Malaysia can turn drug repurposing into a public-good engine

Countries, health systems, and patients across the Global South face significant challenges in accessing treatment due to high costs, particularly for cancer and rare diseases. Novel targeted cancer therapies can reach RM15,000–20,000 per dose, and personalised gene therapies for rare conditions may exceed several million ringgit. This puts them far beyond what most patients and healthcare systems can afford.

Drug repurposing – the practice of finding new uses for existing medicines – offers Malaysia a practical pathway to affordable innovation. By building on compounds with established safety profiles, countries can shorten the journey from laboratory evidence to clinical use. This is particularly important for rare diseases and cancers, where traditional drug development is often prohibitively slow and commercially unattractive.

But repurposing is not only a scientific strategy; it is a health-system strategy. When key pharmacological properties are already understood, researchers can focus on demonstrating efficacy in populations with urgent unmet needs. The result is a more efficient model of innovation, one that is especially relevant for middle-income countries seeking to balance cost, access, and quality. Malaysia is well positioned to lead in this space.

Malaysia’s translational platform

Malaysia’s Health Reform White Paper and New Industrial Master Plan 2030 both emphasise the importance of strengthening domestic pharmaceutical capacity, advancing clinical research, and improving access to affordable treatments. Together, these policies create the foundation for a national drug-repurposing ecosystem that links discovery, development, regulation, and delivery.

This vision aligns with the work of the International Affordable Diagnostics and Therapeutics Alliance (IA-DATA), a collaborative initiative aimed at placing Global South countries at the forefront of developing accessible medical solutions. Since 2025, IA-DATA has expanded partnerships across Malaysia, convening stakeholders from government, academia, industry, and civil society to advance both diagnostics and therapeutics.

The case for repurposing anti-malarial Artesunate

For a successful national drug repurposing policy there must be a pipeline that creates a path from scientific discovery to policy implementation. One promising candidate being tested in that pipeline is artesunate, an established anti-malarial now being evaluated in Malaysia for colorectal and pre-cervical cancers. IA-DATA is supporting Phase II trials across multiple government hospitals, alongside translational research into mechanisms of action in several tumour types. Artesunate’s appeal lies in its known safety profile, affordability, and availability. But its real significance is as a proof of concept: repurposing does not eliminate the need for rigorous science and well-designed trials. Rather, it enables these processes to proceed more efficiently.

Industrial capacity matters

For such efforts to translate into real-world impact, industrial capacity is essential. Malaysia’s generic pharmaceutical manufacturers, including local firms such as government linked company Duopharma, can play a pivotal role in scaling up production and ensuring reliable supply.

This also aligns closely with the New Industrial Master Plan 2030, which identifies pharmaceuticals as a key growth segment and points to opportunities in generics, Active Pharmaceutical Ingredients (APIs), biologics, and clinical research as part of a broader push for domestic capability and supply-chain resilience. This is not merely an economic opportunity; it is a matter of health security. Recent geopolitical disruptions have underscored the vulnerability of global supply chains, reinforcing the need for domestic resilience in essential medicines.

Why repurposing fits rare disease

Malaysia recently launched a National Rare Disease Policy, a roadmap to improve diagnosis and access to therapies for patients with rare diseases. Drug repurposing is particularly well suited to rare diseases and cancers, where patient populations are small and conventional large-scale trials are often infeasible. In these settings, innovation depends less on larger datasets than on smarter study designs.

Conventional large randomised trials may not be feasible in rare diseases as patient numbers are usually small. Patients with rare diseases and cancers also often face delayed diagnoses. In this setting, the goal is not simply to find another promising compound, but to build a development pathway that can actually reach patients in time. Repurposing an existing drug can cut down the time needed to find a viable treatment.

Malaysia can position itself as a regional hub for such approaches within Asean. Multicentre recruitment across neighbouring countries would help address the challenge of dispersed and under-diagnosed patient populations, while shared regulatory and research frameworks could reduce duplication and accelerate progress.

Pathways to impact

Malaysia is strengthening links between science, policy, and access for therapeutics. Initiatives such as the Universiti Malaya Affordable Diagnostics and Therapeutics (UMADT) programme under the Higher Education Ministry, in collaboration with the Health Ministry demonstrates how this can be achieved. By integrating basic science, clinical research, regulatory pathways, and implementation strategies, a drug repurposing ecosystem is being built that can ensure that promising findings translate most rapidly into accessible treatments.

International collaboration is also critical. Partnerships with initiatives like drug repurposing accelerator REMEDi4ALL in Europe can help pool expertise, align methodologies, and create shared development pathways. These networks can make repurposing more systematic, credible, and scalable.

The broader lesson is that innovation should be judged not only by novelty, but by public value. Countries bearing a high burden of disease should play a central role in shaping the solutions they need. Drug repurposing offers a pragmatic way to do so, enabling faster, more equitable access to effective therapies.

Malaysia has already demonstrated that locally driven research can dramatically reduce treatment costs, as seen in its work on hepatitis C. The development of antiviral ravidasvir, a joint collaboration between Health Ministries in Malaysia and Thailand, Egypt and Drugs for Neglected Diseases Initiative (DNDi) successfully reduced the cost of a course of treatment from over RM300,000 to less than RM2,000. By building on this momentum, Malaysia can become a regional model for affordable, patient-centred innovation. Repurposing will not replace conventional drug development, but it can make innovation more inclusive – and more aligned with global health priorities.

 

Professor Sanjeev Krishna is Em Professor of Medicine and Molecular Parasitology and a Visiting Professor at Universiti Malaya. He is also the Director for the South-South Diagnostic Alliance, a project under the umbrella of the International Affordable Diagnostics and Therapeutics Alliance.

 

Dr Ivy Chung is a Professor of Pharmacology based at the Faculty of Medicine, Universiti Malaya. She is the lead Principal Investigator for the Universiti Malaya Affordable Diagnostics and Therapeutics program, a project under the umbrella of the International Affordable Diagnostics and Therapeutics Alliance. She has 15 years of experience in higher education teaching, research, and industry engagement.

 

Dr Yolanda Augustin is a Clinical Oncologist at City St George's University of London and a Honorary Visiting Lecturer at Universiti Malaya and Universiti Malaysia Sarawak. She is a lead co-ordinator of the International Affordable Diagnostics and Therapeutics Alliance.