“How wonderful it would be, if we could connect with all our relations and let them know we are thinking of them.”
The Noetic team heard these poignant words spoken by Tanya Talaga at a recent talk here in Toronto, to celebrate the launch of her new book, The Knowing. Ms. Talaga is a renowned Canadian investigative journalist, who, for decades, has written for national outlets on a wide range of issues, including health and education. Moreover, she is a fierce voice on Indigenous matters, bringing light and colour to the experiences of communities across Canada.
The Knowing is especially powerful, because it is very personal. Ms. Talaga weaves history with the story of her own family and their decades-long endeavour, by combing endless census records and newspaper articles, to uncover what happened to her great-great-grandmother – who ‘never came home’, at a time when many Indigenous families were forcibly broken by programs of the Canadian government.
More than any other, today is the time to dwell on this – September 30 being our national day for Truth and Reconciliation in Canada. This single day is meant to acknowledge over a century of forced assimilation and abuse of Indigenous people under the national residential school system, a system now officially recognized to have carried out cultural genocide.
A day feels lacking, particularly when it was only made a federal statutory holiday in 2021, upon the discovery of over 2,000 mass unmarked graves on the sites of former residential schools. That children were taken from their families, women institutionalized and sterilized against their will – can we say we didn’t know? Canadian history is certainly being taught in schools differently now than 20 or 30 years ago, but when discoveries like this make even the New York Times, we can no longer claim ignorance.
The truth is often sobering, but only by confronting it can we learn, heal and grow. We find this especially relevant in trauma and mental health. At Noetic, we usually talk in future terms, on a global scale – we're obsessed with the latest research and technologies shaping the next generation of healthcare. But we equally look backwards to learn from history at a personal level. After all, each patient has a unique story that is both shaped by but also shaping their neighbourhoods, cities and beyond. What sort of a life might a teenager experiencing substance withdrawal in Saskatoon be living, or a senior on pension with undiagnosed bipolar disorder in Vancouver’s Chinatown? How are they similar and different to someone in, say, Riyadh or Tokyo? The more we understand individual contexts and needs, the more we understand what ‘impact’ and ‘innovation’ mean for one patient and for millions.
As a team, we are fortunate to bring together a wealth of diverse experiences and perspectives that guide us in this probing, never mind our years as professional investors. Three quarters of us are first- or second-generation immigrants, with roots tying us to Afghanistan, Hong Kong, India, Malta and Pakistan. The complex histories of those places intertwine inextricably with our childhoods, family stories and how we think about healthcare and social support systems. When we evaluate solutions, we consider not just their scientific defensibility, market and scalability, but, naturally, how they will reach those who are most fragile and overlooked among us.
Take psychedelic-assisted therapies for example, in which Noetic has made investments. Recreational drug use is heavily stigmatized in many cultures, while people of colour, especially Indigenous, Black and Latino men, are disproportionately jailed for drug-related offences. Should these therapies be eventually legalized (the recent US Food & Drug Administration ruling against MDMA notwithstanding), what systematic changes are needed to build trust and understanding with those communities, such that patients across race, age and income groups have access to a beneficial new class of treatment?
To be sure, while rates of mental illness continue to mount at an alarming pace, we are seeing more and more innovation on the horizon. The aforementioned FDA decision earlier in August disappointed many, with MDMA-assisted therapy for post-traumatic stress disorder being rejected in the final mile after decades of clinical research and growing public support. But while challenging in the short term, significant opportunity remains for other psychedelic-adjacent developers to make improvements for future applications, including focusing on drugs that have shorter durations or no hallucinogenic effects at all.
Psychedelics aside, other major developments have recently emerged that are sparking great optimism and excitement for mental health and psychiatry – not least of which was the first approval in decades of a new drug to treat schizophrenia, absent most of the side effects of existing treatments in the market. The landscape for pain management is also advancing, with one treatment being granted priority review in early-2025 by the FDA that could offer patients an option without the risks of opioid-based medications. Meanwhile, GLP-1 drugs for diabetes and weight loss, such as Ozempic and Wegovy, are being investigated as potential treatments for substance use disorder, with one study finding that they may significantly reduce opioid cravings in patients.
Given the current high cost and skyrocketing demand for GLP-1s, timely diagnosis, distribution and payor reimbursement are core targets for change and innovation in this area. Interesting research is also emerging for depression, with low-intensity focused ultrasound still in early stages but showing promise as a non-invasive option for depression. (The above are some of the most commonly diagnosed mental health indications; for more information, please let us know and we would be happy to provide briefs on areas such as neurodevelopmental disorders, personality disorders, eating disorders and more.)
Such developments are highly promising and reflect the upward trend in neuroscience since last year, with M&A activity and regulatory approvals on the rise despite macroeconomic headwinds. While global capital flows have been sluggish overall, this sector activity after decades of stagnation underscores the scale of unmet need in the population and the growing urgency for new solutions. At Noetic, thinking both big and small, we are eager to continue driving such innovation while seeing change spread, one day and one person at a time, from ourselves to our neighbours to our fellow citizens and beyond.
The book club
The Knowing by Tanya Talaga is our book of the month here at Noetic. Next up, we have What Went Wrong With Capitalism by our good friend, Ruchir Sharma. Taking another walk through history, this one highlights how governments have altered markets and economic growth around the world, leading us to where we are today.
“I can see the sun, but even if I cannot see the sun, I know that it exists. And to know that the sun is there – that is living.”
– Fyodor Dostoevsky, The Brothers Karamazov