Biotech startup Altera lands R29m to pioneer Africa’s first universal donor cell platform

In a historic leap for biotech in Africa, Pretoria-based Altera Biosciences has secured R29 million in pre-seed funding to develop a universal donor cell platform aimed at revolutionising transplant medicine. The technology could enable off-the-shelf cell therapies to overcome one of medicine’s greatest challenges: donor–recipient matching - a problem particularly acute in Africa given its unmatched genetic diversity. While this makes Africa a natural proving ground, Altera’s ambitions are global, with the platform designed to expand access to advanced cell therapies worldwide. Led by biotech entrepreneur Alexandra Miszewski and Professor Michael Pepper, director of the Institute for Cellular and Molecular Medicine at the University of Pretoria, Altera is positioning South Africa at the forefront of global medical innovation. In an interview with BizNews, the founders shared their vision to tackle one of medicine’s toughest challenges and elevate South Africa’s role in international biotech. Professor Pepper noted, “If Altera develops the technology to solve this problem here, it could be solved for the rest of the world.” Miszewski added that the funding signals growing confidence in South Africa’s biotech sector and the depth of expertise within the country.

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Edited transcript of the interview

Linda van Tilburg (00:00)

Altera Biosciences has secured 29 million rand in pre-seed funding to advance its universal donor cell platform, marking a significant step for Africa’s emerging cell and gene therapy field. Joining me in the studio are Alexandra Miszewski, biotech entrepreneur, and Professor Michael Pepper, an immunologist and director of the Institute for Cellular and Molecular Medicine at the University of Pretoria. Thank you both for joining us today. Can we start with the why? What problem are you trying to solve?

Prof Michael Pepper (00:36)

As you’ve pointed out, this is a very significant milestone for biotech on the African continent. It’s well recognised that Africa is a major contributor to global disease burden. We make the highest contribution to communicable or infectious diseases. From the point of view of non-communicable diseases, which include cancer and particularly cardiovascular disease, we’re seeing a huge increase on the African continent. But despite that very high disease burden, there is very little that is currently being done to address these areas from the point of view of advanced therapies. This is really the future of medicine, involving gene therapy and stem cells and the sort of things that Altera is doing. 

So, this is a very significant milestone, and we feel extremely privileged to be in this position. What we’re attempting to do is to bring some of these high-impact, underutilised therapies to the African continent, beginning in South Africa, but obviously with a view to extending elsewhere on the continent and definitely beyond the continent itself. As an immunologist, one of the key issues that I need to confront, though I’m no longer practising as a clinician but in my position of research at the university, is the fact that Africa hosts the highest genetic diversity in the world. 

So, we struggle to find a match between donors and recipients when it comes to transplantation, whether it be of cells or organs and tissues. And so we need to find ways of addressing this. The beauty of having to deal with this problem on the African continent is if we can solve it here, we can solve it for the rest of the world. So, our goal is to try and address this through some of the technology that we’re developing. But I think it’s really important to point out that it goes well beyond simply transplantation. 

Transplantation was our point of entry, but the therapies or the platform that Altera is developing, which may eventually result in therapies but has many other applications, will evolve from this problem of genetic diversity and transplantation into many other areas of medicine. And so, it’s not transplantation-limited, but it is the concept or the problem that we’re trying to address that got us started. So, I hope that gives you some sort of idea.

Linda van Tilburg (03:50)

So, Alex, how did you get involved?

Alexandra Miszewski (03:54)

It’s quite an interesting story. Our lead investor, OneBio, knew Michael and me in our individual separate capacities. We were both working on different things and different problems at the time, and Nick Walker at the time seemed to think that Michael and I would be very well matched as a co-founder pair. After speaking to me, I think he reached out to Michael. We met, and I think within an hour of meeting, we decided we were going to do something together. What that was has gone through different iterations, and a few years later down the line, here we are.

Linda van Tilburg (04:41)

What kind of therapies are you developing to address these unmet clinical needs in Africa?

Prof Michael Pepper (04:41)

Maybe I’ll take that one again. I’m not going to go into detail on what we’re developing. It’s really too early in our business. We’ve really just started doing the work. In fact, we’ve only been operational for a very short space of time, and I think it would not be comfortable to go into detail. 

We have a very high disease burden on the continent, and we need to address this using modern therapies. So, if you look at the whole overarching area of advanced therapies, it involves regenerative medicine, which involves stem cells. It involves adoptive therapies, which involve treating cancer, and particularly exciting now is we’re able to treat and cure certain blood cancers, which previously were just not treatable, like leukaemia, lymphoma, and myeloma, using these advanced therapies. 

And then equally exciting is the use of gene therapy. So, what I can tell you is that we are modifying cells using techniques which are really at the forefront, cutting edge of modern medicine, which will then change the way in which the cells behave, and we’ll be able to give them back to patients in a way that will benefit them and hopefully be able to treat their disease. 

As I said, the starting point initially was transplantation, but the direction that we’re heading in goes well beyond transplantation and could end up treating many other diseases. I’ve mentioned cancer and cardiovascular disease. So, I think those are areas that we will ultimately get to. 

But as I said at the beginning of this question, I don’t think it would be wise to go into too much detail at this point. Not from the point of view of wanting to withhold the exciting work that’s going on. I just think it’s too early. If you had to ask me this question again in a year’s time, I’m sure I’ll be able to tell you a lot more when we have a lot more under our belts and we can speak with confidence. Should I say I don’t necessarily subscribe to the idea of jinxing a project, but I think to say more than is absolutely necessary at this point is probably not in the best interest of the company.

Linda van Tilburg (07:27)

Well, absolutely understood. I don’t want you to reveal your IP.

Alexandra Miszewski (07:31)

Just to echo what Michael says, what’s very unique about this company, not different to other biotech companies, but quite different to the companies we typically see funded in South Africa, which are predominantly tech companies, is that the entire value basis of this company is our intellectual property. 

So, you know, we’ve got a lot of work to do from an IP point of view; patents need to be filed, and for anyone who’s not aware of things to do with IP law, as far as IP law goes, as soon as something’s in the public domain or you disclose it before you file the patent, it is no longer protectable. So, as Michael said, it’s not that we don’t want to talk about it; I think it is too early, and we’ve still got a lot of very important work that is aligned with our IP strategy that needs to be executed before we can speak about it more openly.

Linda van Tilburg (08:36)

Michael, can you share more about the research that is done at the University of Pretoria and the expertise at South African universities?

Prof Michael Pepper (08:52)

I’d be delighted to, absolutely, and I think I would speak for all universities in South Africa, not just the University of Pretoria. Just as background, I lived and worked in Geneva, Switzerland, for 20 years and then came back to South Africa 20 years ago, and I had the incredible privilege of being at the cutting edge of modern medical science. Coming back to South Africa and being able to apply that in a very unique setting. So, from a research point of view, that unique setting is that we have a very high burden of disease, and we have some diseases which are more prevalent in South Africa when compared to the rest of the world. 

So, that gives us a unique opportunity to go into areas that perhaps people in other parts of the world would not be able to do. That’s the first thing we have. I know this sounds macabre, but from a scientist’s point of view, it’s like being in a playground and having everything that we could possibly access. Obviously, that’s not in the best interest of the patients, but certainly from our point of view, we have so much that we can work on. 

The second thing is that South Africans are by nature extremely resourceful and highly energetic people. You will have seen they’ve done extremely well all over the world, and so when you combine that resourcefulness with this opportunity, there’ve been many firsts in the world. I think probably one of the most notable is where I did medicine, at UCT. That was Chris Barnard, and most recently with COVID-19, with Professor Tulio de Oliveira, we were able to get ahead of the disease, and South Africa made many major contributions. 

So, I think in terms of all the universities, and obviously that includes the University of Pretoria, we are in a favourable position because we have such an incredible workforce, and we have these opportunities to make important contributions. So, how does this apply to Altera?

Well, we are now in a position to address some of the major contributors to disease burden in South Africa and elsewhere on the African continent. And as I said, because of our genetic diversity, this then allows us to apply this in many other parts of the world. So, we’re poised to make an important contribution. 

What has been tricky up to now is that raising the level of funding that Alex managed to raise for Altera has been difficult, but we’ve shown that it is now possible, and I hope this will trailblaze for other biotech companies who want to work in equally important, if not the same, area. 

Given the fact that there seems to be a diversification globally away from traditional areas of doing research, the Global North, I think as the Global South, we are now poised to make very, very important contributions going forward. And so that’s, I think, where a lot of the excitement around Altera comes in, is that we are in a position now to make a major contribution, and we’ve shown that it is possible to raise the funding to do this. Now we just need to get the work done and make sure that we can, you know, euphemistically put our money where our mouths are and make this work and be successful.

Linda van Tilburg (12:53)

Alex, what does this R29 million investment signal about the potential of Africa’s biotech sector?

Alexandra Miszewski (12:59)

I think this definitely signals an increase in confidence in the South African biotech sector and the skills and expertise that exist here. I think where there’s still room for improvement, we’ve got first-class science that happens in multiple different disciplines throughout South Africa. 

What really has been missing is the bridge between science and commercialisation. The setup we’ve got in the way we’ve raised funding is really, really interesting. So, OneBio is the biotech VC specialist in South Africa, and they are more than just a VC; they actually are a venture builder. And I think we’ve benefited from this first-hand. They brought Michael and me together, said, we’d love you to work on a problem. Let’s see what we’re all interested in, excited about, and let’s come up with something that can be funded. 

They really worked very, very hard with us over quite a long period of time to get to the version of Altera as it is today. I think you look at how unbelievably knowledgeable they are, their contribution partnered with one of our other big investors, which is eSquared Investments, Allan Gray’s venture capital arm. With eSquared’s patient capital approach, being sort of an evergreen fund for founders like Michael and myself, that suddenly creates a really, really interesting and effective capital situation for a biotech venture, which by nature is a much more patient, long-term investment. 

So, I think it’s a really, really positive signal. I think we’ve shown that it can be done, and I hope that there are many, many other companies that come after us. Hopefully, we’ve addressed or figured out ways through the maze of obstacles we’ve had to navigate to get here.

Linda van Tilburg (15:19)

Where do you see Altera in a year or five years?

Prof Michael Pepper (15:23)

I am based full-time at the university. The company is based here. We’re doing the work here; the students are here. So, in a year’s time, we will still be here. We’ll still be working on the project, doing the science. The vision, clearly, if everything goes our way, would be that Altera evolves into a standalone company outside of the university where it would probably have influence well beyond South Africa, whether that means having labs and offices in other countries, that could well happen. 

But we’re hoping that this will evolve, and the sky really is the limit, I think, for anybody, not just for ourselves, for anybody working in this space. And whether we remain on our own or we partner with other people on one or more of the many opportunities that we have in the country will be determined by the science, by the data that we generate. But I think neither of us is setting any sort of limit on this. 

We want to take this as far as humanly possible. I think it’s really important that I speak for both Alex and myself when I say that we’re driven by the need to make a difference. So, we have this opportunity which has been given to us. We have a need which needs to be satisfied. 

And I think for both of us, the prime driver here is to be able to address that need through this incredible opportunity and, at the end of the day, to make a difference. 

As Shakespeare said, when you shuffle off this mortal coil, which we all will do eventually, you can’t take any of this with you, but you can leave something behind that’s going to make a difference. And I think for both of us, that’s our major driver: we really want to make a difference as South Africans, proud South Africans, but also as global citizens, and so that this is applicable to other parts of the continent and to the rest of the world.

Alexandra Miszewski (17:23)

Just to echo what Michael said, we sometimes talk about that very first meeting we had. I think there were two things that we both bonded over immediately. Firstly, we both love horses, but that doesn’t have a huge relation to Altera, and secondly, exactly what Michael said, we both really want to see the things we work on, all the way from the bench to the bedside, have a real-world impact. And I think, if you look at our team and how energetic and passionate and dedicated everyone is, I don’t think that vision is applicable only to Michael and me. I think you see it throughout the whole company.

Linda van Tilburg (18:23)

Michael, can I just come back to what you said about Africa’s genetic diversity? Can you elaborate on that?

Prof Michael Pepper (18:37)

Yes, absolutely. I think it is a fascinating story, and it goes back a very, very long way. So, women and men originated on the African continent. I think there’s no question about that. I think everybody would agree. Whether it was in one place or multiple different places on the continent at the same time is open to debate. The point is that modern humans originated on this continent, and then there was the so-called out-of-Africa migration, which happened in the north of the continent, where a very small number of people left the continent and ended up populating the rest of the world. 

So, from a genetic point of view, because that number was so small, the diversity in that group of people that left Africa was very limited when compared to the diversity across the rest of the continent. 

And as I say, those are the people that have populated the rest of the planet. If you compare the diversity amongst everybody that is not African, it’s very limited. So, if you wanted to do, for example, a transplant between people that are of European origin, because their diversity is so limited, it’s easy to find a donor and a recipient match. T

The problem is if you’re on the African continent and you’re living with people that are so different genetically, finding an exact match between two people that are here is much more difficult because of those differences. So, how have those differences come about? 

Well, first of all, time. Over a very long period of time, those differences start to creep in, and there are more and more of those differences. The other is that as people adapt to the local environment, their genomes are specifically selected for to cope with those differences in the environment, and so that’s how we end up having such a diverse population on the continent. 

Even though we probably only represent about 18% of the global population, we probably represent well over 50% of the total diversity amongst modern humans. And that actually counts in our favour in certain ways. For example, in the work that we do in genetics, where we look for variants, so those are differences in certain genes which may be responsible for certain diseases. I

If you want to look for variants that are possible within a given gene, you just need to look on the African continent. You’ll find a large number of them. Whereas if you were to look in a very restricted population, where multiple generations originate from one or two founders, you can have a limited number of differences between the different generations. 

So, that’s why it’s so exciting to work on the African continent because we have this huge diversity. But then, as I mentioned at the beginning, that counts against us from the transplantation perspective because it’s difficult to find matches. And that was Altera’s point of departure. 

But I do want to emphasise it’s not the only direction that we’re moving in. If we manage to achieve what we’ve set out to do, we’ll be able to move into many other areas outside of the field of transplantation.