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What is Moonshot Thinking?

I revisited a Q3 2018 report from StartUp Health around digital health funding earlier this week. It contains insights into the most active investors, functions and technologies from January to end of September 2018, and generally paints a rosy picture of growth within the digital health funding landscape.


It’s fascinating stuff. Not least because Q3 2018 achieved the highest quarter performance since tracking began in 2010, with a whopping $4.5bn generated through seed, venture, corporate venture and private equity funding. What truly captured my imagination, however, were the “10 Health Moonshots” listed within the introduction.

A cartoon image of two figures in lab coats engaged in astronomy within a room. One figure with blue hair points toward the window revealing the night sky, while the other observes through a pink telescope.

Devised with the aim of improving the wellbeing of at least one billion people each, the 10 Health Moonshots represent the bold mission of a group of entrepreneurs, investors, industry leaders and government organisations to transform human health. 


The Moonshots are as follows:


1) Access to Care

Delivering quality care to everyone, regardless of location or income


2) Cost to Zero

Radically reducing the cost of care by a factor of a million


3) Cure Disease

Curing disease using data, technologies, and personalised medicine


4) End Cancer

Ending cancer as we know it


5) Women’s Health 

Prioritising women’s health, including preventative care and new research


6) Children’s Health

Ensuring every child has access to quality care, regardless of economic status


7) Nutrition & Fitness

Providing access to a healthy environment and supporting an active lifestyle


8) Brain Health

Unlocking the mysteries of the brain to improve health, wellness and mental health


9) Mental Health & Happiness

Connecting mind, body and spirit in the pursuit of happiness


10) Longevity

Adding 50 healthy years to every human life

Now, at first glance you might think 3 or 4 of these sound, at best, preposterously optimistic and, at worst, downright impossible. But that’s kind of the point.


You don’t change the world by accepting the status quo. 


There’s a particularly shrill, soul-numbing ensemble number in the 2006 hit High School Musical (blame the kids!), entitled “Stick to the Status Quo”. With a tune that could have been lifted straight from Hairspray, the many cliques of an American secondary school encourage their peers to keep schtum about their passions and aspirations — baking, cello playing, hip-hop dancing — so as not to “mess with the flow”, AKA the society-imposed expectations of who they are, what they represent and how they should act.


Tell that to the Steve Jobs, Elon Musks and Jeff Bezos of this world. 


Whilst rebellious teenagers may subscribe to the belief that “the rules are there to be broken”, entrepreneurs, pioneers and inventors go a few giant leaps further… Tell them the “sky is the limit” and they’ll no doubt ask “why?” Why should there be any limit at all? Why can’t they travel beyond the sky to places no person has been before? Why can’t they achieve the things that we thought were impossible? Or things we’ve never thought of at all?


These types of folk — visionaries, if you will — are typically destined for greatness. They don’t see problems, they seek solutions. You only need watch the documentary FYRE on Netflix about the calamitous Bahamas festival that never happened to see how easily and quickly everything can fall apart at the seams if you talk the talk but cannot walk the walk.

A cartoon image of a scientist looking into a microscope. To the right is a whiteboard with a series of scientific equations written on it.

Elizabeth Holmes, founder and CEO of Theranos, could have written the book on talking the talk, but investigative journalist John Carreyrou saved her the bother.


Carreyrou’s account of Holmes’ immense deception — Bad Blood: Secrets and Lies in a Silicon Valley Startup — was released in May 2018. 


A true page-turner, the book untangles the staggering web of lies surrounding her now-defunct blood-testing startup, Theranos — a company that has hit the headlines repeatedly in the past few years. Styling herself as a female Steve Jobs, Holmes became the world’s youngest female self-made billionaire with Theranos valued at an estimated $9 billion at its peak. But it wasn’t to last…


Thanks in no small part to Carreyrou’s tenacity in the face of increasing pressure and threats by Holmes and her team of lawyers, the inaccuracies and shortcomings of Holmes’ establishment were laid bare for all to see. A 2018 article in Vanity Fair perfectly summarises Carreyrou’s findings:


"Almost every word coming out of Holmes’s mouth as she built and ran her company was either grossly embellished or, in most instances, outright deceptive…the company she built was just a pile of one deceit atop another. When Holmes courted Walgreens, she created completely false test results from their blood tests. When the company’s chief financial officer found out, Holmes fired him on the spot. 


"Holmes told other investors that Theranos was going to make $100 million in revenue in 2014, but in reality the company was only on track to make $100,000 that year. She told the press that her blood-testing machine was capable of making over 1,000 tests, when in reality, it could only do one single type of test. She lied about a contract Theranos had with the Department of Defense, when she said her technology was being used in the battlefield, even though it was not.


"She repeatedly made up complete stories to the press about everything from her schooling to profits to the number of people whose lives would be saved from her bogus technology. And she did it all, day in and day out, while ensuring that no one inside or outside her company could publicly challenge the truthfulness of her claims."


The book’s cover has a quote from Bill Gates emblazoned on the front — “I couldn’t put this thriller down”. Except it isn’t a thriller — or at least not in the traditional sense that we’d expect when roaming the fiction aisles of Waterstones. It’s a work of non-fiction, and a damning one at that. 


The disgraced founder has since been charged with felony conspiracy and “massive fraud,” after allegedly misleading patients, health care professionals and investors about the blood-testing technology being developed by Theranos. If found guilty, she could face two decades in prison. Less “moonshot”, more “shooting yourself in the foot”… 


But not all big thinkers are compulsive liars with sociopathic tendencies… 

A cartoon depiction of a pink telescope against a light blue sky with fluffy white clouds. Through the circular view of the telescope, a space scene unfolds featuring a tethered astronaut surrounded by stars on a black background.

There are targets that once appeared totally unreachable — like walking on the moon — that suddenly become do-able and run-of-the-mill. Forget the moon, let’s all move to Mars! Can’t handle the heat on Mars? Let’s hop over to Jupiter with our specially designed space suits!


In April 2019, the first ever pictures of a black hole were released, much to the delight of Muse superstar, Matt Bellamy. But I can’t have been the only person to have felt surprised that this was a ground-breaking and historic first? Indeed, I’m not sure I’ve ever sat and contemplated what a black hole looks like. I likely assumed I’d seen one in a textbook at some point in my school days and that had satisfied by limited inquisitiveness on the subject.  


But no. I hadn’t seen one before. Nor had anybody else. And the picture proved to be a really big deal. 


This excerpt from the Physics World article “Seeing the Unseeable” shed light on the matter for me, detailing the extreme complexities involved in capturing such a shot:


"The images of M87* aren’t just scientifically significant. Obtaining them was an experimental tour-de-force too. As the smallest angle that a telescope can resolve is inversely proportional to its diameter, you’d need a dish as big as the Earth to see a black hole, the largest of which would fit snugly inside our solar system.


"Astronomers’ solution was the Event Horizon Telescope — a network of 13 radio telescopes, whose signals are combined using very-long-baseline interferometry. Atomic clocks had to be installed at each location to perfectly “time stamp” the images, while data banks from the telescopes had to be flown to a common data centre for processing.


"The ensuing image, which hit the headlines and went viral on social media, was also a triumph of data analysis. Astronomers observed the black hole over four days in April 2017, generating a staggering five petabytes of data they’ve spent the last two years crunching through… Their heroic efforts have paid off, transforming the event horizon from a purely mathematical concept, scrawled on blackboards and written in lecture notes, to a measurable, physical entity."


When you look at health care from that perspective, the StartUp Health Moonshots aren’t so preposterously optimistic after all. Perhaps, given the right environment, level of funding and the collaborative brilliance of scientific and technological brains, a cure for cancer can be found. And soon.


And maybe some bright spark along the way will discover the secret to eternal life, too. I know one thing for sure, though — it won’t be this guy… He chose poorly.


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