#41: Outsmarting Cholera

Hey folks, it's Quinn. Since we recorded this conversation, we've renamed the podcast. It used to be called important, not important, which is what you'll hear in the episode, and it's still the name of the company. But now the podcast is called, the most important question.

That is, what can I do? It's the question we get the most from all of you, and it turns out it's the question I've really been asking guests for almost 200 episodes now. So here we are, the most important question. Please enjoy this old conversation.

Thanks for listening, and thanks for giving us shit. Welcome to important, not important. My name is Quinn Emmett. And I'm Brian Colbert Kennedy.

And there's Teddy. Hey, Ted. Hey, how are you? Look at this mash face, even Nevin.

Hey, today's topic, Brian. How smart in Colorado? Yep. Here's the thing, Colorado is still around.

Oh, I thought it was dead. And it still really sucks. But there's hope on the treatment side, at least. And what's that hopes name, Brian?

That hopes name is Dr. Min Min Yen. Yeah, that's right. Dr.

Yen is the CEO of her medical startup, Phage Pro, where she's developed viruses to target Colorado bacteria because antibiotics arise are final losing battle. She's got a PhD on molecular microbiology from Tufts University, and she started her own lab because, bang, that's how she rolls. Why wait around for stuff when you can do it yourself? This is another one of those really fun ones, where I feel like we should develop a small segment in the middle of the podcast, where we just say, hey, Brian, how would you develop a virus to target?

Yeah, that's what we should do. But literally, what is the first step? I have no idea. Is it by a microscope?

Is it a microscope, right? I think it's first. It's don't be me. Be a whole different person, step number one.

So many different choices. Make all of the choices different. Yeah, man. She's very smart, and she's literally just getting started.

Yeah, I love talking to these folks. We're going to be world changers. Pretty awesome stuff. Awesome.

All right. Let's get into it. Let's talk to Dr. Yen.

Our guest today is Mimi Yen. And together, we're going to talk about Al Smarting. Call her up. Mimi, welcome.

Thank you. Thank you for the invites. I'd like to be here. Well, you say that now.

Give it an hour. Yes, you wait. Now we're very happy to have you. OK, so Mimi, just tell us real quick who you are and what you do.

Sure. So right now, I am currently the CEO of Phage Pro. And we're a biotech startup that uses phages or viruses that specifically target in co-bacterial in order to alleviate the diseases in global health. So specifically, we're going to call her right now.

Very good. First question. So phages, they have been known about this in 1920s. And they are maybe viruses that just like we have animal viruses that go after our human cells.

Bacteria also have viruses that specifically target and kill bacteria only. Those are called bacterial phages or phages for short. So they were discovered in the 1920s and looked at for a long time for therapeutic applications, especially for antimicrobial purposes. But then antibiotics came along in 1940s.

So the US and most of Western Europe really focus all of their attention on antibiotics. It was like this magic bullet. Whoops. Whereas Eastern Europe, interesting way enough because they're like, we don't want to be like the West.

We're going to not focus on antibiotics and focus on developing these phages further. So actually right now in the Republic of Georgia, what they have set out is like a center that you go in. And if you have a bacterial infection, they have this whole library of phages that they screen to tailor the phage therapy for your particular bacterial infection. So that's pretty cool.

Wow. Brian's going to have a lot of questions. I'm excited to get the answer to them, though. I hope I have the answers.

Well, that's why you're here. So let's get there. All right. So we'll get a conversation going here.

We are big believers in questions that you visit, action answers. So we're going to talk about Cholera and how you're going to defeat it yourself and what we can do to help you along the way. That sounds all right. Yeah, sounds cool.

All right. She just went along with us. All right. It's wonderful.

So maybe we have one important question we'd like to start with if you actually did listen to some of the other episodes. You might know what it is. Instead of saying, tell us your whole life story, though I am curious how you got to where you are. We'd like to ask, maybe why are you vital to the survival of the species?

I did hear the question. And I was like, oh, my God. If it makes you feel any better, I ask Brian every morning when he walks in. He's still not answering me.

I will get it one day. I don't know about me, specifically. But I do think that the stage research community as a whole can provide an alternative as we're searching for solutions to the rise of antibiotic with the sense around the world. And so the way that I got started with this is that when I was doing my college undergrad, I was like all about global health and engineering solutions.

I really did it know what direction to take that in. So I decided to go to grad school and did a PhD in microbiology at Tuscany University with Andrew Camilly. And he's this well-renowned expert internationally and caller that he was also getting into the study of phases. And he was interested in figuring out whether or not he could be used as an intervention.

And I joined his lab. I decided that that was going to be my way of contribution. So I actually went to Haiti in 2014. And it must have been crazy.

It was. It was definitely eye-opening. And that was four years already after the earthquake. And really, it didn't seem like anything had been fixed or changed.

I know there was a lot of A that went through. And sometimes when that happens, there's redundancies. And not everyone's working as efficiently as possible to make the greatest impact, unfortunately. So I had gone down to Christian Bell to help train from the scientists in theology, but also just to study the color epidemic there.

And that's what really gave me the motivation as to the role that I wanted to play in global health. I wanted to be not just a scientist at the bench. I wanted to actually make an impact. So when Andy and I talked afterwards, we decided to really go for it for my thesis project, do the animal model testing, see if it works, and turns out it did.

Congratulations. Thank you. So that's what we're trying to bring to market now with other sort of challenges that we're working through. Oh, yeah, we're going to get into that.

Thank you for that. Let's establish some context for today's topic, which is defeating cholera. It's definitely not pronounced cholera. Not that I could be total.

I think I'm wrong. I don't think so. Oh, yeah. I was in the US.

She's so kind about it. Yeah. Thank you. No, to be clear, you should definitely tell both of us whenever we're wrong in the sternest possible town.

Don't dance around it. All right, so we just like to get everybody, the two of us, you, though I assume using 10% of your brain to talk to us, are amazing listeners at home or on the subway or driving and texting, wherever they are, on the same page. Brian might have some questions. This will take that long.

Maybe just tell us again everywhere we're wrong. So cholera, it's not pretty. A lot of folks, we've listeners all the world, but in the US, it's pretty exceptionally rare at this point. So I feel like people might not be as familiar with it as most everywhere else, but it is a bacteria infection of the small intestine.

Is that correct? Yeah. And it most time leads to a terrible diarrhea, sometimes within hours, leading to severe dehydration and often death. So three to five million people a year, get it?

Ranging anywhere. This is a big range, of course, depending on the pandemic. Our break is 30,000 to 150,000 deaths a year. We've had seven or so pandemics over the last 200 years.

Is that about right? Yeah, we're currently in the longest running one. Yeah. Oh, that's great news.

Well, I've got my notes. And it mostly comes from, as I understand it, unsafe water and sometimes food like seafood. As far as I understand, only humans are affected by it. And it seems like in a lot of things, we talk about rising sea levels and flooding should make it even more prevalent.

Shocker. Shocker that everything is connected. Yep. We know it goes back as far as a fifth century BC.

Somebody founded Britain's Sanskrit, which is great. Another thing we haven't fixed. And as with everything else, antibiotic resistance is growing. Are you looking at Zimbabwe or Yemen?

The disease is very, very real and very dangerous. In a lot of places where sanitation is not up to snuff. So on that note, maybe he's going to tell us how she's going to fix it. Now, like so many diseases where we're facing or we've talked about, especially bacteria stuff, our best methods seem to be starting to come up part of the same, starting to fail.

As one of our previous episodes, Dr. Godum Dantas taught us effectively, bacteria has been around a hell of a lot longer than us and has a hell of a lot smarter than us. And anything we've succeeded at seems to be the low-hanging fruit that they've kind of let us succeed at. So, Mimi, talk to us again now.

What exactly you were working on? Where it came from and how this applies to the current situation? Sure. So like you said, Pahler is transmitted through the water.

Primarily, it's in places that really don't have functioning water and sanitation infrastructure. But what we're increasingly starting to recognize is that 40% of the cases are actually due to household transmission as well. So when someone in the house gets cholera, unfortunately, because of the disease, it's spread everywhere. And the family members are immediately at risk.

So basically, there's this two-day window after the first patient comes down with cholera that the family members actually start to experience cholera symptoms themselves. And what we're specifically doing with our intervention is disrupting that transmission cycle. So what our product does is its age-based. So it uses pages that are specifically targeted towards the bacteria that cause cholera.

And we want family members to take it when their sick person comes down with cholera symptoms so that they could protect themselves within that high-risk window, while they're taking care of their loved ones. I'm sorry, I don't mean to interrupt there. So you're saying the sick person takes it, or the family takes it in a preventative measure? The family takes as a preventative measure.

OK, interesting. Yeah, so with any sort of diarrheal disease in global health, really, the best solution is the world rehydation salts, solutions, sorry. And regardless of what the audiology of that disease is, or else, really is the way to go because it's cheap, it saves a lot of lives. And you don't have to diagnose which bacteria am caused it.

And we're not using data as a therapy for that reason. We don't think it's feasible as a therapy in this particular case. But as an intervention, in the best case scenario, when family members bring in their sick loved ones into the clinic, if they can get our product and bring it back to the household, everyone in that household is protected also during this risk window disrupt the household transmission, and hopefully disrupt community transmission as well. So it's working to protect everyone immediately.

So I'm going to try to pick some questions out from in there, trying to imagine this scenario a little bit. So let's say Brian and Teddy and I share a house, a small room like we are right now. Brian gets it. Well, well, maybe you got it.

No, let's go with you. What is my first let's start again, let's try to dial it back to like, how to make peanut branch out of here. What is the what's Brian's first symptom? He's going to start.

Sorry, Brian. No, it's fine. I'm used to it. I'm going to switch all of the body's water is going to start flooding into the small intestine and come out.

Wow. Wow. OK, so that's when my window. That's when my clock starts ticking.

So how long is my window where your treatment is effective? Like, how long do I have to go get that treatment before it doesn't count? Or is it just a decreasing level of effectiveness? Can you explain that a little bit?

Approximately two days. The studies have shown. OK, that's decent. Yeah.

It sounds decent. Right. That's very white people troubles. In places where it's hard to get to health care clinics, we have to take a different model in order to reach those people.

But in the best scenario where there is an infrastructure for diarrheal diseases like in Bangladesh, for instance, there's this whole center. They really done a good job in trying to reduce the number of diarrheal disease there. You would go into the clinic with your person who's sick. And then, ideally, we would give the product so that during that two-day window that you came in, you would be protected before experiencing the symptoms yourself.

Interesting. Sorry to back up real quick. You just say 40% of people who get color out, get it from a family member or somebody close to them. Yeah.

That's approximately guidance. Yeah, it's a lot. It's something that wasn't as recognized before. And even at 40%, everyone in the global health field understands that surveillance is lacking indeed.

It's lacking so that's not what the grain is all. But it's still a huge percentage. And if we could really disrupt that transition, we could probably make a huge impact on the disease burden then. And how does it get transferred between people just in the air?

No, it's the oral fecal route. Oh. Don't be bad for me here. You're on here for a reason.

So unfortunately, with color out, because of the rapid nature of the disease, your fluids are just going to come rapidly out of your body. So there's a lot in that household that's being spread around. And usually children are really affected by it. So if you ever tried taking care of a sick child, whether I were, you know, it's not going to be sanitary, of course.

So unfortunately, that's how the family members are going to be exposed to it just by the sheer amount that's around. Man. OK, I just want to, again, dial it back a little bit and build this something eventually here. So there's no vaccine for color, right?

The prevention is sanitation, safe drinking water. Is that right? There is a vaccine. There's an oral color vaccine that's been developed and it actually is recommended by the DEP-U-H-O.

And that side of things has been interesting in terms of the way that it's developed. And in case the oral color vaccine requires two doses, and administered by a health care worker. And you take the first dose, and then a week later, you take the second dose, and a week later after that, that's when the early onset of protection really is. There are some studies that are trying to show the efficacy of just the best single dose at the beginning.

But in any case, because vaccines depend on the immune system in order to mount protection, that protection is not going to be fast enough within those two days where these family numbers are really at risk. So that's the niche that we're trying to protect. If the best case scenario, you have a sick family member, you get the vaccine, the first dose on day zero, you still have to wait. And by that time, it's too late.

Right. Is that vaccine, that oral vaccine, out there, is that available or distributed? It is distributed. So, it's totally- It was interesting what was going on over here, is what that means.

Yeah, so I think in a lot of cases, we aren't proactive enough in global health. So the one scenario that I could think of in recent years where the color of vaccine has really been given proactively is when the Rohingya refugees went into Bangladesh to the Khasazar, and the Dariels Center that I mentioned previously in Dokkapping with Ash, the people there really had a lot of foresight in that they went to the WHO, asked for the number of doses to prevent color in this refugee population, to prevent an a color outbreak from starting there. So, that I think is an outlier in terms of how we're usually responding to humanitarian crises like these. So, if you look at Yemen, there's a million cases of color there already, and that was just in the last year or so.

And that's as far as the past, the number of cases that happened in Haiti in seven years, eight years, since the color epidemic broke out. So, even though the oral color vaccine is out there, there's still a lot of logistical issues, there's a lot of supply and demand issues that need to be addressed. And of course, we're thinking about those for our product as well. How do we go about bypassing them?

Or what can we do at the beginning stations? We're fortunate enough to learn from the lessons from before, how can we make our product more easily distributed and more stable? How can we really get it to the populations that need it the most without running into all of these complications? What form does your treatment take?

Sounds like Ghostbusters. It sounds like Ghostbusters. Choose the destroyer. Yeah.

I'm sorry, again, we're just trying to paint a picture. Is it a pill? Is it a shot? Is it a patch?

Sure. And so, the animal models, we did it as a liquid formulation. But that is subject to a lot of stability issues. So there's a lot of countries that have color that are hot in human climates.

So, and then the culture, it's not particularly functional, it's in these countries. So ideally, we're working right now, I'm making it into a tablet formulation. So that it doesn't have to be stored at four degrees Celsius. So that if it gets left somewhere outside for a week, it's still stable, the family members can still take it.

But that's something we're working on right now. Does your treatment have a shelf life? Can people just buy it at a time, like the iPad? And not have to worry about that window.

If you get sick, you just open medicine cabinet, take the treatment and you're good, no clinic? Yeah, ideally, so there's a couple of issues with that. So, with the oral color vaccine, the shelf life for that, I forgot how many, it's on the 90 of years, that has to be at four degrees Celsius and the WHO stockpiles two million doses per year, which is not a lot. So, in order to even be a product to be distributed in that type of infrastructure, we have to have a shelf life of three years at least, at four degrees Celsius.

Wow. What if you can get it to be the pill? I think we go for much longer, at a hot and humid, like 40 degrees Celsius type of weather. And what's interesting then, with your question of whether you can buy it before, then it comes into how our pharmaceuticals moved around in global health, like in a lot of countries, the informal healthcare system is what people turn to.

They don't go to the clinic, they go to someone local, or they go to someone who has a lot of medicines that are normally highly regulated in the US. And antibiotics happens to be one of those things that is kind of just given out sometimes without any of the prescription. It's, for us, we're still trying to figure out how we can use that to our advantage, is that we start off with this stage product and really start building up the stage manufacturing distribution of actual community and ecosystem where fates can be distributed like antibiotics, so that if we have a stable page tablet, it can be given over the counter. So that's something we're trying to work out and figure out what is the best way to actually get into the hands of the people in a safe manner.

What is the, geopolitically, the biggest problem areas right now? Way to start. Great. I know, sorry.

The places where it'll be hardest to do call or prevention are places that have war. So I mentioned Yemen, but the Democratic Republic of Congo actually has just like a steady state of high-collar cases because of what's going on there. And when people are dying, it's really hard to say, like, no, you can't use antibiotics. It doesn't matter to them, the global trend of antibiotic resistance, right?

So it's hard to say to them, no, I know you have this medicine in your hand that you believe that is going to work, but I don't want you to take it. Or I don't want the government to distribute it. In terms of navigating that, how do we tell the streets of health, for instance, we need to start looking for other alternatives or you need to start distributing this other alternative that we think is going to be successful, but there's no test case for it right now. Navigating that and getting people to adapt to that, I think is going to be quite difficult, especially in the face of civil war and refugee camps where there is so much need.

Do, and I recognize you guys are just, you're so far from this, you're just coming out of animal trials right now, which is great, but existing things like the vaccine and such, or just OS, the oral treatments, facing looking at countries like Yemen, which are just destroyed in so many ways, how do they break down their efforts as opposed to maybe just trying to help somewhere that's a little bit easier first? Or how do they approach a situation like that? How is that being handled? I've been talking to a few people about this.

So for the oral color vaccine, the way that it's distributed, it's really dependent on the people on the ground, the organizations working on the ground. So NSF, any local organizations that really know the area and the culture, you have to depend on them and trust your local partners to distribute and understand all of the complications that would come with that in that setting. And I would say that we're still figuring it out. Like the global health community is still figuring it out, obviously since Colorado is still around and it's been around like these other things.

One time, if long time BC or something. And the best case is really doing a whole infrastructure overhaul, but a lot of the governments that we don't have the money. Like if you look at Haiti, for instance, the UN, when they finally admitted, oh, our bad, sorry about the Colorado. I mean, what, that just did not get in.

I know it was a couple of years ago now, but oh my God. Yeah, I was, and also it sounds like the number of people that I talked to about this years later and they don't know anything about it. They're very anxious. Why don't you recap that super quick for us and tell everybody what I think.

Yeah, like you said, it's not being a big issue here. I think a lot of people just have no idea. Yeah. So earthquakes were created in 2010, devastated the whole area, and then that meant a lot of service, people were coming in to help out.

And that's great, but as part of it, when the UN workers from Nepal came in, unfortunately there wasn't enough screening, there wasn't enough training as to how human waste should be handled while they're in the country. And someone had cholera and it went into the water, the water because of the flooding in the area, it just spread throughout the country so quickly. Right now, it's kind of bad though, the cholera epidemic is slowing down in Haiti, not because there's been really any changes to the infrastructure or the prevention, but in part because so many people in Haiti have gotten cholera and survived it, that they're immune to it. So one of the factors in the epidemic falling down is that previous exposure.

And that's so interesting because it is in effect an island, and it's so curious what that's gonna do to the survival rate there. Yeah, and now it's all stuck there, it's like in the water, and unless there's sanitation infrastructure that gets put in place for it, what do people are going to continue to get cholera over the next few generations if they haven't had previous exposure to it? So the UN finally owned up to the part that they played in it. It's hardly like, we do get angry, but we also have to understand that the global health community as a whole, we have to make sure that we don't get into our silos that we're not fighting each other because we all want the same thing.

So understandably, the UN, there was a lot going on, and I've never been in a situation where earthquake just happened, and you have to be on the phone. I'm sure there's a lot of issues that come along, but they really did block up. Yeah. They admitted to it being their fault, and they committed money to helping with the infrastructure.

I really haven't seen much come out of that. And calling it infrastructure takes time, and it takes a lot of money, and it takes a lot of political will and stuff like that. So that's what happened, unfortunately. It's still going on.

If you go down there, they're so-called epidemic, still freaking out. It's been eight years. It's been eight years. Yeah.

Of course, it's not a news cycle, but that's the entire point of what we're trying to do here. Right. Right. I should note as a brief intermission to our majority American listeners, again, we don't really have a follower here.

I'm sure there's cases here and there, but we are not perfect. You might be pretty happy with your sanitation systems and your Britifilters, but have a look at Flint, Michigan. Look at our flooding, our sea level rise, and that's just starting. It just takes a case or two to come over here on a plane, and we're dealing with this too.

I don't want to be a scaremonger. I never try to be, both in thinking about how you and we're going to work towards this, how you take action to help these folks, infrastructure and war-wise and how you vote and where you donate your money. Reminder, these things can come home, and we're facing a whole lot of interconnected threats that can bring these things to our doorstep pretty quickly. So just don't tune out on this one.

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That's very exciting. Congratulations. Thank you. Now on the flip side of that, what sort of obstacles are you running into?

Funding. That's always the answer, isn't it? So weird. Number one answer.

Oh, so weird. That's always what people think of. How have you been funded to date? How did this whole show being started?

Yeah, so Andy is at Tassie University, and he's a 10 year professor, so he has an i8 grant. He also was a Howard Hughes medical institute investigator. OK, what the hell is that on? And that was, that's like a really prestigious appointment where Howard Hughes Medical Institution is a nonprofit that will select certain professors that are really making advances in science for community, and they'll give them millions of dollars.

Wow. Andy was one of those professors, and then I was coming in during his, it's like five-year appointments. So I was coming in during his second five-year appointment as a grad student. So a lot of the money, including a fellowship that I got from that same institution, actually funded my Haiti trip, funded a lot of my supplies and stuff.

So that's the academic funding. And then right now, we're looking to move out of Tassie University so we can have our own space. And we're just starting to do a fundraising question now. So we have to be quite diverse in our portfolio, as opposed to a lot of other biotech startup, our money-impaking ventures.

So we're not going to VCs or angels, really, because I can't promise them a 10x return on something. But really how much is human life in terms? Well, I mean, that just comes back to the fact that Silicon Valley is focusing on all the wrong fucking things. Exactly.

So we applied to a grant from NIH, which is specifically for small businesses. We're looking at the Welcome Trust. Hopefully there's grant money there. What's the Welcome Trust?

Like similar to Gates Foundation in terms of the amount of help it gives global health is out in the UK. It funds a lot of basic science research. It funds postdocs, professors, funds, global collaborations. There's a whole bunch of stuff in this portfolio.

But it's one of the biggest contributors to basic science research in the Western world, at least. That's interesting, though. The funding and what you're able to offer in return, which sounds insane, because what you're offering is to fix one of the world's oldest bacteria-focused diseases. And that's what they're getting in return, which is.

Yeah, come on. It's a pretty big return. I understand. But you guys aren't a nonprofit, right?

So people can't, you know, these institutional investors or angel investors or VCs or whatever, this is not a charitable cause, right? Right. So what we decided recently is we were incorporated at us at a traditional PCORP. We're looking at converting into a public benefits corporation.

So that means that our shareholders, if we don't choose the more commercial path to go down for our company, we can't be held liable for that. We have a social mission. It's built in to our charter. So that's what we're looking to convert to.

And the reason that we chose for profit is because of the small business grant, of the funds that can go to small businesses. We wanted to take advantage of a lot of the funding available for biotech startups. Because ultimately, we still are a biotech startup, just with a prioritization in global health. So we're trying to ride both worlds, basically.

And it's been interesting because I'm at an intersection of not only biology, global health, but business as well, which is not usual, I feel like. So I'm trying to balance all of those communities and figure out the best way forward for our organization as to how to take advantage of all the resources. It sounds like there's a lot of calculations there. Like there's definitely trade-offs in one way or another.

Like you can't be a nonprofit or else you can't provide for the small business grants because a nonprofit is not a small business. And yet at the same time, you can't promise to connect to the next returns to somebody because et cetera, et cetera. You really, because this is not a drug or a treatment that should be this immensely profitable thing. Right.

So then we have to start being creative. And there's been a lot of time spent on, okay, maybe we should reach out to family offices. So high net with individuals, usually have someone manage their money, maybe reach out to them. We can reach out to foundations like grants.

I was thinking, I don't have the network for this, but that would be great. Reaching out to people who are rich in the countries that have cholera, because the US, like you said, how many people know about it? They do. It's thought of as a disease that has already been eliminated in a lot of the world.

Sure. Let's say someone who grew up in India, someone who grew up in Nepal, they grew up knowing about cholera. And if they had the funds for it, I wonder if they would be filling their pick about it. And I'm sure if you can as well.

So that was one of my strategies. How's the road to handout? I mean, look, clearly you've got to be pretty wide ranging and flexible. Good news is apparently a lot of parts of America have stopped vaccinating their children.

So all of these diseases that Americans are like, oh, that's dead. They're coming back and we're being made more aware of them because these fucking idiots think they're smarter than their doctors. Oh, yeah, that's great news. Really good news.

So maybe a big call or a break will happen here. And then some rich people from here will help out. Perfect. Great, great, great.

We got you all set up. Hey, I want to pause before we get to our action steps here and get emotional for a second. Do you feel like now you're on the right path personally? You mentioned you didn't know exactly how to apply yourself in this specific capacity, looking where you are now, trying to decide how to focus your company legally, funding wise, how to move into human trials, the impact you can have and the difficulties, the wide ranging and incredibly complex difficulties of distribution and war.

Do you feel like you're going in the right direction? Mimi? Yeah, I could say for the first time, at the start of the company, I feel like everything's pulling together. So I incorporated with Andy and another co-founder of Lynn in 2016 in October.

And it was right on the cusp of me finishing up my PhD. I actually started a part-time master's in public health degree program as well at Boston University at the same time. Part-time, part-time master's degree. Yeah, wait, and also.

No big. Did you say you finished your PhD? Yeah, two years ago. I started my PhD thesis and then incorporated in thing week.

And we have failed to address you as doctor this all time, which is great. That's just not good. Start over, Brian. Start the whole fucking thing over.

Goddamnit. Oh, no. Being called doctor is like a little weird. No, I get it.

But you know what? And maybe you don't feel this way. But I've got some incredibly smart and hardworking lady doctorates in my family. And I think it's so important for young people, men and women, to know about young women such as yourself that have gone through it and succeeded.

And hear the word doctor and have that respect. That's a big deal. I think it's important. Thank you.

I'm sorry. I feel like I could talk all day about women of the presentation and women of color presentation. But it was a whole other thing. We're happy to run it back to do that one next time.

So anyways, you were saying that now you feel like, please, get going. Yeah, it was a lot of hats to wear two years ago. And I felt like I was drowning in all of it because I didn't know anything about business. I did it.

I was trying to finish my degree. And ultimately, it's incredibly helpful, especially in my line of work. But it was December last year, where I've gotten so many nose from people that I was like, all right, I have one year before my student loans kick. I have to either get enough traction that I think it's worth it, or I'm just going to have to put it aside for now and think of something else.

So in January of this year, I started pushing cards on all funds to really get the name out there. It's overwhelming to go from two years of nose to finally some person being like, oh, I can help you out. And that's all from my other co-founder. It's April.

And that felt awesome. Still having someone else to bounce ideas off of us. And then finally signing that RNSR, how did business development and marketing? I was like, oh my god, I had a team.

Like someone believes me. And then since then, we just went through a summer program at MassBio, which is this nonprofit in the Boston area that connects a lot of academics with the business side of things to help them through. A lot of us don't really know how to exactly take something from the lab to the market. Getting into that program, having 12 mentors sit down, focus on me for an hour each week.

That was something that I never imagined. But I would ever have the privilege of doing. So it's been amazing and a little scary. Got a thing.

I was like, you're like, ah, nobody will help me. And then you're like, wait, why am I sitting in the middle of these 12 people? It's quite the switch. Yeah, exactly.

And then the MIT Tech Review was, I thought I was dreaming when I actually got on the list. So for my part, I am very optimistic about how we're moving forward. There's a lot of generous people out there that are willing to give expertise. They're willing to provide time.

And I think for my part, I need to do a good job. But lining all of those resources so that they can be used most effectively and efficiently to move forward. And that's been a hard lesson because I've always been kind of all over the place. But learning to manage, learning to actually have workflow processes, like all the product managers and stuff that I never thought I would need are really being put to the test right now.

So I am very excited going forward. That's awesome. That is a hell of an answer and a candid one like that. Well, Brian is opening up such a wallet?

Yes. Are you considering donating to my part? It's very possible. I got to tell you though, maybe you offered to buy me avocado toast like an hour and a half ago.

That didn't happen either. So don't fucking hold your breath. Quinn is so generous that any time I even try or reach anything or reach for my wallet or anything, he always says no. It's not my fault I didn't do it.

OK, we'll see. You refuse. But this is a good segue. All right, so we've said we've mentioned before, obviously, Colorado isn't super prominent in the US anymore.

But obviously, it is the hellish nightmare in so many other places. That's a technical term. Yeah, no, I'm technical. Yeah.

So for medicine, to sanitation, to distribution, to war, it's a huge issue. What can our listeners do? How can our listeners help support both your research and Colorado prevention efforts around the world? Obviously, money helps.

Yeah, but let's get specific. But yeah, where should they be applying themselves? Let's start with individual actions. If we wanted to talk about donating, it's really the organization that I do in a lot of work on the ground in terms of distribution.

And that would be organizations like Doctors Without Borders. It would be UNICEF. There's Gavi, which is the vaccine alliance. And I would say partners in health, there's a lot of community health worker work that is absolutely amazing.

And they reach places that a lot of the clinics don't reach. So people who are helping refugees, who are helping the populations that don't normally have access, even primary health care, those are the places we want to donate to because those are the ones who will be involved in the act of distribution of whether it be hand washing, services or vaccines. They're going to have the logistics and the infrastructure to set that up. And then for funding basic research, there's a lot of nonprofits, unless it's actually in Seattle, my green city.

It's so pretty up there. I've never been, but I feel like I would love it. You've got to go. It's so green and beautiful.

It's pretty great. I feel like it'd be my soul city. There is the Infectious Diseases Research Institute. That's the main one that you want to look into donating.

They do a lot of, they're not a profit, but they're a research institute that's looking to take translational drugs for TB, malaria, all of the big hitters out there. What do you feel like are the big actionable questions we should be asking of our representatives? So, you know, we've gone from clicks you can take with a mouse, but when someone uses a tool like 5calls.org or something or writes a letter, however, that works with a pen and a paper or something of that injury. What?

That's written very into that. And is actually speaking to their representative or they're at a town hall. Again, it's particularly not difficult, but almost out of left field one, which it shouldn't be because it's not here. What should they be talking to the representatives about?

Sure. And so that's something that I struggle with as well, because I am very caller focused, but with my global health training now, it really is strengthening infrastructure. It's looking at primary healthcare systems and building that up. It's building distribution and stuff.

So instead of just talking about callers specifically, I would say there are policies that the US takes that affect global health on a wide scale. US government is one of the biggest funders of global health services. And the biggest executive order that has made a huge impact since it was signed is the Global GAG order. I'm not sure if you guys have heard about it.

It was signed in January 2017, I believe. And it's also called the Mexican city policy, I think. But basically it is protecting life in global health. So any healthcare center that is funded by US money that is access to contraception and abortion services, they can't do that anymore.

And that not only a maternal and child health view is terrible, but also these healthcare clinics are not only specifically providing us their HIV, their helping with ORS and helping with diarrheal diseases. So they can lose half of their funding and try to do operations that way and try to do everything that they can to do all the other diseases with half of their operational funding, or they can reduce their abortion services and contraceptive services. So it really has made a huge impact globally with this particular GAG order. So when people talk to the representatives about it, more people need to actually know that it happened first of all, and fight back against it.

That's insane. Yeah, that's pretty concise. That is the exact type of thing I don't think anybody has heard about. And if they did, they've probably forgotten, because as I look out the window, there's just flames everywhere.

Anyway, we have we have we have people a little bit here. We can't not thank you enough for coming on today. Yeah, for sure. Thanks for letting us be your your first.

To be clear, you're not out of here yet. Don't go back up and around. Yeah, hold on. I'm just thanking you.

Easy. Who else should we talk to? Doctor, yeah, and other other world changers out there like you, that we could sit down and chat with. And it doesn't have to be people specifically in your field of work, but somebody who's kicking ass on cancer or trying to save the world from climate change or trying to send us to space.

Anything. You can always just email these to us later, but I think people like to hear names as well. But yeah, any ideas would be awesome. Well, from a science perspective, I would say that scientists who just recently won the Nobel Prize for her direct evolution of enzymes.

That's super cool from a pharmaceutical. And a trying to make a cleaner industry. That's Dr. Francis Arnold.

If you can get her, that would be really awesome. I would like another prize winner. That'd be great. Yeah, sure.

That sounds easy. No big deal. Oh, yeah, that's not really fine. But it's ours.

You know, see what you come up with. Yeah, perfect. Thanks for making these a jerk. No, that's great.

So thank you. And if you do think of any more, we'll take any wrecks. Yeah, I will definitely email. Really?

Thank you. All right. We have a little lightning round of questions for you. Yep.

First one. Not a lightning round question, but here we go. Shut up, Brian. Hey, maybe when was the first time in your life to do something meaningful?

Oh, good. Good. Good. Good first reaction.

Did you say this year? Yeah. Oh, cool. It's here.

And I actually, so I called myself to a scientific officer for a very long time. I didn't think I had expertise or the experience to be CEO of a biotech startup, a global health startup, whatever. And then I went to the MIT Women's Unconference, where I got selected to be among the people who could pitch there. And that's when I was like, oh, I'm actually a badass thing that people recognize as good work.

I promoted myself. Good. That was awesome, man. I deserved.

So yeah, that was really the first time when I believed in myself, really, because I just thought I was a better scientist. So I thought I would sign the shit out of it. And then other people would shake it and run and actually do some good with it. But this year is when I decided I would be the person to do something with it.

Fuck yeah, man. That's so important. I love that confidence. Strong and alive.

Yeah, we literally need it. Hey, Mimi, who is someone in your life that has positively impacted your work in the past six months? It cannot be Brian. Oh, god, that was my first answer.

Oh, we know. We know. And it's much appreciated. I would have to say Andrew Camilly, who is my PI advisor and now my co-founder.

I think it's very rare for a professor, a tenured professor, especially to be so generous with his time, his work, really giving credit, and career support to the people in his lab instead of just using them as minions. So without his support, I would definitely not be here today. Awesome. That's awesome.

That's nice. What do you do when you feel overwhelmed with all this work? Specifically, what's your self-care? Oh, my god.

Flaming hot Cheetos? Are you kidding me? Amazing. All my friends know that once I go into a dark place, I need so many in this line by the way.

They're not speaking of things I can call us cholera. Yeah. I have to say, my girlfriend is a huge fan of Flaming Hot Cheetos. That is her, like, one thing also.

And just to punch myself up a little bit here for her birthday, I got her a cake that was shaped like a bag of them. Hi, look at you. Pretty good. Thank you.

They didn't taste like them because I think they're horrendous. But if that's your thing, get it out. You know, on the West, I'm actually in LA right now. On the West Coast, you guys have extra Flaming Hot Cheetos, and that has been medical.

You know what? If necessary, not so much. Extra Flaming Hot. Are they just jet black?

Can you imagine sitting in that conference room? Hey, I got the idea. I got it. I know what we're going to do.

Extra. Should we just call it extra? Yeah. Just extra.

It's quite as hot. I call them my black label Cheetos because they're not good. Hi. I'm going to have to find these.

We're in LA, too. They must be at my local 7-Eleven or whatever. Exactly. All right.

I'm going to get them. Thank you for that. My girlfriend's going to be very happy. All right, Brian.

Bring it on. Here we go. How do you consume the news, Dr. Ian?

That's changed over the past year. So I'm sure everyone is trying to struggle with how do you make sure that you're not pulled into this deep pit of despair when you read the news recently? So I try to stay informed briefly. So like the New York Times morning and evening briefly, the daily scan, make sure things and have my mind when I really want to dig into something.

I actually do my research. I go on Google and try to look for more articles, opinions about it. And I do try to make sure that I'm getting all perspectives. So I think we asked we are.

I am in the camp that we need to understand where everyone's coming from in order to actually solve the root of a problem. Like when you go into a negotiation, you think, OK, what is the other person wanting? What are they? What are their motivations for feeling the way they do wanting the things that they want?

And perhaps that's not the solution that most people come with. But for me, that's the perspective I need so that we can all come to the same page. So I try to make sure that now that I know that I know that I know that I exist on social media, that I am at least during my readings of the news, I make sure to look at other perspectives as well. And not only do us, also how internationally, how people write about issues in the US as well.