US biotechs increasingly use sites like Australia to accelerate development, as Create Medicines did by moving from concept to clinic in under 12 months. What was once viewed with suspicion is now a key strategy to generate data faster and more cheaply, competing with the speed of China's ecosystem.

A treaty between the FDA and Brazil's health department allows clinical trials conducted in Brazil to be accepted by the FDA. This provides a pathway for biotech startups to drastically reduce R&D costs and accelerate timelines without compromising the "gold standard" of US regulatory approval.

Rather than aiming directly for high-stakes clinical trials, Effion Health's go-to-market strategy begins with post-market, real-world evidence studies. This approach allows them to demonstrate their technology's value in a real-world setting, building a strong case for adoption in earlier, more critical drug development phases.

Moving first-in-human studies to countries like Australia and China is now a core business strategy, not just a cost-saving measure. It allows U.S. biotechs to navigate a more flexible regulatory environment and accelerate development timelines.

Unlike European or Asian peers, Latin American fintech companies can leverage natural consumer overlaps to expand directly into the lucrative U.S. market. This "funnel up" strategy, driven by shared demographics across borders, presents a distinct growth advantage not available to firms from other regions.

Faced with complex U.S. regulations, Sure's founder went to South Africa. He leveraged its single-regulator system and his personal roots to land his first insurance partner. This validation then served as crucial social proof to sign the same company's U.S. division, de-risking a much larger market entry.

Amidst growing uncertainty at the US FDA, biotech companies are using a specific de-risking strategy: conducting early-stage clinical trials in countries like South Korea and Australia. This global approach is not just about cost but a deliberate move to get fast, reliable early clinical data to offset domestic regulatory instability and gain a strategic advantage.

To avoid premature scaling, Nubank required three conditions before entering a new country: 1) Profitability in its core market (Brazil), 2) Secure banking licenses and funding, and 3) A tech platform that could launch a new market as a "call option," not an "all-in" bet.

Instead of only funding internal innovations, UPMC Enterprises actively sources best-in-class technologies globally and uses its integrated health system to pilot and validate them. This accelerates adoption of cutting-edge solutions and provides a unique value proposition beyond just capital.