Startup Battlefield winner Salva Health is changing the game in breast cancer detection

Six years ago, while researching for a college entrepreneurship competition, Valentina Agudelo identified a troubling gap in breast cancer survival rates between Latin America and the developed world, with women in her native Colombia and the rest of the continent dying at higher rates due to late detection. Today, Agudelo is the co-founder and CEO of Salva Health, and recently took home the top prize at TechCrunch’s Startup Battlefield. On the latest episode of Equity, she joins Rebecca Bellan to discuss how her company is using the Julieta device to revolutionize early breast cancer detection. But before we dive into that, a quick reminder: applications are now open for this year’s competition, so make sure to get yours in! Listen to the full episode to hear more about: How their flagship product, Julieta, is making early breast cancer detection more accessible and efficient. The unique hardware-as-a-service model and its impact on rural healthcare. Salva Health’s expansion plans and exploration of other medical conditions like osteoporosis and liver cancer. Valentina’s experience competing in TechCrunch’s Startup Battlefield and the challenges of securing funding for female-led startups. Equity is TechCrunch’s flagship podcast, produced by Theresa Loconsolo, and posts every Wednesday and Friday. Subscribe to us on Apple Podcasts, Overcast, Spotify and all the casts. You also can follow Equity on X and Threads, at @EquityPod. For the full episode transcript, for those who prefer reading over listening, check out our full archive of episodes here. Credits: Equity is produced by Theresa Loconsolo with editing by Kell. We’d also like to thank TechCrunch’s audience development team. Thank you so much for listening, and we'll talk to you next time. Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Anthony Ha?

  This episode of Equity is brought to you by Schneider Electric. Schneider Electric, your energy technology partner.

• 0:17Rebecca Bellan?

  Hello and welcome back to Equity, TechCrunch's flagship podcast about the business of startups. I'm Rebecca Beland, and this is the episode where we bring on industry experts to help us explore a trend in the tech world and dive deep. Today, we're joined by Valentina Agudelo, co-founder and CEO of Salva Health, the winner of TechCrunch Startup Battlefield 2024. Valentina is going to give us a rundown of her experience competing in Startup Battlefield at Disrupt last October, but before we get into that, just to note that we have begun accepting applications for this year's competition, so be sure to get yours in. Okay, without further ado, I give you Valentina Agudelo. Valentina, welcome to the show.

• 0:53Speaker 02

  Thank you very much for a break. I'm very happy to be here.

• 0:55Rebecca Bellan?

  Just for our listeners who are aware, you're calling us from your office, you're with your tech team over in Medellin, Colombia, so if we hear a little background noise, that is why. Where else are you guys based?

• 1:06Speaker 02

  In Bogota as well.

• 1:07Rebecca Bellan?

  Bogota as well.

• 1:07Speaker 02

  We have our management team in Bogota and our tech team based in Medellin.

• 1:11Rebecca Bellan?

  Man, you're so lucky. I love spending time in Bogota and Medellin. Both are such incredible cities.

• 1:16Speaker 02

  And thank you for saying that. Medellin and Bogota are both very beautiful cities. Everyone should come to Colombia once in their lifetime.

• 1:21Rebecca Bellan?

  Absolutely. One thing I love about your technology, Salva Health, so your mission is to help people who, I mean, while there's amazing cities out there, your mission's to kind of help people get access to healthcare who are not in the main cities, who are more rural, who are farther away from health centers. Can you talk a little bit about your company's mission and how you got to where you're at today?

• 1:43Speaker 02

  Of course. Thank you for that. So at Salva, our mission is essentially to save lives through early disease detection using technology to do so. And we developed our first device called Hulita, which is focused on detecting breast cancer early with a portable and painless screening device that allows us to identify women that are at risk of breast cancer and then have them prioritized for proper diagnosis and retreatment. When we were starting Julieta, we realized that there is a very big access barriers with current or traditional screening exams. In Colombia, for example, less than 5% of women undergo regular preventive screenings due to that lack of access. And lack of access can come in many different ways, most of them being, for example, geographical, where although mammograms, for example, are extremely precise and gold

• 2:26Speaker 02

  standards for screening, they do have very big access barriers due to their costs, the requirements of infrastructure, specialized personnel, and even other more personal barriers where women feel very uncomfortable, they feel pain, they are exposed to radiation. And all of this sums up, and barriers are so high that they limit the availability for women. In Colombia, not only do women don't get screened, but most of them don't even have access to a mammogram in their place of residency. So they have to travel outside of the state that they live in so that they can actually access a mammogram. And that's where our, our mission began, exactly. It's with the purpose of when women can't access the exams, the exams have to go to the women, they have to reach the women. And with that objective in mind, we developed Julieta.

• 3:10Rebecca Bellan?

  So then talk a little bit more about what Julieta is. I mean, at Disrupt, you did a, you did a live demo on, on a man who, men also get breast cancer, let's just, everyone should know that. And you did a live demo on a man who kindly removed his shirt so you could put some kind of device on his breast. Can you tell us a little bit about that?

• 3:28Speaker 02

  Yeah, that was our shirtless man, our volunteer. He was actually my dad. I have to spoil that. He was the only volunteer that we could find that was willing to go shirtless onstage in front of a thousand people.

• 3:39Rebecca Bellan?

  What a great dad.

• 3:40Speaker 02

  The, the device is essentially a set of electronic card inside of a casing, and then it has one set of cables that has 12 outputs, six for each breast, and then each one of those is connected to like a star distribution card, I would say, where we connect each of those electrodes to the breast directly so that we can guarantee that the device is always placed in the same position in the woman's breast. And then it also comes with an app, a web app, that actually allows us to use the device. So through the app, you can execute the screening and then interpret the results. And it is all done automatically, it is completely painless, it doesn't require radiation exposure, it's non-invasive, et cetera.

• 4:22Rebecca Bellan?

  And so this measures the tissue density with electrodes that attach to each breast. And you said gives results in minutes to the app, whether that's on a phone or a tablet or on someone's computer, I assume.

• 4:31Speaker 02

  Correct. It's essentially measuring electric conductivity in the tissue. So just to keep it simple, the breast is composed of water, fat and muscle. And when there is an anomaly present, the composition of those three elements varies. And that's what we're trying to measure with our device. And the entire screening lasts less than two and a half minutes. And then the interpretation is done in less than 10 seconds, which is part of the value that we add because we don't require any specialized personnel to actually execute or interpret the results. And even though we do use an app, the app doesn't really require internet connectivity the entire time. And the device itself doesn't have to be connected to a power source.

• 5:09Rebecca Bellan?

  Wow.

• 5:10Speaker 02

  Which again is part of the design that allows us to focus on underserved communities in rural areas.

• 5:16Rebecca Bellan?

  Yeah, I do want to think about how you incorporated the idea of scaling this or spreading it into the markets that you want through the design. But first, just this is not a replacement for a mammogram, right? It's early detection so that if there's an anomaly, then someone knows, okay, it's time to get a mammogram. Is that right?

• 5:32Speaker 02

  Yeah, exactly. This serves more as a priority system where it can actually identify the women that are at risk and then have them prioritized. Our intention here is not to replace mammograms or radiologists at all. We just want to expand or complement their efforts. So mammograms are extremely useful, but they're limited. With our device, we can actually make mammograms accessible to women that really need it.

• 5:55Rebecca Bellan?

  And so this is kind of a hardware as a service slash software as a service play? How do you commercialize this or how do you intend to commercialize it?

• 6:03Speaker 02

  For the most part, it's actually hardware as a service where we distribute the devices and then we only charge per screening. And our strategy there is basically identifying the groups that agglomerate the most patients. In Colombia, for example, that would be the insurance companies. So insurance companies have millions of patients that they have to cover. And when we negotiate directly with them, we can distribute the devices to the healthcare centers or community centers that they contract with and then charge them only per screening. And that's a very Important part of the value that we generate because we eliminate the purchase burden for the service providers. Usually healthcare centers and those in remote areas specifically have a very limited CapEx investment budget. So by eliminating their acquisition costs, we're actually making it more accessible.

• 6:47Speaker 02

  And it also allows us to remain in control of our devices so that we can guarantee continuous improvement because we can use the data to leverage our AI potential and then guarantee the quality of our screenings as well.

• 6:58Rebecca Bellan?

  And then how accurate is the software that you have today in early detection?

• 7:03Speaker 02

  Right now, our precision is at a weighted eighty-two percent. It's eighty-one percent sensitivity and eighty-four percent sensibility.

• 7:10Rebecca Bellan?

  And are you working, do you expect to get to a hundred percent or ninety-seven percent or how are you working towards that?

• 7:16Speaker 02

  Yeah, of course. Our main purpose is to continuously improve our metrics. I would say, however, that the precision results that we have right now are quite competitive in the industry. It has taken us a long time to be very precise with those results. So we've developed a series of clinical trials as of now. But we are continuously improving and creating different methods, trying to identify other patterns in the breast so that we can complement our measurements and improve our precision.

• 7:40Rebecca Bellan?

  And so now you're in the stage of doing clinical trials for the most part, or have you expanded beyond that since?

• 7:45Speaker 02

  That's a great question because when we participated in TechCrunch in October, we had just reached our main big milestone, which was we were approved for medical device manufacturing in Colombia. And then at the end of last year, we were approved for commercializing our device. So we got our FDA equivalent approval in Colombia. And that allowed us to start trial testing our device in the real world, I would say. We had tested it in thousands of patients, but in a controlled research environment. And now we are actually partnering with other healthcare providers and other insurance companies so that we can test it in rural areas and in remote patients. So that we can see how our device behaves in the places that it is supposed to be.

• 8:27Rebecca Bellan?

  So are any of these commercial pilots, are you revenue generating at this stage?

• 8:30Speaker 02

  We are, but it's almost symbolic at this point, if I'm being honest. That's not the purpose for us right now because we are a research team, we're a scientific team. What we are trying to do is deploy, test, and then validate that our value proposition works in the real world. So we do have some contributions from the service providers that are working with us to the research, but it's not a direct payment for the screenings yet.

• 8:57Anthony Ha?

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• 9:26Rebecca Bellan?

  I'm curious, what brought you to this goal? Like, what brought you to thinking about the lack of healthcare access that people in rural areas have, specifically for something like breast cancer?

• 9:37Speaker 02

  The origin story is quite random, I would say, actually. I studied business at my university in Bogota. And during our second year, end of second year, we have a startup competition. For that competition, I partnered with two of my best friends from university. And we decided that we wanted to do a project that was from women, for women. So we started exploring sexuality, menstruation, menopause, all of these topics that are usually taboo, especially in a society like Colombia. And while we were doing our research, the mother of one of them had thyroid cancer. And we were kind of seeing the family go through the process, and the treatment, and how painful it was. And we kind of just connected the dots. We started researching thyroid cancer because of her, and because we wanted a project from

• 10:22Speaker 02

  women, we kind of reached breast cancer. And at that point, during our research, we realized that breast cancer mortality specific is only, is almost ironic at this point. So on one side, you have that breast cancer has a survival rate above 90% when it's diagnosed at early stages, and that the other is the leading cause of death by cancer amongst women worldwide. And what this told us is essentially that this is no longer a medical problem. Doctors know how to treat and cure breast cancer if we give them the time to do so. And that was the key piece for us. The survival rate of breast cancer drops to 30% when it is diagnosed at late stages. And late detection is so common that it happens in more than 60% of cases. Of course, in underserved or in emerging countries like Colombia, that's even higher.

• 11:04Speaker 02

  And that's what caught our attention. We started understanding why lead detection happens or is so common, or why did the healthcare system become so used to having lead detection cases? And we realized that it's a lack of access. And when we understood the problem, we knew that this was no longer a problem for doctors, it was a problem for entrepreneurs that could challenge the system and find a way to solve it.

• 11:27Rebecca Bellan?

  Yeah, there's a desire among a lot of entrepreneurs, especially ones who have scientific backgrounds, to solve these really hard problems. I wonder how you've been able to balance that with also trying to secure funding. I don't know if you've secured any venture capital, but you know, specifically, these hard to solve cases that maybe aren't like huge moneymakers, VC kind of shies away from, add on to it the fact that it's focused on women's health, and as we know from the data, women's health doesn't get a whole lot of funding, women's issues don't get a whole lot of funding despite the fact that we have half the spending power in the world. So I'm just wondering how you've kind of balanced those challenges.

• 12:05Speaker 02

  Yeah, that's actually a great question, and it's quite sensitive, I would say. So these research projects are very capital intensive, and they do require partnerships and key alliances to be developed. So the first thing that we did was partner with one of the largest insurance companies in Latin America, and they essentially helped to fund most of our research. And then in terms of funding, we have participated in a few competitions that are equity free. So Core Tech Branch is the most important and the biggest that we've participated in, but other initiatives have helped us fund the project. And in terms of investment, we have had a few investors join us throughout the journey, but it has been mostly family offices and impact investors. So we do have

• 12:46Speaker 02

  a few funds that are going, but they're more focused on impact than just revenue generating startups, I would say. So the complexity that you mentioned about female issues not getting funded, that is true, but you have to add to that the complexity of emerging markets, and to that, a female founder. It kind of makes it quite challenging to be perceived as a safe investment for VCs, and we have definitely felt that, unfortunately. But once you kind of understand the system, there's kind of Two alternatives, you either fight against it or try to navigate it. And we understood who our ideal investor was and we navigated the system towards that. So now we're more focused on funds in Latin America or in Asia that do understand the issues that we're facing.

• 13:30Speaker 02

  And of course, female-led funds and focused on healthcare mostly.

• 13:34Rebecca Bellan?

  So for others in this space, I've spoken to a ton of different femtech companies that are building things like devices for pelvic floor health and things like that. They find also issues getting the right funding or being taken seriously, or as you say, seen as a serious bet. What advice would you give to other startups and other founders who are looking for the right partnership, the right marriage with an investor?

• 13:56Speaker 02

  It's definitely hard to generalize. In our case, what has worked is to really understand our own thesis. So just as a VC has a thesis and they're kind of evaluating you through the process, we have to do the same with our potential investors. So during our first conversations, I really tried to focus on understanding what their incentive is, what they're looking for, what their target is, and whether that aligns with me as well. I think that there's kind of a dynamic where startups are almost following the VCs the entire time and trying to fit into their thesis. And we kind of forget to do the same due diligence our way. And that is part of the trap, I would say, that some founders fall into, unfortunately. And then with corporates, you do have to be very cautious in who you want your partners to be.

• 14:39Speaker 02

  In our case, for example, with SURA, which is the insurance company that I mentioned, we were very lucky that they opened the doors to us when we were very early on. But that definitely is, I would say, a risky decision for a startup when you don't know how committed the insurer or the corporate is going to be and what their incentive is for you to join them. I think the main advice would be just to make sure that you know what that investor can bring to the table other than money. There is definitely many ways to get funding that are not receiving a direct investment. And just for founders to stay aware that the most expensive way to finance your initiative is to give away equity. So there are other alternatives. We have like the grants competitions, as I mentioned.

• 15:22Speaker 02

  There's other vehicles that you can use. There's debt for very high-risk lenders. I think that there's many alternatives and if you keep in mind that this is a very important decision for you as a founder because it is the most expensive way to fund yourself and you have in mind what you're targeting and what your thesis is for receiving that investment, you will definitely find the right partner. But also be patient, so it does take a lot of time. Be aware of when you want to fundraise or when you require the money because as a founder it's going to take, I would say, fifty percent of your time. It is normal that most of the conversations that you have don't fit into what you're looking for or the investor is looking for, so you have to be patient with that. And also I would say give yourself time to fundraise before you run out of money.

• 16:04Speaker 02

  So people kind of have their runway and they start fundraising maybe three months or four months before that. I would say start fundraising a year before you run out of money so that you're calm and that you can actually take the time to negotiate in the best terms for you without having that pressure.

• 16:19Rebecca Bellan?

  Hmm, that's a good point. When you are pitching and looking for investment, you had mentioned before certain ways how you've designed the hardware in a way that will allow it to eventually scale. Is that something you bring up much in pitches?

• 16:34Speaker 02

  Of course, and that's a great point because when you, again, you're talking to investors, one of the biggest concerns that they have is that having hardware is not as scalable as the software as a service model, which of course it's true, but there are alternatives making a hardware as a service model very scalable. So with our design, I would say there's two chapters. The first one is to actually make the device work for what we're promising that we can do. So making the device work in rural areas and communities that are very underserved is very big challenges in terms of geographic conditions and others. That is the first one, is to make sure that the hardware is the correct product. And then the second is to industrialize as much as possible in the production process and the distribution process.

• 17:15Speaker 02

  So for example, we have a supply chain that is already industrialized where we have the capacity to produce thousands of devices per month without any issues, which also is part of our answer to that scalability question. When it comes down to production, we have the suppliers that can answer the job. And then in the distribution channels, it's the same thing. So make sure that it's It's not Salva that has to go entity to entity, city to city distributing the devices, or that it doesn't require any personnel from our side. That's part of the negotiation that comes in with the insurance companies that we talk to, for example, so we don't take responsibility to actually distribute the devices. But because we are using technology in a very optimal way, we can actually monitor the distribution, the production,

• 18:00Speaker 02

  and then the support system for each device. So with that continuous remote monitoring, we can guarantee that the entire supply chain is working efficiently and that can be scaled.

• 18:11Rebecca Bellan?

  Yeah, you hear this a lot from founders about building scale. Like, don't just solve the problem in a way that's like maybe most efficient to solve the problem once. You have to solve it hundreds of thousands of times.

• 18:21Speaker 02

  Right. And I would say in that sense, we're kind of lucky because our product literally affects at least most of the women in the world, I would say. It's a system that works for any woman, anywhere, and that allows us to be scalable as well. So this device doesn't require any personalization or it doesn't have to be localized country to country. It's a universal system that is working with the body composition, which kind of makes it an easier way to scale products itself.

• 18:47Rebecca Bellan?

  So what is next for Salva Health? What do you want to do for 2025? What are your goals this year?

• 18:51Speaker 02

  I would say that our biggest milestone is definitely commercial growth in Colombia and in Peru. So we've closed our first client in Peru. We're also expecting to close our initial clients in Mexico. And we have a trial in Venezuela as well, and hopefully in a few countries in Africa. So we have a very big expectation to grow and pilot in many countries at once. We have gotten regulatory approval and we will expect to continue going on regulatory approval. So we're focusing on the FDA and other regulatory entities that allows to kind of expand more globally. But for 2025, the focus is just launching, stabilizing Colombia, Peru, and then pilot launching in a few other countries.

• 19:31Rebecca Bellan?

  And are you on path to, or have you already received the green light from InVima?

• 19:37Speaker 02

  Yes, correct. So that was the miles under the reach at the end of 2024. We were approved by InVima.

• 19:43Rebecca Bellan?

  And this is Colombia's government regulatory body for overseeing. It's like our FDA, right? That's what you said before.

• 19:48Speaker 02

  The FDA equivalent. That is our biggest milestone to date, I would say. And something that is also coming our way, not on Julieta, but for SALVA, is that we've identified that this pattern that we use to identify breast anomalies can actually be used for other pathologies in other parts of the body as well. So what we're doing with SALVA is now exploring other alternatives where we can target other high incidence pathologies that also have a underserved community, and we're focusing on other alternative products. Right now, we are exploring osteoporosis, fatty liver, and pulmonary cancer.

• 20:23Rebecca Bellan?

  Amazing. And just before we sign off for the day, I wanted to hear a little bit about how your experience at Battlefield was. Disrupt is already coming up again. We're selling tickets. Yeah, just curious how the experience went. Has it helped propel anything for SALVA since he won? How did it feel to win?

• 20:41Speaker 02

  I would say participating in Disrupt was already life-changing, but to win it was pivotal for SALVA. It put us on the map. It got us talking with many VCs that we would have never reached. It kind of set the playing field where we were no longer the Latin American startup trying to face the world, but we were already in the middle of San Francisco. It sent a message that there is a lot of potential and technology developments in Latin America. It also sent a message that female-led startups and women's health, it's starting to arise and it's getting attention. So I think that definitely helped us a lot. Of course, the funding helped us potentialize our development, but again, it just opened so many doors for us. Many people that I would have

• 21:24Speaker 02

  loved to meet that I couldn't open their doors to us because we had that French stamp.

• 21:29Rebecca Bellan?

  So any advice, any quick advice for some of the startups who will be competing this year?

• 21:33Speaker 02

  What helped us the most was the belief that we have in our purpose and just preparing, anticipating every question that we could, but just trusting that our mission is powerful enough to be at the battlefield and apply, of course. The first challenge is to just go for it and try.

• 21:49Rebecca Bellan?

  Yeah, and you did, and you won, and it was great. I found it very exciting. I was in the, in the audience rooting for you guys personally. Not that I had any say over who won, but I thought it was a really great pitch. And you guys had really good delivery and you answered the questions well. So yeah, for any of our listeners who are going to compete, we can link to Salva Health's video in our show notes. But we're just about out of time. If our listeners want to connect with you online at all, where can they find you?

• 22:12Speaker 02

  Our website is salvahealth.co. Instagram would be salva.hel. And then on LinkedIn, I would be happy to connect with anyone.

• 22:20Rebecca Bellan?

  Excellent. Well, thank you so much again for joining us on the show. And to our listeners, you can find me on X, on Blue Sky, and you can find Equity at Equity Pod on both of those as well. Talk to you next time. Equity is produced by Teresa Locan Solo with editing by Kel. We'd also like to thank TechCrunch's audience development team. Thank you so much for listening, and we'll talk to you next time.