The team behind Aindra system

India recorded the highest estimated number of cervical cancer deaths in 2018, say a research paper published in the Lancet Global Health . The research in the world's leading medical journal for global health reveals that China and India, together made up more than one-third of the global cervical cancer burden in 2018, with India contributing with 97,000 cases and 60,000 deaths, while China recorded over 106,000 cases and 48,000 deaths.Highlighting a clear urban-rural divide for cervical cancer prevalence in India, the study concluded that cervical cancer continues to be a major public health problem affecting middle aged women, particularly in less resourced countries.On a mission to turnaround the status quo, Adarsh Natarajan-led, Bengaluru-based Aindra system has come up with a much useful innovation, offering not just world class diagnostic capabilities in detecting cervical cancer, but a faster turnaround time for its test results too. With the price per test averaging between Rs 200-400, the AI-enabled smart screening system is positioned in the market in such a way that it remains very 'affordable' to the masses, opines its makers, who cite 'affordable healthcare solutions for all' as their core mission."The high incidence and mortality rates in cervical cancer cases indicate that one woman dies every seven minutes in India due to this type of cancer. As the first beachhead, we have developed a system that detects cervical cancer at an early stage, and at the very point of sample collection. This is a quick, affordable, accessible and reliable test for the huge population of the economically poor," says Natarajan, the firm's CEO.The key offerings of the medtech firm currently consist of an intelligent screening system to carry out the PAP smear test, which is the gold standard test for cervical cancer screening and widely used by gynecologists and pathologists. More than 90% of cancer screening test advised is a PAP smear test and all major clinics, diagnostic labs, small/large corporate hospitals and community hospitals use this test for screening cervical cancer.Maintaining that cervical cancer is one of those cancers that is completely curable if detected at an early stage, the 40-something founder adds that the firm's computational pathology platform analyses PAP smear samples at the point-of-care to call out 'normal' or 'abnormal' results, all in under a few hours.The IIM-Bangalore graduate further flags that as per the existing diagnostic framework prevalent, the entire sample collection to report delivery takes anywhere between 4-6 weeks in India depending on from where the sample has been collected. However, the techpreneur holds that by using the company's technological intervention, the entire process is accomplished in less than an hour's duration, thereby not only increasing the convenience of getting a test done, but also ensuring that the medical experts are available in time to help save a patient's life. Natarajan believes his solution is an apt answer to the challenges seen not only in India, but in lower middle-income countries globally. No wonder, acknowledging the startup's bright potential, organisations including BIRAC, Villgro, USISTEF, Millennium Alliance, Government of Karnataka's Idea2PoC, IKPEden and Bangalore Bioinnovation Centre, have so far supported it.Aindra system's intelligent screening system automates the analysis of the PAP smear slides. Explaining the innovation, the startup's founder adds that a woman who wishes to get screened can visit the local health centre where the AI-backed system, called CervAstra is deployed. There, a regular PAP smear sample will be prepared. This sample is then stained through Intellistain, an automated staining device. Subsequently, the stained sample is passed through VisionX, a slide scanner that images the slide and gives out an image that can be used for telepathology and digital pathology. The digital image is then analysed by an algorithm that classifies the samples into Normal or Cancerous. All of this happens at the point of care, saving the woman from hurdles of getting to a diagnostic centre in a bigger town.Asked how the idea behind Aindra Systems come about, Natarajan says the idea that India, despite being a technological powerhouse, on the one hand, was importing anywhere between 70%-80% of its medical devices, and on the other, was plagued with bad health outcomes, led the team to dig deep and unearth some of the reasons for this dichotomy."What we realised was that as a country, we were trying to retrofit systems built for large centralised healthcare systems to geography that required a point-of-care, lower volume solution," he contends.One anomaly flagged by Natarajan is the fact that across India, there is an inherent dearth of qualified medical professionals. To make things worse, amongst the qualified medical professionals, close to 80% of them are based out of urban areas, whereas about 70% of the country's population lives in rural areas, which makes any cervical cancer detection a Herculean task for the masses, he rues.Although the deep-tech startup is yet to launch commercially, it has so far completed its product development, which includes a set of four units in the system -- hardware, firmware, software, artificial intelligence and cloud technologies.Currently, while the firm's cervical cancer screening system remains its primary service targeted at the clinics, diagnostic labs, hospitals, NGOs and government segment, it has also developed independent medical devices which cater to separate functions within the diagnostic setup.Lauding the work of Natarajan, Dr Vani Ravikumar, Lab Operations Head, Metropolis Healthcare Ltd, says, "There is a dire need for a solution that supports population based screening and Cervastra serves that need by helping pathologists render their services to the masses without geography being a constraint. I have been working with Aindra for the validation of Cervastra and it is great to see the amalgamation of technology and medicine to create accessible and efficient solutions."In its process of validation and pilot runs, the company has so far enabled the screening of over 500 women of two NGOs in Karnataka. It has also had deployments in a couple of large hospitals and diagnostic centres. While its pay per test model remains its primary revenue generation stream, going forward, it plans to target other customer segments. These include segments such as gynecology clinics, tier 2-3 nursing homes, tier 2-3 hospitals, many more diagnostic labs and NGOs, among others.In the next five years, the 12-member strong firm, is aiming to test about three million women."We are launching the product commercially and marketing the same aggressively in the coming fiscal year 2020-21, wherein we aim to screen five lakh women across India and also possibly one country outside of it," he positively concludes.(With inputs from Ashmeet Kaur)