Altai Capital Challenges OraSure Board, Citing 'Chronic Underperformance'

LOS ANGELES, CA – March 17, 2026 – Activist investor Altai Capital Management has escalated its conflict with OraSure Technologies, Inc. (NASDAQ: OSUR), publicly releasing a letter sent to the diagnostics company’s board that outlines a blistering “five-pillar case for change.” Altai, which holds a 5% stake in OraSure, is demanding the appointment of its two director nominees to the board, setting the stage for a contentious proxy battle ahead of the 2026 Annual Meeting of Shareholders.

The letter accuses OraSure’s leadership of overseeing a period of “significant and continued underperformance” marked by strategic missteps, poor corporate governance, and a disconnect between executive pay and shareholder returns. Altai is pushing for a settlement that would place its nominees, Rishi Bajaj and John Bertrand, on the board to oversee a full strategic review, which could include a sale of the entire company.

A Five-Pillar Case for Change

At the heart of Altai’s campaign is a detailed critique of OraSure's performance and governance. The investment firm points to the company's stock, which has dramatically lagged behind peers and broader market indices over both five- and ten-year horizons. According to Altai, shareholders have lost 60% of their investment since 2023 alone, a period characterized by what the firm calls “repeated operational and strategic failures.”

Financial data appears to support the claims of a steep decline. An investment of $10,000 in OraSure ten years ago would be worth just over $4,100 today, representing an average annual loss of 8.46%. The last five years have been particularly brutal, with the stock returning -72.58%, a stark contrast to the S&P 500's gain of over 69% in the same timeframe.

Altai also takes direct aim at the board’s alignment with shareholders, alleging that independent directors collectively own less than 1% of the company's shares while collecting over $250,000 each in annual compensation. “They bear little financial risk for decisions that have destroyed shareholder value,” the letter states. This theme of misaligned incentives extends to the executive suite, with Altai highlighting that over 90% of CEO Carrie Eglinton Manner’s estimated $15 million in tenure compensation is not tied to share price performance.

To address this, Altai has nominated its founder, Rishi Bajaj, and healthcare technology veteran John Bertrand. The firm touts Bajaj’s success in transforming ContextLogic, which saw its share price surge over 120% after a major acquisition, and Bertrand’s experience building the company behind the first FDA-cleared autonomous AI diagnostic. Altai asserts its nominees will seek to align their compensation directly with shareholder returns.

Performance Under the Microscope

OraSure's financial woes are deeply rooted in the collapse of its COVID-19 diagnostics business. The company’s revenue plummeted 54% in 2024 to $185.8 million, down from $405.5 million in 2023. This revenue shock flipped the company from a net income of $53.7 million to a net loss of $19.5 million. The primary culprit was the precipitous drop in sales of its InteliSwab COVID-19 test, which fell from $257.5 million in 2023 to just $45.1 million in 2024 and have since become negligible.

The negative trend has continued, with total net revenues in the third quarter of 2025 falling 32% year-over-year. The company's fourth-quarter 2025 earnings also missed forecasts. With a market capitalization hovering around $216 million, a negative net margin of nearly 60%, and a negative EBITDA of $57.4 million, the company is burning through cash at an alarming rate. This performance stands in sharp contrast to the broader diagnostics industry, which is projected for double-digit growth, fueled by innovation in areas like AI-powered diagnostics and at-home testing—sectors where Altai's nominees claim expertise.

A Company at a Strategic Crossroads

OraSure’s management has not been idle in the face of these challenges. The company issued a response to Altai’s campaign, framing the activist’s intervention as “untimely and disruptive” just as its own transformation strategy is beginning to bear fruit. Since late 2022, OraSure has undertaken significant restructuring, reducing its global workforce by approximately 40%, closing four sites, and consolidating manufacturing operations in Pennsylvania. These moves, the company states, have already yielded a 37% reduction in annual administrative expenses and improved gross margins.

Management is pinning its hopes for a turnaround on a pipeline of new products and a renewed focus on its core business. The company recently filed for FDA 510(k) clearance for a rapid molecular self-test for Chlamydia and Gonorrhea and an at-home urine collection device for sexually transmitted infections. It also recently acquired BioMedomics and Sherlock Biosciences to bolster its molecular diagnostics capabilities. OraSure’s leadership insists these initiatives, combined with the stabilization of its core HIV and genomics franchises, will enable a return to revenue growth in 2026.

To signal confidence in its strategy, the board has authorized a $40 million share repurchase program. However, this defense has not deterred Altai, which argues that a piecemeal turnaround is insufficient and that a full strategic review, including the potential sale of the company, must be on the table to maximize value for long-suffering shareholders.

The escalating conflict now presents OraSure investors with a clear choice. They can either maintain faith in the current board's long-term transformation plan or support Altai Capital’s push for more immediate and radical change. With Altai formally preparing to file a definitive proxy statement with the SEC, the battle for control of OraSure's future will be decided by its shareholders at the upcoming annual meeting.