. It's part of being impatient, I think. I like to make things happen and I like to work with people that align with that. And for me, that's how at least I establish accountability and it's not easy, but that's the only way to move things forward. And being patient, it's a great skill. I grew up thinking that it was a flaw, but actually it's what drives me and what makes me drive things. And wanting to see the action through. I think that's actually really great advice. Something I'd learned along the way about really realizing it quite like that is it's so much enthusiasm. Everyone has ideas. Everyone wants to partner. Everyone could be a distribution partner or whatever in 6, 12, 18 months time. But hopefully, how do you actually move? To all of that, how do you assess it? Is there actually someone that you want to work with or if they're just more noise? So the idea of actually having an initial mini task and see if that person follows through, I think that's really interesting advice. Is testing your partners or potential partners as hardly as possible? I love that. In hindsight, there's so many moments I can think of where we were made, having a bigger picture conversation with someone that I absolutely could have come up with a smaller task to just see how we work together, so I think that's great advice. I love the picture. I mean, I'm here to change the world, right? Let's start from there. But then always, and the end of that conversation, even if it's a 15-minute conversation, there has to be, okay, but what will do tomorrow? Let's start from that. And it's, I want the enthusiasm. I am very, it's like enthusiasm, a very passionate person. You know that. But it has to be also realistic, because it's only that long that I can be engaged with pure enthusiasm without action. And yes, for even stack from the, okay, tomorrow, what are we doing? What, what, how do we start? Great advice. I love that finishing meetings with that as well. I think it's really easy to have nice catch-ups, nice meetings. Oh, it's so great to connect. So then it's like, don't really know what we're going to go and do off the back of it. So I think that's really, really great advice. Okay, we've kind of covered that from a like ecosystem and found a standpoint. For any investors listening, what would you like them to maybe know, understand, go about a little bit differently if their goal is to support this wider ecosystem in terms of supporting women's health innovation, but also for their own deal flow and pipeline. So investors are part of their ecosystem, right? So I, the way I think it's important to think about the women's health ecosystem is, that is, this $1 trillion opportunity within healthcare, not as wellness within healthcare. And wouldn't be amazing if they got tap into that $1 trillion. It would be very important to, I think, they have to be part of all the conversations, even if that's about legislation, even if that's NHS pathway. I think it's very important for investors to understand that pathway, to understand how they can support them blocking, because I do think that there are ways they can support them blocking certain blockages and in how to align incentives with different sizes of investors, of course, how we can support creating even incentives for different types of investors. So I, I'm already engaging with investors, but also anyone listening, please come to me and tell me what do you see, because that's how I like to operate. I want to see what do people see from their perspective? What do they, what do they get stuck and work with us to see how we can unblock it? So that's my, my code to action, maybe. I love that. What have we not? covered so far today that you think is important to round off this episode, either for founders, for investors, for anyone else in the ecosystem. So as you said, the ecosystem is more than just those two roles. Oh my God. I was prepared for for that. I think please stop me, misusing the word ecosystem. Because it makes my life a little bit difficult now. Not necessarily. I want to actually work with the ecosystem. What words should I use instead? Well, if it's three actors, you're working with name them. I don't know. Is this a rhetorical question? Or should we? There's always free types of people at our events. I would, yes, I would just name them. I would say this is an event for startups and investors. That's it. Is not the ecosystem event? I don't think I've ever done an event. I know you're not saying this just at me, but I don't think I'd ever done an event where I have only wanted investors and founders because the whole point of the company name Nexus was that I thought that that was a bit overly narrow. So yeah, I don't think I have ever done an event where there has been any less than free. But yes, I'll make sure that if I'm doing, I won't refer to ask the ecosystem. I don't, I think talking about the topic is better than talking about the ecosystem. Like why are we here all together to talk about? Because if we are not in this event, bringing actually the whole ecosystem, let's not talk about the ecosystem. If you're bringing together different stakeholders to talk about this topic, you're being together different stakeholders to talk about this topic. I think that's the most, the more accurate way of describing it, just and this is just to be able to understand the scale of the problem. That's where my, my, my issue is that if we talk about ecosystem and we talk about three types of people or groups of people, we don't really see the size of the problem. And we exclude by nature the actors that actually can mobilize chains within the ecosystem. This is where I find it difficult and counterproductive if you like, because I talk about the problem of being fragmented, of wanting to connect the ecosystem, to build the ecosystem. And people don't understand what it means to build the ecosystem. And this is because we have been talking about the ecosystem as something much smaller than what it is. Any tips for quote unquote ecosystem builders or let's call them community and event builders. In terms of getting some of those other stakeholders there, because I think, I've always tried to do a good job of lots of personalized outreach to get those range of perspectives into the room. So is it just found as an investors? But yeah, I would absolutely love certain MPs in events or people that are working in the government. Or there are so many areas, pharmaceutical companies, there are so many areas where I would absolutely love more people from those sectors to come into the events to the community. So what tips would you kind of have for me or for anyone else this thing, but mostly for me, to in order to make a experience whether that is an event, the community in general, whatever that experience is, make it more holistic across the ecosystem. That's a difficult thing to do. I mean, I know what I'm getting myself into because I have the experience from the inside. This difficult thing to do, the resources, the capacity within this organization is quite limited. And the way to engage them will require you to have an output. And we'll get to see the tangible output that will transform women's health. Right? So once we start, once the stakeholders start seeing that, that will be an incentive for them to engage. Saudi sandwiches and crisps, not incentive for all stakeholders. Got it. Dan, we keep trying, we keep trying. We only have a few minutes left as absolutely floating. So where can people find out more about you and what you're building and getting touched? So, XX innovation, we are, you can engage with our website. We have articles on their website talking about the problems from a completely different lens. And always ending the article with actions, tangible actions, you can take. So, www.exexinnovation.com, the XX innovation on Instagram, XX innovation on LinkedIn. And of course, I am very happy to talk to everyone and anyone at any point. Please pick my mind. Please come with your problems. I love to hear about your problems. Tell me where you get stuck. I will find a way to help you and will find a way to transfer that info, that information to the translated into action into women's health. That's all into a drive action. So please come to me. Powerful. Thank you. I love it. I genuinely can't wait to be set. I mean, before we go and get this exact table. But we're sitting at a table in six to 12 miles when I'm really, really excited to see what we're talking about then. So yeah, thank you so much for being here today and sharing those perspectives. I've learned a lot. So I really appreciate your time. Thank you so much for having me.

Podcast Summary

Key Points:

  1. Dr. Chrissy, founder of XX Innovation, focuses on turning evidence into outcomes for women's health by addressing systemic problems across policy, regulation, research, innovation, and investment.
  2. The current women's health ecosystem is fragmented, misaligned, and lacks patient involvement, with startups and investors often misusing the term "ecosystem" to refer to only a few actors.
  3. Key barriers include misperceptions about regulation (e.g., fear of regulators, which are actually supportive), misaligned incentives (e.g., investors favoring wellness routes over clinical pathways), and a lack of early engagement with stakeholders like regulators and the NHS.
  4. Dr. Chrissy emphasizes the need for a connecting tissue (like XX Innovation) to bridge gaps, break silos, and accelerate innovation from evidence to patient access.

Summary:

Dr. Chrissy, founder of XX Innovation, discusses the systemic challenges in women's health, drawing from her government experience at the UK medicines regulator. She highlights that the ecosystem is fragmented, with misaligned incentives and a lack of patient involvement, often misusing the term "ecosystem" to focus only on startups and investors.

A key issue is the misperception of regulation; regulators are supportive and offer free advice, but startups avoid engagement due to fear. Another barrier is the misalignment of investment, where investors push companies toward wellness routes instead of clinical pathways, hindering long-term solutions. Dr.

Chrissy stresses the need for early collaboration across all stakeholders—regulators, investors, healthcare systems, and patients—to break silos and accelerate innovation. Her organization, XX Innovation, aims to act as a connecting tissue, providing guidance on regulatory pathways and funding strategies. She advocates for patient-centered approaches and systemic action to overcome these challenges, ensuring that evidence-based solutions reach patients faster.

The conversation underscores the importance of community and shared learning to drive tangible outcomes in women's health.

FAQs

XX Innovation is a non-for-profit organization founded by Dr. Chrissy Sergaki that drives systems change in women's health, focusing on turning evidence into outcomes by aligning stakeholders across the ecosystem.

She was inspired after writing a paper on the vaginal microbiome and realizing there is a trillion-dollar opportunity in women's health that remains unrealized due to a fragmented ecosystem and lack of communication among stakeholders.

The main problems are a fragmented ecosystem across the entire journey from innovation to patient care, misaligned incentives among stakeholders, and a knowledge gap across the ecosystem.

Regulation is perceived as difficult due to startups' fear of the process and language, but regulators actually want to help get innovative products to patients safely and offer free advice programs.

She advises startups to engage with regulators early, as it is never too early to have conversations, which can help with fundraising and navigating the pathway to market.

There is a lack of investment, with many startups forced to take a wellness route due to investors preferring faster revenue paths, while diagnostic and medical device innovations require longer-term capital.

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