You’re Never Too Small to be an Acquirer

Design Clinical Pathways for Global Adoption

From the beginning, Somer designed Hera’s clinical roadmap with one guiding rule: every decision had to make sense not just in the U.S., but everywhere the company might one day operate.

“Our company is building products that can be adopted globally, and that was always at the core,” she says. The result is a model of capital efficiency that balances regulatory pragmatism with clinical credibility — a blueprint for startups that can’t afford to make geography or trial design an afterthought.

Start Where the Data and Dollars Go Furthest

That mindset led to an unconventional call for a U.S. company: launch HERAfem, Hera’s cervical cancer screening tool, in Latin America first. “94% of cervical cancer deaths occur in low- to middle-income countries,” Somer explains. “The technology was developed in that environment, by people who understood the limitations of Pap smears and built a solution around them.”

Mexico became the starting point for a reason. Its regulatory agency, COFEPRIS, functions much like FDA but carries broader influence across the region. “A COFEPRIS approval opens doors into Guatemala, Honduras, Chile, the Dominican Republic — so many LATAM countries recognize it,” she says. “And there are other markets, like parts of Southeast Asia or India, that see it as a comparable review process. It can speed things up globally.”

At the same time, Somer points out that FDA requirements allow flexibility in where patients are enrolled. In a 500-patient study, for example, only half must be U.S.-based — a detail that dramatically changes the cost calculus. “You’re probably talking about $3,000 per patient in the U.S. versus maybe $1,000 in the Dominican Republic or Puerto Rico,” Somer notes. “Puerto Rico is great because it falls under FDA jurisdiction, but costs are much lower, and you get R&D tax incentives on top of that.”

Australia adds another lever: the government reimburses a portion of clinical-trial spending. “They’ll match your trial dollars,” she says. “You basically get double the clinical trial for half the cost.”

Still, Somer warns against chasing savings without context. “You have to consider prevalence,” she says. “If you can’t recruit patients efficiently, the overhead will eat up what you saved on per-patient cost. It’s not just about cheap data — it’s about the right data.”

Build the Right Team — and Align the Right Endpoints

That balance between precision and pragmatism extends to Hera’s choice of clinical partners. Somer learned early that working with a large, name-brand CRO doesn’t guarantee quality. “Let me tell you, you’re getting the C-squad,” she says. “You’re not the big account — you’re the one they train new people on.”

Instead, Hera partners with smaller, integrated CROs that manage regulatory, reimbursement, and clinical functions under one roof. “We use a boutique firm out of Atlanta called Tamm Net,” she explains. “They can do everything. Having all of these capabilities in the same house where you're not competing for attention with the J&Js or Bayers of the world is incredibly helpful because there's continuity of understanding.” 

The real advantage, she says, is continuity. “When your regulatory, reimbursement, and clinical strategies are being built together, there’s a shared understanding of how each decision affects the next step,” Somer notes. “You don’t finish your trial and suddenly realize your endpoints don’t support your reimbursement claim.”

That mistake can be fatal for startups. “I’ve watched companies die mid-trial because they ran out of money or didn’t reach statistical significance,” she says. “You can’t afford to do it twice.”

For Hera, smart clinical strategy isn’t just about cost control — it’s about survival. By treating geography, design, and partnerships as parts of a single system, Somer has built a roadmap that gives Hera the best odds of finishing strong, not just starting fast.

Raise Money That Fits, Not Money That Flatters

When Somer left venture capital to start Hera Biotech, she assumed her investing experience would give her an advantage. In some ways it did. In others, it created blind spots she had to unlearn the hard way.

“The biggest lesson I learned is that my experience in a VC was not common,” she says. “We were truly early-stage investors — funding things that had preclinical or safety data. Now you hear people say early stage and they mean, ‘Are you six months from the FDA?’” She laughs. “I feel like I’m in The Princess Bride: I don’t think that word means what you think it means.”

The disconnect extended to fundraising itself. Like most founders, Somer began pitching what seemed like the obvious investors — women’s health funds. But the conversations rarely went anywhere. “People would say, ‘There are all these women’s health funds now. Why aren’t they funding you?’” she recalls. “Well, do your job, and we wouldn’t have to have women’s health funds.”

The real issue, she discovered, was structural. “If you look at their portfolios, they say women’s health, but it’s mostly direct-to-consumer or digital-health products. I’m not DTC. I’m not digital. I’m hard-science, life-science, traditional regulatory pathway.” The mismatch forced her to rethink Hera’s positioning entirely. “You have to know your audience really well,” she says. “We reframed Hera as an AI-driven precision-diagnostics company that focuses on women’s health — not the other way around.”

That shift in framing opened doors to investors who might otherwise have overlooked the company. It also led Somer to challenge one of the most repeated pieces of startup advice: don’t take stupid money. “Everybody says, ‘You don’t want stupid money.’ I’d say as long as stupid money is neutral money, it’s not bad money,” she explains.

To her, the difference comes down to alignment. “Bad” money carries predatory terms or unrealistic expectations. Neutral money may come from investors without domain expertise but who share your time horizon and risk profile. Smart money adds value — but it’s not the only kind worth taking. “Just because someone hasn’t invested in your space before doesn’t make them a bad investor,” Somer says. “If the terms are clean and the incentives are aligned, that’s good money.”

She also points out the gendered dynamic behind that calculus. “It’s easy to say ‘don’t take bad money’ when people are lining up to fund you,” she says. “But for women founders who are knocking on more doors and being told no more often, sometimes you have to think differently. If you’re starving, you’re going to eat what’s in front of you. You just have to make sure it doesn’t come with too many handcuffs or guardrails.”

Quoting her South Texan dad, she says: “If you’re not going to be the prettiest girl at the dance, you have to be the easiest to dance with to fill your dance card.” It’s tongue-in-cheek, but the logic holds: if you’re not the flashiest company in a fundraising cycle — and most aren’t — you need other advantages. Being responsive, transparent, and easy to work with often counts more than valuation hype.

For Somer, the real key is staying in motion. “You’ve got to be in the game,” she says. “If you’re not in the game, you’ll never get a name-brand investor.”

Her advice to founders evaluating term sheets is simple: focus on alignment, clean terms, and long-term fit — not prestige.