The Future Of Drug Discovery Is 4 Billion Years Old (Viswa Colluru, Founder & CEO at Enveda)

Medicines are hope. The way to make patients feel powerful is to put great medicines in their hands, which means both discovery and ultimately delivery. There's really only one problem in biotech. It's drugs that work in the lab don't work in people. And because my job was to create landscapes of where the industry was evolving and where Recursion's technology platform sat within that view, I made a striking observation that 100% of our collective human effort to solve that gap lie in the biology bucket. Mm-hmm. Most often we tend to conflate innovation and novelty. But if I look around, most things that have changed the fabric of our lived experience were actually not new when they did so. And so if you make the calculation that most ideas that change the trajectory of human life are actually old, then you're increasing your odds that you are on the inflection. Even LLMs, when they changed the world, were like, by AI terms, fairly old, nearly a decade. Yes.

A third of all drugs ever approved by the FDA owe their origins to a molecule first found in nature. Aspirin from willow bark. Morphine from poppies. Metformin from a plant called goat's rue. Despite that, at some point the pharmaceutical industry walked away, moved in a different direction, convinced that synthetic chemistry and rational drug design were the future. Viswa Koluru thinks that was a catastrophic mistake. His company, Enveda Biosciences, has raised over $500 million to build a search engine for nature's chemistry, using AI to decode the millions of molecules that evolution spent 4 billion years perfecting. Since its founding in 2019, Enveda has identified 18 candidate drugs With 3 in trials, pioneering a radically more efficient and economical model in the process. In our conversation, Viswa and I discuss the deeply personal reason he got into drug discovery, what competitive table tennis taught him about managing a company, and why he believes the pharmaceutical industry's biggest breakthroughs might come from the oldest laboratory on Earth. I'm Mario. And this is The Generalist. This episode is brought to you by Brex. If you're a founder, the hardest part isn't the idea. It's scaling fast without getting buried in back office work. That's where Brex comes in. Brex is the intelligent finance platform for founders. With Brex, you get high limit corporate cards, easy banking, and high yield treasury, plus a team of AI agents that handle manual finance tasks for you. They take care of things like expenses, all according to your rules, so you can move faster while staying in full control. 1 in 3 startups in the US already runs on Brex. You can too at brex.com/mario. This episode is brought to you by Ahrefs Brand Radar. If you've tried searching for your brand in ChatGPT or Google's AI results, you've probably noticed something. It's not always clear why certain brands get mentioned Or why yours doesn't. That's the problem Ahrefs Brand Radar solves. It helps you see how your brand shows up across AI-powered answers. Not just in search engines, but also on platforms like Reddit and YouTube. Instead of guessing, you get real data based on millions of actual user prompts. You can quickly check your share of voice, find out which websites or sources are influencing those answers, and see where competitors are getting ahead of you. What makes it different is that it doesn't rely on simulations or small samples. It's built on large large-scale, real-world data, so you're seeing what people are actually asking AI. There's no complicated setup either. Just enter your brand and start exploring. Visit ahrefs.com/generalist to learn more about Brand Radar. Viswa, we had such a fun, interesting conversation when we met for the first time last fall, and it made me really want to go a lot deeper with you. So thanks so much for being here.

Thank you for having me. Longtime listener, first-time caller, as they say.

Well, thank you so much. In researching a little bit of your story, one of the things that stood out to me was that your father was a pharmacist.

He was. He actually inherited my city's first pharmacy called Visakhapatnam Medical Stores. And I come from a city named Visakhapatnam, or Vishakhapatnam. And I grew up around medicines.

And from what I could tell, You know, it has such interesting links to what you're doing now. There was sort of a mix of both sort of what one might call sort of traditional Western medicine and then more sort of Ayurvedic, not homeopathic. How would you describe the sort of 2 types?

I think the oldest form of medicine, which is from the radical act of observation of what happens when you consume something that occurs naturally and you've been taught and cultured to consume for a very long time, you know, I think On my way over, I'm battling a bad bout of nausea. And the thing that still works for me is ginger. And I think, you know, Dramamine Natural is nothing but ginger.

Yes. Yes. So you grew up seeing all of this, you know, all of the different types of medicines on offer.

Absolutely. And I think that, as I can see you're laying the breadcrumbs, was one of the key influencing factors in me having maybe both the right amount of skepticism and belief, but having both of those from a place where I figured that there was a marriage made in heaven that we weren't yet seeing.

What do you remember about that place? Because it seems like probably a big part of your childhood.

You know, I would accompany my parents to the pharmacy 'cause they were both, you know, essentially helping run the house. And my First memory was looking at 2 different drugs and asking why one was priced at a tenth and learning what generics meant at age 7. My other memory, which is very distinct, is recognizing that 2 drugs where one of them had like chloride or a salt ion next to it was the same thing, and the active principle was effectively equivalent. And how the healthcare journey, at least in India, depended a lot on people being able to access and afford medicine. And also there are some— I realized that there were just some afflictions where you went to the doctor, but they didn't really have a medicine for you. And what's interesting is that, you know, these patients would come over and they would seek advice effectively with the pharmacist as a second doctor. And all of these things left, you know, a very clear impact that medicines meant hope and that when you are ill, you want nothing but to feel better.

Was that how you saw your life path from a very early age? Did you expect to be a pharmacist, be a doctor?

Absolutely not. I thought it was all interesting, but I was dead set on becoming a computer scientist that worked in Silicon Valley, like any good middle-class South Indian boy born in the 1990s. But of course, life had other plans.

How did that even come onto your consciousness? You say like every boy in South India in the '90s, but were there sort of key inflection points where you became really fascinated by technology?

I think it was the first time where Early adopting relatives were able to afford personal computers and were able to do things that my dad's accountant or his typewriter assistant took so many months to do. And then there were definitely neighborhood kids that had come to America, studied engineering, and come back with really cool toys. And also glimpses of what seemed like a magical future life where technology was driving change that we were just not able to glimpse from the other side of the curtain. And, you know, I think the fact that today you have folks born maybe between '75 and '95 in Silicon Valley being, you know, a vast majority of South Indians, including large tech CEOs. And I think it was very much a product of the culture and crucible of the society we grew up in at that time.

Were you the kid sort of trying to build websites yourself or programs yourself, or how did that manifest for you?

Oh, it manifested for me really by choosing to study computer science instead of commerce and economics, which was one of the first electives in middle school.

Oh, wow.

Falling in love with programming, the logic of writing an algorithm. I still think that Today, I try to map things out in steps independent of the language, whether it's English for a pitch deck, right? Or whether it's Python, even though I don't code, I might get back into it. Thanks to Claude, we can all not worry about compiling or syntaxes. But I think it influenced how I break down problems and how I thought about how the underlying structure of any argument must be made.

And you had a sort of key moment in your childhood which seems to have really changed that path, which is your mother got very sick. What was it that afflicted her, and how did that sort of impact the way that you thought about the rest of your life, really?

Yeah, I think that was the moment that defined my childhood and ultimately, I think, put me on the path that has me sitting on this couch here today. And it was my mother's diagnosis in the late '90s, so I was you know, 8 or 9 years old. And after being sick for a few months and not getting the help that she needed, we went and saw, you know, a super specialist that just did a lot of tests. And it came back that she had a type of blood cancer, which I would go on to find out very soon, thanks to our own personal computer and the internet, as chronic myeloid leukemia. It is when your bone marrow produces, you know, undifferentiated cells, too many white blood cells, and they start to kill your marrow and other organs. And at that time, it was effectively a death sentence. They told her she had about 5 years to live and that she was ineligible, perhaps on the AIDS side, and we were on the financial side, to receive a bone marrow transplant, which was really your only hope at that time. We were told, well, you know, if you had the money to go travel to the United States, States and you could get this done at Sloan Kettering, you know, they could probably deal with the conditioning regimens. So the things that you need to wipe out the previous marrow and yet keep the patient alive in that very, very precarious state. So that was not an option for us. And then we would go on to find out in the coming weeks that even to give her those 5 years, we would have to somehow marshal about 4 times my dad's annual income every year. So It very much became the precipitating moment of focus for our family, purpose for us. And also, I think, where I learned the meaning of courage from my mother, who showed up after that moment, actually not a single day asking, why me? Or in any way insinuating that life had treated her unfairly. She jumped into action. She used to help my dad at the pharmacy and so on, but she launched multiple small home-based businesses. To supplement our income, keep her busy, challenge her to grow. And what started off as, you know, a tiny spare bedroom effort to arrange dry flowers and decorate people's homes or create small gifts grew into, I think, one of the most exciting homegrown businesses in about 4 or 5 years. And about 48 hours before she died, She was adamant that my father go finish an assignment that she had accepted from a hotel nearby to decorate the hotel for Christmas Eve.

Wow.

And to this day, my sister and I talk about the sheer resolve that she must have had in that moment of excruciating pain and taught us that courage isn't about not feeling fear. It's about moving forward despite it.

How old were you when that all happened?

I was about 13 or 14 years old, and I think old enough to recognize that my life would never be the same again, but young enough to not be cynical about it.

Yes.

And I realized if I look back and reflect on her journey, the piece that gave her the most power was the creation and approval of a new medicine called imatinib, more famously known as Gleevec, from Novartis. And when she couldn't access it after the first few bottles, because it was $2,200, I still remember the exact number per month. And that was several times my family's combined annual income. I realized that the second real piece was her getting access via a foundation that Novartis set up in partnership with someone else. And so For me, it became medicines are hope. The way to make patients feel powerful is to put great medicines in their hands, which means both discovery and ultimately delivery. And that's a big part of what would go on to influence some decisions I've made. And I've not really talked about publicly about choosing to work on small molecules or medicines that you can take and distribute in pill form cheaply and where you can reliably turn them into generics. Right. So yes, that period of life was effectively when I'd say the quadrants of my compass were set.

You saw the hope, but also clearly you saw the limitations of, of this paradigm and can't help but, but change who you are in some really fundamental ways, right?

Yes.

And so then you go and study in the US, well, first in India and then go to the US for a PhD.

That's correct.

What was the sort of shape you had in your mind of the way that you wanted to help at that point?

Yeah, I wasn't quite sure exactly what form that will take, but I wanted to be involved in the discovery of medicines and maybe their production or delivery. And I ended up studying a major that was essentially a marriage between biology and chemical engineering. It was literally called biotechnology. So I have a bachelor's in technology in biotechnology.

I love that.

And that was a very eye-opening time. I realized I had a penchant for research, even though we didn't do much fundamental research in college, and ended up choosing the biology side of things. And by that time, I had gone from maybe a B-, A-, depending on the year, student to someone that was obsessed with this problem. And I would prep for about 2 and a half years my GRE applications in order to find a place at a good graduate school in the US. And as fate would so have it, you know, my deep extensive preparations and 5 or 6 backup schools that I applied to all rejected me. But my number one choice was the University of Wisconsin at Madison. 2 of my favorite textbooks in college were written by professors there. And somehow, by the skin of my teeth, including when daylight savings time moved the interview by an hour, and I didn't realize it because no one else changes their clocks, I somehow managed to make the interview and then make it through the interview to get into the cellular and molecular biology program as one of 13 kids that year. And this was in 2011. And so I moved from sunny South India to sunny Madison, Wisconsin.

Yes, I wondered about that as a culture shock. It feels like that's about as steep as it gets. What was that like?

It was actually very interesting. The first shock I experienced was the cold. My first winter there, I think the temperatures hit -40, which fun fact for you is the same temperature in either scale. So -40 Celsius is the temperature at night.

Wow, that is a fun fact.

And it's also the temperature at which instantly your nose hair will freeze if you go outside. So I found out both of those things, but really fell in love with the spirit of inquiry at a top-tier American university, the lack of hierarchy, and I think my first taste of what makes America uniquely special. is that as far as I can tell, it is the purest form of meritocracy that we have, where who you are or where you come from matters less than what you can do and how you think. And I found that to be deeply infectious. And it was when my love story with this great country started.

I think I'm right in saying that Satya Nadella also went to Wisconsin, maybe. And I remember him in one of his It must be in Hit Refresh, his book, talking about how it was responsible for him stopping smoking because it was so cold outside that he was like, I can't do this.

That's right.

So, you know, that's a well-trodden path.

It is a well-trodden path indeed.

Maybe we can talk a little bit about what you were studying at the University of Wisconsin. You'd sort of— you can tell me how clear the steps were when you began, but you really started to get interested in immunotherapy, which had gone through, you know, really a fall from grace, from interest.

Several times.

Several times. So yeah, how did that like appear on your radar, and why did you think it was worth spending time on?

You know, the 2 textbooks I mentioned, one of them was a book called The World of the Cell by Professor Wayne Becker, who had gone emeritus by the time I came on campus. But one of the later chapters in the book was about cancer. And it was very interesting because 95% of the book was about fundamental cell biology, but he's got this one chapter on cancer as a fundamentally cellular disease. And that lens allowed him to look beyond genetics of cancer and ask, what are interesting ideas that haven't yet come to fruition that may hold tremendous unfulfilled potential? And this last paragraph or 2 talked about this concept of engendering an immune response against cancer. And this for me was really interesting because like all cancer patients, my mother had gone through a remission-relapse cycle, actually multiple. And as she was treated with toxic chemotherapies early on in her journey, she probably accumulated mutations and her cancer you know, effectively mutated into lymphoma at some point, which she also then beat. And so I started asking the questions of her doctors, well, why did this happen? And they said, well, you know, there's a few hypotheses. Your cancer can become stem cell-like and come back in another form, or maybe your original cancer, which she ultimately ended up succumbing to, you know, was never really removed by the medicines we gave her. And they call these micrometastases. And at the end of the day, what makes cancer lethal is its ability to spread. If it stayed in one place, it would just be called a tumor and a benign tumor, and you can go and surgically remove it. And so this was very interesting to me because it was essentially an antidote at the cellular level. And so you can escape a chemical because of vasculature or genetics or mutations, but if you truly, you know, allow and create the ability of immune cell to recognize a cancer cell, You get rid of every last virus in your body after you get the flu, right? And you recover. So that was very interesting to me purely on a first principles basis. At that time, I had not realized its storied history. And over the course of the coming years, as I was studying it, I would appreciate that old ideas are actually where a lot of latent potential lies in a way that would, you know, more often than not go on to change the world.

Yes, I certainly agree with that. I was trying to do just a bit of research in advance of this, and it was fascinating to me how far back versions of immunotherapy have gone, even in treating cancer. And, you know, 1800s, there are people trying to do versions of this. I wonder what it says about your mind that you're sort of predisposed to look so deeply at something that other people are are overlooking or that you feel that people are overlooking? Like, does that just sort of seem to be part of your innate makeup? Did something teach you to do that?

You know, I think I've reflected a lot on this because we'll come back to courage, I think, as a central theme for how you can build great companies and change the world. And it is not something I've ever felt compelled against. In a way that I think most of my peers or other people I've known feel the pressure. And I don't know where that comes from, but I think the same thing that forces you to conform to a particular manner of like dressing or speaking is what forces you into the current zeitgeist of thinking. Because you want to feel Validated. You want to feel smart. And I'm going to borrow this from our mutual colleague Pablo, who told me that one of his metrics that he looks for when he was finding founders for Hummingbird is the ability to accept low status for a long time.

Yes.

And I think that is a very interesting lens through which to evaluate effectively an equivalent of the marshmallow test. But I think what's interesting, and I'm very grateful for this because I didn't make the part of me that is like this, is I never felt like low status was something I had to accept. I was just okay with it. I realized early on, you know, I grew up in a very wealthy neighborhood through sheer chance, even though we weren't wealthy, and that most people spend time thinking about themselves. And I would realize I spent a lot of time thinking about myself, which means that most people aren't thinking about you.

Yes, true.

Even as a kid, I had that realization one day, and I think that sort of released the pressure to look a certain way. And that by extension, I think untethered me from the mores of, oh, you have to research. If I was starting my PhD in 2011, it was all about oncogenes and small molecule inhibitors to RAS proteins, which are effectively what advanced chemotherapy was, no one was joining immunotherapy labs at that time. And that theme, I think, would hold me in good stead through the arc of my career and put me on this seat.

Yes. There's a great blog post called The Moat of Low Status, which I think does a great job of talking about what Pablo names there. And for folks' context, Pablo, you know, was an investor at Hummingbird and then, you know, upgraded to Invada. The challenge of picking one of these overlooked ideas is that they can really go dormant for an extremely long time, right? Like, you know, there's examples of the ancient Greeks even knowing some of the core mechanics that would make the steam engine happen, but they were used as toys, you know? Uh, And so you can go centuries or, you know, so, so long without these things coming into fruition. What gave you confidence that, hey, this— my life isn't going to be wasted if I spend it in this area? Because there maybe was an inflection that you were seeing or some signals that this wasn't going to be just, you know, 200 years away, let's say.

You know, I actually flipped it in my head and I said, most often we tend to conflate innovation and novelty. But if I look around, most things that have changed the fabric of our lived experience were actually not new when they did so. Steam engine, yes, initially toys and then to power water wells and then ultimately locomotion in water actually before the railroad.

I love that you know this so much better than I do. I brought it up, but you've gone deeper than

that. Same thing is true for electric cars, neural networks, alternating current, the internet, transistor, rockets, flight. And I was like, wait a minute, that's also true for statins, morphine, rapamycin, transplant medicine. And this for me was interesting because if you made the bet that most often, even LLMs, you know, when they changed the world were like by AI terms fairly old, nearly a decade.

Totally.

And so if you make the calculation that most ideas that change the trajectory of human life are actually old, then you're increasing your odds that you are on the inflection if you just pick an idea that's old enough where you also feel like both the constraints that restricted its potential are clear and that the world in ancillary technologies has developed enough that the idea could be revisited. Right. So those are the two things you have to evaluate. So one of the big leaps I'd make from my time in graduate school is to actually leave immunotherapy, which had then been rechristened to immuno-oncology, which held a lot more sway and budgetary power than immunotherapy, was to actually go to the intersection of computer science and biology because I thought that, you know, the story was far from done. The idea had gone through many troughs of disillusionment, but computers and processing power and our ability to store and move data had been increasing exponentially. And so I said, wait, this is an unfinished idea that I think deserves attention. And so I found myself in AI drug discovery, what, like nearly a decade before it became cool and half a decade before the term even was coined.

Yes. Before we get to that, you know, in looking at sort of the work you did at University of Wisconsin, you know, it's full of all of these, you know, terms that I can't pretend to understand. You have, you know, working on new vaccination methods, new DNA, novel DNA vectors. And, you know, looking at your LinkedIn, you have all of this, and then you also have that you are a part of the University of Wisconsin Table Tennis Club. It made me wonder why that is in there and what that meant to you. Like, was that the way that you blew off steam during this period? Was that where you made your friends?

So what's funny is, I always grew up really wanting to play tennis. And I still remember watching Roger Federer beat Pete Sampras on a 16-inch CRT TV that we all used to have back in the day that you needed to give a solid whack once in a while because the antenna wasn't perfect. And I went up to my dad and I said, Dad, I really want to play tennis. He's like, great, let's go check some places out. And we go check them out. And effectively they're about, in that time, in the mid-'90s, about $100 a month.

Oh, wow.

US. And my dad was like, yeah, no, we're not doing this. And instead he's like, let me go do this for you. Let me go buy you a table tennis paddle racket and find you a good coach. And so we found an academy that was subsidized by the government. for $1 a month. And so I went to play table tennis every day instead of tennis and fell in love with how fast the sport was, how it demanded flexibility, and that became my thing. So I would go on to actually choke in every tournament in high school.

Oh, wow. No way.

And learn a lot about myself and how I dealt with pressure to perform because I didn't feel that in any other domain. But I felt that because I felt like I had to win because I was only one of the few kids that had coaching. And overcame that partly and would go on to be on the table tennis team at the University of Wisconsin, which is really Indian and Chinese kids. And it was also overwhelmingly undergraduate, so college students, not graduate students. And so it was this really insane, beautiful window into American life. through the lens of an immigrant in a competitive sport that was viewed as a drinking game. And I fell in love with the intercultural mix, you know, competitive play. I would go on to be, even though not the best player, captain the team and even coach the team.

Oh, wow.

As a retired player for a year or two and made some of my best friends that way. I don't think we ever did spectacularly when I was on the team. We were like in the top 20 in the country. But we did beat Harvard

at the

nationals. And I was like, that's good. I'm going to keep that in my back pocket.

I bet that, you know, that would have made your family very proud, right?

Absolutely. It was great.

You know, there are plenty of, I think of someone like David Foster Wallace who talks so much about and writes so interestingly about the parallels between tennis and life and writing and creativity and all these sort of things and math. Are there any sort of observations that you have about the way that table tennis or those lessons feed into your daily life?

I think this is true of any sport, but the biggest observation I made that I perhaps drew parallels and lessons from is that competitive sport is really about winning one match at a time. And each match is its own journey and is won equally, I would say, in mind and strategy as opposed to skill and practice. Which is why I think I got picked to be captain and coach is because I would see these extremely talented kids that could beat me left-handed blindfolded, not kidding. And I had a teammate who was so good she could hear the spin, so she could receive a serve from just the sound. And all they really needed was a dispassionate but interested observer that taught them in the matter of a few points, you know, I wouldn't say teach, maybe guided them towards the particular dynamics of that matchup. And so it was really about winning one match at a time, which is a metaphor that I really like. And each match, as you might imagine, is not about rankings or numbers. It's really about what what happens on that day and your ability to win in the mind as much as it is winning with your body. And that for me is, I think, a lesson I still take to this day. David versus Goliath is not as lopsided as it seems ever.

And so you bring those lessons from the table to life at Recursion Bio, which sort of had these 2 sort of this tech and this bio component coming together and riding this new exponential wave that you sort of mentioned. How did that specifically become the place where you decided to spend your time? I imagine there weren't maybe that many companies even that fit that bill.

Not at all. And it was actually a wayward LinkedIn ad that caught my attention. And of course, as highly skilled immigrants that enjoyed taxpayer subsidies for advanced degree, you only have 60 days to find a job or else you have to leave the United States. So like everything else I'd been doing since my time becoming someone obsessed with trying to be successful in this domain, I spent a lot of time researching companies and jobs. And I think somewhat ironically, this one fell in my lap. It had the most interesting story. And I would go on to Marvo, continue to hold my fascination for technology, during this time, which had taken the form of smartphones, which were half a decade ahead of my life in India at that time. That's no longer true, but it was back in the day. And my Samsung Galaxy, whatever, S13—

Yes.

—had a facial recognition program that was actually not bad for that time. And with no pre-training on my face and just a couple of photos, half the times it unlocked my phone. And I recognized that that belied a deep improvement in processing and algorithms, specifically of visual data and pixels. And what Recursion was doing was effectively facial recognition for cells. And I could grasp that very early on in even their job ad and the videos that Chris and others had on YouTube. And I said, wait a minute, this sounds really cool because the way that the industry was at that time obsessed with treating disease, and to some extent still is, is by mapping out molecular underpinnings and figuring out what genes may be causing a particular disease. But no one was asking, hey, what does that do to a cell? And can we somehow generate very interesting, believable, underwritable patterns and correlations in biology that were not driven by a priori theoretical explanation. And that for me was very interesting. And the way that Recursion in its original form wanted to use that technology was also very, very elegant, which is normally you have this massive body of literature that develops over decades that reaches a tipping point about how you think a disease works. And then you create a drug for it by trying to manipulate one node or another. But rare disease patients and rare diseases, which are in the thousands, so there's about 5,000 to 7,000 diseases that are caused by mutations in a single gene. And they're rare, like teleologically they're rare because most genes are conserved for a reason. And if you lose their function entirely or if you gain too much of it, then it becomes toxic in utero, right? But there are small, like about a fourth of the genome, where you can have some loss of function or gain of function where you can still be born and you can be, you know, usually somewhere between sick and very sick. And these diseases, while the genetic cause is known, there's not enough of a body of literature that's been built up because the interest and the funding isn't there. For you to take an approach and say, you know, I'm actually going to study this one pathway that I think is dysregulated because of this gene. And so this ability to shortcut through facial recognition of cells, the study of rare diseases in a way that can be directly applied to drug discovery felt deeply intellectually satisfying and impactful to me because those patients most go through a very long journey to even be diagnosed. Only to be told there aren't medicines. And so it was a very easy bet. And I would be the first hire that I think Chris claimed at that time that he didn't personally interview. And so I'm very glad that, you know, he found me up to the mark after he came and saw me. He was away traveling at that time.

Not just up to the mark because he writes such a phenomenal parting post when you left a few years later that—

I think that says more about him than me.

Well, I don't know about that. I've really ever seen that happen before. So it says something about both of you probably that, you know, a CEO goes to the trouble to write about what it was, a departing outstanding employee or something like that.

Yeah, I was, I think I'm happy, I'm happy that I was on the ride at that time. But, you know, he's an incredible, incredible founder CEO.

What did you learn from him? Like what, you know, are there things that you take from the Recursion time that into your operating today?

Absolutely. And I wrote a unpublished letter in response to that and shared that with my colleagues at that time. And I think I made a few salient points then, but 2 that stick out to me today here on this couch. One is I saw the way that Chris operated with a sense of urgency. For example, we had, I think, a partner visiting a tiny office, which was about twice the size of this studio at that time. Or we had a bunch of new employees joining the next day and all the desks needed to be rearranged. So he just, you know, came after— he came back to the office after 5 o'clock and he was like, hey, whoever's here, we're just going to move the furniture ourselves. And we just rearranged all of it. And I was like a week into my job.

Yes.

And I didn't know what corporate life was, you know, how a CEO was supposed to behave. And thanks to Chris, I never picked up any bad habits. Yeah. You know, I'm still happy. doing everything from the now famous Jensen quote of cleaning toilets to moving furniture, which I actually saw Chris do. So that was maybe one thing is this bias towards action and the action being urgent by default. The second is I think we— it was very clear that not only the application of AI, but this unbiased discovery of new hypotheses that may not be treading, you know, well-erected goalposts was very different from how the industry thought. And it required a lot of courage. And I would spend my first part of my career there really trying to sell the Recursion approach as the first platform product manager, probably first product manager in tech bio at that time. Yeah. which I dubbed as connecting the creators to the customers, right? Selling that to pharma and being essentially the victim of many blank stares. And I think this idea that if you believe in something from first principles, it is completely okay being misunderstood was maybe something, another dimension of courage relative to what my mother showed me. That I picked up at that time.

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Yeah, I mean, I was, I was having the time of my life at Recursion. I would go on to make incredible friends, many of whom are now at Enveda, luckily. And I did not want to leave at all, but I realized during my time at Recursion that there's really only one problem in biotech. It's drugs that work in the lab don't work in people. And because my job was to create landscapes of where the industry was evolving and where Recursion's technology platforms sat within that view, I made a striking observation that 100% of our collective human effort to solve that gap lie in the biology bucket. And this was interesting to me because we had medicines before we had biology labs and before we even had molecular biology as a formal scientific field. And that was simply by focusing on interesting chemistry. Our ancestors walked the Silk Road, drank the milk of the poppy, realized that that soothed their ankles and their feet, and that they could sleep a good night's rest after drinking that. That allowed us to discover opioid biology, gave us morphine, understand how pain works, and till today have really the only solution for breakaway pain. And for me, that was interesting going back to my roots. where, as a South Indian boy, I had my friends, family, mother, grandmother give me herbs whenever I was ill, you know, like that ginger I had this morning. And it struck me that there were many other morphines, aspirins, artemisinins to be found, Nobel Prize-winning, disease-busting, you know, billion-people-treating medicines that where a large section of society somewhere on this planet would be unsurprised by that discovery. And so I started asking the simple question, if things that work in the lab don't work in people, and hundreds of millions of people believe in something working in people, doesn't that warrant a second look? I didn't know it at that time fully, but I would go on to recognize that that was how the industry started. And this was an unfinished idea. Like immunotherapy, like AI drug discovery, It was an unfinished idea. And I just didn't quite know at that time how unfinished, but I knew enough to know that, you know, I knew of several plants just off the top of my head where I've experienced, you know, their effects. And I know that millions of people would be unsurprised if there was a modern medicine found, but we weren't paying any attention to it. So that became the precipitating, I would say, realization. And maybe the observation that no one was doing it. Not only was no one doing it, when I tried to find out why no one was doing it, I uncovered a tremendous amount of stigma. And that stigma was rooted in past failure, which I was actually leaning towards, not away from. And that stigma was essentially misconstruing absence of evidence as evidence of absence. And, you know, it would've perhaps discouraged me if not for the fact that around that time, as I was thinking through this idea, there was a company called GW Pharmaceuticals that had gotten the first approved, first novel anti-seizure medication approved in a very long time. And it was nothing but a purified form of the cannabis extract with essentially one compound called cannabidiol. It was non-psychoactive, but it was tremendously neuroactive. And if you trace the origins of the cannabis plant, I think there's a 2,000-year history of treating symptoms of what we now recognize to be seizures. And so there was this massive section of the world that was like, of course. And that company would go on to get bought for $7 billion, and they didn't even change anything. All they did was they generated the evidence. And so I said, given my background, given my training and naivete, given my roots and my desires, that I was perhaps the best champion for this idea because I couldn't find another one.

Yes.

And I said, if I don't do this, I'm going to regret it for the rest of my life. And I didn't quite frame it as elegantly as Jeff Bezos, But I knew that if I let that moment pass, I may never do it again. I never have the opportunity to do it again. And that may end up being one of my biggest regrets.

You mentioned that, you know, all of this energy is focused on the biology and that, you know, maybe the industry didn't start that way, but that's where it was when you found it. For folks that aren't familiar, like, why did it evolve in that direction? And why has it found, you know, why has it been so hard to move it away from that?

You know, I think the scientific method in general biases towards breaking things down and simultaneously calling them fundamental. For example, I think if you go visit CERN, the word fundamental is thrown around almost on every billboard inside the museum and even formal writing explaining science to you because they think that they're studying things that are so small that they make up everything. And I think biology has been a victim of that broader scientific movement. And I think anyone that lives life and observes it recognizes that almost everything that matters is emergent. Consciousness, your lived experience, disease, even obesity, something that's simply the accumulation of fat, is as much a disease of fat tissue as it is a disease of the brain and the gut. And I think that broader movement edged the currents of biology, number one. The second is at the turn of the millennium, the molecular biology revolution had reached its zenith. So our ability to sequence genes and all of a sudden correlate mutations in genes, these were called massive GWAS studies, genome-wide association studies. And if you look at papers in the 2000s, that was what the most exciting labs were doing. And it was for the first time sequencing hundreds and then thousands of people and saying, oh, look, this gene here has a number of mutations that either protects from or predisposes you to this other disease. And so it became very elegant to say that a single gene was responsible for something. And there are, like any good distribution, I think complex diseases that can be either treated or ameliorated by a single effector. And this became sort of the dominant way of thinking. But I do think that is also a result of technology. We invented a sequencer for genetics. And so that became the most voluminous form of data. And this data, I think, both became highly amenable to the scientific zeitgeist of trying to reduce problems down to really simple things. And I think the human predisposition towards correlation, right? We love— our brains were wired for correlation, not truth, right? We're like, oh, I see like a pattern behind the bushes, that must be a tiger, right? Yeah. And so I think these 2 things made it so that we said, oh wait, most disease can and should be caused, and if not caused, at least treated by a single chemical or now, you know, other modalities like RNA that allow me to tweak this one protein, which is expressed in this one tissue or is expressed in the disease tissue of interest in order to cause this balance between benefit and risk. And if you think about it from an evolutionary perspective, going back to genetic diseases, the lesson lies right there that most of these genes and proteins exist for a reason. So perhaps completely ablating their function is walking a very tightrope physiologically.

Yes.

Which is what we go on to find out. And because so much of life is emergent, life exists essentially to turn your breakfast into you, to make energy cycle and matter flow, or the other way around. And all of that happens through a deeply coordinated symphony. And so symphonies are rarely one-protein shows, right? Or one-musician shows. And I think that has— those are the things that are driving some of the low success rates that we see today.

So we have, I think, a rich shape of the problem here of, you know, all of this energy directed through one paradigm, stigma, where people, you know, are sort of Maybe looking down at saying, take ginger for this or take willow bark for this.

Yeah.

And then, you know, this evidence of— or this absent evidence. Did you have a shape in your mind of a solution at that point?

For me, it was very simple. As Charlie Munger says, you know, take a simple idea, but then treat it seriously. I just wanted to say, look, if there's hidden chemistry, that's interesting. It is not the first time that chemistry would teach us biology. So you mentioned the willow bark, which gave us the molecule that would go on to become aspirin. We didn't find aspirin because we studied inflammation through and through. In fact, the study of aspirin taught us about inflammation. And that same pattern holds true for rapamycin, teaching us about metabolism and then eventually immunity and aging. It also holds true for warfarin, which comes from the University of Wisconsin, stands for Wisconsin Alumni Research Foundation, WARF, where a Wisconsin farmer made observations that would give us a blood clotting medicine that was the mainstay till about half a decade ago, where warfarin taught us about the role of vitamin K in blood clotting, not the other way around. And I said, it wouldn't be the first time that we learn biology through chemistry, because this chemical pool that nature has made is deeply evolutionarily selected for activity. Yeah. And so there's a reason that molecule exists in that shape and form. And understanding how it mediates its function in a biological system has, on average, given us a Nobel Prize every other year. We make a big deal of the AlphaFold Nobel Prize and a big deal of the CRISPR one, but discovering vitamin D, for example, which was— the active form was discovered at the University of Wisconsin, led to a Nobel Prize. Discovering cholesterol led to a Nobel Prize. Like, understanding how plants make cholesterol make their equivalent of cholesterol and how humans share that biosynthetic pathway, I think, was another prize.

Yes.

So this for me was very interesting. Going back to things that work in the lab don't work in people, let's just start with things that work in people. That requires us to put chemistry, not biology, back at the center of the process. Those were maybe like the 3 legs of the stool.

Okay. And so you set out to do this new business yourself. I think you raise a very small pre-seed round to do something this ambitious. $225,000, right?

That's right. It was. And the first check-in was mine, which was the entirety of my life savings, which was $55,000, which felt like a tremendous amount of money. By that time, I had out-earned my father his entire career. So it did feel like an incredible amount of money. But yes, it was a very small amount for a biotech.

How did you get to the stage that you needed to get to to get this off the ground?

Winning one match at a time.

Yeah.

It was very clear to me that I was just going to always have to out-execute what people would expect in order to get the capital needed to brandish an old idea. New ideas are hard to sell, but old ones even harder. And so very practically, it became very clear that the kind of answers I would need to provide to people's latent questions were, are there interesting medicines to be found? Interesting defined as potent.

Yes.

For big markets, right? In this overlooked area of chemistry, no matter what layers of priors you use, whether it is ethnobotanical use, whether it's geographical diversity, whether it's chemical diversity, it doesn't matter. I think it was very clear that I had to prove that they were powerful medicines still left to be found. And what is the best way to do that without completely burning a hole in your bank account is to actually take reasonably reliable mouse models of disease where whether or not they perfectly translate to humans, they allow you to benchmark against existing medicines. So I took some of the biggest markets— pain, neurodegenerative disease, inflammatory disease— and I said, even though I may not find the precise molecule like the salicin in the willow bark, Can I at least prove that this mixture of compounds has efficacy through unique mechanisms that beats existing standard of care in efficacy or safety or convenience, which are the 3 things you really care about in terms of product attribute? And I said, there's no way you can generate mouse studies in these big conditions with a quarter of a million dollars. The only way you can is if you own the vivarium. Because I just pulled out a scratchpad and did the math on how many mouse biologists I would need, what these chemicals would cost to induce the disease, and then what the plant extracts would cost. And the math wasn't adding up to what I was being quoted by CROs. I was being quoted $150,000 to do a single study. And so I said, wait a minute, like, you know, what if we just somehow did this ourselves? So I got on a 40-hour economy flight to India, $700, and interviewed multiple people I had cold messaged on LinkedIn in hotel lobbies. Many folks didn't respond, and then many of whom did didn't show up because they're like, wait, are you a real company? Why do you want to meet me in a coffee shop?

What do you want to do?

Or a hotel lobby? That's not the culture in India. But ended up finding 3 brave, intelligent souls that said, find us a lab and we're in. And through a funny twist of fate, after looking at multiple cities, I would find Enveda's first home a kilometer and a half from the home we were living in when my mother first got diagnosed with cancer.

Wow.

And it was a bunch of ex-US-trained biotech entrepreneurs that decided that India needed a strong biotech ecosystem and started a lab. And we would be their first So

$150,000 is the sticker price. What did it end up costing you to do, let's say, one of these studies?

We did about 10 studies with that money.

Wow. I'm sure it's a parallel you're familiar with, but it reminds me so much of the story where Elon Musk gets quoted the sort of first prices on the rockets, and then he's on the plane ride home with his spreadsheet and figuring out, this doesn't make sense. I can do this myself. Okay, so you run these 10 studies. How does that, you know, to sort of bring people into that process, how do you then sort of whittle down towards the one and now maybe 2 things that you've really ended up focusing on?

Yeah, the short answer is like, you know, we would go on to develop now what I think is over 18 candidate medicines.

Wow. Okay.

3 things in clinical trials.

Got it.

But initially the idea was to just show the breadth Of what this could do. And we found, you know, in very obvious places that didn't take a lot of complex reasoning in the first order, potential medicines that could improve immunity against cancers, against infectious disease, that doused inflammation, that improved pain responses, and that improved memory. And these were some of the big problems facing, you know, the medical field today. And so the question really was, okay, if we have this substrate that's hidden in these plants, the big bet we're taking is that a majority of that could be reduced to a single compound. And that felt like a reasonable bet given the history of the field, because plants make a lot of similar compounds. Because effectively, plants don't have an adaptive immune system. As one of my favorite authors of these reviews had once written, Plants can't stand up and walk away from a problem, so they have to produce all potential solutions to future problems. And so they make a lot of interesting chemistry. And just like you make a lot of interesting T-cell receptors for all future viruses, plants make a lot of chemistry to modulate everything from the bees that pollinate them, you know, to the herbivores that eat them, to the humans that they either want to attract or not attract. And so it was a reasonable bet in short, to make that, you know, we can find a single exemplar chemical that would reduce that molecule. But the question was how. So that was a big question, which is how do we find the needle in nature's haystack, quite literally? And the 2 things that you need to kick off a drug discovery campaign is the structure and the function. And if you can do that and say, oh, I actually want to find the one compound in here that's anti-inflammatory or neuroprotective, How do I do that? How do I find the functionally active piece, and how do I find the structurally attractive piece? Those are the two things. So natural products or this, you know, history of look— looking within nature to find medicines has historically yielded tremendous successes, but it was unreliable when you considered the fact that many compounds that start off from nature end up not having the properties to make a good medicine, at least how we define it in modern times. And so how do you make this serendipitous endeavor systematic? And that is to be able to quickly weed out the ones that will fail, which means we need to find the structure and function of all of the molecules, like, in that leaf in order for me to quickly say which one of these may one day be the next aspirin. And if you take too long to find out the needle, then you may say, oh, I actually ended up with a strand of hay. It's the wrong structure. It's one that I don't think I can ever manufacture stably, or it's the wrong function. What I thought was active is actually not quite active. And the reason is that nature doesn't make individual compounds in neat vials. It makes thousands of molecules in one mixture, essentially. So that was the how piece. The where piece was also interesting. There's 400,000 terrestrial plants, I think, as defined by the Royal Botanical Society. In terms of species. So how do you look, right? And where do you look? So for us, it was very simple. We said different cultures must have all used plants that are similar. Let's find plants that different cultures used for similar symptoms. And we actually published a paper showing that, you know, the statistical likelihood that 2 plants were used for similar symptoms is actually fairly high. across different traditional medicine systems and benchmarked against randomness, the odds are extremely low that that would've happened. And so that was the 2 simple things that we needed to figure out is, what are the best plants if I want to treat pain, for example? And once I know what those are and I know they're active, how do I find the needle in the haystack? Which means annotating the structure and the function. And this problem had a parallel that we talked about, which is sequencing. So genetic sequencing allows you to take any sample and ask what the genes are and what they do by quickly identifying what one nucleotide does relative to the other, right? Where it sits in the sequence. So we had to essentially build a sequencer for life's chemistry instead of life's genes. And that was the definition of the problem that I would take maybe about a year, year and a half, To figure out.

Wow.

Yeah.

And so just to sort of put a finer or rather maybe even a coarser, rougher version of this, you're looking, you know, saying people in China for centuries, millennia have been using this plant for pain management. People in, you know, Peru have been using this. People in Europe have been using this. What is sort of like the connective tissue here? What's the unified function and structure, and what can we learn from that such that we can then maybe hone in on something?

Yeah. What are the common chemicals between those related plants? And then you say, great, like, let me go take, test them out, and explore the chemistry of those plants more fully. So fun fact for you, you know, in an average sample, we only know 1 in 20 compounds. And, you know, if you think about the fact that 2 billion people will eat a tomato today before the sun sets,

Yes.

Right? The fact that we know approximately 1 in 4 compounds for a tomato, which is one of the best studied plants, is crazy. And we know maybe 1 in 10 compounds in human blood. So we know more about the genes of random viruses from the bottom of polar ice caps, literal study from 2024, where scientists went to Antarctica, took advantage of the thawing permafrost, sequenced ancient retroviruses, And they were able to map those genes contained in those genomes about 30% of the time. And if you take human chemical signal from blood, which should be the most studied matrix in the world—

Yes.

You end up with, you know, 10, 15% of the masses actually being annotated. And our scientific co-founder, fun story if we go into that, you know, the godfather of computational metabolomics has, I think in the last 2, 3 years alone doubled the size of the known human metabolome, which is essentially the chemical code that you produce as a result of metabolism, right? Converting your food into you, and discovered hundreds of thousands of new compounds.

Wow.

Right? And so there's so much where this comes from, going back to my comment earlier of me not knowing how unfinished this idea was, how much of the world's chemistry was unknown, and why that is deeply interesting.

Yes. And so how many, to try and sort of understand the quasi-pipeline here, how many of these plants did you have to look at to get to 18 candidates and 3 in trials?

You know what's funny is that the first chunk of those, maybe about a dozen, came from us studying less than 80 plants.

Wow. So there really was good actual sort of The intuition or the sort of historical knowledge was there that you could target.

Was there, and that it was very rich. There was a lot of— not to push plant metaphors here, but low-hanging fruit. And the best part is we don't see that running out anytime soon at all. So this was very interesting and very exciting for us as we saw the fruits of our labor.

Yes, there you go. And so the 3 sort of leading products so far Maybe you can talk a little bit about those and how advanced they are and what you hope to see over the next few years.

So we didn't anticipate this, but the sheer volume with which we could find interesting molecules and turn them into medicines now about 4 times faster stable state. So a year in finding a first chemical hypothesis and finishing all of the studies required to call that a candidate, and about 10 times cheaper, so about $1 million instead of $10 to $15 million, was something that would emerge naturally. So we didn't ever shoot for volume. We just wanted enough shots on goal.

Yes.

That does justice to the idea on a risk-adjusted basis. This sheer breadth and depth of the pipeline would be something we would just come to enjoy as we realized that nature had done a tremendous amount of pre-work in making these molecules essentially compatible for life, for safety reasons, and then having utility for efficacy reasons. So with that as background, it was very clear to us early on that, you know, one of the big things we're going to have to solve is inflammation. And early on, you know, we knew there was lots of ways we could target this, move it to different diseases. But as the market turned and it became clear that the industry was moving towards medium-priced drugs for a large disease, so think obesity. And if you were paying keen attention to the trajectory of chronic diseases, it was clear that this was where the market was heading, especially if you were inside. And so we said, great, let's target inflammation, let's target a chronic disease, and let's target a big pain point. And so one of the biggest inflammation diseases that has an open pain point is eczema, 25 to 30 million adults in the US alone. And if you have anything but mild disease that requires what we call advanced therapies, you're stuck between a rock and a hard place. The rock is you can take medicines called JAK inhibitors. You've probably seen television ads if you visited America recently for drugs like Rinvoq. They're called JAK inhibitors, and they're oral pills that were— that are very effective, but they're the sort of things that require consistent lab monitoring, and they could put you in the ER. And dermatologists don't like that because they enjoy the only medical specialty where they don't need to go to the ER. Have you ever seen a dermatologist in the ER? No. And so it's hard for the patients. It's not something doctors care about. It does work. And The Rock, was you can take drugs like Dupixent, which are injectables, which are biologics like Humira was for rheumatoid arthritis, and they work really well, but you also have to inject yourself frequently. And if you have skin as your primary pain point, then injecting yourself becomes something both physically and psychologically burdensome for patients. Yes. And so today, Dupixent, you know, only treats about 900,000 patients, I think, in the US. and still registers over $10 billion or so in revenue from that single disease. So we recognized delivering a safe oral medicine for a disease like eczema, which could also extend into similar diseases like asthma. They're all called atopic diseases. There hasn't been a non-steroid approved for asthma since Singulair, which was 20 years ago. So we said this was a big market, and so we took one of the plants that was used to treat symptoms of atopic dermatitis and asthma, or diseases that we now call those things, and identified a potent anti-inflammatory molecule and showed that it worked via mechanisms that we didn't quite understand, but had the efficacy of a JAK inhibitor, which is like, you know, those medicines that have the black box warning that could put you in the hospital, but didn't seem to have any of those liabilities and could be given once daily orally. And so this became our first program, and we would go on to spend a lot of time understanding its unique mechanism, unique molecule, put it in patients, see that the safety was pristine, at least in early phase studies. We did a pet dog study because pet dogs are the best model for human eczema, and they have 100% positive predictive rate for novel mechanisms.

Oh, wow.

And in the pet dog study, we noticed that they had the efficacy of, you know, a JAK inhibitor, which is the best, most potent drug we've made. And we recently talked about this publicly, but in our first patient study, which was small, 9 patients, we actually ended the trial early due to the extent of efficacy we're seeing. By some measures, we actually exceed a JAK inhibitor.

Oh, wow.

While still retaining the safety profile of a Dupixent injection, if not better, on both accounts. And so it's been a fun journey and goes back to my first crystallized idea, which is there are millions of people that would be unsurprised by this discovery. In fact, our chief medical officer is married to a Malayali woman, and when he was making a slide deck around this plant and first talking about the release of our data, he was putting a picture of the plant and his mother-in-law came. And she was like, oh yeah, like that plant was in our garden, and we used to drink it when we had fevers and, you know, we had difficulty breathing, or we used to make it into a balm for skin rashes. And here we are today.

And so what needs to happen now from, you know, these effective dog studies, this 9-person study? What does that pathway look like before you can really start to have it out in the open?

We are in 2 Phase 2 studies right now, and drug discovery and development usually goes from Phase 1 for safety, Phase 2 for a balance of safety and efficacy and for you to figure out the right dose. And you do a Phase 3 study. Sometimes you have to do 2. We'll see where the FDA lands on this. They're changing their tune, but you do large Phase 3 studies to prove this benefit-risk-reward ratio for patients. And we expect to finish our Phase 2 studies this year and the next and our Phase 3 studies in the year or 2 after that. So we want to get this medicine to launch You know, within this decade.

Yes.

And that would be huge. We think it is the second biggest consensus market in the world today is a safe oral for inflammatory diseases. The biggest one, of course, is obesity.

Yes.

Which is our second drug.

And so, yeah, maybe we can talk about that one's maybe still in phase 1.

That one is in phase 1 as we speak. We haven't said much about the mechanism publicly, but What is very interesting is that it represents an evolution of our platform. I planted the seeds in this conversation, but, you know, most of human blood is unknown. And while we're all excited about peptide hormones and, you know, everyone has their peptide guy, nature's made hormones in 2 forms, and that is small molecules like melatonin, testosterone, estrogen, and peptides like GLP-1 and insulin. And everybody can identify peptide fragments floating around in the blood because they rely on traditional technologies of identifying in a mass spectrometer a peptide fragment and then just matching it to the DNA because all proteins come from DNA. But you would need the Invader platform, which figures out how molecules break apart in a mass spectrometer to identify the structure of unknown molecules to discover new chemical hormones. So we said, why not discover new chemical hormones? And in the last, you know, few years, we've identified over 4 dozen new or interesting chemical molecules that seem to regulate different disease states, including everything from, you know, pain to feeding and satiety. So we turned one such hormone that's regulated after exercise and after eating that your body produces. and said, what if we turned this into a medicine for obesity? And what we would go on to find out is that it modulates this really interesting signal in your brain called the leptin system that tells you when you're full. So just like insulin has 2 types, you have type 1 diabetes when you don't have insulin, and you have type 2 diabetes when your body stops listening to insulin. Leptin is very similar. Initially, it was discovered in patients that had a rare genetic form of obesity where they ate a lot because they didn't have any leptin enzyme. But most of us today are walking around with way too much leptin, like type 2 diabetes, like type 2 obesity, where your body doesn't recognize the leptin signal anymore. And so we're very excited to maybe make perhaps one of the only, if not the first molecule to go into humans with this mechanism.

Given the, you know, interest in that space and also the level of competition, what is the rock and the hard place that you see there that you're trying to sort of Find the sweet spot on. Yeah.

So today it's become very obvious that GLP-1s, for one reason or another, do not provide a long-term solution. There was a study that came out, I think literally this past week, where they looked at over 3,000, if not 30,000, thousands of adults that had access to $11 copay GLP-1, and they traced cardiovascular risk and overall treatment adherence. And, you know, their study also found that the vast majority of people start dropping off, you know, in month 3, 6, and by the end of the year, they're off treatment even though they can afford it and have access to it. And that when they do, their cardiovascular risk comes back to make it worse than before.

Wow.

So you have to use it for 3 years, I think they said, to have an 18% cumulative risk in cardiovascular events. But if you stop using it at the end of year 1, you start reversing that and you actually end up in a worse place where you have 4 or 5% greater risk of cardiovascular events. So 2 takeaways. People are stopping for one reason or another.

Because it's injections primarily?

Probably injections. There's some degree, maybe even outside of this cohort, of affordability, but it's likely a combination of both of those and the side effect profile.

Yes, right.

Right. The side effects don't really go away. And in fact, every time you dose dose escalate, you feel them. But over time, people have reported everything from either not responding at all despite having the side effects to their response essentially going away. So you have this combination of factors that make the drug not something sticky, right? And not being sticky could be worse off for you than not starting in the first place. Yeah. So those are the 2 big takeaways. Now, if you study chronic diseases that have a similar etiology, That we all know. And if you're South Asian, have multiple relatives that suffer from, it's 2 other diseases of a similar scale, magnitude, and time arc. It is high blood pressure, right? And high cholesterol, hypertension and hyperlipidemia. Now, both of those are treated not by a highly effective pill that has a deep side effect profile or an injection. They're treated by a safe once-daily oral that your doctor can start you on. In somewhere on year 2 or 3 of your 5-year journey of, of having high lipids. Right. And so we think that as much as GLP-1s are extremely exciting, they play a very perfect role for induction, which is you make a fat person less fat. But there's a big arc of time where you need to keep that person not fat for a long time, or ideally you would've caught them before they become BMI 30 or 32. And you give them something that allows them to stay on it for a long time, right? Like you take your statin before you have an atherosclerotic vasculature, and that leads to a stroke or a heart attack.

Yes.

So 2 years ago, we said what the world needs is a once-daily oral that's complementary to GLP-1, that has an extremely low side effect profile, that allows preservation of muscle, and does not cause nausea, vomiting, or diarrhea. And so we went and made that when it was, again, not cool to do that. And today we're very, very glad we did.

Yeah, we're reaching the end here, but perhaps very briefly you can tell us a little bit about what this third sort of advanced candidate is and then, you know, maybe a little bit about what you hope the next 10 years look like. What does Enveda look like in 2036?

Absolutely. So our third candidate very quickly comes from a plant, long history of being used to treat symptoms of what we now know as ulcerative colitis. We went after a very interesting inflammatory pathway and long story short, discovered a once-daily pill, similar rock and hard place to atopic dermatitis. But we discovered a once-daily pill that puts the power of 3 different biologic treatments in a single pill. And the story of how we discovered it, why that mechanism allows you to inhibit, you know, what it otherwise takes 3 proteins to do is a story for another time. But again, putting Safety, efficacy, and/or convenience in the hands of the patient is very, very important to us. And we think this treatment could be very exciting because in ulcerative colitis and Crohn's, you eventually develop resistance. And so it's this never declining pool from a market perspective, but it is very, very, I'd say, troublesome and challenging if you're a patient.

Yes.

Because you have to cycle off of therapies and eventually you run out.

Ah, wow.

So instead of We think by putting multiple therapies and those mechanisms in a single pill, we'd be able to both cause deeper remission but longer remission for patients. And that's in phase 1 studies, and we're very excited about what it'll do.

Wow.

So big diseases, first-in-class medicines, which is the opposite of where the industry is heading with China, which is to make slightly better medicines or combine 2 really well-understood biologics in a single pill. or a single biologic called bispecific. Very different take on the industry. Ultimately, we think the industry is underwritten by convenience, but is transformed by innovation. GLP-1 was a new mechanism when it came by, and there are many, many, many stories. Imatinib, so the thing, the medicine that changed my mom's life was a new medicine. Yeah. And it's usually these first-in-class medicines that end up changing the world. And in a parallel to venture capital, it is companies that have these first-in-class medicines when they were first invented that end up capturing the vast majority of the lifecycle of the return and becoming big enterprises. So Merck with Keytruda, 30-something percent of Merck's EV. Sanofi with Humira and now Rinwoq, I think combined 60%, Skyrizi. Sanofi with Dupixent, 30%, even though they only own half the drug. Lilly is a trillion-dollar company, but 80% of their EV is Mounjaro. These were all medicines that were written off, both mechanistically and for the market. Lilly, I think famously at one point said obesity was a $100 million market, not a $100 billion market. So they were off by a thousandfold. Okay, so we think first-in-class medicines, especially if you can look beyond where other people can look, and you can use chemistry to get to them is an incredible place for 10x returns, 1,000x returns, power law returns. We also think that you can realize these returns only if you end up owning these medicines, right? The Dutch company that sold Humira, nobody knows of them. You know, the tiny startup that made Keytruda that eventually ended up at Merck, nobody knows of them. Right. Large pharma can afford to miss the boat on innovation, as once someone told me, because they just buy the boat. So it's very clear to us that we need to be an integrated pharma company and we need to work on mega blockbuster markets as long as we believe our thesis and our technology can deliver products that can create those markets. So over the next 10 years, Enveda hopefully becomes a company with multiple incredible molecules on the market and create markets. Like imagine the remaining 20 million adults that will use their atopic dermatitis medicine because it's both convenient.

Yes.

And it's efficacious. And so molecules that make markets and then we'll let the, you know, the forces of capitalism do the rest and hopefully use that to both preserve and respect culture and preserve and respect the fragile environment in which we live and create the incentive and the narrative to do both.

Well, I always like to end with a sort of final wrap-up question. If you had the chance to assign a book to everyone on Earth to read and understand, what would you want to give people?

For me, that would probably be The Vital Question by Nick Lane. And Nick talks about this Incredible Black Hole That Lies at the Center of Biology, which is why is complex life the way it is? And he makes a very compelling argument that it is not genetics or inflammation or information flow, but it's actually energetics and the flow of electrons and electrochemical gradients that dictate how complex life evolved. Wow. And so I highly recommend that.

That's a, that's a new recommendation for the podcast. So I'm, I'm always glad for that. Um, thank you so much, Viswa. This was such a pleasure.

Thank you for having me, Mario.

That's it. Thank you for listening to this episode of The Generalist Podcast. Please subscribe on Apple Podcasts, Spotify, or your preferred podcast app. Ratings and reviews help others discover these discussions. So if you enjoyed the conversation, I'd be grateful if you could take a moment to leave one. For all past episodes and more, visit us at thegeneralist.substack.com. See you next time as we continue to explore the future.