Exceptional Extras, March 2014

Circ MedTech

On a mission

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As Co-founder and President of Circ MedTech, Tzameret Fuerst has created a company with the potential to save millions of lives in the fight against AIDS.

When Tzameret Fuerst opens her mouth, you cannot help but listen. The Israeli-American social entrepreneur mesmerizes audiences around the world when she introduces PrePex — a pioneering device that could save 3.5 million lives.

Her company, social enterprise Circ MedTech, has one goal: to create the first AIDS-free generation through surgery-free adult male circumcision. The 42-year-old mother of two is passionate about the cause.

“There are 24 hours in a day, and it takes the same amount of time to think small as it does to think big,” she says. “So if you’re going to have an impact, make it big.”

Born in Israel and raised between there and the US, Fuerst has always been a bridge between the two cultures. This metaphor, which once only represented her commute between the two countries, now has numerous meanings for her.

Today, she is the link between the developed and impoverished worlds, between the private and public health sectors and, most importantly, between the AIDS problem and its solution. In 2007, the World Health Organization (WHO) published a study recommending adult male circumcision as a means to reduce the spread of HIV/AIDS infection in sub-Saharan Africa.

Multiple studies have revealed circumcision reduces the likelihood of AIDS infection by about 70% due to the removal of cells in the foreskin that are particularly vulnerable to infection. The WHO, US Government, UNAIDS, the Bill & Melinda Gates Foundation, and the World Bank set an ambitious goal to circumcise 20 million men by 2015.

Reducing the spread of these infections could save 3.5 million lives and US$16.5b in long-term health care costs. One of Fuerst’s business partners identified the challenge in 2009, after attending a lecture aimed at recruiting surgeons to perform surgical circumcisions in Africa.

He left with the realization that with existing resources, there was no way Africa would meet its goal with a surgical solution. “Within 10 minutes of hearing this story, I bought a plane ticket. Five days later, I was on a plane to Rwanda,” says Fuerst.

Learn more about what medtech companies need to do to survive in this challenging climate in our Pulse of the industry: medical technology report 2013

“By the time I came back, it was clear I’d found my mission.” Shortly after that inspirational lecture, Circ MedTech’s founding team, which has a combined 70 years of experience in medical innovation, had developed a solution: PrePex.

In a matter of months, the first non-surgical adult male circumcision device was being tested in Rwanda. “I had never been to Africa before and I had no experience in medical devices or public health,” admits Fuerst. “But I came into this with a desire to change the world, and when that is your motivation, you learn fast.”

Fuerst had spent 12 years in strategic marketing roles in Israel and the US before reassessing the direction her career was taking. “I felt that my energy and my passion were not being focused in a direction that made me fulfilled,” she says.

“It was at that point — and I didn’t know it then, but I know it now — that I became a social entrepreneur.” This change led to five years in the nonprofit sector, founding advocacy and social organizations for the American Israeli community in New York. 

“I wanted to do something that was meaningful to my soul, not just to my pocket.” The African AIDS story brought Fuerst back to Israel and the business sector in 2009. “When the PrePex story began, I was emotionally at the right place at the right time,” she says.

“The nonprofit industry requires long grant and donation cycles, slowing down the innovation pipeline. I missed the tempo and dynamism of the business sector and wanted to experience a double bottom line: shareholder value and social impact at once.”

Her experience in the nonprofit sector aided the company’s fundraising success and gained the attention of impact investors, including Acumen Fund, a nonprofit global venture firm, which made a significant investment in 2011.

Connecting public and private

Fuerst is passionate about private companies working together with government and donors to meet public health goals.

“Entrepreneurs can move at the speed of light with private capital to develop groundbreaking products. Governments can help on the policy side and with massive logistic challenges, and donors provide capital to execute on a broad scale. Magic happens when combining the strengths of each side.”

She speaks at length about the challenges as a social entrepreneur in the public health space, highlighting the skepticism toward for-profit companies. “If we were set up as a nonprofit, it would have taken us years longer to develop PrePex — ultimately costing millions of lives and billions of dollars in donors’ funds.”

“There are 24 hours in a day, and it takes the same amount of time to think small as it does to think big.”

Circ MedTech, like many social enterprises, was created to achieve major public health goals, but it needs to be profitable to attract investors, Fuerst says.

“There’s a tension between for-profit social enterprises and public health. It would be helpful if both sides could come to the table to understand each other’s needs so that the private sector can keep investing in innovation to help solve public health goals.”

With the support of President Obama’s emergency plan for AIDS relief and the Bill & Melinda Gates Foundation, and approval from the US Food and Drug Administration, all priority African countries are running pilot programs using PrePex.

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The company’s most significant achievement is in Rwanda — an early adopter of the device — where more than 4,000 men have undergone circumcision by PrePex. While there is another circumcision device vying for the African market, PrePex is the first device to receive the coveted WHO prequalification, which ensures medical equipment meets global standards.

“Every 16 seconds someone dies from AIDS.”

At present, no other device has received prequalification status. Fuerst emphasizes PrePex is the only non-surgical device that does not require injections, is completely bloodless and requires no sterile settings.

Approximately 2 million men in sub-Saharan Africa have been circumcised since the WHO’s campaign was launched in 2007, achieving 10% of the goal. Before Circ MedTech and PrePex, the outlook was grim.

PrePex can achieve scale, says Fuerst, and while not the whole solution, in conjunction with surgical circumcision it can help achieve the WHO’s target of 20 million men by 2015. “Something radical has to happen for 90% to be achieved in three years, which is half the time in which they’ve achieved 10%,” says Fuerst.

“PrePex is that groundbreaking innovation that will help turn the tide on the pandemic of our generation.” For now, Fuerst’s eyes are firmly set on 2015, and she has no time to spare: “Every 16 seconds, someone in the world dies from AIDS. When you know that fact, every second becomes vital.”