In Ukraine we have a saying “Our people are here, there and everywhere!” This saying may be pleasantly annotated with: “Who represent Zaporizhzhia and Ukraine with their work”.
Almost 14 years ago, MIG ran a story about a young doctor, Rostyslav Semikov, who at that time was studying for a master’s degree at Oxford University. Today, Rostyslav and his wife Alla are co-founders of Audubon Bioscience [USA]. This company is a very innovative organization which facilitates the activities of a group of companies in 12 countries around the world with 100 employees. They are engaged in the biotechnology and biobanking business.
Currently, Rostyslav Semikov is focused on building a basis for future research in the field of cancer diagnostics and treatment.
Dr. Semikov’s professional background includes such qualifications as surgeon, researcher, scientist, manager, and entrepreneur.
MIG interviewed Dr. Rostyslav by phone.
Zaporizhzhia – Kyiv – Oxford
To begin with, we would remind that his path was not strewn with roses. In the mid-2000s, being an excellent student, the winner of many student awards, prizes; graduating with a diploma cum laude, he had to leave his hometown for reasons of unfairness on part of the administration of Zaporizhzhia State Medical University.
The door to the master’s degree education closed to the young surgeon, he was denied a job in his specialty and not allowed to do an internship in America. As a member of the Protestant Christian Church, Rostyslav had good contacts in the West. In addition, he had an academic supervisor who was the then incumbent rector’s rival in rectoral election. These realities proved a real challenge to his progress after graduating.
“Do you think you’re smarter than our professors who don’t travel abroad?” – This was a question posed to him and his parents, as they came to inquire not to ruin their son’s career.
The blows were heavy, but fate (and Rostyslav believes that God himself) decided otherwise. When he was about to give up and accept an invitation to move to the United States and do his residency there, an unexpected meeting took place with the Baptist pastor, Volodymyr Kunets, founder of the Kyiv Church of Peace, Love and Christian Unity. At the request of Pastor Kunets, his longtime acquaintance, Mykhaiyo Saliuta, chairman of the Kyiv City Council’s Healthcare Commission, rector of the Kyiv Institute of Ecology and Medicine and chief physician of Kyiv’s second largest hospital (Chervonyi Khutir), received a permit to assign the young doctor to work in Kyiv, but in the specialty of “general practice – family medicine”.
A good example of this work and the practical effect of these efforts was the partnership that developed with the representative of Shepherd’s Foundation, a graduate of the internationally acclaimed Mayo Clinic, Dr. Ronald Hoekstra. Dr. Hoekstra is a highly esteemed neonatologist. Dr. Hoekstra visited Kyiv on a regular basis to share his experience with neonatologists at the Chervonyi Khutir, and later brought them, at his own cost, for internships to his Minnesota clinic. This clinic was renowned as one of the best places in the world for extremely preterm babies to be treated and provided an opportunity for a normal life. Shepherd’s Foundation also collaborated in collecting and sending several containers of equipment for the hospital in Ukraine.
Rostyslav helped Dr. Hoekstra organize all this in Kyiv. Later on, the Presidential Administration became interested in this program, and the program was extended to the whole of Ukraine – dozens of Ukrainian neonatologists visited Minnesota to learn international best practices.
When Rostyslav became aware of a last-minute opportunity to compete for a master’s degree in international health at Oxford University (in the newsletter of former participants of the students exchange program FLEX), he decided to give it a try. Dr. Saliuta, friends from the Embassy and representatives of the foundations helped with letters of recommendation and advice. As a result, the Ukrainian was selected among many other applicants and received a full scholarship worth about seventy thousand dollars.
“This is God’s miracle, even dreaming of this seemed unrealistic!” Rostyslav said.
Under the terms of the program, two theoretical semesters were followed by the third semester of practical work and a master’s thesis. This thesis had to be written based on the results of practical work. Rostyslav chose China for his internship and practical research. This is the point from which our conversation began.
With China and Ukraine following similar paths of socialist-type to market-oriented medicine
– Why China? What did you study there? What kind of experience have you gained?
– At that time [2008] I was interested in the management and economics of the health care system. The “system” we are speaking of almost ruined my career; I wished to challenge it. Similarly to Ukraine, China faced the transformation of its healthcare sector from socialist-type to market-oriented, although, the country is still ruled by the communists. It was interesting for me to see how all this worked, and to compare it with what was going on in Ukraine.
Under the academic supervision of Harvard Professor Winnie Yip and Dean of Shanghai University Professor Jin Ma, in two months I visited Chinese hospitals and universities, attended faculty meetings, communicated with chief physicians, students and lecturers. In addition, I studied research papers on the subject.
China’s health care system seemed to have a lot of distortions. On the one hand, clinics apply modern medical treatment methods and use state-of-the-art technologies, but on the other hand, the opportunity to obtain such quality services is limited.
Medicine in China was not available to everyone, there was no universal insurance coverage. Most low-cost services were covered by public health insurance, but high-tech services (such as examinations based on computer or CT technology) were not. Hospitals tended to perform too many expensive examinations, some of which were not necessary at all. And there were too many such expensive diagnostic centers.
There were also abuses when pharmaceutical companies made official payoffs to hospitals for prescribing expensive drugs, and that was not a proper way of incentivizing medical personnel. That hit the pockets of ordinary Chinese people, who were often forced to sell their apartments or homes to cover the cost of expensive treatment.
Unfortunately, a similar imbalance can be still observed in Ukraine. In contrast to highly developed countries, we often prescribe drugs without proven efficacy … You can find some interesting data on this subject here: [“Drugs for Ukrainians: 14 billion hryvnias for pseudo-medicine(study)”]
In other words, there have been and still remain certain common trends, although reforms in China generally progress at the faster pace.
After my research related to how China’s healthcare system is funded, I wrote a research paper and received a master’s degree. I also co-authored several articles with my Shanghai colleagues in Chinese magazines.
In addition, I also had the opportunity and participated in an internship in healthcare management at Imperial University in London.
Politics prevented the introduction of sickness funds
– What happened after returning to Ukraine?
– At that time, the incumbent mayor of Kyiv Leonid Chernovetskyi divided the health care system of the city into three relatively independent regional associations. On the recommendation of Mykhaylo Saliuta, I was invited to work by Daniel Karabayev, head of the Local Medical Association “Livoberezhne”, whom I consider to be one of the best Ukrainian innovators and practitioners in healthcare management and organization. I was offered to look for new models of financing medical care that would allow urban medicine to develop. Simply put, to search for extra budgetary funding.
Though it seemed adventurous, because I desired “reforms”, I decided to give it a try.
Getting started was a difficult task. Ukraine did not recognize foreign diplomas at all. For one month, I took courses in healthcare organization at the polyclinic in Teremky [a district in Kyiv], where the department of the National Institute for Advanced Training was located. I was not able to be officially admitted working without its certificate. I was told my Oxford diploma was not appropriate, that I needed to take these courses at Teremky outpatient clinic.
Subsequently, there were eight months of work in the state healthcare management office LMA “Livoberezhne”. We offered Chernovetskyi to set up sickness funds as a predecessor of insurance medicine. This scheme having already been introduced in Zhytomyr, and I spent a great deal of time negotiating with doctors, patients and officials, which resulted in a huge folder of documents with draft resolutions that were agreed upon and considered for implementation. But… the case was put on hold due to the regular election of the city council, then mayoral election, then re-election… In short, there was no political will to do anything at that time.
How to organize advertising in hospitals
– How is it that you landed yourself in a private company?
– It was very disappointing to me that after almost one year of work, our efforts failed to yield any meaningful results. In addition, being in public service, I received about $100 USD in monthly salary. I spent twice that much on room rent alone!
When I was looking for ideas on how to raise extra-budgetary funding, I noticed that advertising in hospitals was poorly arranged. Posters, flyers and information leaflets were glued, shelved or scattered around and sometimes formed debris, and the effectiveness of these promotional activities was questionable.
It came to mind it would be a good idea to establish a company capable of organizing the system. Because pursuing such an endeavor would require more time than my work as a public employee would allow, I decided to quit my job in the public sector in favor of private business. I had investigated several advertising companies and chose the best approach with partners, and we founded “Promo Vision”.
We signed information services contracts with dozens of clinics around the city. We designed and installed special stands in shop windows on which pharmaceutical companies advertised their products for a certain period. We also placed social advertising at other times. Some of the money we earned from these services was donated to hospital charitable foundations. We developed these processes in a ethical and transparent manner. I held office as the director of Promo Vision for two years.
Can you tell us why electronic medical appointment booking failed 10 years ago?
– Your career history also includes an IT startup project, is it right?
– Yes, my friend Yuriy Matso was employed by Yevhen Utkin, who founded Kvazar-Micro company in 1990 and was one of the most successful pioneers in the IT sector in Ukraine. The company distributed INTEL products, and then began to installing SAP software for Ukrainian companies. In 2005-2006 they merged with Sitronics. Under Utkin’s guidance, the company was listed on the London Stock Exchange with a market capitalization of $2.3 billion (USD). It was quickly becoming the largest high-tech company in Eastern Europe. After this, they began investing in small projects of their own.
One of the companies they invested in focused on the development of software for clinics that wanted to introduce an electronic medical appointment booking and electronic prescription systems. I was offered to communicate with hospitals.
The idea was very interesting and innovative, but since public hospitals lacked proper computer equipment and Internet, the company did not make it. The private clinics and doctors at the time were not really ready for it either.
We worked on the project for a year, together with enthusiasts from Kvazar-Micro, but the management chose to phase out it. Ironically, a couple of years later, several other companies successfully launched the service based upon the same idea.
Success depends on many factors
– Did you have to look for a job again then?
– Yes. Having just married, I had a new family to take care of.
Despite international diplomas and considerable, diverse experience, I had difficulty finding a position. I got a job as a sales manager at a Belarusian-Ukrainian company that supplied Japanese blood test equipment to laboratories. I personally visited more than a hundred laboratories in Ukraine (in state outpatient clinics and hospitals) but sold only a few analyzers. Hospital laboratories were dilapidated and in very poor condition. The general response our sales efforts was, ‘We really want to buy, but cannot afford such equipment.’ They were ready to buy any Chinese alternative instead without doing proper testing due to the low pricing of the Chinese equipment.
– Finally, you began to cooperate with an international company that was engaged in biobanking. With your experience as a scientist, researcher, manager, entrepreneur…
– Yes, they were looking for a person who could combine all these things, and they found me through a recruitment agency. I submitted my resume to several platforms. I was looking for something strategic and long-term. At this point in my life, I was not interested in a one- or two-year position, but a much longer career position. I was looking to enjoy my work, but more importantly results of that work. Success depends on many factors; this time I got more than I was dreaming for. Again, I see Providence in this.
– And then you organized a biobanking company of your own…
– That’s correct, but the process was not an easy one.
Reasons for collecting biological samples
– Please, tell us in more detail. First of all, what is biobanking?
– In general, it is the collection of biological samples and clinical data for research involving the study of DNA and RNA [carriers of hereditary information of all living beings – ed.]. They are collected as they relate to various diseases, such as HIV, hepatitis, Alzheimer’s and Parkinson’s diseases, however cancer accounts for 70 percent of such research.
Medical professionals try to establish causal links between genetic data, the course of the disease and its response to different types of treatment. For example, a person may have an inherited predisposition to high blood pressure or diabetes. This is reflected in his/her gene “card”. Genes are also exposed to their own “diseases” or damage, called mutations, and they can cause cancer. Some of them are “provocateurs” or the root cause of the disease, and others only “accompany” cancer. It is important to know how to distinguish between them, because drugs that are effective in treatment of one mutation are helpless when it comes to the treatment of another, and vice versa.
Modern medicine is becoming more individualized.
It is not only broad-spectrum antibiotics that face transition to niche drugs that fight a specific species or group of bacteria.
Such transition is accompanied by the process of establishing an accurate diagnosis within the shortest possible period and the selection of effective drugs to many diseases, especially cancer.
This is a very painstaking process. To develop one drug, tens of thousands of molecules need to be tested. It takes years, thousands of patients are involved, a huge amount of information is accumulated and billions (not millions) of dollars are spent (for one medical drug).
Biological samples are used for testing models and efficiency, i.e., for achieving results on a molecule in vitro before testing it on animals, and on humans subsequently. Biosamples include tissues from removed tumors, blood, urine, saliva, etc. Everything that contains genetic biomarkers of disease.
How did Audubon Bioscience come into being
I was involved in a Ukrainian-Swiss company in business development management – I attended and spoke at international scientific conferences and did contracting work with researchers who ordered our services.
About two years later, I had an opportunity (a miracle again) to pursue post-graduate studies at the Louisiana State University Medical Center in New Orleans. I was to participate in research in brain cancer. The opportunity was organized by our good American friends (Maurice and Marie Cabirac), with whom I lived as an exchange student back in 1977-78. They introduced me to the professor there at LSU and helped me raise money for a scholarship fund for salaries and accompanying research materials.
The costs for this fellowship were even higher than for Oxford. We needed $120,000 (USD) for the first year alone. For my wife and I, it was an enormous amount of money. My wife and I didn’t even own a car at that time and just finished making mortgage payments for the apartment. The Cabirac’s raised $20,000 from their acquaintances and contributed $10,000 of their own money to the scholarship fund, but we were still short $90,000, and only had a short time to get the funds together. As had happened before in my life, the money was unexpectedly found, albeit on the very last day. Maurice and Marie decided to take the required $90,000 from their retirement savings. They are ordinary Americans, and it was a lot of money for them, but they wanted to give me and my wife this chance. It was not an investment, but a friendly aid on their part.
From this scholarship fund, the university paid me a post-graduate student’s salary $4,100 (USD) a month, but the amount remaining after taxes, health insurance and rent was very insufficient for a family of four people (including a newborn baby). To comply with American law, I had to either continue my research activities by finding a grant and terminating employment contract with my previous employer and set up my own company. Because the law did not allow us to officially have any side job anywhere else, I only had one option.
At this point I agreed my former employers that I intended to organize a company in the United States to support their activities. We named it after a neighborhood in New Orleans (Audubon), the city in which Jazz was born. This company would represent their interests in North America, look for clients and support them in every possible way. In June of 2016 this is what my wife Alla and friends Maurice and Marie Cabirac this is what I did.
However, the company I had been working for changed their plans and refused to cooperate further. As a result, having no grant to continue the brain cancer research after the first year, I had to focus on developing my own company.
We initially signed agreements with American clinics and a German biobank. A few months later, in August 2016, my colleague Oleg Kokhanenko (also a doctor from Zaporizhzhia) and I began to do business with clinics in Georgia; this because arrangements with my previous employers prohibited me from working in Ukraine for one year. Later, I joined Ukraine Bioscience, a company founded by Dmytro Urakov (a doctor from Kyiv). Then, in 2017 after returning from the United States, Audubon Bioscience Co began opening affiliated companies in Romania, Hungary, Turkey, Bulgaria, Armenia, and later in Africa – Nigeria, Ghana…
A chain with multiple links
– Please, explain in plain language the chain of processes carried out by your group of companies.
– In general, the mechanism is as follows:
- Audubon Bioscience Co. (USA) receives orders from pharmaceutical companies, state-owned research laboratories and biotechnology universities for services that involve the collection of biological samples and clinical information from various patients.
- They communicate to us clearly defined parameters of required samples: type of cancer under research, patient’s age, what kind of treatment the patient received (if any), etc. We have concluded such agreements with about 120 clinics around the world and know very well the needs of our customers. (For example, when it comes to orders regarding prostate cancer cells, we contact urology clinics to find out whether they have patients with such parameters.)
- If our supplying agencies can provide these samples and biographical information, we encourage these physicians to ask patients to provide postoperative research materials. I would like to emphasize once again: we do not collect fragments of healthy organs, but postoperative leftover biological material, most of which is subject to disposal.
- Everything is done in coordination with the ethics committee of a medical institution, which monitors the rights of patients so that they are properly informed to avoid harm to their emotional health. These are international research standards.
- The patient must give written consent.
Like transplantations, the donor never receives a direct material benefit from the donation. But we usually pay for an extended package of diagnostic tests in private laboratories. If American or European researchers find an error in the Ukrainian diagnosis (sometimes this happens), we always inform the doctor and make effort to ascertain why or how happened. Thus, the patient receives significantly improved diagnostics free of charge. - Medical courier services deliver samples to laboratories – we concluded agreements both with providers of courier service and laboratories. In laboratories, samples are tested and repackaged (if necessary) pursuant to clear storage procedures and are sent directly to customers.
This may seem easy, but in fact there is a lot of complex logistics and work with specific information, specialized terms, and so on. To properly preserve nucleic acids (DNA, RNA), there are dozens of different protocols and several different temperature regimes of storage and delivery (from a room temperature to minus 80˚ C and minus 150˚ C). Just imagine that every month many hundreds of such samples and their data are simultaneously collected, processed and transported to hundreds of hospitals in ten countries on four continents. Putting all these together requires a lot of effort from a lot of smart people, and in addition to finding and teaching them, you must provide whatever is necessary for their work, including competitive salaries.
Finding the right people for the right roles
– What is the most interesting thing for you as a CEO when it comes to ensuring smooth operation of this complex mechanism?
– Primarily, it is important to get the teamwork going. When everyone understands the scope of his/her authority and is able to assume these responsibilities, things can work. I gained a great deal of valuable experience working with people in the church, in the institute, in the non-government and public sectors. Even from back when I was a leader in my youth group at the church, then presided over a student research society at the university; all these experiences helped me develop organizational skills. I also chaired an alliance of Christian professional associations and later become a middle-rank official of a local government. Each time I had to learn how to organize and coordinate the work of teams.
At first, I didn’t really want to be a leader and get involved in doing organizational things.
It was more comfortable to watch how things were going from the sidelines. However, as it turned out, formulating the right tasks, finding the right people, giving them the right roles and helping them achieve better turned out to be a very interesting challenge and a necessary skill. I see it very similar to what a football team coach does, whose task is not scoring goals but developing strategies, finding great players, helping them find their place on the pitch, suggesting the best ways of interaction between them and more. It is difficult, but it saves time and lays a solid foundation for an effective team.
When people are ready, I do not have control over their every step, but can delegate authority to them. I am more interested in strategies and macro management, rather than going into every detail. In the long run, I want to focus more on fundamental matters rather than the details.
I do a lot of delegation in the Audubon Bioscience group of companies. I only deal with details when it comes to a truly complex issue, but this is less often the case, because the team is very good and improves its level every day.
We made great progress in five years: from zero to 100 employees, from zero to $6.5 million (USD) in revenue (although all years the company’s profitability was nearly zero as we reinvested everything in development). Without outside investment, the process of growing was very difficult and painful. Currently, the company’s capitalization, according to our market estimates, is more than $50 million (USD) before investments. Forbes Ukraine has recently estimated us at $50-100 million (USD), even though we are not promising great projected value on projects that cannot presently be implemented. We have a clear and easy-to-understand model that has been effective for several years. In this model, my role is to be the mastermind and strategist who engages the best specialists, builds a team and moderates the process.
– I read that you recently succeeded in raising almost half a million dollars through crowdfunding. Where will this money go?
– These funds will be used to increase working capital, developing resources and implement our own research projects in the near future. It was highly important to us that people have contributed from one hundred to several thousand dollars, to the future of our company, through this crowdfunding.
In the future we want to develop our own laboratories and carry out our own research. Also in the future, we hope to develop new diagnostic tools and drugs for the treatment of cancerous diseases. These tools and drugs will be made more accessible to patients, including those in Ukraine. And, of course, we want to engage domestic scientists and therefore help the Ukrainian biotechnology industry to get on the path of development.
We have very capable and talented people, which is proved through achievement in the IT industry on the international plane. Why can’t we (as Ukrainians) catch up with countries like India or Pakistan in biotechnology? As the COVID-19 pandemic has shown, the ability to produce masks, tests and medicines domestically is a matter of national security. For example, Indonesia and Cuba were successful in developing their own coronavirus vaccine in proper time, and we failed …
We see deepening international cooperation as crucial for modern science, which internationally, has already started to use artificial intelligence; thus, we are striving to cooperate with Japan, the European Union, Switzerland, and possibly Israel and Singapore.
– What is the overarching goal of all your work?
– Improving people’s health. I once dreamed of doing this as a practicing surgeon. Now I do it as a manager of an organization that helps researchers. In the future, I intend to get engaged in the management of scientific research.
In addition to my work, I am involved in public and charitable activities.
- Together with my friends from leading Christian denominations (Catholics, Orthodox, Protestants), we have established the Peace and Development Foundation to attract modern education and innovations to Ukraine.
- Given the challenges of the times, we are looking for ways to better unite our society in the face of a common threat and help bring peace to our land. We have started a series of interviews with church representatives and moral authorities on this topic with the purpose of generating practical initiatives.
- Together with the Ministry of Health, we are working on the development of biotechnology in Ukraine, we have already created a small aggregator of free online educational programs from the world’s best universities.
- In the future, we intend to use the Foundation for the provision of educational grants to young people – not only doctors but also teachers, lawyers, representatives of socially important professions.
My parents invested a lot of effort and money into my education and upbringing, both academically and spiritually. Accordingly, I understand very well, from my own experience, the importance of proper education in this world’s environment.
In general,… My goal is to serve God and people through my vocation!
– Given all the activities you are involved in, do you have enough time to spend with your family?
– If there is no harmony in your family life, nothing would be as it should be, and all the effort would be meaningless. The other day my wife Alla and I celebrated the tenth anniversary of our engagement. We have two wonderful children – daughter Milana, 8, and son Daniel, 5. There have been many very difficult circumstances in my life and business over the years, and without their support it would have been impossible for me to achieve significant success.
After 8 pm I spend almost all my time with my family, my wife and I put the children to bed in the evening, pack them for school after breakfast in the morning, and then I take them to school. We spend almost all weekends together. I do my best to allocate my time in a way that I have enough time to relate in a meaningful way with my wife and children, for work, for public activities, and for ambitious goals.
However, I still don’t have time to do everything; for example, I hung up drapes in the apartment in one room, then, six months later, finish hanging them up in the second! However, our lease ends soon, so I say hanging the second set might be pointless 😊
– Thank you for an interesting conversation! Good luck!
by Hanna CHUPRYNA
Photos are provided by Rostyslav SEMIKOV and taken from open sources
EPILOGUE
In addition to those mentioned in the text, Rostyslav asked to express special gratitude to the following teachers who supported and made a significant contribution to his professional development:
- Professor Valentin Pariy, lecturer on health management at NMAPE at the Teremky polyclinic, president of the Zhytomyr Oblast Health Insurance Fund, who later moved to work as a medical director at Kyiv’s most advanced private clinic, Oberih.
- Ihor Chermak, who headed the Kyiv Municipal Clinical Hospital No. 1 (Chervonyi Khutir) after Mykhaylo Saliuta, greatly contributed to the improvement of the neonatology department at the hospital and the development of cooperation with Ronald Hoekstra.
- Vadym Kozlov, an urologist at the Kyiv Municipal Clinical Hospital No. 1 in 2005-2006, the only one in this hospital who responded to Rostyslav’s requests and invited him to assist in surgical operation and trained him in surgery. Then he founded and successfully developed his own network of high-quality private clinics “Harmony of Health”
In ukrainian language Article was posted on mig.com.ua 09.02.2022
