Preventing breast cancer

Vara is an AI-healthtech with a mission of making reliable breast cancer scanning accessible to women all over the world. They are developing an AI-based breast cancer screening system for clinics, which combines computer vision and leading clinical research to support faster and more accurate medical decision making.

They have the largest mammogram dataset in the world, with more than 8 million scans (more than twice the closest competitor!). They’ve obtained regulatory approval for European-wide roll-out in 2019 and are currently expanding into Asia, Middle East and Latin America.

Current Funding
Team Members
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The Founders

Jonas Muff
Co-Founder & CEO

Jonas brings a business background from University of St. Gallen, where he als led the Start Global Initiative as their President.

Stefan Bunk
Co-Founder & CTO

Stefan did his masters in IT-systems engineering at the Hasso Plattner Institute, where he then worked as a research assistant.

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As Merantix’s first founder, Jonas has shaped the Merantix Network for all founders to come after him. Assembling a team, establishing the relationship with other ventures, as well as fundraising - he has built his company from square one without an internal predecessor. Today, his experience is invaluable for the Venture Studio. He joined me for an extensive conversation about the future of healthcare, the principles of leadership and the benefits of being a young founder. 

Finn: I am sitting here with Jonas. He is the CEO of VARA Healthcare, Merantix’s first company. Jonas, welcome!

Jonas: Hi Finn, thank you very much for the opportunity to talk to you.

Finn: Let’s jump right in: You built your company in Healthcare. What is your vision for this sector, say by 2050? And this can be very raw. So generally, what are major pain points within the sector, where do you expect to see most progress?

Jonas: Wow, 2050 is very much down the road…

Finn: That is actually what Clemens said as well when I asked him about the future of mobility (laughter).

Jonas: ...but I can give it a try! When I think about healthcare, one of the most obvious shortcoming is that we tend to interpret healthcare as treating sick people with their symptoms as opposed to keeping healthy people healthy; so whenever you feel sick or sore you go to the doctor but for me that is fundamentally inefficient and actually leads to unnecessarily high mortality rates for diseases that are curable. So I think healthcare will move into the direction of trying to understand what is going on with the body and intervene way before symptoms develop. And screening will definitely be an integral part of that.

Finn: In this vision, are you thinking about Germany? Or Europe? Or the western hemisphere? Obviously, healthcare is in very different stages depending on where you look, right?

Jonas: It is definitely a global vision, but you are right: regions are in very different development stages and the US is actually a bit ahead of Europe when it comes to adoption rates. With regards to the developing world, I have some hopes that they might be able to jump the curve and adopt this newer philosophy of healthcare right from the beginning because their systems are a little less regulated and the potential impact with a more preemptive approach is even higher.

It is your number one responsibility to bring in people that are better than you at given responsibilities.

Building Vara Healthcare

Finn: So what does VARA do?

Jonas: VARA follows the vision that I sketched: we believe in screening and we believe it makes a lot of sense to find diseases as early as somehow possible in order to reduce mortality and treatment costs more generally. And we are currently focused on breast cancer screening because it is still one of the most common cancers among women but if you detect it early on, chances to survive are actually very high, whereas those chances decrease quite significantly if you find the cancer too late. So screening is already common worldwide.

The problem is that this requires a lot of radiologists, a lot of human labor and repetitive processes. And it’s a very inefficient process, too. Since we screen healthy women, 97% of all cases are unsuspicious. It is like finding a needle in the haystack. And that is exactly the kind of case where machine learning can help out: we train a machine learning model to rule out these normal cases very confidently and then the radiologists can focus on the more ambiguous cases. It increases the quality of radiological work, it’s cheaper than traditional screening and it increases availability of screening because radiologists can get more done - at a higher confidence level.

Finn: At what stage in this process are you right now?

Jonas: We trained our ML system with millions of labeled mammograms and have built a software layer for radiologists. And we have started to deploy our solution in radiology centers across Europe. First customers are adopting the product and using it in their daily routine - that is the exciting step we are now experiencing and, from what we can tell, our solution really fits into the market and solves an important problem.

Finn: Beyond breast cancer, how easy is your technology stack applicable to other radiological tasks? Do you guys have any plans for expansion?

Jonas: Generally, our stack is very scalable. Of course, there is work involved - regulatory obstacles, acquiring data, testing the algorithms and fine tuning. So it would be a question of months, not weeks. But the technology is generalizable and we hope to tackle further domains at some later stage.

However, one of the things - and Merantix has been a pretty important part of this - that we realized is that it is very instrumental in the early stages of a startup to be very focused. Especially in healthcare, the dominant strategy is definitely to show clinical results and to make sure they are pixel perfect. So breast cancer will remain our focus for now. We really want to prove to our partners that we solve an important problem they have, show it by metrics, grab land. And only from that position of strength would we consider to scale horizontally.

Managing teams and time

Finn: If we zoom in a little bit in on your work: how do you interpret your role as founder and CEO? 

Jonas: I think as a founder, the main thing you need to be aware of is that you are not as good as the specialists you bring in, for example in sales. At the beginning, you are the one that sets up all the processes but at a certain point of maturity you need to bring in experts that are really strong in what they do. As a founder you are always the generalist that initiates projects and brings structure to them but then it is your number one responsibility to bring in people that are better than you at given responsibilities.

Finn: And more specifically: what do you spend the majority of your time on? Surely not only recruiting...

Jonas: I think there are three major things that founders need to take care of operationally. First: fundraising. Regardless of the industry that you are in, it will be your job to make sure the company has enough funds to grow and hit its next milestones. And in the last six months, prior to raising our Series A, that was definitely one of my main projects. Secondly, you are responsible for the leadership team, making sure that the team around you works well, have a relationship with them so that when a problem hits, you have a healthy team that is on it. And lastly, it is my job to ensure that the product we develop has a very strong product-market-fit, which is a more strategic topic. But it’s the decisive factor of a successful company really.

I am also deeply convinced that attitude beats experience.

Ambition and experience: does age matter?

Finn: I hope you forgive me this question: You are 26 now and I am really curious myself, since you described some of these very complex and challenging topics and a team of more than 20 people now at VARA: would you say being this young makes you more capable of doing your job or would it be better if you were, say 55, and had already built a couple of companies before? Is there a  trade-off between being high-energy ambition and experience?

Jonas: That’s a very important question… Personally, it is a blessing to be so young. And it’s certainly been a blessing to be granted such a huge opportunity, considering all the trust that Adrian and Rasmus have put into me. And, of course, as a 26 year old, the learning curve is incredibly steep and I benefit from everything that has happened tremendously. But that is just my personal take.

Finn: And more generally? 

Jonas: In general, as you have said, there are pros and cons. To be honest, in a lot of situations, more experience wouldn't hurt. Experience is an asset and that is also why I built an experienced team around me. And Merantix is very crucial, too, because the entire studio is not only an investor at our stage but still a coach, really.

But I am also deeply convinced that attitude beats experience. And with attitude I mean a couple of things: attitude to always want to learn more and to improve. And that is a buzzword of course, but I do think it makes a difference if you really live it. And one of the things I have seen a lot is that experience makes you a conventional thinker usually. You think about a certain problem in a predefined and preoccupied way. But if you are young and inexperienced you have the chance to redefine best practices.

And finally, discipline beats experience. When you are young, you are hungry, and you work hard and develop yourself. And with the amount of responsibility you take on, you also need to develop the right habits outside of work that help you to perform well on the job: keep doing one-on-ones, talk to your team, build relationships. And if you follow these principles you are likely to outperform people that are more experienced than you.

Finn: Thank you very much for joining me. Best of luck with Vara!

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