Catching up with Ashish Koshy, the M42 executive leading the UAE’s push for personalized medicine

M42 Health is overseeing the Emirati Genome Program, which has mapped the genetic code of more than 500,000 people in the UAE, representing one of the largest initiatives of its kind in the world. 

Abu Dhabi Department of Health Chairman Mansoor Ibrahim Al Mansoori has called the project “a contribution to Arabs and to the world,” a key to improving health outcomes, tailoring personalized medicine and preventing disease. To date, only 1% of the world’s genomes that have been mapped are of Arab descent. The resulting reference genome in the M42 project is aimed at more personalized and preventive healthcare for the UAE’s citizens and a greater understanding of rare genetic disorders and new treatments. 

The national program is shaping practically everything at healthtech behemoth M42 Health, created less than two years ago when Abu Dhabi’s Mubadala Health and G42 Healthcare merged, bringing labs, technology, hospitals and clinics under one brand. 

Similar efforts are underway in Saudi Arabia and Qatar to map the local population’s genetic code. But Mansoori says the UAE is ahead. 

This week, M42 announced a new research partnership with Microsoft, Harvard University and MIT. The collaboration, announced in Dubai during the Arab Health conference, will give research teams access to M42 data in a secure environment, its developers say, to advance clinical research and drug discovery.

To talk about the business and how M42 is building on these partnerships, The Circuit caught up with Group Chief Operating Officer Ashish Koshy on the sidelines of the World Economic Forum meeting in Davos, Switzerland, earlier this month. This interview has been edited for brevity and clarity. 

The Circuit: More than a year after the merger of Mubadala Health and G42 Healthcare, you are out and about. Here at Davos, you have had a large presence and later this month at Arab Health. What is on your agenda and what are you hoping to get by being, pardon the phrase, on the circuit?

Ashish Koshy: The year 2023 has been a significant year for integration. M42 was created with the merger between Mubadala Health and G42 Healthcare. G42 Healthcare brings the digital tech and genomics, and Mubadala Health having the state of the art facilities. 

It’s been a wonderful year of integration and yet we were able to launch some cutting-edge initiatives. One is Med42 which was launched in October as the world’s first open access, clinical large language model to pass the U.S. Medical Licensing Exam. To date, to my knowledge – and in spite of AI changing by the minute – there’s nothing yet that has crossed that benchmark, which showcases the power and the mandate that was created with this merger. 

Second, one of the largest products we launched is the pharmacogenomics initiative. You’ve heard of the Emirati Genome Program: a large population-scale genetic sequencing program. The question is, okay, what’s next? We are now returning to patients [that shared their DNA sample], and telling them what pharmaceutical drugs work for them based on their genetic makeup. This is a national initiative. We want to work with partners here in the AI space specifically on strengthening our roadmap. We’re saying we’re here and we’re open for business. 

TC: The last time I talked to you, when you were CEO of G42 Healthcare, you were Mr. Personalized Medicine. But your portfolio has changed with the Mubadala Health merger. Can you dig into what your remit is now?

AK: Personalized medicine is still on the agenda! It’s on the agenda. M42 is one of the largest integrated healthtech companies in the world. We have 450 facilities, business operations in 26 different countries and an employee size of 20,000. What has changed since the last time we spoke is our portfolio has the Omics Center of Excellence, which is running DNA sequencing at scale. We have IROS which is running clinical trials. We have an environmental science business, which is running programs specifically testing wastewater samples and proactively understanding risks to the environment.

TC: That was an interesting COVID learning…

AK: Absolutely. And it’s still working and right now it’s supporting multiple initiatives in public health. We have a digital health pillar, one of the key products is called Malaffi which is the health information exchange. So we’ve created a platform, and irrespective of which hospital you are in, the data is centralized [in the UAE]. So that’s the G42 Health universe. 

On the Mubadala Health side, you have Cleveland Clinic Abu Dhabi, Imperial College, we have HealthPlus, we’ve got IVF facilities and a recent acquisition called Diaverum, which is the third-largest dialysis network in the world. It’s currently running large dialysis programs, including in Saudi Arabia. In a nutshell, our portfolio includes state-of-the-art facilities to digital health. 

TC: Speaking of that deal, M42 bought Diaverum in April 2023, it reportedly valued this Swedish company at $2.5 billion. Are you looking at further acquisitions? Are you looking for technology vendors? The word ‘partner’ is thrown around a lot. Can you drill down what partnerships mean in an M42 context?

AK: Our mandate set by the board and our shareholders is to bring in tech-enabled solutions that will improve patient outcomes, go on that journey for personalized medicine and also ensure we improve the operational workflow and improve margins within the business. Now, if there are tech solutions, if there are companies or partners that are ahead of the curve currently and we can plug and play into the ecosystem that I just described, 100% it’s part of the mandate. There’s no one-size-fits-all all in terms of the acquisition approach, but if it fits into our synergistic goals, and also long-term vision, then yes.

TC: Do you have geographies that you’re interested in or particular technologies?

AK: I think we are agnostic on geographies. I think it’s based on what the partner or the company provides, even if it’s healthcare in a different part of the continent or world but fits into the metrics that we just described, it’s definitely open for discussion.

TC: I’m curious about the futuristic vision the UAE has for healthcare, particularly for its citizens. It wants to map the genome of every Emirati citizen, and one day invite expat residents, of which we are many, to participate and for personalized medicine to be the norm.

AK: You can participate! Just don’t expect the government to fund it for now. You can walk into a facility and say hey, here is my signature on the consent form, I want to be part of this initiative. And you can get that done. 

TC: How much will it cost?

AK: I think roughly around I need to double-check on that but roughly 1000 dirhams, ballpark figure. Don’t quote me on that. 

TC: From the resulting genomic profile you get, how does M42 plug that into the UAE’s broader healthcare goals?

AK: I think the UAE is well in advance of other countries across the globe in building this national initiative. Be it a Malaffi initiative, which is a national centralized platform, connecting all the hospitals together. Some countries or governments say, Why do we do it? But the UAE had that before COVID and see how Abu Dhabi managed COVID. We launched this genomics initiative pre-COVID. And that’s when, eventually when COVID came you wanted sequencing partners to run large-scale COVID variant sequencing. So absolutely I think in terms of future vision, the foundation has already been laid by the UAE. I’m talking even beyond M42. Be it on the data infrastructure, be it on sequencing, be it on biobanking. I think it’s open for business for life science companies to come and invest into Brand Abu Dhabi and partner with companies like M42.

TC: These are highly technical areas that require a lot of skill, a lot of graduate degrees in one room. How are you hiring? What jobs are open? 

AK: Our doors are always open for the right talent. And the fact that M42 offers everything even beyond a physician or a nurse portfolio all the way to cloud ops. So the range of opportunities that M42 offers is a lot and we’re constantly on the lookout for global talent. From the top of my head, specifically on AI, we were doing a lot on initiatives around Med42 and building an AI system. We’ve got an active collaboration with Microsoft which is a strong strategic partner for us. We’ve got active hiring specifically on the environmental science business, because there’s a huge thing now post-COP28, a huge focus on climate change. These are three main pillars, but in hospital operations, always we are looking for talent.

TC: You’re an expat. You decided to make the move to Abu Dhabi. The question always is, do you plan to stay?

AK: I came here in 2016, 2017, on a six-month stint, like the typical consultant, and never left. I was talking to some of my colleagues here. The UAE offers a wonderful ecosystem compared to some of the other countries around the neighborhood. It’s inclusive, it’s tolerant. It offers business opportunities. So yeah, I don’t want to leave at all and now the fact that we are bringing and rewarding talent with Golden Visas, we see a huge influx of people that want to come in, which makes our job easier to hire the right talent. The UAE is home for me and I don’t intend to leave.

Weekly Circuit: Mideast cyber partners + Linking libraries

👋 Good Monday morning in the Middle East!

Cybersecurity and space exploration are emerging as fruitful areas for joint research and investment between Arabs and Israelis. That was the message that rang out from one conference hall to another in Tel Aviv last week, where cabinet ministers, scientists and investors hailed the prospects for Middle East cooperation made possible by the 2020 Abraham Accords.

At the Cybertech 2023 conference, top government officials responsible for cybersecurity in the UAE, Bahrain, Morocco, Israel and the U.S. appeared together onstage to talk about the benefits of regional partnership. “The first word needed for success is trust, and what you see in front of you today is trust,” said Salman bin Mohammed bin Abdullah al-Khalifa, CEO of Bahrain’s National Cybersecurity Centre. “We’ve all been working together behind the scenes but now we’re past that stage, and I think we now want to see this trust in action.” Read The Circuit’s interview with Israeli tech patriarch Yossi Vardi, who hosted both Cybertech and the subsequent DLD Tel Aviv Innovation Festival last week.

Across town at the 18th Ilan Ramon International Space Conference – named for the Israeli astronaut who died with six American crewmates in the 2003 Columbia space shuttle disaster – discussion of Arab-Israeli cooperation generated headlines. “Today we are witnessing a new era of space exploration, one that is marked by cooperation between countries, private companies and research institutions,” said Sarah bint Yousef Al Amiri, the UAE minister of state for advanced technology and chairwoman of the UAE Space Agency. “Let us continue to work together and make the impossible possible.”

Debate continued to rage in Israel over the prospects of a credit downgrade because of Prime Minister Benjamin Netanyahu’s proposals to limit the power of the judiciary, which opponents have branded undemocratic. Thousands marched for the fifth week in a row at protest demonstrations in Tel Aviv, Jerusalem and Haifa. Jacob Frenkel, former governor of the Bank of Israel and ex-chairman of JP Morgan Chase International, criticized the prime minister for dismissing warnings about investor risk. “When JPMorgan makes a recommendation, take it very seriously,” he said in a television interview. Netanyahu, who flew to Paris last week for a meeting with French President Emmanuel Macron, also met with business leaders there and said he heard no concern about dangers of investing in Israel.

The UAE’s envoy to Israel, Ambassador Mohammed Al Khaja, met with the current governor of the Bank of Israel, Amir Yaron, who has also cautioned about the impact of the judicial reform package on Israeli markets. Al Khaja tweeted his appreciation to Yaron “for sharing your insights & prospects of Israel’s economy & the growth potential by engaging all sectors of society. We look forward to continue working together to realize the full potential of our countries’ thriving economies.”

Welcome to The Weekly Circuit, where we cover the Middle East through a business and cultural lens. Read on for the stories, deals and players at the top of the news. Please send comments and story tips to [email protected].

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OFF THE SHELVES

Missing pieces to cultural puzzles appear in UAE-Israel library ties

Nearly 120 years ago, Hermann Burchardt, a German Jewish explorer, was traveling in the Middle East, talking to Arab leaders and taking photographs, Jenni Frazer reports for The Circuit. Among the iconic pictures was what is thought to be the first image of the founding father of Abu Dhabi, Sheikh Zayed bin Khalifa Al Nahyan, known as Zayed the First. He was the great-great-grandfather of the current president of the United Arab Emirates, Sheikh Mohamed bin Zayed Al Nahyan.

Murder mystery: Although the pictures Burchardt took in Abu Dhabi became famous in the region and reproduced many times, his personal impressions of the people and places he photographed remained a mystery. He and his fellow travelers were murdered in Yemen in 1909 and his journals were assumed to have been lost. Eventually, via the estate of Eugen Mittwoch, a German scholar of Islamic and Judaic studies, Burchardt’s missing diary — and hundreds of pages of correspondence, notes and official documents, together with numerous photos — all found their way to the National Library of Israel in Jerusalem.

Filling in the blanks: It was this material that delighted Hamad Al-Mutairi, director of the archives department of the Emirates National Library and Archives (NLA), based in Abu Dhabi, when he and other colleagues visited Israel last summer. For Al-Mutairi, seeing the Burchardt collection in Jerusalem was thrilling, and filled in the blanks for his researchers. “We were able to see details about the kind of food he ate, and the type of traditional hospitality given to him at that time as a traveler in the region.” The Emirati visit — and a memorandum of understanding between the two libraries — is a direct and tangible result of the Abraham Accords, signed initially between Israel and three partners — the UAE, Bahrain and Morocco — in 2020. 

Joint exhibit: The Burchardt material is essential to drawing a fuller picture of the first years of the individual emirates that now make up the UAE. The Israelis have provided Abu Dhabi with digital copies of Burchardt’s diary and the accompanying papers, which will become part of the NLA collection. “We didn’t stop there,” said Al-Mutairi. “We’re now trying to find the right time to put together some sort of exhibition about Burchardt, charting his journeys across the region. It might be online or it might be physical.” The formal agreement between the two libraries will ensure that the material will marry the holdings that each has; and in the meantime, experts from the two institutions will work together to enrich and expand background information and metadata related to the archive’s contents, including translations, greatly increasing its value to scholars across the globe as a rare reflection of Gulf history.

Oral history: The UAE has built up an enviable body of material based on oral history, while the Israeli library has tended to focus more on physical collections — its Islam and Middle East collection, for example, includes priceless documents and manuscripts not even found in much of the Arab world. Samuel Thrope, curator of the Islam and Middle East collection in Jerusalem, said he has been talking with colleagues at the NLA about oral history connected to a project on Clinton Bailey, an American-Israeli researcher who spent 50 years documenting Bedouin culture and society. The Bailey recordings — all 350 hours of them — are “super-interesting,” said Thrope, and chronicle Bedouin life in the Negev and Sinai between the late 1960s and 2009. “They have all been cataloged and digitized — and now we are in the process of transcribing them.”

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CIRCUIT Q&A

Catching up with Yossi Vardi, wisecracking patriarch of Israel’s startup culture

Leaning back on a big white couch in the lobby at Tel Aviv’s Habima national theater, where he was hosting one of Israel’s most influential annual technology conferences, Yossi Vardi gets ready to shmooze. At 80 years old, he’s dressed in a scruffy black winter jacket and positions himself at the foot of Habima’s grand curving staircase, The Circuit’s Jonathan Ferziger reports. Inevitably the investors, CEOs and government ministers rushing to lead panel discussions at last week’s DLD Tel Aviv Innovation Festival catch his eye and pause to say hello. In Hebrew, English and Yiddish, Vardi trades quips with them – many of whom consider him their mentor – basking in his reputation as the adorably ornery grandpa of Israel’s startup culture. He doesn’t always remember people’s names so he asks them to draw close and examines their conference badge. One budding entrepreneur wouldn’t leave after a two-minute pitch, and Vardi told him his idea wasn’t worth listening to.

AOL deal: Over the arc of Vardi’s career, which took him from procuring crude for the energy-starved nation in the 1970s as chairman of the Israel National Oil Company to selling ICQ, the first widely used instant messaging software that his son Arik created with three friends, to AOL for $407 million, Vardi has been a leader in Israel’s tech world. He has since led, invested in or helped build more than 70 startups, and is in demand as a speaker around the world about how Israel earned its name as the Startup Nation. He was the recipient of the Prime Minister’s Award for Life Achievement. In between Vardi’s brief conversations with roughly two dozen conference participants heading up the stairs, The Circuit interviewed him about the difficulty of raising venture capital, investor concern about Israel’s judicial reforms, normalization with Arab countries, artificial intelligence and what makes a good startup entrepreneur.

The Circuit: How do companies survive this period when investment capital is drying up?

Yossi Vardi: First of all, they need one very important thing, which is luck. The second thing is money. Money has been disappearing very quickly and therefore some companies will perish and some companies will resolve this by being acquired by other people. We saw it in 2000, we saw it in 2008 to a lesser degree and we’re going to see it again now. It’s not a pleasant situation, but this is business, this is the cycle.

Israeli startup executives are marching in the streets against the government’s proposed judicial reforms and some companies are threatening to take their money out of the country. What impact does that have on foreign investors?

We are now in a very, very sensitive situation. Some people say it will be disaster, while the government says everything is wonderful. We have to stare directly at the crisis and figure out how to resolve it, because the question is not who is right and who is not right. Suppose the worst scenario appears and we lose the tech industry. Some people will say we are sorry. But it’s too serious to just say we’re sorry. We are playing here with a nuclear economic situation. I really hope that we get sober and learn how to reduce the risks.

What impact do the normalization agreements with the Gulf states have on investment?

You have to remember that the two fundamental agreements Israel has reached with Arab countries are with Egypt and Jordan, which stopped the killing of people. This is something holy. We must arrive at some kind of arrangement with the Palestinians. I think the Abraham Accords are important. They enhance the legitimacy of Israel in the eyes of other members in the region. So they’re a segue for us to do more things. In this respect the Abraham Accords are important and I hope they will develop further. When the economic situation of the world is good, we get a wonderful flow of funds. I don’t think business with the Gulf states is going to tilt the needle, but it’s very welcome.

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Movie Buyout: AMC Theatres sold its stake for $30 million in a joint venture that brought cinemas to Saudi Arabia in 2018. The international movie theater chain said it was bought out by Saudi Entertainment Ventures, its local partner, which will carry a license for the AMC’s brand and content. The New York-based entertainment company has been trying to manage a high debt load stemming from the Covid-19 pandemic. In Saudi Arabia, AMC said it “will transition from a management and investment role to a pure licensing relationship.”

Wellness Highway: Dubai is considering a plan to build a glass-covered “wellness highway” looping around the city, which would be powered by sustainable energy and contain 93 kilometers (58 miles) of paths for biking and running.

Bedouin Film Festival: Rahat, Israel’s largest Bedouin city, is hosting its first film festival over four weekends this month. Some 40 films, including movies from Saudi Arabia, Iran, Italy, France and Spain, will be screened at the Rahat Center for Fine Arts. The event includes the premiere of “Jirah,” a documentary by Rahat filmmaker Yosef Abu Medigam.