Cures, Not Management

Drug development rewards chronic conditions at scale: therapies patients take indefinitely. That model has produced remarkable medicine for large populations. It has also produced a vocabulary: management, intervention, treatment. Words that describe ongoing relationships, not endpoints.

For conditions affecting a few hundred or a few thousand people, that model was never going to arrive. But many of these conditions have known genetic mechanisms, identifiable molecular targets, and patients generating real-world data every day. What they lack is not scientific possibility. It is infrastructure, incentive, and the willingness to name the goal plainly.

When the mechanism is known and the data is structured, a cure is not a fantasy. It is an engineering problem. Engineering problems get solved when the right people have access to the right data.