Reme-D founder Salma Tammam is revolutionising the world of infectious disease testing

When did you make the leap to founding your own company?

People often associate PCR testing with COVID or the nose, but we tell them it’s used for cancer testing, it’s used for other infectious diseases, it’s used for genetic diseases. If we could do this for COVID, why not for HIV? Why not for hepatitis? Why not for a lot of diseases? I took an active decision and quit my academic job in 2022. People thought I was stupid, but I mean, they still think I am sometimes. That’s okay.

We started focusing on infectious diseases that were a problem in Africa, Middle East, such as hepatitis, HIV, and tuberculosis. We didn’t just want to localise the manufacturing by running a technology transfer agreement with one of the big players. We wanted to make something that was more suited to the environments that we work in. And this is why we went on to change the attributes of the tests that made it suited to low resource settings. The majority of our tests are room temperature stable. The protocols are simpler, so it’s easier for a laboratory technician to conduct the test; you also need to operate a machine for a smaller amount of time, which helps if you're working off of a generator or solar.

What was the biggest transformation for you, going from education to running a company?

I got into a lot of trouble and made a fool of myself for a good year, I would say. As an academic, you know the science, you see the application, but you don’t know the pathway to the product.

At the beginning, we thought that we could use someone else’s manufacturing facility, but from a regulatory perspective, this wasn’t possible. So we needed to start our own factory, and we needed to understand what were the technical requirements; we needed also to understand that even when you are regulated, this does not make you a credible governmental vendor. For infectious diseases in Africa, the majority of the testing is conducted to the end-user for free, which is a very good thing. But you have to qualify as a government supplier. And for us in Egypt, this often came with at least an additional year of approvals and third-party evaluations.

What do you feel was the biggest hurdle?

The obvious one was that if you want to raise funding, you need to speak the language of funders. And as a scientist and as an academic, you don’t know this language, which meant that you have to learn it the hard way by getting into a room with funders and having them look at you and say, ‘No, sorry, we don't see it.’ But this was addressed with educational content through support organisations and initiatives such as Cartier Women’s Initiative.

There is this other aspect that countries in Africa are not known for being able to put out scientific products yet. The majority of doctors and laboratory technicians have been accustomed for so long to products that come from the US or the EU or China. So when you come to them and tell them that this is an Egyptian product, the first thing that comes to mind is a lack of trust. This is a problem that hits hard because I was educated in Germany and if I had produced this product in Germany, this issue of trust and credibility would not have come. And this is one of the biggest barriers because to be able to attract more funding, you have to build trust. And this trust came harder and slower than we initially anticipated because we did not foresee this problem.

We thought that when we offer something that was more suited to the conditions, more affordable, that it would be adopted very easily. But it came with a lot of perceived notions and ideas of what quality means.

Do you have any advice specifically for how to combat that kind of attitude?

Initially you just have to push products that are of sufficient quality to have cheerleaders that support you, but I also think it has a lot to do with policy. In some countries, the governments prioritise local products. And even with policymakers, there is a chain that follows afterwards. And this chain has to be aligned on the same end goal, which is having good local products.

So having a track record proving that this thing is efficient is one thing. But then trying to push it from a policy perspective is what will take it to another level. It’s not a battle that you can fight on your own. This is why something like Cartier Women’s Initiative is very important because it gives you an international audience. And from a policymaker perspective, when they see that something is being repeatedly credited for being useful, good, then they start thinking, where can we start using this and how can this be put to benefit?

Is there a specific case study that really validated that you were on the right track?

Blood bag testing is a very critical thing because when anyone who donates blood, you need to make sure that this blood is free from infectious diseases, particularly hepatitis, HIV and syphilis. And when you work in low-resource settings, you have to somehow find the best balance between affordability and safety. We were able to bring the tests to a very low price, and we are now working with a group of blood banks in Egypt that are all running PCR testing. This is a breath of relief because this is the optimal way to test blood for safety. And this is the way that it is done in, I would say, developed countries. So when you are able to uplift the level of something like that, this is very reassuring.

What do you feel would be the next big milestone for Reme-D?

We’re three years old as a company, and we’ve pushed into the market around 30 tests. We prioritised infectious diseases given the current situation.

Our first milestone is to push more products, mostly focused on genetic diseases. A very interesting thing is that when you look at genetic diseases, a test developed in the US would not necessarily work in the Gulf area, because the genetic mutations are different and unrelated.

The second thing is going into more countries. As of today, we are working in Egypt, Sudan, and Kenya. But we would love to start working initially in West Africa as well, potentially also Pakistan, maybe one day Malaysia.

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