High-Impact Health Interventions

Abstract
A Practical Guide: Get 500 Years of Clinical Research in 20, Avoid the Apocalypse, and Make Humanity Filthy Rich by Giving Papers
Keywords

war-on-disease, 1-percent-treaty, medical-research, public-health, peace-dividend, decentralized-trials, dfda, dih, victory-bonds, health-economics, cost-benefit-analysis, clinical-trials, drug-development, regulatory-reform, military-spending, peace-economics, decentralized-governance, wishocracy, blockchain-governance, impact-investing

A dFDAcompetes with smallpox eradication as history’s best health intervention by ROI, cost per quality-adjusted life year, and total impact.

QALY Comparison Chart

Note: The bar represents the mid-point of the uncertainty range, and the error bars indicate the lower and upper bounds of the estimate. For “Smallpox Eradication,” the upper bound is illustrative of its high, open-ended impact.

Comparison Table

Intervention Estimated ROI (Return per $1) Cost per QALY Gained (ICER) QALYs Gained per $1M Notes & Sources
Decentralized drug assessment framework 1.19M:1 (PRIMARY: all core benefits) Dominant (cost-saving) 5,000–90,000+ Systemic, global, leverages all R&D; see Cost-Benefit Analysis
Smallpox Eradication 159:1 to 400:1 Dominant (cost-saving) 10,000+ Smallpox eradication ROI
Childhood Vaccination (US) 10:1 to 16:1 Dominant (cost-saving) 1,000–10,000 Childhood vaccination
Clean Water & Sanitation (LMICs) 4:1 to 21:1 Dominant/very cost-effective 1,000–10,000 Clean water & sanitation
Tobacco Control (taxes, bans) 20:1 to 1,057:1 Dominant/very cost-effective 1,000–10,000 Tobacco control
Hypertension Screening & Treatment Varies / Cost-Saving $500–$1,600 200–2,000 Hypertension screening
Statins for High-Risk Patients Varies / Cost-Saving £280–£8,530 50–200 Statins
Polypill for Primary Prevention (High-Risk) Varies / Cost-Saving up to £18,811 per QALY 50-200 Polypill
Generic Drug Substitution Highly Cost-Saving Dominant (cost-saving) 100–1,000 Generic drugs

Key

  • ROI: Return on investment; dollars saved or value created per $1 spent.
  • Cost per QALY Gained (ICER): Lower is better; “Dominant” means saves money and improves health. Values may be in USD ($) or GBP (£).
  • QALYs Gained per $1M: Rough estimate, varies by context and population.

Conclusion

A decentralized drug assessment framework is projected to have a higher ROI and more QALYs per dollar than almost any other single health intervention, rivaled only by foundational public health measures like smallpox eradication and mass vaccination in low-resource settings. Most other interventions, while highly cost-effective, do not approach the systemic leverage or scale of such a framework.