Thinking Global and Executing Local
Interview with Aether Biomedical CEO Dhruv Agrawal
Key Learnings From Dhruv's Experience
Nail down your problem statement early. Don’t try to compete in medtech by delivering more or less the same offering, only cheaper. Bring real value to people’s lives by addressing their genuine problems. Keep listening and learning, even after you’ve launched your initial product.
Grants can provide critical support without giving up equity, but over-relying on them can turn a startup into a research operation rather than a growth-focused company. To convince VCs, prepare thoroughly and create a comprehensive data room. If you have solid commercial numbers, this can be more effective than your pitch deck.
Carefully evaluate market opportunities and avoid spreading yourself too thin too soon. While starting multi-regionally may be necessary for niche fields like prosthetics, it's important to prioritize markets based on their potential impact and your available resources. Begin by focusing on regions with higher success potential, as trying to establish a presence everywhere can dilute efforts and slow growth.
With both parents as doctors, Dhruv’s path to medicine was practically set in stone. He enrolled in medical school in India after meeting his future co-founder while they were both preparing for medical entrance exams.
When he received what his father still jokingly calls “the worst gift he ever gave” for his 18th birthday—a 3D printer, it became Dhruv’s window into the world of prosthetics and upper-limb bionics. He had a genuine passion for designing products and was already experimenting with building prosthetic hands. Dhruv started a biomedical innovation club in college with his future co-founder. Later, leaving medical school, they turned it into a full-fledged startup, formally incorporated in 2017 as Aether Biomedical. A year later, the company relocated to Poland, where they established their headquarters, and where, due to the war in Ukraine, many people were in need of prosthetics.
When building their flagship product, ZEUS, the Aether team identified four key limitations in the bionic prosthetics market and made it their mission to address each. The result is a multi-articulating bionic hand that can provide various types of grips, like a power grip, a pinch grip, or a key grip, to hold objects of different sizes and shapes. “We're still far away from the human hand, but as close as possible with technology right now,” Dhruv says.
Now, with a team of around 60 people based primarily in Poznan, Poland, and a presence in over 15 countries, including the U.S., India, and various parts of Europe and Southeast Asia, Dhruv and the Aether team are pushing forward. ZEUS is used by more than 600 patients worldwide, and the company is looking into expanding its reach.
Guest
CEO of Aether Biomedical
Dhruv Agrawal is the CEO of Aether Biomedical. He found his true calling in building prosthetics while he was studying medicine and proceeded to co-found Aether when he was 18. Dhurv holds degrees in electrical engineering and data science, along with a postgraduate diploma in medical device regulatory affairs. Since starting Aether, he has helped raise over $15 million in funding and guided the launch of the ZEUS bionic hand, now deployed worldwide, including those impacted by the war in Ukraine.
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Identify Gaps that Truly Need to be Filled
”The most important thing to really nail down is an honest response to the problem that you are solving,” Dhruv says, “The first time when I started looking at prosthetics, the problem that I wanted to solve was the fact that prosthetics were so expensive.” Making prosthetics more accessible was his dream as a teenager. However, competing on price alone rarely leads to sustainable success in medtech. When it came to founding a startup, identifying and addressing real gaps in the prosthetic market was essential.
Dhruv team focused on four areas where ZEUS stands out:
Grip strength: Many bionic hands lack the grip strength needed for manual tasks, especially for blue-collar workers. ZEUS’s grip strength reaches 150 Newtons—though half of a human hand’s, it surpasses most competitors’ bionics by 30%-40%.
Durability: Prosthetics often break from daily bumps and drops as often as a couple of times per year, even during ordinary activities. Through multiple iterations, ZEUS achieved an impact-resistant design that withstands everyday mishaps.
Fast, local repair: Traditional prosthetic repairs can take 4-6 weeks, passing between the patient to the clinic, the distributor, the manufacturer, and all the way back to the patient. ZEUS’s modular “Lego-like” design allows in-clinic repairs within 15 minutes, reducing downtime and dropouts.
Software support: ZEUS integrates end-to-end patient monitoring, allowing users to track performance and access support remotely, meeting modern expectations for a complete user experience.
Achieving all these has been a process of constant iteration. “The first version lacked the core improvements we have today. All the four key features that we have now, which makes ZEUS a really strong, competitive device in the market, were actually features that were put onto the product after product launch,” Dhruv reflects.
He advises not to look at product launch as something like ”you've done your job, and now you start to count the money and it's all about sales.” Each feature of ZEUS was added in response to real user feedback. It’s a powerful reminder for entrepreneurs not to get bogged down by perfection on the first try—listen to users and refine the product continually.
The Aether team started with modest initial funding—$35,000 from an angel round, followed by a $50,000 grant from the Polish government that prompted the company’s move across the continent. They later secured a $250,000 round, which allowed them to build an MVP that could be fitted on a patient. For that, they needed passion just as much as they needed skill. Dhruv describes his VP of Engineering to illustrate: someone deeply passionate about mechanical design who would study CNC machines before bed for inspiration. Without ever handling a real bionic hand due to cost constraints, he devised functional solutions from manuals and videos alone. Dhruv believes that the drive to solve problems creatively and passionately was essential for their early growth, as it enabled the team to push boundaries without traditional resources.
Think of Grants as Supplements to Your Fundraising
“Non-dilutive funding was the lifeline that kept us going through tough times,” Dhruv shares. Starting with an initial $50,000 grant from the Polish government, Dhruv applied for many forms of non-dilutive funding to support Aether’s early stages. Over time, the company has secured over $6.5 million in non-dilutive capital, which was critical for Aether to operate without sacrificing equity.
However, Dhruv warns, “You don’t want to become a company that’s only about applying for grants. At that point, you’re not a startup; you’re a research group.” Grants can be time-consuming and carry uncertainties, especially if project requirements shift. Dhruv’s advice is to treat non-dilutive capital as a supplement rather than the main lifeline, using it to extend and leverage private investment.
When it came to seeking further venture capital funding, Dhruv learned the importance of creating a comprehensive data room—a collection of documents that provides potential investors with an in-depth look at the company. “A solid data room goes beyond the basics like pitch decks and financial projections,” he advises. A compelling data room guides investors to view the company as envisioned by its leaders, aligning them with the company’s mission and roadmap. By proactively addressing potential concerns, the right narrative with your data room prevents investors from independently forming conclusions that may not reflect the full picture. It also avoids the delay of back-and-forth document requests, ensuring a smoother, more efficient funding conversation.
Building an effective data room also requires real-world feedback. “Talk to a lot of investors,” Dhruv suggests. “The questions they ask will help you refine your data room and preemptively address concerns in future pitches.” For Dhruv, this iterative approach to fundraising—learning from each pitch, adapting, and answering investor questions—has become a key component of Aether’s capital-raising strategy.
Honestly Evaluate Your Market Opportunities
The general approach to commercialization in medtech is to achieve a dominant presence in one market and move on to the next. However, due to the nature of the prosthetics industry—a niche field with a small, globalized market with smaller revenue margins—Aether needed to be multi-regional from the start in order to be viable.
This decision to operate across Europe, the U.S., and select markets in Asia came with challenges. “We’re spread a bit thin,” Dhruv admits, noting that initially, they could have better evaluated some early opportunities. Some markets didn’t pan out as expected. It reminds Dhruv of his father’s words: “Learning from your own mistakes doesn't make you smart. Learning from others' mistakes is what defines smart people from others.” His advice is to do your homework before running too lean tyring to reach multiple markets.
In Dhruv’s view, focusing on the U.S. from the beginning would have been more effective, given its larger potential. “We spent a year and a half in the European market without much success. But as soon as we entered the U.S., we started seeing real progress.” With this experience, Aether’s global reach today is well-structured, with team members dedicated to different regions—Europe, the U.S., and broader markets across Asia and the Middle East. This delegation allows each regional lead to adapt their strategy to local conditions without diluting focus, which Dhruv believes has helped Aether address each market's unique needs.
Given the complexity of the prosthetics field, Aether’s commercialization approach had to account for multiple stakeholders. Each market requires working closely with prosthetists—who fit and recommend devices—as well as patients, the end users. In Aether’s strategy, building a two-way relationship is essential: they want prosthetists to feel confident recommending ZEUS to patients, and they want patients to ask for ZEUS by name. This two-pronged approach shapes their marketing and sales efforts globally, balancing B2B efforts with targeted B2C outreach to drive awareness and trust among both practitioners and users.
While Aether’s global push was a commercial requirement, entering Ukraine after Russia’s invasion in 2022 wasn’t even a question for the company. Globally, upper-limb amputations make up only about 5% of all amputations, and an even smaller fraction of these cases can benefit from bionic hands. In Ukraine, however, 25-30% of recent amputations involve upper limbs. While the prosthetics industry generally focuses on lower-limb devices, meaning most specialists are trained for lower-limb fittings, the sudden demand for upper-limb prosthetics in Ukraine has created a gap in both available devices and trained professionals.
To answer this need, Aether partnered with Ukrainian NGOs like Superhumans and Unbroken to supply ZEUS prosthetics. “The work in Ukraine requires not just a good product but a skilled workforce to fit and manage these prosthetics,” Dhruv notes. To bridge this gap, Aether invited experienced clinicians from the U.S., Europe, and India to train local professionals. This way, they laid the groundwork for long-term rehabilitation support.
Looking forward, beyond the immediate crisis, Dhruv sees an even greater need. “At some point, whenever this stops, and I hope it stops very soon, the next big question will be, how do we rehabilitate the hundreds of thousands of people who now have to live their entire lives with some disability?” Ukraine will require a wave of innovation and support across prosthetics, orthotics, musculoskeletal rehabilitation, neurological care, and more, and Aether is already at the forefront of anticipating this need.
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