The shelved pipeline: AI can find strategically abandoned medicines and bring them to patients.

A lot of capital is pouring into artificial intelligence (AI) that designs new molecules, while a parallel supply of de-risked, clinical-stage drugs is overlooked. Strategic and business decisions, in the absence of scientific failure, account for a substantial and rising share of late-stage terminations. This review distinguishes strategic recovery, advancing clinical-stage assets shelved without scientific failure, from repurposing and rescue. Meanwhile, a historic patent cliff is pressing companies to refill pipelines faster than novel discovery allows. Recovering these drugs is commercially proven, and a large and fast-growing reservoir sits in China, whose registries are poorly indexed against Western ontologies. This review argues that agentic AI applied to multilingual trial corpora makes recovery possible and asks what open, clinically governed infrastructure could bring these medicines to patients.