Every Cure: turning old drugs into new hope

Eighteen months ago, we spoke with Dr. David Fajgenbaum about his nonprofit, Every Cure, which was inspired by his own battle with a nearly fatal rare disease. David nearly died five times from idiopathic multicentric Castleman disease (iMCD) before he discovered his own treatment by repurposing an old drug.  

Reusing existing drugs to treat conditions they were not originally designed for is common. For example, Viagra was first used to treat cardiac angina before being repurposed for erectile dysfunction, and now it also serves as a life-saving treatment for a rare pediatric lung disease. This is just one example among many.  

At Every Cure, David and his team are dedicated to saving and enhancing lives through drug repurposing. They use AI to predict the highest potential repurposing opportunities by looking across all 4,000 approved drugs and 18,000 recognized diseases for the 300 million people worldwide suffering from diseases that currently lack treatment. We decided to catch up with David to discuss how this process is accelerating.  

This interview was edited for clarity and concision.

Your work continues to attract significant coverage, including profiles in The New York Times and The New Yorker. You recently gave a TED Talk. You were also named the overall winner of Newsweek’s AI Impact Award and included on the 2025 TIME100 Health list. What have been the most exciting developments for you in the past 18 months? 

The most exciting part is that our AI platform can now quantify the likelihood of each drug treating every disease, and it’s already helping patients. With around 4,000 drugs and 18,000 diseases, we can generate all 75 million prediction scores. It takes about 17 hours to do this for every drug and disease combination – down from roughly 100 days when we started. 

We’ve also used our algorithm’s scores to identify treatments that saved patients’ lives, demonstrating that this powerful platform can be lifesaving. 

And the third point is this amazing team we’ve assembled. We have people with diverse backgrounds united by a clear mission: saving and improving lives by repurposing drugs. 

Can you share a specific success story when a life was saved based on your algorithm's prediction? 

The first drug we recommended based on our algorithm was for someone about to be transferred to hospice care. He was out of options, and this drug ranked highest for his condition. It saved his life, and he has been in remission for two years. We published this case in the New England Journal of Medicine. 

This highlights what’s possible for one patient and disease. But when scaling across all drugs and diseases, we look for the top predicted drug overall – not just the best for a specific disease. This maximizes the impact we can have. As a nonprofit, we can pursue opportunities where drugs are affordable, diseases are rare and no commercial case exists. 

What moments give you the most satisfaction from your work? 

Every time we hear about a patient benefiting from a repurposed drug, whether through our AI platform or other efforts we’ve made, it’s hard to find the words … It’s not just about hearing that someone is alive, but it’s what they’re doing in this “overtime” that means so much to me – knowing they've walked their child down the aisle on their wedding day or started their freshman year of college. These stories mean everything to me. 

The patients we’re able to help motivate us, and the patients we’re not able to help today motivate us to push harder. With every patient helped, we think about the next one. This connection between progress and ongoing need fuels our team and attracts data-sharing partners like Elsevier, philanthropists providing funding and individual doctors and patients offering valuable ideas. It’s truly been a combined effort.  

What's the next big goal? 

We aim to treat 15-25 diseases that currently lack effective treatments by 2030. We organize our work into three main areas. Sometimes, our AI platform helps us identify drugs in early development stages, which we call ‘frontier explorers’. These require additional laboratory work. Other times, we find drugs with preliminary lab data that still need clinical trials; for these ‘clinical gems’, we invest funds to prove their effectiveness. Lastly, we find opportunities where trials have already been conducted, but the drugs are not yet used by all the patients who could benefit. We support these ‘unsung heroes’ by raising awareness and, in some cases, working toward guideline inclusion and FDA approval. It has been very exciting to see ideas turn into real patient impact. 

How do knowledge graphs apply to drug repurposing? 

Knowledge graphs act as a key foundation for our drug repurposing predictions. Think of a biological knowledge graph as a two-dimensional map that includes every drug, disease, gene, protein and medical concept you can imagine. Each concept is stored in one place, with lines connecting related concepts to show their relationships. For example, we know that interleukin-6 is elevated in Castleman disease. So, you have Castleman here, interleukin-6 here, and a line connecting them. 

Imagine doing that across tens of millions of biomedical concepts and relationships. You’ve effectively mapped out the entire world's knowledge of biomedicine, providing perfect training data for algorithms to understand drug-disease relationships and identify new treatment possibilities. 

How do you collaborate with partners like Elsevier and other organizations using AI for drug repurposing? 

Working with Elsevier has been a pleasure. We are big fans of Elsevier's efforts to translate biomedical discoveries into real-world applications. They’ve provided data that we incorporate into our proprietary biomedical knowledge graph, and they also offer valuable expertise in data science and drug repurposing. It’s not just about supplying data but also sharing know-how.  

We are also very fortunate that other labs are doing similar work, and being a nonprofit creates a supportive environment for computer scientists and biomedical researchers to share insights. For instance, Marinka Zitnik at Harvard University has been an incredible thought partner as part of our technical advisory board. 

Drug repurposing attracts people who share core values focused on helping others quickly, since there is no money to be made in repurposing drugs if drugs, doses or formulas remain unchanged. 

What do you see as the biggest challenges? 

Identifying promising opportunities is just the first step. We still need laboratory work, clinical trials and collaboration with regulators, insurance companies and manufacturers. Repurposing a drug costs less than 1% of developing a new one, but it remains challenging and still quite expensive – which is why funding will always be an ongoing challenge. 

The third challenge is the overwhelming sense of urgency that everyone at Every Cure feels to help people. We’re constantly reminded through encounters with patients suffering from terrible diseases. Most team members have taken pay cuts, changed industries or made sacrifices just to be here. Their only purpose is to assist patients. Balancing the desire to help with the reality of our pace is a constant challenge. 

Do you see promising technology that will help accelerate your mission? 

I believe there are multiple ways technology can help speed up our impact. As AI advances toward theoretical superintelligence, we anticipate that predictions and their potential impact to greatly improve. 

Another area for innovation is in how quickly and efficiently we can evaluate options in laboratory and clinical trials. There’s been a push toward more affordable cellular models, organ-on-a-chip models and decentralized clinical trials where patients can participate from anywhere. 

And, unlike a company that develops a platform and risks being replaced, we’re a nonprofit. We want to use every new product and platform that can help patients. We’re constantly seeking better solutions.  

How do you collaborate with the wider rare disease network? 

When we identify a great opportunity to repurpose a drug, we reach out to the relevant disease organizations. We work closely with them to better understand what the patient community is experiencing, ensuring appropriate study designs and clinical trials. 

Read: ‘Turning rare disease research into a common goal’

What we currently lack is a way to work with groups where no repurposed drug has yet been identified for their disease. At Every Cure, we focus on impact-driven drug repurposing – scanning all drugs and diseases to find the greatest opportunities for impact. Most drug repurposing is either disease-driven, targeting a specific disease and searching for drugs for that condition, or drug-driven, focusing on a particular drug and looking for diseases it might treat. We believe our impact-driven approach – allowing impact to guide us in choosing which drugs for which diseases – is the best way to help as many people as possible with our available resources. 

Besides donating money or expertise, how can people help? 

In addition to donating money or volunteering to be an expert, anyone can amplify the information we share online. Tell your aunt who is about to have breast cancer surgery that injecting lidocaine around her tumor before surgery might reduce her risk of recurrence and death. Tell your neighbor who has a child with delayed speech development to get tested for an antibody against the folate receptor – an existing drug, leucovorin, may help those with cerebral folate deficiency with their speech development. In fact, a story we did about this with CBS, resulted in a three-fold increase in leucovorin prescriptions after it was aired. That’s impact! 

We aren't a drug company. We don’t have the resources to go door-to-door or put up billboards. And we don’t make money from increased sales. We rely on incredible people wanting to help others by spreading the word. 

How is your own health? Is your magic cure still proving to be magical? 

Thanks for asking. I just crossed 11 and a half years of being in remission on this medication, and actually, this month, it will be 15 years since I first got sick. I just wrote to one of my doctors about that and how I couldn’t believe it was so long and I’m alive to say it. It's mind-blowing. 

Every day, I feel like I’m going to wake up and find out that my amazing wife, kids and the Every Cure team were all just part of a dream. But for now, whether I’m in a dream or this is reality, I’m just going to keep appreciating every minute I have.

Related articles: 

https://www.elsevier.com/connect/turning-rare-disease-research-into-a-common-goal

 https://www.elsevier.com/connect/elsevier-and-every-cure-treating-rare-diseases-with-generic-drugs-at-scale

 https://www.elsevier.com/connect/repurposing-drugs-for-rare-diseases-cancer-and-beyond

 https://www.elsevier.com/connect/genai-the-double-edged-sword-revolutionizing-drug-discovery