Request for Proposals: Generic Drug Repurposing

Rationale

Promising treatments for some of the world’s most neglected but high-burden diseases may already exist — sitting on pharmacy shelves around the world, manufactured at scale, and costing a fraction of new medicines. They just haven’t been tested for the right indication yet.

Generic drug repurposing offers a powerful and speedy route to new treatments. These medicines typically have well-characterized safety profiles, are already registered with regulatory authorities, and already flow through local supply chains. They’re usually affordable, because they are long off-patent and produced by multiple manufacturers. The path to patient impact can be dramatically shorter and cheaper than for a novel compound: the drug is made, the toxicology is done, and the regulatory pathway is partially cleared.

Yet precisely because these medicines cannot be patent-protected, the commercial incentive to test them for new uses is absent. We believe there may be several plausible high-impact opportunities — supported by mechanistic evidence, pharmacokinetic data, and early clinical signals — that remain untested simply because no one will pay to investigate them.

Coefficient Giving has supported around a dozen clinical repurposing trials to date, as well as proof-of-concept repurposing trials through Cures Within Reach. Early indications suggest that these trials are a promising strategy, and so we are interested in surfacing later-stage ideas that may fit our funding criteria and scale our impact.

We suspect that there are other neglected ideas for repurposing generic medicines — and we hope this RFP helps to surface them.

Summary

The aim of this RFP is to provide grants for clinical repurposing trials aimed at benefitting patients from low- and lower-middle-income countries (LMICs) as defined by the World Bank.

The available budget for this call is up to $20 million USD, depending on the quality of proposals. We expect to fund multiple proposals under this call, but there is no maximum size for individual proposals. If we receive more high-quality proposals than our budget can support, we will seek co-funding from partners.

What we are looking for

We’re excited to support projects that have the potential for rapid uptake in LMICs, but are bottlenecked by the need for clinical evidence. We’re particularly interested in ideas that could address a high disease burden, as well as projects utilizing locally available medicines for other purposes.

We are interested in proposals for late-stage (i.e. Phase IIc/III) clinical repurposing trials. Supportive evidence could include preclinical data, observational studies, previous clinical trials, and/or clinical observations. We expect that most late-stage trial proposals we fund will already have some clinical evidence of safety and efficacy in humans.

Earlier-stage ideas aiming for “proof of concept” might be a better fit for this Cures Within Reach call.

We are open to a wide range of trial designs, provided they are likely to be acceptable to policymakers, ethical review boards, and regulators. We prefer trials that can be completed within a five-year period.

We encourage researchers to submit letters of interest even if they have substantial work to do on trial design, assembling collaborators, developing a budget, etc. If you already have funding from other sources, we are happy to consider co-funding projects.

Eligibility criteria

• Repurposed therapies must be approved/recognized as safe for human use by a WHO-Listed Authority, e.g. the U.S. FDA or European Medicines Agency.
• Generic drugs, nutraceuticals, supplements, indigenous medicine, combination therapies, and vaccines are eligible.
• May include host-directed therapies.
• Applicants may be based anywhere in the world.
• Therapies must be repurposed, i.e. tested in a new indication for which they are not already approved/widely used in clinical practice.
  • This may include population expansion — e.g. demonstrating a generic medicine is safe and effective to use in pregnant women or children.
  • This may include combination therapies in which one or more components are a generic repurposed medicine.
• Eligible institutions must have a research Institutional Review Board, Ethics Review Committee, or similar in place.
• Applicants must have past or current experience with human clinical research.
• Proposed plans must follow the WHO’s or other regulatory agencies’ standards for Good Laboratory Practice (GLP), Good Clinical Practice (GCP), and Good Laboratory and Clinical Practice (GLCP).

Selection criteria

• Size of addressable disease burden from repurposed therapy (typically measured in disability-adjusted life years), as represented by an improvement over existing treatment options currently accessible in LMICs
• Therapy uptake potential in LMICs
• Quality and experience of the research team
• Relative neglectedness of the approach by other funders — we are particularly interested in proposals unlikely to receive funding from elsewhere
• Quality and depth of evidence supporting the purported use case
• Probability that the clinical trial can be successfully completed

Deadline & how to apply

Applications will remain open until 11:59pm U.S. Pacific Time on Monday, May 11, 2026. Letters of interest must be submitted at the link below, as Word documents not exceeding three pages. 

Click here to apply

They should cover:

• Proposed generic therapy and new indication(s) it would be tested for.
• Rationale for the idea/potential benefit if successful.
• Existing evidence in support of the proposed repurposing (including references).
• Current standard of care in LMICs.
• Proposed team and brief description of relevant clinical trial experience.
• If known, proposed trial design.
• If known, tentative or indicative total budget range (this can be refined at a later stage).
• Whether you have approached other funders about this idea (both ongoing or unsuccessful).

What is the process?

Top-rated letters of interest will be invited to a series of conversations that may result in a request to submit a full proposal.

Letters of interest will be rated by Coefficient Giving staff, though we may employ expert consultants under NDA to help assess proposals. We may also share submissions with other grantmakers who may be interested in your proposal. 

Principal investigators will be contacted approximately 4-6 weeks following the LOI submission. You will be informed whether you are in one of the following categories:

1. Strong Interest from Coefficient Giving. We will begin a series of calls to discuss project scope, budget, and the overall proposal.
2. Reserve list. Pending budget availability, we may move you to the “Strong Interest from Coefficient Giving” stage within 2-3 months. But otherwise, your submission will be considered unsuccessful.
3. Unsuccessful application. We regret that we will not be able to provide feedback at this stage.

If you have any questions about this request for proposals, email us at repurposingrfp@coefficientgiving.org.