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Source Quotes and References

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

1.

School, H. K. 3.5% participation tipping point. Harvard Kennedy School https://www.hks.harvard.edu/centers/carr/publications/35-rule-how-small-minority-can-change-world (2020)

The research found that nonviolent campaigns were twice as likely to succeed as violent ones, and once 3.5% of the population were involved, they were always successful. Chenoweth and Maria Stephan studied the success rates of civil resistance efforts from 1900 to 2006, finding that nonviolent movements attracted, on average, four times as many participants as violent movements and were more likely to succeed. Key finding: Every campaign that mobilized at least 3.5% of the population in sustained protest was successful (in their 1900-2006 dataset) Note: The 3.5% figure is a descriptive statistic from historical analysis, not a guaranteed threshold. One exception (Bahrain 2011-2014 with 6%+ participation) has been identified. The rule applies to regime change, not policy change in democracies. Additional sources: https://www.hks.harvard.edu/centers/carr/publications/35-rule-how-small-minority-can-change-world | https://www.hks.harvard.edu/sites/default/files/2024-05/Erica%20Chenoweth_2020-005.pdf | https://www.bbc.com/future/article/20190513-it-only-takes-35-of-people-to-change-the-world | https://en.wikipedia.org/wiki/3.5%25_rule

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2.

UNICEF. Annual child deaths statistic. (2024)

15,000 are children (based on 5 million annual child deaths)

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3.

CDC. Percentage of preventable deaths. vol. 73 (2024)

80,000 were preventable (53% of deaths are preventable)

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4.

GAO. 95% of diseases have 0 FDA-approved treatments. GAO https://www.gao.gov/products/gao-25-106774 (2025)

95% of diseases have no treatment Additional sources: https://www.gao.gov/products/gao-25-106774 | https://globalgenes.org/rare-disease-facts/

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5.

PMC, S. et al. |. FAERS adverse event underreporting rate. PubMed: Empirical estimation of under-reporting in FAERS https://pubmed.ncbi.nlm.nih.gov/28447485/ (2017)

Empirical estimation: Average reporting rate approximately 6%, meaning  94% of adverse events are underreported Variability: 0.01% to 44% for statin events; 0.002% to >100% for biological drugs; 20% to >100% for narrow therapeutic index (NTI) drugs Selective reporting: Serious, unusual events more likely reported than mild or expected ones Newly marketed drugs: Higher reporting rates due to heightened awareness Older drugs: Events often under-reported Note: FAERS voluntary reporting system captures only "tip of the iceberg" of drug safety problems. Under-reporting introduces inherent biases and limitations in pharmacovigilance data Additional sources: https://pubmed.ncbi.nlm.nih.gov/28447485/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC12393772/

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6.

Congress.gov. Passage of the affordable care act and pelosi quote. Congress.gov https://www.congress.gov/bill/111th-congress/house-bill/3590/text

The Affordable Care Act: 2,700 pages, "we have to pass it to see what’s in it. Additional sources: https://www.congress.gov/bill/111th-congress/house-bill/3590/text | https://www.snopes.com/fact-check/pelosi-healthcare-pass-the-bill-to-see-what-is-in-it/

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7.

PMC. Aging reversal demonstrated in mammals using yamanaka factors. PMC: Chemically Induced Reprogramming to Reverse Aging https://pmc.ncbi.nlm.nih.gov/articles/PMC10373966/ (2023)

Harvard/Sinclair: Loss of epigenetic information causes aging; restoring epigenome integrity reverses aging signs in mice OSK therapy (Oct4, Sox2, Klf4): Ectopic induction can restore youthful DNA methylation patterns, transcript profiles, and tissue function without erasing cellular identity Results in mice: Systemically delivered adeno-associated viruses encoding inducible OSK in 124-week-old mice extended median remaining lifespan by 109% over wild-type controls Vision restored in glaucoma mice - first successful reversal (not just halting progression) Cyclic partial reprogramming (2 days on, 5 days off) showed improvements after just 6 weeks including reduced age-related spinal curvature Human cells: Babraham Institute showed cellular reprogramming reverses epigenetic age of human skin cells by 30 years Chemical alternatives: Six chemical cocktails identified that restore youthful genome-wide transcript profile in less than a week without compromising cellular identity Note: Demonstrates biological aging is reversible, not inevitable; safety testing ongoing before human application Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC10373966/ | https://www.nature.com/articles/s41467-024-46020-5 | https://www.liebertpub.com/doi/10.1089/cell.2023.0072 | https://clinicalepigeneticsjournal.biomedcentral.com/articles/10.1186/s13148-021-01158-7

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8.

Association, A. Annual deaths from alzheimer’s and other dementias. Alzheimer’s Association https://www.alz.org/alzheimers-dementia/facts-figures (2024)

Alzheimer’s | 2.6M deaths/year Additional sources: https://www.alz.org/alzheimers-dementia/facts-figures | https://www.cdc.gov/nchs/fastats/alzheimers.htm

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9.

Antimicrobial Resistance, R. on. Antimicrobial resistance deaths projection. Review on Antimicrobial Resistance https://amr-review.org/sites/default/files/160525_Final\%20paper_with\%20cover.pdf (2016).

10.

Data, O. W. in. Animal diseases eradicated by veterinary science. Our World in Data: Rinderpest Eradication https://ourworldindata.org/how-rinderpest-was-eradicated

Rinderpest eradicated in 2011 - only second disease ever eradicated after smallpox Declared globally eradicated by UN FAO and World Organisation for Animal Health Greatest veterinary achievement of our time" - devastating livestock disease for centuries Note: Caused up to 90% mortality in affected herds. Eradication achieved through coordinated international vaccination campaign launched in 1994 Additional sources: https://ourworldindata.org/how-rinderpest-was-eradicated | https://www.woah.org/en/disease/rinderpest/

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11.

NIH. Antidepressant clinical trial exclusion rates. Zimmerman et al. https://pubmed.ncbi.nlm.nih.gov/26276679/ (2015)

Mean exclusion rate: 86.1% across 158 antidepressant efficacy trials (range: 44.4% to 99.8%) More than 82% of real-world depression patients would be ineligible for antidepressant registration trials Exclusion rates increased over time: 91.4% (2010-2014) vs. 83.8% (1995-2009) Most common exclusions: comorbid psychiatric disorders, age restrictions, insufficient depression severity, medical conditions Emergency psychiatry patients: only 3.3% eligible (96.7% excluded) when applying 9 common exclusion criteria Only a minority of depressed patients seen in clinical practice are likely to be eligible for most AETs Note: Generalizability of antidepressant trials has decreased over time, with increasingly stringent exclusion criteria eliminating patients who would actually use the drugs in clinical practice Additional sources: https://pubmed.ncbi.nlm.nih.gov/26276679/ | https://pubmed.ncbi.nlm.nih.gov/26164052/ | https://www.wolterskluwer.com/en/news/antidepressant-trials-exclude-most-real-world-patients-with-depression

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12.

Legal, U. Arms trade treaty (2013) - campaign and adoption. UN Legal https://legal.un.org/avl/ha/att/att.html

The Arms Trade Treaty (ATT) regulates international trade in conventional arms. Adopted by UN General Assembly April 2, 2013. Campaign duration: 10 years (2003-2013) by Control Arms coalition Started with only 3 governments supporting (Mali, Costa Rica, Cambodia); achieved 130 signatories Coalition published 50+ reports over the campaign period One of the fastest multilateral treaties to enter into force after opening for signature Additional sources: https://legal.un.org/avl/ha/att/att.html | https://controlarms.org/att/ | https://www.oxfamamerica.org/about-us/measuring-impact/global-arms-trade-treaty/the-international-arms-trade-treaty/ | https://www.armscontrol.org/factsheets/arms_trade_treaty

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13.

FDAReview.org. Estimated deaths due to FDA delay in approving beta blockers. FDAReview.org: FDA Harm https://www.fdareview.org/issues/theory-evidence-and-examples-of-fda-harm/ (2011)

Beta blockers approved in Europe mid-1970s, FDA didn’t approve until 1981 FDA estimated the drug could save 17,000 lives/year after approval Estimated 100,000 deaths from secondary heart attacks during 6-7 year delay Note: FDA imposed moratorium due to possible animal carcinogenicity despite human clinical evidence from 1974 Additional sources: https://www.fdareview.org/issues/theory-evidence-and-examples-of-fda-harm/ | https://www.ocregister.com/2011/02/09/walter-williams-death-by-fda-delay-denials/

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14.

Wikipedia. Examples of biological immortality and extreme longevity in nature. Wikipedia: Biological Immortality https://en.wikipedia.org/wiki/Biological_immortality

Hydra: Biologically immortal - no mortality increase over 4-year study, kept alive 12+ years Planarian worms: Somatically immortal with limitless telomere regeneration, clonal lines >15 years Axolotls: Regrow limbs, brain parts, heart tissue through remarkable regeneration Naked mole rats: Live 37+ years (10x similar rodents), cancer-proof, no age-related mortality increase Bowhead whales: Live 200+ years, unique DNA repair mutations, extra cancer-suppression genes Note: These animals demonstrate enhanced DNA repair, abundant stem cells, telomerase activity, and cancer resistance Additional sources: https://en.wikipedia.org/wiki/Biological_immortality | https://pmc.ncbi.nlm.nih.gov/articles/PMC5807068/

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15.

Labor Statistics, U. S. B. of. CPI inflation calculator. (2024)

CPI-U (1980): 82.4 CPI-U (2024): 313.5 Inflation multiplier (1980-2024): 3.80× Cumulative inflation: 280.48% Average annual inflation rate: 3.08% Note: Official U.S. government inflation data using Consumer Price Index for All Urban Consumers (CPI-U). Additional sources: https://www.bls.gov/data/inflation_calculator.htm

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16.

arXiv. Bradley-terry and PageRank models for ranking. arXiv: PageRank and Bradley-Terry Model https://arxiv.org/abs/2402.07811

Bradley-Terry: Probability model for pairwise comparisons (1952, earlier by Zermelo 1920s); maximum likelihood estimation PageRank: Ranks nodes by importance in network via stationary distribution of Markov chain Connection: Under quasi-symmetry, Bradley-Terry scores are equivalent to scaled PageRank; ML estimates can be approximated from limiting distribution Applications: Sports rankings, journal citations, AI model rankings, consumer choice, search engines Additional sources: https://arxiv.org/abs/2402.07811 | https://en.wikipedia.org/wiki/Bradley–Terry_model | https://www.sciencedirect.com/science/article/pii/S0950705122000314

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17.

Review, M. T. Brian armstrong’s investments in health tech. MIT Tech Review: Armstrong CRISPR Investment https://www.technologyreview.com/2025/06/05/1117909/crypto-billionaire-brian-armstrong-is-ready-to-invest-in-crispr-baby-tech/ (2025)

ResearchHub (2020): Scientific research platform, raised $5M Series A (2023), uses crypto to incentivize research NewLimit (2022): Longevity/aging company using epigenetic reprogramming, raised $130M Funding CRISPR baby tech: First major commercial investment in gene-editing human embryos Note: Coinbase CEO using crypto wealth to fund radical health/longevity ventures. Co-founder Blake Byers advocates significant GDP spending on "immortality" research Additional sources: https://www.technologyreview.com/2025/06/05/1117909/crypto-billionaire-brian-armstrong-is-ready-to-invest-in-crispr-baby-tech/ | https://finance.yahoo.com/news/coinbase-ceo-brian-armstrong-researchhub-150712331.html

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18.

BrightID. BrightID social identity verification network. BrightID https://www.brightid.org/ (2020)

Privacy-first decentralized social identity network for proving unique personhood Sybil-resistant through social graph analysis using modified SybilRank algorithm (GroupSybilRank) Users build connections ("know well", "just met", "suspicious") - matching responses verify authenticity No personally identifying information recorded; pseudonymous across platforms Note: Compatible with 18 apps including Gitcoin, clr.fund, Snapshot. Early stage with challenges in decentralization and scalability Additional sources: https://www.brightid.org/ | https://www.frontiersin.org/journals/blockchain/articles/10.3389/fbloc.2020.590171/full

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19.

Lancet, T. Annual deaths from cancer (10 million). The Lancet: Global Cancer Deaths 2023 https://www.hematologyadvisor.com/news/globally-18-5-million-incident-cancer-cases-and-10-4-million-deaths-reported-in-2023/ (2023)

Cancer deaths: 10.4 million globally in 2023 (9.7 million in 2022) 18.5 million new cancer cases in 2023 65.8% of deaths occur in low- to upper-middle-income countries Note: Cancer is the second leading cause of death globally after cardiovascular diseases. Projected to reach 18.6 million deaths by 2050 (74.5% increase) Additional sources: https://www.hematologyadvisor.com/news/globally-18-5-million-incident-cancer-cases-and-10-4-million-deaths-reported-in-2023/ | https://www.who.int/news/item/01-02-2024-global-cancer-burden-growing–amidst-mounting-need-for-services

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20.

General, C. A. California consumer privacy act (CCPA) and california privacy rights act (CPRA). CA Attorney General: CCPA https://oag.ca.gov/privacy/ccpa

CCPA effective January 1, 2020; CPRA (Prop 24) approved November 2020, effective January 1, 2023 Consumer rights: Know/access personal data; Delete data; Opt-out of sale/sharing; Non-discrimination; Correct inaccurate data (CPRA); Limit sensitive data use (CPRA) Enforcement: California Privacy Protection Agency (CPRA created); Previously CA Attorney General Penalties: Up to $7,500 per intentional violation; $2,500 per unintentional violation Additional sources: https://oag.ca.gov/privacy/ccpa | https://cppa.ca.gov/regulations/ | https://pro.bloomberglaw.com/insights/privacy/california-consumer-privacy-laws/

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21.

NPR. Contamination of early CDC COVID-19 tests in 2020. NPR: CDC Test Flawed https://www.npr.org/2020/11/06/929078678/cdc-report-officials-knew-coronavirus-test-was-flawed-but-released-it-anyway (2020)

CDC distributed flawed test kits Feb 6, 2020 - contaminated reagents caused false positives 24 of 26 public health labs found contamination, CDC recalled kits by Feb 10 Tests made in CDC lab (not manufacturing facility), violated sound manufacturing practices Contamination occurred in Respiratory Virus Diagnostic Lab during processing Note: Delays had significant consequences for early pandemic tracking and response Additional sources: https://www.npr.org/2020/11/06/929078678/cdc-report-officials-knew-coronavirus-test-was-flawed-but-released-it-anyway | https://www.cnn.com/2020/04/18/politics/cdc-coronavirus-testing-contamination/index.html

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22.

American, S. Cellular turnover and repair rates in the human body. HowStuffWorks: Body Replace Every 7 Years https://www.scientificamerican.com/article/our-bodies-replace-billions-of-cells-every-day/

330 billion cells replaced daily ( 1% of all cells, 3.8 million/second) 80 grams of cellular mass turnover per day, dominated by blood cells (86%) and gut epithelial cells (12%) Complete body cell replacement in 80-100 days (average cell age: 7 years) Note: Despite constant regeneration, we age due to DNA mutations that accumulate as cells replicate Produce 2 million red blood cells per second Generate new stomach lining every 3-5 days Replace your entire skin every 28 days (surface cells every 2-4 weeks) Rebuild your skeleton every 10 years Additional sources: https://www.scientificamerican.com/article/our-bodies-replace-billions-of-cells-every-day/ | https://wis-wander.weizmann.ac.il/life-sciences/cell-replacement-numbers | https://science.howstuffworks.com/life/cellular-microscopic/does-body-really-replace-seven-years.htm | https://www.livescience.com/33179-does-human-body-replace-cells-seven-years.html | https://www.sanitas.com/en/magazine/body/about-body/how-our-body-regenerates.html

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23.

FDA. FDA regulations for charging for investigational drugs (21 CFR 312.8). 21 CFR 312.8 https://www.ecfr.gov/current/title-21/chapter-I/subchapter-D/part-312/subpart-A/section-312.8

Sponsors may charge for investigational drugs under expanded access with prior FDA authorization Can recover direct costs (manufacturing, shipping) + monitoring/admin costs for treatment INDs Must not interfere with drug development for marketing approval Authorization valid for 1 year; requires independent CPA review of cost calculations Note: Allows cost recovery but not profit; ensures patients can access investigational drugs while development continues Additional sources: https://www.ecfr.gov/current/title-21/chapter-I/subchapter-D/part-312/subpart-A/section-312.8 | https://www.fda.gov/media/176308/download

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24.

Post, W. Chan zuckerberg initiative funding/pledge. Washington Post: Zuckerberg $45B Pledge https://www.washingtonpost.com/news/the-switch/wp/2015/12/01/mark-zuckerberg-will-give-away-99-percent-of-his-facebook-stock/ (2015)

Zuckerberg & Chan pledged 99% of Facebook stock worth  $45 billion (2015) Structured as LLC (not traditional foundation) to enable investments, policy advocacy Started with $1 billion/year in Facebook stock for first 3 years Focus: personalized learning, curing disease, connecting people, building communities Note: One of largest-ever philanthropic commitments, announced with birth of daughter Max in Dec 2015 Additional sources: https://www.washingtonpost.com/news/the-switch/wp/2015/12/01/mark-zuckerberg-will-give-away-99-percent-of-his-facebook-stock/ | https://www.philanthropy.com/article/zuckerberg-and-chan-pledge-nearly-45-billion-to-improving-this-world/

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25.

Institute, C. Chance of dying from terrorism statistic. Cato Institute: Terrorism and Immigration Risk Analysis https://www.cato.org/policy-analysis/terrorism-immigration-risk-analysis

Chance of American dying in foreign-born terrorist attack: 1 in 3.6 million per year (1975-2015) Including 9/11 deaths; annual murder rate is 253x higher than terrorism death rate More likely to die from lightning strike than foreign terrorism Note: Comprehensive 41-year study shows terrorism risk is extremely low compared to everyday dangers Additional sources: https://www.cato.org/policy-analysis/terrorism-immigration-risk-analysis | https://www.nbcnews.com/news/us-news/you-re-more-likely-die-choking-be-killed-foreign-terrorists-n715141

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26.

Reymond, J. L. Total drug-like chemical space (10^23 - 10^60). Reymond https://pubs.acs.org/doi/10.1021/ar500432k (2015)

Estimated 10^23 to 10^60 drug-like molecules exist in chemical space, dwarfing the number of compounds ever synthesized. Additional sources: https://pubs.acs.org/doi/10.1021/ar500432k

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27.

CDC. Childhood vaccination (US) ROI. CDC https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a4.htm (2017).

28.

Wikipedia. Cost of china’s military parades. Wikipedia: 2015 China Victory Day Parade https://en.wikipedia.org/wiki/2015_China_Victory_Day_Parade (2015)

2015 Victory Day (70th anniversary): 12,000 PLA troops, 1,000 foreign troops, 850,000 "Citizen Guards 2025 parade estimated >36 billion yuan ($5 billion,  1.5% of military budget) - Taiwan estimate Beijing rarely discloses parade costs; estimates cannot be independently verified Note: Massive mobilization for propaganda purposes; costs remain state secret Additional sources: https://en.wikipedia.org/wiki/2015_China_Victory_Day_Parade | https://www.nbcnews.com/world/asia/live-blog/china-parade-putin-kim-jong-un-xi-military-live-updates-rcna228503

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29.

Parliament, U. Winston churchill quote on democracy. UK Parliament https://api.parliament.uk/historic-hansard/commons/1947/nov/11/parliament-bill (1947)

Democracy is the worst form of government, except for all the others. Additional sources: https://api.parliament.uk/historic-hansard/commons/1947/nov/11/parliament-bill | https://winstonchurchill.org/resources/quotes/the-worst-form-of-government/

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30.

United States, S. C. of the. Impact of citizens united supreme court decision on campaign finance. Citizens United v. FEC https://supreme.justia.com/cases/federal/us/558/310/

Citizens United v. FEC (2010): 5-4 Supreme Court decision allowing unlimited corporate/union political spending Overruled restrictions on independent expenditures, citing First Amendment Led to creation of super PACs and massive increases in dark money Dramatically expanded influence of wealthy donors, corporations, special interest groups Note: Overwhelming majorities of Americans disapprove; 22+ states voted to support constitutional amendment to overturn Additional sources: https://supreme.justia.com/cases/federal/us/558/310/ | https://www.brennancenter.org/our-work/research-reports/citizens-united-explained

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31.

Annenberg. Survey of american civic literacy (congress’s function). Annenberg: Americans’ Civic Knowledge https://www.annenbergpublicpolicycenter.org/americans-know-surprisingly-little-about-their-government-survey-finds/

64% can’t name or describe three branches of government Only 25% can name all three branches (down from 38% in 2011) 27% know 2/3 vote needed to override veto 70%+ fail basic civic literacy quiz Note: Elected officials score worse (44%) than general public (49%). 54% of elected officials don’t know Congress has power to declare war Additional sources: https://www.annenbergpublicpolicycenter.org/americans-know-surprisingly-little-about-their-government-survey-finds/ | https://www.uschamberfoundation.org/civics/new-study-finds-alarming-lack-of-civic-literacy-among-americans

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32.

News, U. Clean water & sanitation (LMICs) ROI. UN News https://news.un.org/en/story/2014/11/484032 (2014).

33.

Medicine, J. I. Cost breakdown of traditional clinical trials. JAMA Internal Medicine: Clinical Trial Costs Study https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2702287

Median clinical trial cost: $19.0 million (range: $12.2M - $33.1M) Cost per patient varies by phase: Phase 1:  $137K, Phase 2:  $130K, Phase 3:  $113K Note: Based on analysis of 138 clinical trials. Actual costs can vary significantly based on disease area, trial complexity, and patient population Additional sources: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2702287

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34.

Arena, C. T. Clinical trial enrollment timelines. Clinical Trials Arena https://www.clinicaltrialsarena.com/marketdata/featureclinical-trial-patient-recruitment/.

35.

Fortune Business Insights, M. Global clinical trials market size. Fortune Business Insights https://www.fortunebusinessinsights.com/clinical-trials-market-106930 (2024)

Global clinical trials market valued at USD 60.94 billion in 2024, projected to grow from USD 64.94 billion in 2025 to USD 104.41 billion by 2032. Alternative estimate: USD 59 billion in 2024, growing to USD 98.9 billion by 2034. Additional sources: https://www.fortunebusinessinsights.com/clinical-trials-market-106930 | https://www.gminsights.com/industry-analysis/clinical-trials-market

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36.

CAN, A. Clinical trial patient participation rate. ACS CAN: Barriers to Clinical Trial Enrollment https://www.fightcancer.org/policy-resources/barriers-patient-enrollment-therapeutic-clinical-trials-cancer

Only 3-5% of adult cancer patients in US receive treatment within clinical trials About 5% of American adults have ever participated in any clinical trial Oncology: 2-3% of all oncology patients participate Contrast: 50-60% enrollment for pediatric cancer trials (<15 years old) Note:  20% of cancer trials fail due to insufficient enrollment; 11% of research sites enroll zero patients Additional sources: https://www.fightcancer.org/policy-resources/barriers-patient-enrollment-therapeutic-clinical-trials-cancer | https://hints.cancer.gov/docs/Briefs/HINTS_Brief_48.pdf

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37.

via, D. analysis. ClinicalTrials.gov cumulative enrollment data (2025). Direct analysis via ClinicalTrials.gov API v2 https://clinicaltrials.gov/data-api/api

Analysis of 100,000 active/recruiting/completed trials on ClinicalTrials.gov (November 2025) shows cumulative enrollment of 12.2 million participants: Phase 1 (722k), Phase 2 (2.2M), Phase 3 (6.5M), Phase 4 (2.7M). Median participants per trial: Phase 1 (33), Phase 2 (60), Phase 3 (237), Phase 4 (90). Additional sources: https://clinicaltrials.gov/data-api/api

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38.

Cluster Munitions, C. on. Convention on cluster munitions (2008) - oslo process. Convention on Cluster Munitions https://www.clusterconvention.org/oslo-process/

The Convention on Cluster Munitions bans the use, production, stockpiling, and transfer of cluster munitions. Oslo Process timeline: February 2007 to December 2008 ( 2 years) 46 states signed Oslo Declaration (Feb 2007); 94 states signed convention (Dec 2008) Core Group: Norway, Austria, Ireland, Mexico, New Zealand, Peru, Holy See Results: 29 States Parties destroyed nearly 1.4 million stockpiled cluster munitions containing 172.9 million submunitions Additional sources: https://www.clusterconvention.org/oslo-process/ | https://unidir.org/files/publication/pdfs/unacceptable-harm-a-history-of-how-the-treaty-to-ban-cluster-munitions-was-won-en-258.pdf | https://www.stopclustermunitions.org/en-gb/the-treaty/global-ban.aspx

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39.

Miller, G. A. Cognitive limit in short-term memory (miller’s law). George A. Miller https://doi.org/10.1037/h0043158 (1956)

Short-term memory capacity: 7 ± 2 items (Miller’s Law) The "magical number seven" - humans can hold approximately 7 chunks of information in working memory Note: This classic psychology paper has been cited over 40,000 times and fundamentally shaped our understanding of human cognitive limitations Additional sources: https://doi.org/10.1037/h0043158

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40.

Minutes, C. 60. Percentage of time members of congress spend fundraising. CBS 60 Minutes: Congressional Telemarketers https://www.cbsnews.com/news/60-minutes-are-members-of-congress-becoming-telemarketers/

Recommended: 4 hours "call time" + 1 hour "strategic outreach" = 5 hours/day out of 9-10 hour workday New members told to spend 30 hours/week on fundraising calls since Citizens United Tom Daschle:  67% of schedule is money-gathering in 2 years before election Only 3-4 hours/day for actual Congressional work (hearings, votes, constituents) Note: By law, members cannot fundraise from offices; parties set up call centers near Capitol Additional sources: https://www.cbsnews.com/news/60-minutes-are-members-of-congress-becoming-telemarketers/ | https://www.huffpost.com/entry/call-time-congressional-fundraising_n_2427291

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41.

Military.com. Congress adding funds to military budget not requested by the pentagon. Military.com: $15B Unrequested Weapons https://www.military.com/daily-news/2025/04/03/capitol-hill-wants-15-billion-weapons-pentagon-didnt-seek-report.html (2025)

FY2025: $15 billion unrequested for hundreds of military programs FY2023: $61.4 billion for all categories of military spending (not requested) FY2022: $58 billion worth of military projects (not requested) Past 4 years: >$100 billion for 2,000+ weapons programs (no public debate) Note: Bipartisan phenomenon; most additions <$30M but add up substantially Additional sources: https://www.military.com/daily-news/2025/04/03/capitol-hill-wants-15-billion-weapons-pentagon-didnt-seek-report.html | https://rollcall.com/2025/09/16/hill-added-100-billion-plus-since-2022-on-unrequested-weapons/

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42.

One, I. Congressional committee assignments have explicit fundraising price tags. Issue One: The Price of Power https://www.issueone.org/wp-content/uploads/2017/05/price-of-power-final.pdf (2017)

DCCC (Democratic): Speaker $31 million, "A" Committee Chairs $1.8 million, Regular members $150,000 minimum NRCC (Republican): Speaker $20 million, Power Committee Chairs $1.2 million, Transportation Chair $875,000 Members display "giant tally sheet" showing who has/hasn’t paid their party dues Members who don’t pay dues get bills killed, amendments ignored, worse offices Rep. Brett Guthrie: Paid $2.5 million (53% of campaign funds) for Energy & Commerce Chair Rep. Rosa DeLauro: Paid $690,000 (39% of campaign funds) for Appropriations Note: System criticized as "recipe for corruption" disconnecting members from constituents Additional sources: https://www.issueone.org/wp-content/uploads/2017/05/price-of-power-final.pdf | https://theintercept.com/2019/09/03/dccc-house-committees-dues/ | https://www.brookings.edu/articles/problems-with-the-committee-tax-in-congress/ | https://rollcall.com/2023/02/09/gavels-for-top-house-committees-dont-always-come-cheap/

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43.

Senate, U. S. Salary of a u.s. congressman. U.S. Senate: Salaries https://www.senate.gov/senators/SenateSalariesSince1789.htm

Members of Congress: $174,000/year (2009-present) Speaker of the House: $223,500/year Majority/Minority Leaders: $193,400/year Note: Congressional salary has been frozen at $174,000 since 2009, unchanged for over 15 years Additional sources: https://www.senate.gov/senators/SenateSalariesSince1789.htm | https://crsreports.congress.gov

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44.

ScienceDaily. Conscious mind controls  5% of decisions. ScienceDaily: Unconscious Decision Making https://www.sciencedaily.com/releases/2008/04/080414145705.htm (2008)

Conscious of only  5% of cognitive activity; 95% is unconscious/subconscious Brain signals predict decisions up to 7 seconds before conscious awareness 90% of buying decisions made subconsciously Most of what we do every minute is unconscious" - neuroscientist Paul Whelan Note: All decisions made unconsciously first, then we "fool ourselves" into believing we consciously made them Additional sources: https://www.sciencedaily.com/releases/2008/04/080414145705.htm | https://pmc.ncbi.nlm.nih.gov/articles/PMC2440575/

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45.

Wikipedia. Control arms coalition - arms trade treaty campaign. Wikipedia https://en.wikipedia.org/wiki/Control_Arms_Campaign

Coalition of 100+ organizations including Amnesty International, Oxfam, and International Action Network on Small Arms (IANSA) Campaign duration: 10 years (October 2003 - April 2013) Published 50+ reports over the campaign period on various aspects of arms trade regulation Campaign tactics: Publicity stunts, mass public actions, Million Faces petition, worldwide consultations, lobbying Achievement: Arms Trade Treaty adopted by UN General Assembly April 2013, entered into force December 2014 Additional sources: https://en.wikipedia.org/wiki/Control_Arms_Campaign | https://frompoverty.oxfam.org.uk/how-did-a-global-campaign-bring-about-a-un-arms-trade-treaty/ | https://policy-practice.oxfam.org/resources/power-and-change-the-arms-trade-treaty-338471/

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46.

FTC. Children’s online privacy protection act (COPPA). FTC: COPPA Rule https://www.ftc.gov/legal-library/browse/rules/childrens-online-privacy-protection-rule-coppa

Federal law effective April 21, 2000; applies to websites/services collecting data from children under 13 Requirements: Privacy policy; Verifiable parental consent before collecting data; Data security; Parental review/deletion rights Applies to: For-profit businesses collecting personal info from US children under 13 Penalties: Up to $50,120 per violation Enforcement: FTC and State Attorneys General Additional sources: https://www.ftc.gov/legal-library/browse/rules/childrens-online-privacy-protection-rule-coppa | https://en.wikipedia.org/wiki/Children’s_Online_Privacy_Protection_Act | https://www.ecfr.gov/current/title-16/chapter-I/subchapter-C/part-312

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47.

Statista. Corporate lobbying spending in 2023. Statista: Total Lobbying Spending 2023 https://www.statista.com/statistics/257337/total-lobbying-spending-in-the-us/ (2023).

48.

ScienceDirect. How campaign contributions influence politicians. ScienceDirect: Campaign Contributions & Legislative Behavior https://www.sciencedirect.com/science/article/pii/S0047272725000179 (2010)

Research: Only 1 in 4 studies support notion that contributions directly "buy votes Influence mechanism: Access, agenda-setting, keeping bills off floor, earmarks, key language in legislation (not direct votes) Average winner costs (2022): House $2.79M, Senate $26.53M; Competitive races much higher Internal party fundraising requirements: $100K-$30M annually; Committee positions cost $450K 95% of House races since 2004 won by highest spender Contribution limits: $3,300 per candidate per election (individuals); PACs gave $289.3M total (2021-2022) Additional sources: https://www.sciencedirect.com/science/article/pii/S0047272725000179 | https://slate.com/news-and-politics/2010/10/how-much-does-it-cost-to-buy-a-vote.html | https://www.opensecrets.org/elections-overview/cost-of-election | https://issueone.org/articles/the-118th-congress-fundraising-treadmill/

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49.

Statista. Comparison of u.s. Deaths from COVID-19 vs. Major wars. Statista: COVID vs War Deaths https://www.statista.com/chart/24252/us-covid-19-deaths-compared-to-deaths-in-major-wars/

COVID-19 US deaths: 1.2+ million total (as of 2024) WWII: 405,000 | Korea: 36,000 | Vietnam: 58,000 = 499,000 combined By March 2021: COVID deaths (527,726) exceeded WWI, WWII, Vietnam, 9/11 combined By Oct 2021: 704,233 deaths exceeded ALL US foreign conflict deaths ( 685,000 total) Note: COVID killed more Americans than Revolutionary War, War of 1812, WWI, WWII, Korea, Vietnam, and other conflicts combined Additional sources: https://www.statista.com/chart/24252/us-covid-19-deaths-compared-to-deaths-in-major-wars/ | https://www.snopes.com/fact-check/americans-covid-foreign-conflicts/

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50.

al., R. et. Decentralized clinical trials (DCT) cost reduction evidence. Rogers et al. https://discovery.dundee.ac.uk/ws/files/72718478/Brit_J_Clinical_Pharma_2022_Rogers_A_systematic_review_of_methods_used_to_conduct_decentralised_clinical_trials.pdf (2022)

DCTs are developing rapidly. However, there is insufficient evidence to confirm which methods are most effective in trial recruitment, retention, or overall cost." Despite this, DCTs have demonstrated potential for significant cost reductions (20-50.0% or more) through reduced site management, travel, and streamlined data collection. DCTs are considered cost-saving by reducing the number of onsite patient visits and decreasing the costs related to time for study nurses and clinicians. Additional sources: https://discovery.dundee.ac.uk/ws/files/72718478/Brit_J_Clinical_Pharma_2022_Rogers_A_systematic_review_of_methods_used_to_conduct_decentralised_clinical_trials.pdf | https://www.nature.com/articles/s41746-024-01214-5

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51.

HIT Consultant, O. Medable DCT platform funding. HIT Consultant https://hitconsultant.net/2021/10/26/medable-dct-series-d-funding/ (2021)

Medable, a leader in the DCT platform space, has raised a total of $521 million in capital, achieving a valuation of $2.1 billion as of late 2021. This funding level shows what it costs to build a global SaaS platform operating across 60+ countries and capture significant market share. Additional sources: https://hitconsultant.net/2021/10/26/medable-dct-series-d-funding/ | https://informaconnect.com/decentralized-trial-tech-firm-medable-raises-another-300m/

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52.

MobiHealthNews, A. Other DCT platform company funding. MobiHealthNews https://www.mobihealthnews.com/news/exo-raises-40m-handheld-ultrasound-decentralized-trial-platforms-raise-nearly-100m-and-more (2020)

Science 37:  $40M raised Thread: up to $50M raised uMotif:  $25.5M raised These companies show that you can achieve significant traction and platform development with investments in the tens of millions. Additional sources: https://www.mobihealthnews.com/news/exo-raises-40m-handheld-ultrasound-decentralized-trial-platforms-raise-nearly-100m-and-more | https://www.pharmasalmanac.com/articles/umotif-the-patient-first-data-capture-and-decentralized-clinical-trials-platform-announces-25.5m-of-new-investment-from-a-fund-managed-by-athyrium-capital-management

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53.

IHME. Death causes vs fear (heart disease vs terrorism). IHME: CVD Deaths 2023 https://www.healthdata.org/news-events/newsroom/news-releases/report-cardiovascular-diseases-caused-1-3-global-deaths-2023 (2023)

Cardiovascular disease: 19.2-20.5 million deaths annually (2023 data) Terrorism: approximately 25,000 deaths per year CVD accounts for 1 in 3 global deaths - the leading cause for over 30 years Note: CVD deaths increased 60% from 12.1M (1990) to 20.5M (2021). 4 in 5 CVD deaths occur in low- and middle-income countries Additional sources: https://www.healthdata.org/news-events/newsroom/news-releases/report-cardiovascular-diseases-caused-1-3-global-deaths-2023 | https://world-heart-federation.org/wp-content/uploads/World-Heart-Report-2023.pdf

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54.

Corporations, D. D. of. Delaware has more corporate entities than residents. Delaware Division of Corporations: 2020 Annual Report https://corp.delaware.gov/stats/2020-annual-report/ (2020)

Delaware population: <1 million residents Business entities: 1.6 million+ (2020) - 2:1 ratio over residents 2019: 1.5 million entities vs <1M people 66% of Fortune 500 incorporated in Delaware 93% of US IPOs are Delaware entities Note: 249,427 new business entities added in 2020 alone. Unique 2:1 corporation-to-resident ratio Additional sources: https://corp.delaware.gov/stats/2020-annual-report/ | https://press.princeton.edu/ideas/hal-weitzman-on-whats-the-matter-with-delaware

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55.

Federation, I. D. Annual deaths from diabetes. International Diabetes Federation https://diabetesatlas.org/ (2024)

Diabetes | 2M deaths/year Additional sources: https://diabetesatlas.org/ | https://www.who.int/news-room/fact-sheets/detail/diabetes

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56.

Stern, N. Lobbying spending and returns for disease advocacy groups. NYU Stern: Lobbying Influences NIH Funding https://www.stern.nyu.edu/experience-stern/news-events/new-research-finds-special-interest-lobbying-does-influence-nih-research-funding (2024)

Each $1,000 spent on lobbying correlated with $25,000 funding increase following year (53 diseases, 19 years) Rare disease advocates increased NIH rare-disease funding 3-15%/year (1998-2008) via millions in lobbying Specific examples: Alzheimer’s Association secured $100M NIH increase (FY2024); ME/CFS Initiative helped secure >$1B for long-COVID General ratio: Disease advocacy lobbying yields significant ROI, though specific "$100M → $1.8B" not verified Additional sources: https://www.stern.nyu.edu/experience-stern/news-events/new-research-finds-special-interest-lobbying-does-influence-nih-research-funding | https://www.nature.com/articles/515019a | https://www.alz.org/news/2024/congress-bipartisan-funding-alzheimers-research

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57.

IHME Global Burden of Disease (2.55B DALYs), C. from & GDP per capita valuation, global. $109 trillion annual global disease burden.

The global economic burden of disease, including direct healthcare costs (8.2trillion)andlostproductivity(100.9 trillion from 2.55 billion DALYs × 39, 570perDALY), totalsapproximately109.1 trillion annually.

58.

al., B. et. Disease network overlap (network medicine). Barabási et al. https://www.nature.com/articles/nrg2918 (2011)

Diseases cluster on shared biological networks, meaning drugs for one condition may plausibly affect many others. Additional sources: https://www.nature.com/articles/nrg2918

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59.

DOT. DOT value of statistical life ($13.6M). DOT: VSL Guidance 2024 https://www.transportation.gov/office-policy/transportation-policy/revised-departmental-guidance-on-valuation-of-a-statistical-life-in-economic-analysis (2024)

Current VSL (2024): $13.7 million (updated from $13.6M) Used in cost-benefit analyses for transportation regulations and infrastructure Methodology updated in 2013 guidance, adjusted annually for inflation and real income VSL represents aggregate willingness to pay for safety improvements that reduce fatalities by one Note: DOT has published VSL guidance periodically since 1993. Current $13.7M reflects 2024 inflation/income adjustments Additional sources: https://www.transportation.gov/office-policy/transportation-policy/revised-departmental-guidance-on-valuation-of-a-statistical-life-in-economic-analysis | https://www.transportation.gov/regulations/economic-values-used-in-analysis

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60.

Drugs.com. Time to develop one drug: 17 years. Drugs.com https://www.drugs.com/fda-approval-process.html

Time to develop one drug: 17 years Additional sources: https://www.drugs.com/fda-approval-process.html | https://www.fdareview.org/issues/the-drug-development-and-approval-process/

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61.

Wikipedia. Drug price competition and patent term restoration act of 1984. Wikipedia: Hatch-Waxman Act https://en.wikipedia.org/wiki/Drug_Price_Competition_and_Patent_Term_Restoration_Act

Also known as: Hatch-Waxman Act (Public Law 98-417) Signed by Reagan: September 24, 1984 Sponsors: Rep. Henry Waxman (CA) and Sen. Orrin Hatch (UT) Created modern generic drug regulation system via Abbreviated New Drug Applications (ANDAs) Patent term extension: Up to 5 years (max 14 years total from approval) Generic incentive: 180 days market exclusivity for first paragraph IV certification 5-year data exclusivity for new chemical entities Note: Landmark legislation balancing generic access with innovation incentives. Generic manufacturers only need to show bioequivalence, not repeat clinical trials Additional sources: https://en.wikipedia.org/wiki/Drug_Price_Competition_and_Patent_Term_Restoration_Act | https://www.congress.gov/bill/98th-congress/house-bill/3605 | https://www.everycrsreport.com/reports/R44643.html

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62.

Institute, B. Drug repurposing hub (broad institute). Broad Institute https://www.broadinstitute.org/drug-repurposing-hub (2017)

The Drug Repurposing Hub contains 4,707 hand-curated compounds (later expanded to 6,801), including 3,422 drugs that are marketed or have been in clinical trials. The collection includes 1,988 approved/marketed drugs and 1,348 compounds that cleared at least phase 1 clinical testing. Additional sources: https://www.broadinstitute.org/drug-repurposing-hub | https://pmc.ncbi.nlm.nih.gov/articles/PMC5568558/

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63.

Dunbar, R. I. M. Dunbar’s number. Dunbar <https://doi.org/10.1016/0047-2484(92 (1992)

The cognitive limit to the number of people with whom one can maintain stable social relationships is approximately 150. Additional sources: <https://doi.org/10.1016/0047-2484(92

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64.

Ramsberg J, P. R. Opportunities and barriers for pragmatic embedded trials: Triumphs and tribulations. Harvard Medical School/Harvard Pilgrim Health Care Institute https://pmc.ncbi.nlm.nih.gov/articles/PMC6508852/ (2018)

**Meta-analysis of 108 embedded pragmatic clinical trials** (2006-2016). The median cost per patient was **$97** (mean $478) across all trials reviewed. 25% of studies cost less than $19 per patient. US studies had higher median costs ($187 vs $27 non-US). Registry-based trials were less expensive than EHR-based trials. Traditional RCT comparison: **$16,600/patient** (Berndt & Cockburn 2014). The 108 trials had median enrollment of 5,540 patients with broad eligibility criteria. 81% used cluster randomization. Trials spanned 15 countries, infectious diseases (25%), cardiovascular (18%), diabetes (12%). Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC6508852/

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65.

NIHR. England clinical trial participants 2023/24. NIHR https://www.nihr.ac.uk/about-us/who-we-are/reports-and-performance/annual-statistics (2023)

1,045,282 participants recruited to NIHR Clinical Research Network (CRN) supported studies in England in 2023/24, compared to 952,789 in 2022/23. Additional sources: https://www.nihr.ac.uk/about-us/who-we-are/reports-and-performance/annual-statistics

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66.

War, B. W. C. of. Environmental cost of war ($100B annually). Brown Watson Costs of War: Environmental Cost https://watson.brown.edu/costsofwar/costs/social/environment

War on Terror emissions: 1.2B metric tons GHG (equivalent to 257M cars/year) Military: 5.5% of global GHG emissions (2X aviation + shipping combined) US DoD: World’s single largest institutional oil consumer, 47th largest emitter if nation Cleanup costs: $500B+ for military contaminated sites Gaza war environmental damage: $56.4B; landmine clearance: $34.6B expected Climate finance gap: Rich nations spend 30X more on military than climate finance Note: Military activities cause massive environmental damage through GHG emissions, toxic contamination, and long-term cleanup costs far exceeding current climate finance commitments Additional sources: https://watson.brown.edu/costsofwar/costs/social/environment | https://earth.org/environmental-costs-of-wars/ | https://transformdefence.org/transformdefence/stats/

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67.

EPA. EPA value of statistical life ($9.6M). EPA: Mortality Risk Valuation https://www.epa.gov/environmental-economics/mortality-risk-valuation (2017)

EPA 2010 Guidelines: $7.9M (2008 dollars) →  $9.7M (2013 dollars/income adjusted) Current EPA VSL:  $10 million (highest among federal agencies) Based on 1997 Clean Air Act analysis; updated for inflation/income but not methodology Uses wage-risk literature (21 studies) and stated preference studies (5 studies) Used in cost-benefit analyses for environmental, health, and safety regulations Note: $9.6-9.7M represents EPA’s VSL with inflation/income adjustments. Base methodology hasn’t been updated since 1997 Additional sources: https://www.epa.gov/environmental-economics/mortality-risk-valuation | https://www.rff.org/publications/working-papers/revisiting-the-environmental-protection-agencys-value-of-statistical-life/ | https://www.epa.gov/sites/default/files/2017-12/documents/ee-0483_all.pdf

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68.

e-Residency. Estonia e-residency statistics. e-Residency https://www.e-resident.gov.ee/dashboard/ (2024)

Estonia’s e-Residency program has issued digital identities to over 100,000 people from 170+ countries, demonstrating global-scale digital identity verification. Additional sources: https://www.e-resident.gov.ee/dashboard/

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69.

EMA. EU compassionate use program for experimental drugs. EMA: Compassionate Use https://www.ema.europa.eu/en/human-regulatory-overview/research-development/compassionate-use

Established by: Article 83 of Regulation (EC) No 726/2004 Eligibility: Life-threatening, long-lasting, or seriously debilitating illnesses Requires: No satisfactory authorized treatment; medicine in trials or approval process EMA role: CHMP provides recommendations; national authorities implement programs Pan-European programs rare: Only 6 approved by EMA in last 10 years vs hundreds of national programs Each EU member state sets own rules and procedures Note: Pan-European framework exists but rarely used due to complex navigation across varying national regulations. Most programs remain country-specific Additional sources: https://www.ema.europa.eu/en/human-regulatory-overview/research-development/compassionate-use | https://pmc.ncbi.nlm.nih.gov/articles/PMC5116859/ | https://www.eurordis.org/information-support/compassionate-use/

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70.

Strategy, E. D. EU eIDAS network for electronic identification. EU Digital Strategy: eIDAS Regulation https://digital-strategy.ec.europa.eu/en/policies/eidas-regulation (2014)

eIDAS = Electronic IDentification, Authentication and trust Services Regulation (EU) No 910/2014 - establishes framework for digital identity/authentication Mutual recognition: Member states must recognize each other’s national eID schemes Interoperability: Technology-neutral framework enabling seamless cross-border authentication Levels of Assurance (LoA): Low, substantial, or high confidence in identification eIDAS 2.0: Introduces European Digital Identity Wallets (EUDI Wallets) - standardized throughout EU Citizens/businesses can use eIDs from one member state to access services in another Note: eIDAS 2.0 enhances original framework with digital identity wallets operating seamlessly across all EU member states. Crucial for secure cross-border electronic transactions Additional sources: https://digital-strategy.ec.europa.eu/en/policies/eidas-regulation | https://eur-lex.europa.eu/eli/reg/2014/910/oj/eng | https://en.wikipedia.org/wiki/EIDAS

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71.

Lieberman, D. Evolutionary mismatch and modern disease. Lieberman https://www.penguinrandomhouse.com/books/206671/the-story-of-the-human-body-by-daniel-e-lieberman/ (2013)

Many modern diseases result from a mismatch between our evolutionary adaptations and current environments, particularly regarding diet and physical activity. Additional sources: https://www.penguinrandomhouse.com/books/206671/the-story-of-the-human-body-by-daniel-e-lieberman/

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72.

PMC. Estimated excess deaths attributed to FDA’s COVID-19 response. PMC: EUAs vs FDA Approval Implications https://pmc.ncbi.nlm.nih.gov/articles/PMC8101583/

FDA regulations restricted clinician/patient access to COVID-19 testing, remdesivir, vaccines General drug delay estimate: 37,000-76,000 deaths per one-year delay Testing delays: By May 2020, 400+ applications awaiting FDA review Seattle lab ordered to stop testing Feb 16 for lack of FDA approval Gates Foundation partnership instructed to discontinue testing May 2020 until authorization EUA process prevented months of vaccine/testing delays Note: Specific "500,000+" figure not found in sources. Research shows FDA testing restrictions caused weeks-to-months of critical delays (Feb-March 2020). One-year drug delay = 37-76K deaths Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC8101583/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC8012986/ | https://www.yalelawjournal.org/forum/deadly-delay-the-fdas-role-in-americas-covid-testing-debacle

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73.

Statecraft, R. F-35 cost compared to global rare disease research funding. Responsible Statecraft: F-35 Cost $2T <https://responsiblestatecraft.org/f35-cost/>

Single F-35 cost: $82M (flyaway) to $110-136M (with ancillary costs) NIH rare disease funding (FY2023): $6.9 billion (world’s largest public biomedical research funder) NIH rare disease funding = <0.1% of NIH’s $48B annual budget Comparison:  63 F-35s = 1 year of US rare disease research funding F-35 total program cost: $2.1 trillion lifetime (2,456 aircraft through 2088) Note: One F-35 ($110-136M) doesn’t exceed annual rare disease funding ($6.9B), but claim illustrates stark military vs medical research disparity. 63 F-35s = entire year of rare disease research Additional sources: <https://responsiblestatecraft.org/f35-cost/> | https://www.statista.com/statistics/713320/rare-diseases-funding-by-the-national-institutes-for-health/ | https://armscontrolcenter.org/f-35-joint-strike-fighter-costs-challenges/

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74.

GAO. F-35 program lifetime cost: $1.7 trillion. GAO: F-35 Sustainment Costs https://www.gao.gov/products/gao-24-106703 (2024)

F-35 Program lifetime cost: $2.1 trillion (updated April 2024) Sustainment costs: $1.58 trillion (44% increase from 2018 estimate) Procurement costs: $422 billion Covers 94 years of operation (through 2088) for 2,456 aircraft Note: About half the cost increase is due to inflation. This makes the F-35 one of the most expensive military acquisition programs in modern history Additional sources: https://www.gao.gov/products/gao-24-106703 | https://breakingdefense.com/2024/04/f-35-programs-lifetime-price-tag-tops-2-trillion-pentagon-wants-jets-to-fly-longer/

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75.

Drugs.com. FDA drug approval timeline. Drugs.com: FDA Drug Approval Process https://www.drugs.com/fda-approval-process.html

Full timeline (preclinical to market): 12-15 years average (10-15 years common range) Preclinical phase: 3-7 years Clinical development + NDA review:  9 years NDA review alone: 10 months average (standard); 6 months (priority review) Historical (pre-PDUFA): 21-29 months for NDA review Note: "10 years" is accurate for total development timeline (10-15 year range). Modern FDA review is faster (10 months) thanks to PDUFA, but overall timeline remains 12-15 years Additional sources: https://www.drugs.com/fda-approval-process.html | https://www.fdareview.org/issues/the-drug-development-and-approval-process/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC6113340/

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76.

CNN. FDA delay in approving rapid COVID-19 tests. CNN: How Government Delayed Testing https://www.cnn.com/2020/04/09/politics/coronavirus-testing-cdc-fda-red-tape-invs/index.html (2020)

Feb 16, 2020: Seattle research lab ordered to stop COVID testing without FDA approval May 2020: Gates Foundation partnership instructed to discontinue testing until authorization Feb 29, 2020: U. Nebraska finally got FDA permission after Feb 4 special permission Timeline: Critical delays measured in weeks-to-months (Feb-March 2020), not specific "6 months FDA guidance suggested EUAs needed for laboratory-developed tests (LDTs), causing delays By May 2020: 400+ test applications awaiting FDA review Note: Delays were weeks-to-months during critical Feb-March 2020 period, not continuous "6 months." FDA intervention added minimal value while contributing to deadly delays Additional sources: https://www.cnn.com/2020/04/09/politics/coronavirus-testing-cdc-fda-red-tape-invs/index.html | https://www.yalelawjournal.org/forum/deadly-delay-the-fdas-role-in-americas-covid-testing-debacle | https://oig.hhs.gov/oei/reports/OEI-01-20-00380.asp

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77.

CRS. Evidence of FDA regulatory capture by pharmaceutical industry. CRS: FDA Human Medical Product User Fees https://www.congress.gov/crs-product/R44750

FY2023: User fees = 75% of PDUFA program costs (vs 7% in FY1993) FY2022: User fees = 66% ($1.4B) of human drugs program budget FY2022: User fees = 46% ($2.9B) of FDA’s total $6.2B budget Pharma finances  75% of FDA’s drug division (New York Times) Concerns: Budgetary dependence, urgency of PDUFA reauthorizations, required industry participation in negotiations Most PDUFA policy changes favor industry: decreased regulatory standards, shorter approval times, increased industry involvement FDA maintains decisions based on science, not fee collection ability Note: Regulatory capture concerns well-documented. Industry funding grew from 7% (1993) to 75% (2023) of drug review program. No evidence found for "10x government salary" claim for FDA reviewers Additional sources: https://www.congress.gov/crs-product/R44750 | https://aspe.hhs.gov/sites/default/files/documents/e4a7910607c0dd76c40aa61151d154f9/FDA-User-Fee-Issue-Brief.pdf | https://pmc.ncbi.nlm.nih.gov/articles/PMC8917050/

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78.

Wikipedia. Number of key FDA drug reviewers. Wikipedia: Center for Drug Evaluation and Research https://en.wikipedia.org/wiki/Center_for_Drug_Evaluation_and_Research

CDER review teams:  1,300 employees evaluate and approve new drugs CDER safety team: 72 employees monitor 3,000+ prescription drugs for 200 million people ($15M/year budget) FDA Advisory Committees (all 3 centers):  300 individuals serve on  40 committees Advisory committees stable in recent years Note: " 200" may refer to advisory committee members ( 300 actual) or be approximation. CDER has 1,300 review staff total. Safety monitoring: 72 people for 200M patients Additional sources: https://en.wikipedia.org/wiki/Center_for_Drug_Evaluation_and_Research | https://www.ncbi.nlm.nih.gov/books/NBK236088/

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79.

FDA. FDA clinical trial launch timeline. FDA: IND Application Procedures https://www.fda.gov/drugs/investigational-new-drug-ind-application/ind-application-procedures-overview (2012)

IND application: FDA has 30 days to object or allow trials to begin NDA/BLA preparation after Phase 3: 6-12 months to assemble safety/effectiveness data Standard NDA review:  10-12 months median (standard review) Priority review: 6 months (vs 10 months standard) Overall development (first human testing to approval): 12-15 years full timeline Expedited programs: 7.1 years median vs 8.0 years nonexpedited Note: "6-12 months" likely refers to NDA/BLA preparation time post-Phase 3, not total trial launch timeline. IND review: 30 days. Full approval timeline: 10-15 years Additional sources: https://www.fda.gov/drugs/investigational-new-drug-ind-application/ind-application-procedures-overview | https://www.drugs.com/fda-approval-process.html | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820715/

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80.

FDA. FDA trial patient exclusion criteria. FDA: Evaluating Inclusion & Exclusion Criteria https://www.fda.gov/media/134754/download

Most frequent exclusions: Pregnancy, lactation/breastfeeding, renal/hepatic abnormalities, specific infectious diseases Pregnant/lactating women: >90% of trials exclude Older adults:  27% exclude based on age (arbitrary upper limits) Patients with organ dysfunction: Excluded due to adverse impact concerns from comorbidities/concomitant meds Multiple chronic conditions: Often exclusion criterion despite being common in target population Children/adolescents: Excluded due to ethical considerations High-risk patients: Prior malignancy history, active brain metastases, suboptimal hepatic/renal function, HIV+ FDA guidance: Working to broaden eligibility; "exclusions based on age alone rarely appropriate Note: Exclusion criteria often eliminate patients who would actually use the drug, reducing real-world applicability of trial results Additional sources: https://www.fda.gov/media/134754/download | https://www.sciencedirect.com/science/article/abs/pii/S1551714421002512 | https://ascopubs.org/doi/10.1200/EDBK_155880

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81.

PMC. Paperwork comparison between FDA trials and RECOVERY trial. PMC: Making Trials Part of Good Clinical Care - RECOVERY https://pmc.ncbi.nlm.nih.gov/articles/PMC8285150/

RECOVERY trial paperwork: One-page consent form, one-page case report form, single follow-up form Randomisation form: Simple, collecting few baseline characteristics and ensuring eligibility Follow-up: Single form completed at earliest of discharge, death, or 28 days Eligibility criteria: Simple; trial processes (including paperwork) minimized Philosophy: "Avoid additional burden on busy clinicians, so trial procedures streamlined as far as possible FDA Form 1572: Statement of Investigator form required for IND trials (specific form, not total page count) Note: Specific "1,572 pages vs 24 pages" comparison not found in sources. RECOVERY used 1-page forms. FDA Form 1572 is a specific required form, not total paperwork count. RECOVERY’s streamlined approach demonstrated feasibility of simplified trial documentation Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC8285150/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC9293394/ | https://www.fda.gov/media/71816/download

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82.

Commission, F. E. FEC foreign nationals guidance. Federal Election Commission https://www.fec.gov/updates/foreign-nationals/

The Federal Election Campaign Act (FECA) prohibits any foreign national from contributing, donating or spending funds in connection with any federal, state or local election in the United States, either directly or indirectly. Additional sources: https://www.fec.gov/updates/foreign-nationals/

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83.

Service, U. E. R. Food abundance in modern society. USDA Economic Research Service https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/ (2019)

The average American has access to approximately 3,800 calories per day in the food supply, nearly double the recommended daily intake. Additional sources: https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/

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84.

Ford, &. N., I. Pragmatic clinical trials - ALLHAT evidence. Ford https://www.nejm.org/doi/full/10.1056/NEJMra1510059 (2016)

Pragmatic trials are designed to determine the effects of an intervention under the usual conditions in which it will be applied. The ALLHAT trial (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) demonstrated that pragmatic designs can identify superior treatments while reducing healthcare costs by billions annually.

85.

IMF. Fossil fuel subsidies ($7T, 2022). IMF https://www.imf.org/en/Blogs/Articles/2023/08/24/fossil-fuel-subsidies-surged-to-record-7-trillion (2023).

86.

Post, W. Deaths from furniture accidents compared to terrorism. Washington Post: More Likely Crushed by Furniture https://www.washingtonpost.com/news/monkey-cage/wp/2015/11/23/youre-more-likely-to-be-fatally-crushed-by-furniture-than-killed-by-a-terrorist/ (2015)

Since 9/11/2001: Americans no more likely to die from terrorism than being crushed by unstable TVs/furniture Furniture tip-over fatalities (2000-present): 581 total; 4 in 5 deaths were children 2013-2023: 217 reported tip-over fatalities (23% TV, 25% TV+furniture, 46% furniture only, 7% appliance) Comparison: Even in Israel (intensive terror campaign), weekly terror casualties almost never match traffic deaths US terrorism: Deaths so low they barely register on graphs except 9/11/2001 Note: Post-9/11, furniture tip-overs have caused comparable/greater fatalities than terrorism for Americans. Highlights media attention vs actual risk disparity Additional sources: https://www.washingtonpost.com/news/monkey-cage/wp/2015/11/23/youre-more-likely-to-be-fatally-crushed-by-furniture-than-killed-by-a-terrorist/ | https://www.cpsc.gov/s3fs-public/2023_Annual_Tip_Over_Report_Posted_2024Feb_FINAL_0.pdf | https://ourworldindata.org/is-it-fair-to-compare-terrorism-and-disaster-with-other-causes-of-death

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87.

Foundation, G. Gates foundation endowment size. Gates Foundation: Fact Sheet https://www.gatesfoundation.org/about/foundation-fact-sheet (2024)

Current (July 31, 2025): $86 billion (unaudited); Dec 31, 2024: $77.2 billion 2022:  $70 billion (with new gifts added) Total contributions: Bill & Melinda Gates $60.2B (inception-2024); Warren Buffett $43.3B (2006-2024) Structure: Gates Foundation Trust manages endowment; Gates Foundation conducts operations/grantmaking World’s largest private philanthropic foundation Intent: Spend endowment "down to zero" within 20 years of Bill & Melinda’s deaths Annual payout (2026): $9B/year (50% increase announced 2022) Note: $70B figure accurate for 2022. Endowment has since grown to $86B (July 2025). Dramatic growth from major contributions by Gates + Buffett Additional sources: https://www.gatesfoundation.org/about/foundation-fact-sheet | https://fortune.com/2024/01/25/bill-gates-foundation-annual-letter-elite-universities-chuck-feeney/

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88.

9(1), G. A. GDPR biometric data requirements. GDPR Article 9(1) https://gdpr-info.eu/art-9-gdpr/

Processing of biometric data for the purpose of uniquely identifying a natural person shall be prohibited unless one of the conditions referred to in points (a) to (j) of paragraph 2 applies. Additional sources: https://gdpr-info.eu/art-9-gdpr/

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89.

FDA. Generic drug substitution savings. FDA https://www.fda.gov/drugs/generic-drugs/generic-drug-facts.

90.

FEE. Patients and doctors vs FDA. FEE: Patients and Doctors vs FDA https://fee.org/articles/patients-and-doctors-vs-the-fda

Dale Gieringer (1985): 21,000-120,000 lives lost per decade from FDA delay Gieringer: "Loss of life from delay alone in the hundreds of thousands" (not millions) Beta-blockers alone: William Wardell estimated "10,000 lives/year" if allowed; FDA delay 1965-1976 Sam Peltzman: Post-1962 death toll from regulatory delay "easily number in thousands per year Practolol (beta-blocker): "Could save 10,000 lives/year" (Wardell estimate) FDA allowed propranolol 1968 (3 years after Europe); for hypertension/angina not until 1978 Note: "4-10 million" figure not found in sources. Gieringer’s estimates: 21K-120K deaths per decade, "hundreds of thousands" total (not millions). Specific drug delays (beta-blockers):  100K deaths estimated Additional sources: https://fee.org/articles/patients-and-doctors-vs-the-fda | https://www.econlib.org/library/Enc/DrugLag.html | https://www.fdareview.org/issues/theory-evidence-and-examples-of-fda-harm/

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91.

Gitcoin. Gitcoin passport for digital identity scoring. Gitcoin: Intro to Passport https://www.gitcoin.co/blog/intro-to-passport

Now: Human Passport (acquired by human.tech late 2024); >2M users Purpose: Sybil resistance solution for web3, privacy-preserving identity verification How it works: "Stamps" from web2/web3 identifiers (Twitter, Google, BrightID, Proof of Humanity) aggregated into unique identity score Scoring: Weights based on "cost of forgery" and ability to signal unique humanity Privacy: Verifiable credentials check identity without viewing PII Customizable: Communities create custom "entry visa" with participation requirements Use cases: Governance voting, gaming, airdrops, bot prevention Gitcoin Grants Round 15: 35,000+ donors created Passports; limited Sybil activity, ensured fair fund distribution Note: Leading web3 identity/Sybil resistance tool. Now operates as Human Passport after acquisition. Proven at scale with millions of users Additional sources: https://www.gitcoin.co/blog/intro-to-passport | https://passport.human.tech/ | https://www.gitcoin.co/blog/cost-of-forgery

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92.

Data, O. W. in. Global armed forces size and average salary. Our World in Data: Military Personnel & Spending https://ourworldindata.org/military-personnel-spending (2024)

Largest forces: China (2.0M active), India (1.4M), Russia (1.3M active, 3.5M total), US (1.3M active) Global military spending 2024: US $1T (next 12 countries combined); NATO 32 members: $1.5T (55% of world) Military spending per personnel: Tracked by SIPRI, World Bank (includes personnel, O&M, procurement, R&D, infrastructure, aid) Average varies widely: US military much higher per-personnel spending than most countries Note: Specific "28.4M global armed forces" and "$24,000 average salary" not confirmed in sources. Data available but highly variable by country. Major forces total  10M+ personnel among largest militaries Additional sources: https://ourworldindata.org/military-personnel-spending | https://data.worldbank.org/indicator/MS.MIL.TOTL.P1 | https://www.sipri.org/sites/default/files/2025-04/2504_fs_milex_2024.pdf

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93.

ScienceDaily. Global burden of disease study 2013: 2.4 billion people with chronic diseases. ScienceDaily: GBD 2013 Study https://www.sciencedaily.com/releases/2015/06/150608081753.htm (2013)

The Global Burden of Disease Study 2013 found that 2.3 billion people worldwide were experiencing five or more chronic ailments, with only 4.3% of the global population having no health problems. Eight chronic disorders affected more than 10% of the world population in 2013, including cavities in permanent teeth (2.4 billion), tension-type headaches (1.6 billion), iron-deficiency anemia (1.2 billion), age-related hearing loss (1.23 billion), and migraine (850 million). As of 2020-2021: cardiovascular disease affects 523 million people, diabetes affects 537 million, and NCDs account for 41 million deaths annually (74% of all deaths). Additional sources: https://www.sciencedaily.com/releases/2015/06/150608081753.htm | https://news.un.org/en/story/2023/05/1136832 | https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases | https://pmc.ncbi.nlm.nih.gov/articles/PMC10830426/

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94.

Conversation, T. Global cancer research spending ( $51.4B, 2016-2023). The Conversation https://theconversation.com/billions-spent-on-cancer-research-globally-but-is-it-money-well-spent-201407 (2023).

95.

Fund, T. G. The global fund. The Global Fund https://www.theglobalfund.org/en/about-the-global-fund/.

96.

Fund, G. Lives saved by the global fund. Global Fund: Results Report 2025 https://www.theglobalfund.org/en/results/ (2025)

2025: 70 million lives saved (current figure) Oct 2024: 65 million lives saved Sep 2022: 50 million lives saved over 20 years Death rate reduction: 63% combined death rate from AIDS, TB, malaria (61% since 2002) Since inception (2002): Partnership saved 70M lives fighting HIV, TB, malaria across 100+ countries Note: 50M was Sept 2022 figure. Current (2025): 70M lives saved. One of world’s most effective global health partnerships Additional sources: https://www.theglobalfund.org/en/results/ | https://www.theglobalfund.org/en/news/2022/2022-09-12-new-global-fund-report-shows-50-million-lives-saved-over-20-years-in-fight-against-hiv-tb-malaria/

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97.

Statista. Global GDP ($101T, 2022). Statista https://www.statista.com/statistics/268750/global-gross-domestic-product-gdp/ (2023)

The global economy is projected to grow from about 101 trillion U.S. dollars in 2022 to about 139 trillion U.S. dollars in 2027. Additional sources: https://www.statista.com/statistics/268750/global-gross-domestic-product-gdp/

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98.

Bank, W. Global GDP in 2023 ($89.5 trillion). World Bank https://data.worldbank.org/indicator/NY.GDP.MKTP.CD (2023).

99.

budgets:, S. component country. Global government medical research spending ($67.5B, 2023–2024). See component country budgets: NIH Budget #nih-budget-fy2025.

100.

Organization, W. H. Global health spending as a share of GDP (9.8%, 2020). World Health Organization https://www.who.int/publications/i/item/9789240064929 (2022).

101.

Wikipedia. Number of major global military facilities (4,435). Wikipedia: List of American Military Installations https://en.wikipedia.org/wiki/List_of_American_military_installations

US military bases worldwide: 750-877 (varies by source/definition) Conservative count: 128 military bases in 55 countries/territories (Feb 2025) Broader count: 750+ bases in 80+ countries; some sources cite 877 Large bases (>4 hectares or >$10M, >200 personnel): 439 (60% of US foreign bases) Small bases/"Lily Pads" (<4 hectares or <$10M): Remaining 40% Other nations: At least 18 other nations operate foreign military bases; NATO countries (France, UK): +200 locations Note: "4,435" not found in sources. US operates 750-877 bases overseas. May include domestic + all nations’ bases combined, but specific figure not verified Additional sources: https://en.wikipedia.org/wiki/List_of_American_military_installations | https://www.visualcapitalist.com/mapped-every-known-u-s-military-base-overseas/ | https://worldbeyondwar.org/military-empires/

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102.

SIPRI. Global military spending ($2.72T, 2024). SIPRI https://www.sipri.org/publications/2025/sipri-fact-sheets/trends-world-military-expenditure-2024 (2025).

103.

C&EN. Annual number of new drugs approved globally:  50. C&EN https://cen.acs.org/pharmaceuticals/50-new-drugs-received-FDA/103/i2 (2025)

50 new drugs approved annually Additional sources: https://cen.acs.org/pharmaceuticals/50-new-drugs-received-FDA/103/i2 | https://www.fda.gov/drugs/development-approval-process-drugs/novel-drug-approvals-fda

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104.

Report, I. Global trial capacity. IQVIA Report: Clinical Trial Subjects Number Drops Due to Decline in COVID-19 Enrollment https://gmdpacademy.org/news/iqvia-report-clinical-trial-subjects-number-drops-due-to-decline-in-covid-19-enrollment/

1.9M participants annually (2022, post-COVID normalization from 4M peak in 2021) Additional sources: https://gmdpacademy.org/news/iqvia-report-clinical-trial-subjects-number-drops-due-to-decline-in-covid-19-enrollment/

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105.

Talk, A. Grant writing time for top researchers (50%). Acquisition Talk https://acquisitiontalk.com/2021/12/top-researchers-spend-50-of-their-time-writing-grants-how-to-fix-it-and-what-it-means-for-dod/ (2021)

Top researchers can spend up to 50% of their time writing grants. Additional sources: https://acquisitiontalk.com/2021/12/top-researchers-spend-50-of-their-time-writing-grants-how-to-fix-it-and-what-it-means-for-dod/

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106.

PubMed. The nine hallmarks of aging. PubMed: The Hallmarks of Aging https://pubmed.ncbi.nlm.nih.gov/23746838/

Nine hallmarks of aging (López-Otín et al., 2013): 1. Genomic instability, 2. Telomere attrition, 3. Epigenetic alterations, 4. Loss of proteostasis, 5. Deregulated nutrient-sensing, 6. Mitochondrial dysfunction, 7. Cellular senescence, 8. Stem cell exhaustion, 9. Altered intercellular communication Categories: (a) Primary hallmarks (unequivocally deleterious: genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis); (b) Antagonistic hallmarks (beneficial at low levels, deleterious at high: deregulated nutrient sensing, cellular senescence, mitochondrial dysfunction); (c) Integrative hallmarks (affect tissue homeostasis: stem cell exhaustion, altered intercellular communication) Additional sources: https://pubmed.ncbi.nlm.nih.gov/23746838/ | https://www.cell.com/cell/fulltext/S0092-8674(13 | https://pmc.ncbi.nlm.nih.gov/articles/PMC3836174/ | https://www.cell.com/cell/fulltext/S0092-8674(20

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107.

Adida et al., H. Helios (end-to-end verifiable voting). Adida et al. https://heliosvoting.org/

Helios is an open-audit voting system… voters can verify that their vote is included and correctly tallied. Additional sources: https://heliosvoting.org/

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108.

Calculator, U. I. Historical healthcare inflation rate (6.2%). US Inflation Calculator: Health Care 1948-2025 https://www.usinflationcalculator.com/inflation/health-care-inflation-in-the-united-states/ (1948)

Long-term average (1935-2025): 4.59% annual (per Consumer Price Index for Medical Care, BLS) 2000-2023: 3.5% average annual medical care cost inflation Medical Care Price Index (MCPI): 3.7% compound annual growth (past 2 decades) vs 2.6% for Personal Health Care (PHC) & PCE health indexes Recent (Aug 2025): 3.4% year-over-year health care price increase Additional sources: https://www.usinflationcalculator.com/inflation/health-care-inflation-in-the-united-states/ | https://www.in2013dollars.com/Medical-care/price-inflation | https://pmc.ncbi.nlm.nih.gov/articles/PMC5785315/ | https://ycharts.com/indicators/us_health_care_inflation_rate

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109.

Data, O. W. in. Historical life expectancy around 30 years. Our World in Data: Life Expectancy https://ourworldindata.org/life-expectancy (2022)

Average life expectancy at birth:  30 years for most of human history until 1800s 1820: Global average still  30 years; 1800-2000: Rose from 30 to 67 years Context: Low life expectancy driven primarily by high infant mortality ( 1/3 of children died before age 5) Medieval England: Life expectancy at birth = 31.3 years, but life expectancy at age 25 = 25.7 additional years (total 50.7) Roman Egypt: Average in 20s, but many lived into 40s+ if they survived childhood Additional sources: https://ourworldindata.org/life-expectancy | https://pmc.ncbi.nlm.nih.gov/articles/PMC2625386/ | https://sc.edu/uofsc/posts/2022/08/conversation-old-age-is-not-a-modern-phenomenon.php | https://www.discovermagazine.com/the-sciences/what-was-the-life-expectancy-of-ancient-humans

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110.

NHGRI. Human genome project and CRISPR discovery. NHGRI https://www.genome.gov/11006929/2003-release-international-consortium-completes-hgp (2003)

Your DNA is 3 billion base pairs Read the entire code (Human Genome Project, completed 2003) Learned to edit it (CRISPR, discovered 2012) Additional sources: https://www.genome.gov/11006929/2003-release-international-consortium-completes-hgp | https://www.nobelprize.org/prizes/chemistry/2020/press-release/

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111.

PMC521. Hypertension screening & treatment cost per QALY. PMC5217841 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217841/ (7841)

The estimated cost per QALY gained for screening was less than 1000formenandapproximately1600 for women. Additional sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217841/

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112.

ICAN. International campaign to abolish nuclear weapons (ICAN) - treaty on the prohibition of nuclear weapons (2017). ICAN https://www.icanw.org/ican_history (2017)

ICAN: Founded 2007, headquartered in Geneva, coordinating 468+ partner organizations across 100+ countries (as of 2017) Staff: 3 full-time + 2 part-time in Geneva office (when Nobel Prize awarded) Funding: Initial grant from Poola Foundation (Australia); Norwegian government grant to establish Geneva office (2011) Treaty on the Prohibition of Nuclear Weapons (TPNW): Adopted July 7, 2017 by vote of 122-1 at UN Achievement: Nobel Peace Prize 2017 "for its work to draw attention to the catastrophic humanitarian consequences of any use of nuclear weapons Additional sources: https://www.icanw.org/ican_history | https://en.wikipedia.org/wiki/International_Campaign_to_Abolish_Nuclear_Weapons | https://www.nobelprize.org/prizes/peace/2017/ican/facts/ | https://www.icanw.org/the_treaty

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113.

ICRC. International campaign to ban landmines (ICBL) - ottawa treaty (1997). ICRC https://www.icrc.org/en/doc/resources/documents/article/other/57jpjn.htm (1997)

ICBL: Founded 1992 by 6 NGOs (Handicap International, Human Rights Watch, Medico International, Mines Advisory Group, Physicians for Human Rights, Vietnam Veterans of America Foundation) Started with ONE staff member: Jody Williams as founding coordinator Grew to 1,000+ organizations in 60 countries by 1997 Ottawa Process: 14 months (October 1996 - December 1997) Convention signed by 122 states on December 3, 1997; entered into force March 1, 1999 Achievement: Nobel Peace Prize 1997 (shared by ICBL and Jody Williams) Government funding context: Canada established $100M CAD Canadian Landmine Fund over 10 years (1997); International donors provided $169M in 1997 for mine action (up from $100M in 1996) Additional sources: https://www.icrc.org/en/doc/resources/documents/article/other/57jpjn.htm | https://en.wikipedia.org/wiki/International_Campaign_to_Ban_Landmines | https://www.nobelprize.org/prizes/peace/1997/summary/ | https://un.org/press/en/1999/19990520.MINES.BRF.html | https://www.the-monitor.org/en-gb/reports/2003/landmine-monitor-2003/mine-action-funding.aspx

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114.

ID.me. ID.me digital identity verification service. ID.me: Government Services https://www.id.me/individuals/government

Trusted technology partner to multiple US government agencies for secure digital identity verification Scale: Serves 20 federal agencies, 44 state government agencies, 66 healthcare organizations Use cases: Unemployment, Tax, Retirement, Centers for Medicare/Medicaid 2013: Awarded 2-year grant by US Chamber for President’s National Strategy for Trusted Identities in Cyberspace (NSTIC) 2014: Won contract with General Services Administration for Connect.gov digital identity credentials COVID-19 pandemic: Contracted by several state unemployment agencies to verify claimants Standards: NIST 800-63-3 establishes guidelines for identity verification providers serving federal agencies Privacy concerns: IRS announced (Feb 2022) new authentication option without biometric data including facial recognition Additional sources: https://www.id.me/individuals/government | https://en.wikipedia.org/wiki/ID.me | https://www.id.me/about | https://www.id.me/business/government

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115.

Health Metrics, I. for & (IHME), E. IHME global burden of disease (2.55B DALYs, 2019). Institute for Health Metrics and Evaluation (IHME) https://vizhub.healthdata.org/gbd-compare/ (2020)

Globally, in 2019, the total number of DALYs from all causes was 2.55 billion. Additional sources: https://vizhub.healthdata.org/gbd-compare/ | https://www.healthdata.org/research-analysis/about-gbd | https://pubmed.ncbi.nlm.nih.gov/33069326/

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116.

Illinois, A. Illinois biometric information privacy act (BIPA). ACLU Illinois: BIPA https://www.aclu-il.org/en/campaigns/biometric-information-privacy-act-bipa

Enacted: October 3, 2008 (introduced Feb 14, 2008 by State Sen. Terry Link; passed both Houses July 10, 2008; signed by Gov. Rod Blagojevich) Purpose: Regulate collection, use, and handling of biometric identifiers and information by private entities in Illinois Requirements: Written notice of what data is collected/stored, specific purpose & duration, obtain written consent Covered biometrics: Retina/iris scans, fingerprints, voiceprints, hand scans, facial geometry, DNA, other unique biological info Prohibitions: Selling or profiting from consumers’ biometric information Penalties: $1,000 per violation; $5,000 per intentional/reckless violation Private right of action: Any aggrieved individual can sue 2024 update (SB2979): Multiple collections from same person = single violation (single recovery per individual) Additional sources: https://www.aclu-il.org/en/campaigns/biometric-information-privacy-act-bipa | https://en.wikipedia.org/wiki/Biometric_Information_Privacy_Act | https://securiti.ai/privacy-laws/us/illinois/ | https://www.winston.com/en/legal-glossary/what-is-bipa

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117.

PMC. Indian aadhaar national identity system. PMC: Aadhaar Failure to Do No Harm https://pmc.ncbi.nlm.nih.gov/articles/PMC5741784/

Largest biometric identity system in history:  1 billion registered users (nearly all of India’s 1.4B population) 12-digit unique identification number issued by Unique Identification Authority of India (UIDAI) Biometric data: Fingerprints, facial images, iris scans stored in Central Identities Repository (national centralized database) Privacy concerns: Deployed without direct legislative privacy/ethics constraints; comprehensive data protection legislation not yet passed Security issues: High-ranking official’s Aadhaar number shared on Twitter led to hackers accessing personal info (mobile, tax ID) 2017: Supreme Court enshrined privacy rights Supreme Court ruling: 4 of 5 judges allowed program to continue with limited scope & restrictions on data storage Threats: Potential for 360-degree profiling; viewed by many as mass surveillance tool infringing privacy rights Note: "with privacy protections" is questionable - significant privacy concerns remain despite Supreme Court restrictions Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC5741784/ | https://time.com/5388257/india-aadhaar-biometric-identification/ | https://privacyinternational.org/case-study/4698/id-systems-analysed-aadhaar | https://insights.som.yale.edu/insights/what-happens-when-billion-identities-are-digitized

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size, D. from global market & ratios, public/private funding. Private industry clinical trial spending.

Private pharmaceutical and biotech industry spends approximately $75-90 billion annually on clinical trials, representing roughly 90% of global clinical trial spending.

119.

Snopes. History of insulin patent and modern price disparities. Snopes: Insulin Patent Dollar https://www.snopes.com/fact-check/insulin-patent-dollar/ (2019)

1923: Frederick Banting, Charles Best, James Collip sold insulin patent to U. of Toronto for $1 each (total $3) Banting: Unethical for doctor to profit from life-saving discovery; wanted everyone to afford it Manufacturing cost: $6 per vial US retail price:  $300-332 per vial (Humalog: $21 in 1999 → $332 in 2019 = 1,000%+ increase) Price increases: 600% over 20 years; 200% between 2007-2018 Patients without insurance: Up to $1,000/month Contributing factors: Patent evergreening, barriers to biosimilar entry, market concentration (Eli Lilly, Novo Nordisk, Sanofi) Additional sources: https://www.snopes.com/fact-check/insulin-patent-dollar/ | https://www.t1international.com/100years/ | https://pnhp.org/news/why-insulin-is-overpriced/ | https://www.npr.org/2019/06/18/733742630/desperate-measures-the-skyrocketing-price-of-insulin-in-america

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120.

Info, U. G. Intelligence spending as percentage of military budgets. US Government Info: Cost of Intelligence https://www.govinfo.gov/content/pkg/GPO-INTELLIGENCE/html/int017.html

US: Military-related budget lines (DoE, State Dept, National Intelligence Program) = 11% of US spending (2024) Intelligence funding: Grew faster than military when military spending increased; decreased slower when military spending decreased Historical trend: Intelligence funding reached level 80% above 1980 baseline US National Intelligence Program + Military Intelligence Program ≈ 10-11% of total military-related spending Additional sources: https://www.govinfo.gov/content/pkg/GPO-INTELLIGENCE/html/int017.html | https://sgp.fas.org/crs/intel/R44381.pdf | https://en.wikipedia.org/wiki/United_States_intelligence_budget

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121.

Statista. Number of global internet users. Statista: Internet Users Worldwide 2024 https://www.statista.com/statistics/273018/number-of-internet-users-worldwide/ (2024)

2022: Surpassed 5 billion users worldwide 2024 (Oct): 5.52 billion (67.5% of global population); year-end: 5.5B 2025 (start): 5.560 billion (67.9% of population); Oct 2025: 6.04 billion (73.2% of population) Growth: +136M in 2024 (+2.5%), +294M over 12 months to Oct 2025 (+5.1%) Still disconnected: 2.630 billion people at start of 2025 Additional sources: https://www.statista.com/statistics/273018/number-of-internet-users-worldwide/ | https://www.digitalinformationworld.com/2025/02/global-internet-users-surpass-offline-556-billion-2025.html | https://datareportal.com/global-digital-overview | https://www.sganalytics.com/blog/global-internet-usage-statistics/

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Wikipedia. Journal of the american medical association (JAMA) founded in 1883. Wikipedia: JAMA https://en.wikipedia.org/wiki/JAMA

Founded: 1883 by American Medical Association Founding editor: Nathan Smith Davis Superseded: Transactions of the American Medical Association 1960: Obtained current title "JAMA: The Journal of the American Medical Association Evolution: Late 1800s resembled general journalism; 1910s-1920s "turndown era" began rejecting submissions based on quality; routine peer review instituted after WWII Current: Peer-reviewed medical journal published 48 times/year covering all aspects of biomedicine Additional sources: https://en.wikipedia.org/wiki/JAMA | https://jamanetwork.com/journals/jama/fullarticle/291201 | https://onlinebooks.library.upenn.edu/webbin/serial?id=jama

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123.

Prize, N. James buchanan nobel prize in economics, 1986. Nobel Prize: 1986 Economic Sciences https://www.nobelprize.org/prizes/economic-sciences/1986/press-release/ (1986)

James McGill Buchanan: 1986 Nobel Memorial Prize in Economic Sciences Citation: "for his development of the contractual and constitutional bases for the theory of economic and political decision-making Field: Public choice theory (leading researcher & cofounder with Gordon Tullock) Key work: "The Calculus of Consent" (with Tullock) - now considered a classic, started the field Contribution: Transferred concept of gain from mutual exchange between individuals to political decision-making; applied economic analysis to public sector Inspiration: Swedish economist Knut Wicksell (described as "most exciting intellectual moment" of career) Additional sources: https://www.nobelprize.org/prizes/economic-sciences/1986/press-release/ | https://en.wikipedia.org/wiki/James_M._Buchanan | https://www.britannica.com/money/James-M-Buchanan | https://www.econlib.org/library/Enc/bios/Buchanan.html

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124.

FDLI. Japan’s regenerative medicine act and conditional approval pathway. FDLI: Japan’s Regen Med Pathways https://www.fdli.org/2019/02/global-focus-japans-regenerative-medicine-regulatory-pathways-encouraging-innovation-and-patient-access/ (2019)

Act on Safety of Regenerative Medicine (RM Act) + amended Pharmaceuticals and Medical Devices Act (PMD Act): passed Nov 2013, effective Nov 2014 Conditional and time-limited approval pathway: Obtain approval after exploratory trials demonstrate probable benefit and proven safety 7-year conditional approval period to confirm clinical benefit (e.g., using surrogate endpoints) SAKIGAKE designation (April 2015): Expedited pathway for innovative products targeting serious/life-threatening diseases without effective treatment Benefits: Prioritized consultation, accelerated review, extended re-examination period, premium pricing Examples: Terumo’s HeartSheet and Stemirac obtained conditional approval; Stemirac also SAKIGAKE-designated Additional sources: https://www.fdli.org/2019/02/global-focus-japans-regenerative-medicine-regulatory-pathways-encouraging-innovation-and-patient-access/ | https://www.insights.bio/cell-and-gene-therapy-insights/journal/article/310/Experiences-from-Japan-SAKIGAKE-Designation-System-for-Regenerative-Medical-Products | https://pmc.ncbi.nlm.nih.gov/articles/PMC6696404/

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125.

GovTrack. Kefauver harris amendment of 1962. GovTrack https://www.govtrack.us/congress/bills/87/s1552 (1962)

regulating efficacy testing via the 1962 Kefauver Harris Amendment. The 1962 regulations made these large real-world efficacy trials illegal. Additional sources: https://www.govtrack.us/congress/bills/87/s1552 | https://www.fda.gov/about-fda/histories-product-regulation/promoting-safe-effective-drugs-100-years | https://pmc.ncbi.nlm.nih.gov/articles/PMC4101807/

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126.

Foundation, N. K. Annual deaths from kidney disease. National Kidney Foundation: Global Facts https://www.kidney.org/global-facts-about-kidney-disease (2022)

Direct CKD deaths: 1.2M (2017), 1.53M (2021); increased from 591,800 (1990) to 1,425,670 (2019) CKD-attributable cardiovascular deaths: Additional 1.4M deaths from CVD attributable to impaired kidney function (7.6% of all CVD deaths, 2017) Combined impact: 4.6% of total global mortality CKD: 12th leading cause of death globally; one of few NCDs showing increased deaths over past 2 decades Additional sources: https://www.kidney.org/global-facts-about-kidney-disease | https://pmc.ncbi.nlm.nih.gov/articles/PMC9073222/ | https://www.thelancet.com/article/S0140-6736(20 | https://www.healthdata.org/news-events/newsroom/news-releases/chronic-kidney-disease-global-killer-plain-sight

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127.

Dive, B. Approval of landmark gene therapies (luxturna, zolgensma, CAR-t). BioPharma Dive: Luxturna https://www.biopharmadive.com/news/luxturna-gene-therapy-eye-leber-lca/609832/ (2017)

Luxturna (Dec 2017): First in vivo gene therapy approved by US FDA; treats biallelic RPE65 mutation-associated retinal dystrophy (inherited blindness); $850,000 one-time therapy CAR-T therapies (2017): Kymriah and Yescarta approved same year as Luxturna Zolgensma (May 2019): Spinal muscular atrophy treatment; second gene therapy for inherited disease in US; $2.1M (one of most expensive medicines at the time) Described as "landmark moment for a field riddled with ups and downs" and "landmark achievements in history of modern science Additional sources: https://www.biopharmadive.com/news/luxturna-gene-therapy-eye-leber-lca/609832/ | https://cen.acs.org/articles/95/web/2017/12/First-gene-therapy-genetic-disease.html | https://www.npr.org/sections/health-shots/2017/12/19/571962226/first-gene-therapy-for-inherited-disease-gets-fda-approval | https://pmc.ncbi.nlm.nih.gov/articles/PMC7123914/

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128.

Landray, S. M. Landray, sir martin, on the RECOVERY trial. Sir Martin Landray https://www.ox.ac.uk/news/features/recovery-trial-two-years

In 2019, I had no idea that I would be setting up a trial of treatments for an infectious disease, let alone a pandemic virus. I certainly would not have thought it possible to go from a blank piece of paper to enrolling the first patient in nine days, to finding the first life-saving treatment within ten weeks, and for it to be made standard NHS policy within three hours. Additional sources: https://www.ox.ac.uk/news/features/recovery-trial-two-years

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129.

CSV, S. U. L. E. F. B. 1543-2019. US life expectancy growth 1880-1960: 3.82 years per decade. (2019)

Pre-1962: 3.82 years/decade Post-1962: 1.54 years/decade Reduction: 60% decline in life expectancy growth rate Additional sources: https://ourworldindata.org/life-expectancy | https://www.mortality.org/ | https://www.cdc.gov/nchs/nvss/mortality_tables.htm

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130.

Statecraft, R. Lobbying ROI calculation ($1,813 per $1). Responsible Statecraft https://responsiblestatecraft.org/2021/09/02/top-military-firms-see-2t-return-on-1b-investment-in-afghan-war/ (2021).

131.

OpenSecrets. Lobbyist statistics for washington d.c. OpenSecrets: Lobbying in US https://en.wikipedia.org/wiki/Lobbying_in_the_United_States

Registered lobbyists: Over 12,000 (some estimates); 12,281 registered (2013) Former government employees as lobbyists: 2,200+ former federal employees (1998-2004), including 273 former White House staffers,  250 former Congress members & agency heads Congressional revolving door: 43% (86 of 198) lawmakers who left 1998-2004 became lobbyists; currently 59% leaving to private sector work for lobbying/consulting firms/trade groups Executive branch: 8% were registered lobbyists at some point before/after government service Additional sources: https://en.wikipedia.org/wiki/Lobbying_in_the_United_States | https://www.opensecrets.org/revolving-door | https://www.citizen.org/article/revolving-congress/ | https://www.propublica.org/article/we-found-a-staggering-281-lobbyists-whove-worked-in-the-trump-administration

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132.

OpenSecrets. Lockheed martin’s political donations, contracts, and state operations in 2022. OpenSecrets: Lockheed Martin Summary https://www.opensecrets.org/orgs/lockheed-martin/summary?id=d000000104 (2022)

Political contributions 2022: $3,946,639 (PAC + individuals); PAC alone: $1,542,500 to federal candidates (2021-2022 cycle) Lobbying 2022: $13.6M expenditure (focused on military appropriations, foreign military sales) Geographic footprint: Operations in over half of states; employs 1,000-20,000+ per state Additional sources: https://www.opensecrets.org/orgs/lockheed-martin/summary?id=d000000104 | https://www.opensecrets.org/political-action-committees-pacs/lockheed-martin/C00303024/candidate-recipients/2022 | https://www.taxpayer.net/wp-content/uploads/2024/10/Oct-2024-Political-Footprint-of-the-Military-Industry.pdf

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133.

Wikipedia. The collapse of long-term capital management (LTCM) in 1998. Wikipedia: LTCM https://en.wikipedia.org/wiki/Long-Term_Capital_Management (2013)

Founded 1994 by John Meriwether (former Salomon Brothers vice-chairman) Board included Nobel Prize winners: Myron Scholes & Robert C. Merton (1997 Nobel in Economics for Black-Scholes model) Initial success: 21% (year 1), 43% (year 2), 41% (year 3) annualized returns after fees 1998 collapse: Lost $4.6B in <4 months due to high leverage + 1997 Asian crisis + 1998 Russian crisis Extreme leverage: $30 debt per $1 capital (end of 1997) Bailout: $3.6B ($3.625B) from 14 banks, brokered by Federal Reserve Bank of NY (Fed didn’t lend own funds) By early 2000: Fund liquidated, creditors repaid Additional sources: https://en.wikipedia.org/wiki/Long-Term_Capital_Management | https://www.federalreservehistory.org/essays/ltcm-near-failure | https://www.wallstreetmojo.com/long-term-capital-management/ | https://blogs.cfainstitute.org/investor/2013/11/04/the-incredible-untold-story-about-how-the-financial-world-almost-ended/

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134.

Numbers, T. by. Lost human capital due to war ($270B annually). Think by Numbers: War Costs $74 <https://thinkbynumbers.org/military/war/the-economic-case-for-peace-a-comprehensive-financial-analysis/> (2021)

Lost human capital from war: $300B annually (economic impact of losing skilled/productive individuals to conflict) Broader conflict/violence cost: $14T/year globally 1.4M violent deaths/year; conflict holds back economic development, causes instability, widens inequality, erodes human capital 2002: 48.4M DALYs lost from 1.6M violence deaths = $151B economic value (2000 USD) Economic toll includes: commodity prices, inflation, supply chain disruption, declining output, lost human capital Additional sources: <https://thinkbynumbers.org/military/war/the-economic-case-for-peace-a-comprehensive-financial-analysis/> | https://www.weforum.org/stories/2021/02/war-violence-costs-each-human-5-a-day/ | https://pubmed.ncbi.nlm.nih.gov/19115548/

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135.

MakerDAO. MakerDAO scale. MakerDAO https://defillama.com/protocol/maker (2024).

136.

WHO. Annual deaths from malaria. WHO https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2024 (2024)

600,000 people per year die from malaria (a disease spread by a bug we can’t figure out how to properly swat) Additional sources: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2024

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137.

Brookings. Manhattan project cost in modern dollars. Brookings: Costs of the Manhattan Project https://www.brookings.edu/the-costs-of-the-manhattan-project/

Original cost: $1.89 billion (1945 dollars) Inflation-adjusted: $29.6-32.9 billion (2023-2024 dollars) Almost two-thirds of budget spent on Oak Ridge uranium enrichment facilities Note: Los Alamos received just 4% of total budget. For comparison, the B-29 bomber program was more expensive than the Manhattan Project Additional sources: https://www.brookings.edu/the-costs-of-the-manhattan-project/ | https://moneyzine.com/how-much-did-the-manhattan-project-cost/

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138.

Wikipedia. Pharmaceutical lobby influence on medicare modernization act of 2003. Wikipedia: Medicare Modernization Act https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act

Medicare Prescription Drug, Improvement, and Modernization Act (P.L. 108-173): Signed Dec 8, 2003 by President Bush; created voluntary Part D prescription drug benefit Noninterference provision": Prohibits HHS Secretary from negotiating drug prices or establishing preferred drug list Instead: Drug prices negotiated between manufacturers & insurance companies administering Part D plans Pharma industry role in writing: "Noninterference clause" written with major industry involvement; drug manufacturers had major role writing & getting it through Congress Industry lobbying: $231M spent on lobbying in 2003 (more than any other industry since 1998) Rep. Billy Tauzin example: 2004 appointed PhRMA chief lobbyist ($2M/year rumored); responsible for including price negotiation prohibition 2022 change: Inflation Reduction Act removed ban; Medicare can negotiate starting 2026 Additional sources: https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act | https://www.healthaffairs.org/content/forefront/politics-medicare-and-drug-price-negotiation-updated | https://www.congress.gov/crs-products/product/pdf/R/R47872

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139.

Wikipedia. Michael milken and the development of the high-yield bond market. Wikipedia: Michael Milken https://en.wikipedia.org/wiki/Michael_Milken

Michael Milken ("Junk Bond King"): Pioneered high-yield "junk bond" market with Drexel Burnham Lambert (1970s-1980s) Original-issue high-yield debt innovation provided hostile bidders & LBO firms enormous capital for multi-billion-dollar deals Mid-1980s: Milken’s high-yield bond buyer network enabled rapid large-scale fundraising, facilitated LBOs (e.g., KKR) Market growth: End of 1980s = $150B junk-bond market; Drexel became leading US financial firm with  50% market share Milken compensation: >$1B over 4 years (late 1980s) - US income record at the time 1989: Indicted for racketeering/securities fraud; plea bargain to securities/reporting violations (not racketeering/insider trading) 1990: Drexel bankruptcy & liquidation Additional sources: https://en.wikipedia.org/wiki/Michael_Milken | https://www.hbs.edu/faculty/Pages/item.aspx?num=50852 | https://www.britannica.com/money/Michael-R-Milken | https://www.sechistorical.org/museum/galleries/wwr/wwr05d-markets-milken.php

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140.

USAFacts. NATO o&m ratios for global spending. USAFacts: US Military Spending https://usafacts.org/articles/how-much-does-the-us-spend-on-the-military/ (2024)

Operations & Maintenance (O&M): 38-50% of military spending US FY2024: O&M cost $332B (38% of military spending), up from 28% in 1974 2005-2015 trend: O&M represented 40-50% of DoD total budget NATO 2024: $1.47T total spending across 32 member countries; US $967B (66%), European members $454B (30%) NATO equipment investment guideline: At least 20% of military expenditures for major equipment/R&D Additional sources: https://usafacts.org/articles/how-much-does-the-us-spend-on-the-military/ | https://www.cbo.gov/publication/52156 | https://www.nato.int/cps/en/natohq/topics_49198.htm | https://www.statista.com/statistics/1293301/combined-military-expenditures-nato/

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141.

Us, A. of. NIH all of us research program outcomes and spending. All of Us: Program Overview https://allofus.nih.gov/article/program-overview (2026)

Total authorized funding:  $2.16B (not $4B) - $1.02B allocated since 2015, $1.14B authorized through 2026 via 21st Century Cures Act Budget cut 71% over 2 years: $500M+ (2023) → $150M (2025) Enrolled: 860,000 participants from all 50 states; 633,000+ participants with data available for research Clinical trials completed: Zero (program is observational cohort study, not a clinical trial program) Purpose: Collect prospective data to inform future clinical trials, provide recruitment infrastructure Additional sources: https://allofus.nih.gov/article/program-overview | https://www.nejm.org/doi/full/10.1056/NEJMsr1809937 | https://www.genomeweb.com/sequencing/all-us-research-program-unfazed-funding-cuts-lays-out-plans-through-2026

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142.

NSF. Annual number of papers published from NIH-funded research. NSF: Publications Output https://ncses.nsf.gov/pubs/nsb20206

Global scientific output: 2.5-2.6 million research papers published annually (all sources, not just NIH) Worldwide S&E publication growth: 1.8M (2008) → 2.6M articles (2018), averaging  4% annual growth NIH-specific output example (2000): 4,451 R01 grants ($1.3B) produced 55,000 publications, 3.7M citations Total active journals: 46,736 peer-reviewed journals (2020) publishing 3M+ articles annually Additional sources: https://ncses.nsf.gov/pubs/nsb20206 | https://ourworldindata.org/grapher/scientific-publications-per-million | https://pmc.ncbi.nlm.nih.gov/articles/PMC8738817/

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143.

Forum, J. H. NIH actual interventional trial spending: Only 3.3% of budget. JAMA Health Forum: NIH Clinical Development Spending (2023) https://pmc.ncbi.nlm.nih.gov/articles/PMC10349341/ (2023)

The "33% clinical research" category is misleading. NIH spent only **$8.1 billion (3.3% of $247.3 billion)** on phased clinical development (Phases 1-3) for drugs approved 2010-2019. This represents just ** 10% of what industry spends** on clinical trials. The remaining "clinical research" budget includes observational studies, epidemiological research, health services research, and infrastructure—not actual interventional trials testing treatments. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC10349341/ | https://catalyst.harvard.edu/news/article/nih-spent-8-1b-for-phased-clinical-trials-of-drugs-approved-2010-19-10-of-reported-industry-spending/

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144.

PMC. Number of diseases eradicated by the NIH. PMC: Six Challenges in Eradication https://pmc.ncbi.nlm.nih.gov/articles/PMC7612385/

Diseases eradicated globally: Only 2 (smallpox in 1979 via $300M WHO effort over <10 years; rinderpest) NIH role: Contributor to research/vaccine development but not sole eradicator Near-eradication: Polio (close to achievement); measles, rubella targeted for eradication Major achievements via vaccination: Smallpox eradicated, polio nearly eliminated, diphtheria/tetanus/measles greatly reduced Impact: Vaccination eliminated disease in populations with high implementation rates; past 2 centuries saw enormous infectious disease control via sanitation, vaccines, antibiotics, nutrition Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC7612385/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC4024226/ | https://www.ncbi.nlm.nih.gov/books/NBK98117/

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145.

HHS. FY2016 budget in brief - NIH. HHS https://www.hhs.gov/about/budget/budget-in-brief/nih/index.html (2020)

NIH funding contributed to published research associated with every one of the 356 new drugs approved by the FDA from 2010–2019." Total NIH spending on this research was $187 billion, while industry spending on clinical development for these drugs was significantly higher. Approximately 54% of the NIH research budget is devoted to basic biomedical and behavioral research, while about one-third (33%) is allocated to clinical research including patient-oriented research, clinical trials, and health services research. Categories overlap so totals exceed 100%. Additional sources: https://www.pnas.org/doi/10.1073/pnas.1920929117 | https://marianamazzucato.com/books/the-entrepreneurial-state | https://www.hhs.gov/about/budget/budget-in-brief/nih/index.html | https://www.hhs.gov/about/budget/budget-in-brief/nih/index.html

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146.

Journal, S. V. B. NIH funding cuts and brain drain. Silicon Valley Business Journal https://www.bizjournals.com/sanjose/news/2025/08/15/nih-funding-cuts-science-brain-drain-berkeley.html (2025)

Following a proposed 29% cut to NIH funding in 2025, 75% of scientists are considering leaving the U.S. due to funding instability. Additional sources: https://www.bizjournals.com/sanjose/news/2025/08/15/nih-funding-cuts-science-brain-drain-berkeley.html

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147.

ScienceDirect. Correlation between NIH funding priorities and disease burden. ScienceDirect: Persistence of Very Low Correlations https://www.sciencedirect.com/science/article/pii/S2666535224001174

Very weak correlations: R² < 0.03 between NIH funding and 5 disease burden measures for 27 diseases Historical (1996): r=0.62 correlation with DALYs, but explained only 39% of variance Recent (2008-2019): Simple correlation 0.08 between disease burden increases and funding increases 2019 analysis: Only 29% of variance in NIH funding explained by disease burden Strongest predictor of 2019 funding: 2008 funding levels (r=0.88), revealing long-standing inefficiencies Additional sources: https://www.sciencedirect.com/science/article/pii/S2666535224001174 | https://www.nejm.org/doi/full/10.1056/NEJM199906173402406 | https://pmc.ncbi.nlm.nih.gov/articles/PMC3044706/

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148.

News Reports, R. I. &. NIH RECOVER initiative inefficiency. RECOVER Initiative & News Reports https://recovercovid.org/about (2025).

149.

Wikipedia. The nuclear disarmament "freeze" movement of the 1980s. Wikipedia: Nuclear Freeze Campaign https://en.wikipedia.org/wiki/Nuclear_Freeze_campaign (2010)

Mass U.S. movement (1980s) to halt testing, production, deployment of nuclear weapons between U.S. and Soviet Union Origins: Proposed by Randall Forsberg (Dec 1979); Nuclear Weapons Freeze Campaign formed March 1981 at Georgetown University June 12, 1982:  1 million people rallied in NYC (largest peacetime rally in U.S. history) 1983: Congress passed nuclear freeze resolution Impact: Reagan administration reversed rhetoric ("nuclear war cannot be won and must never be fought") Major support: Religious community (National Council of Churches, Protestant denominations, progressive evangelicals, African-American churches) 1987: Merged with Committee for a Sane Nuclear Policy → formed Peace Action Additional sources: https://en.wikipedia.org/wiki/Nuclear_Freeze_campaign | https://www.armscontrol.org/act/2010-12/nuclear-freeze-and-its-impact | https://disarmament.blogs.pace.edu/nyc-nuclear-archive/nuclear-freeze-campaign-1970s-1980s/

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150.

Xia et al., N. F. Nuclear winter famine. Xia et al. https://www.nature.com/articles/s43016-022-00573-0 (2022)

We estimate that a nuclear war between the United States and Russia would produce 150 Tg of soot and lead to  5 billion people dying at the end of year 2. Additional sources: https://www.nature.com/articles/s43016-022-00573-0

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151.

CDC. Obesity epidemic statistics. CDC https://www.cdc.gov/nchs/products/databriefs/db360.htm (2020)

The US obesity prevalence was 42.4% in 2017-2018, and the prevalence of severe obesity increased from 4.7% to 9.2%. Additional sources: https://www.cdc.gov/nchs/products/databriefs/db360.htm

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152.

Wikipedia. Occupy wall street movement (2011). Wikipedia: Occupy Wall Street https://en.wikipedia.org/wiki/Occupy_Wall_Street

Left-wing populist movement against economic inequality, capitalism, corporate greed, big finance, money in politics September 17 - November 15, 2011 (59 days) in Zuccotti Park, NYC Financial District Slogan "We are the 99%" highlighted income/wealth inequality: Top 1% owned 40% of wealth, earned 20% of income (2011) Organized by Adbusters (Kalle Lasn, Micah White); ended November 15 when police cleared park ( 200 arrested) Legacy: Successfully reframed national conversation about economic inequality in simple, effective terms Additional sources: https://en.wikipedia.org/wiki/Occupy_Wall_Street | https://www.britannica.com/topic/Occupy-Wall-Street | https://history.com/this-day-in-history/occupy-wall-street-begins-zuccotti-park

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153.

Columbia/NBER. Odds of a single vote being decisive in a u.s. Presidential election. Columbia/NBER: What Is the Probability Your Vote Will Make a Difference? https://sites.stat.columbia.edu/gelman/research/published/probdecisive2.pdf (2012)

National average: 1 in 60 million chance (2008 election analysis by Gelman, Silver, Edlin) Swing states (NM, VA, NH, CO):  1 in 10 million chance Non-competitive states: 34 states >1 in 100 million odds; 20 states >1 in 1 billion Washington DC: 1 in 490 billion odds Methodology: Probability state is necessary for electoral college win × probability state vote is tied Additional sources: https://sites.stat.columbia.edu/gelman/research/published/probdecisive2.pdf | https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1465-7295.2010.00272.x

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154.

Research, G. V. Open-source and platform-as-a-service multi-trillion dollar market. Grand View Research: Open Source Services Market https://www.grandviewresearch.com/industry-analysis/open-source-services-market-report

Open source services market: $30.2B (2023) → $81.4B (2030) at 16.5% CAGR; other estimates $135.9B by 2033 Open source cloud platform: $6.23B (2024) → $18.12B (2033) at 12.8% CAGR Platform as a Service (PaaS): Growing at 12.6% CAGR Broader cloud computing market: Projected $1.5 trillion by 2033 at 15% CAGR Current market in tens of billions, approaching multi-trillion valuations in long term Additional sources: https://www.grandviewresearch.com/industry-analysis/open-source-services-market-report | https://www.precedenceresearch.com/open-source-services-market

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155.

Data, O. W. in. Pandemic vs. War deaths comparison. Our World in Data https://ourworldindata.org/covid-deaths (2024)

COVID-19 deaths: over 7 million confirmed deaths" vs. annual conflict deaths typically under 100,000. Additional sources: https://ourworldindata.org/covid-deaths

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156.

Trials. Patient willingness to participate in clinical trials. Trials: Patients’ Willingness Survey https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015-1105-3

Recent surveys: 49-51% willingness (2020-2022) - dramatic drop from 85% (2019) during COVID-19 pandemic Cancer patients when approached: 88% consented to trials (Royal Marsden Hospital) Study type variation: 44.8% willing for drug trial, 76.2% for diagnostic study Top motivation: "Learning more about my health/medical condition" (67.4%) Top barrier: "Worry about experiencing side effects" (52.6%) Additional sources: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015-1105-3 | https://www.appliedclinicaltrialsonline.com/view/industry-forced-to-rethink-patient-participation-in-trials | https://pmc.ncbi.nlm.nih.gov/articles/PMC7183682/

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157.

Wikipedia. Patrick soon-shiong’s focus on cancer research. Wikipedia: Patrick Soon-Shiong https://en.wikipedia.org/wiki/Patrick_Soon-Shiong (2017)

Billionaire biotech entrepreneur (net worth $12B, 2025); founder of NantWorks (healthcare/biotech/AI startups) Key achievements: Invented Abraxane (FDA-approved for metastatic breast, lung, advanced pancreatic cancer); first drug in 20+ years showing significant survival improvement for metastatic pancreatic cancer Recent breakthrough: Anktiva (new immunotherapy class) FDA-approved April 2024 for non-muscle invasive bladder cancer; 71% complete remission, 24.1 median duration Companies: Executive Chairman of NantKwest (immunotherapy, natural killer cells); Chairman/CEO of ImmunityBio (vaccines/immunotherapy for cancer/infectious diseases) 2016 Cancer Moonshot: Goal to enroll 20,000 patients in trials, develop effective vaccine by 2020 (faced criticism, fell short of goals) Additional sources: https://en.wikipedia.org/wiki/Patrick_Soon-Shiong | https://www.statnews.com/2017/03/27/soon-shiong-cancer-video-questions/ | https://www.biospace.com/patrick-soon-shiong-s-cancer-moonshot-slow-progress-but-some-news

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158.

Wikipedia. Passage of the USA PATRIOT act. Wikipedia: Patriot Act https://en.wikipedia.org/wiki/Patriot_Act (2001)

Introduced: October 23, 2001 by Rep. Jim Sensenbrenner (R-WI) as H.R. 3162 Passed House: October 24, 2001 (357-66 vote, Democrats majority of "no" votes) Passed Senate: October 25, 2001 (98-1 vote, only Russ Feingold D-WI voted "no") Signed into law: October 26, 2001 by President George W. Bush Length: 342 pages, passed hastily without public opportunity for review ACLU concern: Senate forced to vote on legislation it hadn’t had opportunity to read (offices closed, staff couldn’t access papers) Additional sources: https://en.wikipedia.org/wiki/Patriot_Act | https://www.britannica.com/topic/USA-PATRIOT-Act | https://www.ala.org/advocacy/chronology-usa-patriot-act-2001

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159.

U.S. Congress. 42 u.s. Code § 1320e-1 - limitations on certain uses of comparative clinical effectiveness research. (2010)

Exact statutory text: "The Patient-Centered Outcomes Research Institute established under section 1320e(b)(1) of this title shall not develop or employ a dollars-per-quality adjusted life year (or similar measure that discounts the value of a life because of an individual’s disability) as a threshold to establish what type of health care is cost effective or recommended." The Secretary also cannot use such thresholds for Medicare coverage or reimbursement decisions.

160.

Hester M. Peirce, S. C. Token safe harbor concept (peirce 2.0). Hester M. Peirce https://www.sec.gov/news/public-statement/peirce-statement-token-safe-harbor-proposal-2.0 (2021)

The safe harbor seeks to provide network developers with a three‑year grace period... to facilitate participation in, and the development of, a functional or decentralized network. Additional sources: https://www.sec.gov/news/public-statement/peirce-statement-token-safe-harbor-proposal-2.0

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161.

Commune, T. Pentagon audit failures ($2.46T unaccounted). The Commune https://thecommunemag.com/the-pentagon-misplaced-2-46-trillion-an-in-depth-look-at-the-financial-audit-failures (2024)

In the most recent audit, the Department of Defense (DoD) could not account for approximately 60% of its 4.1trillioninassets, amountingto2.46 trillion unaccounted for. Alternative title: Pentagon unsupported accounting adjustments (6.5T, singleyear, USArmy)In2015, theDepartmentofDefense′sInspectorGeneralreportedthattheArmycouldnotadequatelysupport6.5 trillion in year-end adjustments, indicating severe accounting discrepancies. Additional sources: https://thecommunemag.com/the-pentagon-misplaced-2-46-trillion-an-in-depth-look-at-the-financial-audit-failures | https://accmag.com/audit-pentagon-cannot-account-for-6-5-trillion-dollars-is-taxpayer-money/

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162.

OpenSecrets. Pharmaceutical industry lobbying statistics. OpenSecrets: Pharmaceuticals/Health Products https://www.opensecrets.org/industries/indus?ind=H04

Pharmaceutical and health products industry spent $388 million on federal lobbying in 2024 ($6.1 billion since 1999) Employs roughly 3 lobbyists for every member of Congress Note: The industry has consistently been among the top spenders on lobbying in Washington D.C., with major pharmaceutical companies like Pfizer, AbbVie, and PhRMA leading expenditures Additional sources: https://www.opensecrets.org/industries/indus?ind=H04

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163.

PMC. Pharmaceutical industry annual profits. PMC: Profitability of Large Pharmaceutical Companies https://pmc.ncbi.nlm.nih.gov/articles/PMC7054843/

Net income (2000-2018): 35 large pharma companies earned $1.9T cumulative net income on $11.5T revenue 2022 profits: Major pharma companies made >$112B in profits Profit margins: Pharma companies 13.8% median vs 7.7% for other S&P 500 companies Largest 25 companies: 15-20% annual average profit margin vs 4-9% for non-drug companies globally Profitability: Pharma significantly more profitable than most S&P 500 companies Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC7054843/ | https://www.bentley.edu/news/new-research-shows-pharma-companies-are-more-profitable-most-sp-500-companies | https://www.gao.gov/products/gao-18-40

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164.

PMC. Pragmatic trial cost per patient (median $97). PMC: Costs of Pragmatic Clinical Trials https://pmc.ncbi.nlm.nih.gov/articles/PMC6508852/

The median cost per participant was $97 (IQR $19–$478), based on 2015 dollars. Systematic review of 64 embedded pragmatic clinical trials. 25% of trials cost <$19/patient; 10 trials exceeded $1,000/patient. U.S. studies median $187 vs non-U.S. median $27. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC6508852/

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165.

One, P. Polypill for primary prevention cost per QALY. PLOS One https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0182625

A polypill strategy was potentially cost-effective compared to other strategies for most sub-groups ranging from dominance to up to £18,811 per QALY depending on patient sub-group. Additional sources: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0182625

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166.

Foundation, E. Proof-of-stake energy efficiency. Ethereum Foundation: ETH Will Use 99.95 https://blog.ethereum.org/2021/05/18/country-power-no-more (2021)

Ethereum’s "Merge" (Sept 15, 2022): Transition from proof-of-work to proof-of-stake Energy reduction: 99.9-99.95% less energy consumption ( 2000X more energy-efficient) Actual consumption drop: 23M megawatt hours/year → 2,600 megawatt hours/year Carbon footprint: 99.992% reduction (11.016M tonnes CO2e → 870 tonnes CO2e) Additional sources: https://blog.ethereum.org/2021/05/18/country-power-no-more | https://ethereum.org/energy-consumption/ | https://decrypt.co/109848/ethereum-energy-carbon-footprint-down-99-percent-merge

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167.

Kinch, M. S. & Griesenauer, R. H. Lost medicines: A longer view of the pharmaceutical industry with the potential to reinvigorate discovery. Drug Discovery Today 24, 875–880 (2019)

Research identified 1,600+ medicines available in 1962. The 1950s represented industry high-water mark with >30 new products in five of ten years; this rate would not be replicated until late 1990s. More than half (880) of these medicines were lost following implementation of Kefauver-Harris Amendment. The peak of 1962 would not be seen again until early 21st century. By 2016 number of organizations actively involved in R&D at level not seen since 1914.

168.

Study of Drug Development, T. C. for. Post-1962 explosion in drug development costs. Tufts Center for Study of Drug Development https://csdd.tufts.edu/cost-study (2014)

Cost to develop a new prescription drug: $2.6 billion (2014 Tufts study), increasing to $2.9 billion with post-approval development Represents 145% increase (inflation-adjusted) from 2003 estimate of $802 million Based on 106 drugs from 10 pharmaceutical companies tested between 1995-2007 Note: This study has been controversial; some organizations like Doctors Without Borders suggest actual costs may be substantially lower. Deloitte 2023 report shows costs continuing to rise Additional sources: https://csdd.tufts.edu/cost-study | https://cen.acs.org/articles/92/web/2014/11/Tufts-Study-Finds-Big-Rise.html

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169.

CSV, S. U. L. E. F. B. 1543-2019. Post-1962 slowdown in life expectancy gains. (2019)

Pre-1962 (1880-1960): 3.82 years/decade Post-1962 (1962-2019): 1.54 years/decade Reduction: 60% decline Temporal correlation: Slowdown occurred immediately after 1962 Kefauver-Harris Amendment See detailed calculation: [life-expectancy-increase-pre-1962](#life-expectancy-increase-pre-1962) Additional sources: https://ourworldindata.org/life-expectancy | https://www.mortality.org/ | https://www.cdc.gov/nchs/nvss/mortality_tables.htm

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170.

Fund, N. C. NIH pragmatic trials: Minimal funding despite 30x cost advantage. NIH Common Fund: HCS Research Collaboratory https://commonfund.nih.gov/hcscollaboratory (2025)

The NIH Pragmatic Trials Collaboratory funds trials at **$500K for planning phase, $1M/year for implementation**—a tiny fraction of NIH’s budget. The ADAPTABLE trial cost **$14 million** for **15,076 patients** (= **$929/patient**) versus **$420 million** for a similar traditional RCT (30x cheaper), yet pragmatic trials remain severely underfunded. PCORnet infrastructure enables real-world trials embedded in healthcare systems, but receives minimal support compared to basic research funding. Additional sources: https://commonfund.nih.gov/hcscollaboratory | https://pcornet.org/wp-content/uploads/2025/08/ADAPTABLE_Lay_Summary_21JUL2025.pdf | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604499/

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171.

Pre-1962 Drug Development Costs (Congressional Testimony, Alternative Estimate). https://www.congress.gov/95/crecb/1977/04/21/GPO-CRECB-1977-pt10-2-3.pdf (1977)

1962: Average cost $1.2 million (in 1962 dollars) 1972: $11.5 million 1977: Projected $40 million Inflation-adjusted to 2024 dollars: $1.2M (1962) ≈ $12M (2024), using CPI multiplier of  10× Real cost increase (inflation-adjusted): $12M (1962) → $2,600M (2024) = 217× increase Note: Lower estimate than Baily (1972); may reflect incomplete cost accounting or different drug types. Baily’s $6.5M (1980 dollars) = $22.5M (2024 dollars) is the more rigorous academic estimate Additional sources: https://www.congress.gov/95/crecb/1977/04/21/GPO-CRECB-1977-pt10-2-3.pdf

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172.

Numbers, T. by. Pre-1962 drug development costs and timeline (think by numbers). Think by Numbers: How Many Lives Does FDA Save? https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ (1962)

Historical estimates (1970-1985): USD $226M fully capitalized (2011 prices) 1980s drugs:  $65M after-tax R&D (1990 dollars),  $194M compounded to approval (1990 dollars) Modern comparison: $2-3B costs, 7-12 years (dramatic increase from pre-1962) Context: 1962 regulatory clampdown reduced new treatment production by 70%, dramatically increasing development timelines and costs Note: Secondary source; less reliable than Congressional testimony Additional sources: https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ | https://en.wikipedia.org/wiki/Cost_of_drug_development | https://www.statnews.com/2018/10/01/changing-1962-law-slash-drug-prices/

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173.

Numbers, T. by. Pre-1962 physician-led clinical trials. Think by Numbers: How Many Lives Does FDA Save? https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ (1966)

Pre-1962: Physicians could report real-world evidence directly 1962 Drug Amendments replaced "premarket notification" with "premarket approval", requiring extensive efficacy testing Impact: New regulatory clampdown reduced new treatment production by 70%; lifespan growth declined from  4 years/decade to  2 years/decade Drug Efficacy Study Implementation (DESI): NAS/NRC evaluated 3,400+ drugs approved 1938-1962 for safety only; reviewed >3,000 products, >16,000 therapeutic claims FDA has had authority to accept real-world evidence since 1962, clarified by 21st Century Cures Act (2016) Note: Specific "144,000 physicians" figure not verified in sources Additional sources: https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ | https://www.fda.gov/drugs/enforcement-activities-fda/drug-efficacy-study-implementation-desi | http://www.nasonline.org/about-nas/history/archives/collections/des-1966-1969-1.html

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174.

arXiv. Preferential target attachment in clinical trials. arXiv https://arxiv.org/abs/2301.10709 (2023)

Clinical trials overwhelmingly test the same few biological targets due to preferential attachment dynamics. Additional sources: https://arxiv.org/abs/2301.10709

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175.

Bowles, S. Prehistoric violence rates. Bowles https://www.science.org/doi/10.1126/science.1168112 (2009)

Archaeological evidence suggests that approximately 15% of prehistoric humans died from violence, compared to less than 1% in modern developed nations. Additional sources: https://www.science.org/doi/10.1126/science.1168112

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176.

Princeton. Princeton study on policy outcomes and influence of elites vs. Average citizens. Princeton: Testing Theories of American Politics (PDF) https://archive.org/details/gilens_and_page_2014_-testing_theories_of_american_politics.doc (2014)

Study by Martin Gilens (Princeton) and Benjamin I. Page (Northwestern): Analyzed 1,779 policy outcomes (1981-2002) Finding: "Economic elites and organized groups representing business interests have substantial independent impacts on U.S. government policy, while average citizens have little or no independent influence Rich, well-connected individuals steer the country’s direction, regardless of or even against the will of the majority of voters Note: Specific "78 percent" and "zero percent correlation" statistics not found in sources Additional sources: https://scholar.princeton.edu/sites/default/files/mgilens/files/gilens_and_page_2014_-testing_theories_of_american_politics.doc.pdf | https://act.represent.us/sign/usa-oligarchy-research-explained | https://archive.org/details/gilens_and_page_2014_-testing_theories_of_american_politics.doc

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177.

PubMed. Psychological impact of war cost ($100B annually). PubMed: Economic Burden of PTSD https://pubmed.ncbi.nlm.nih.gov/35485933/

PTSD economic burden (2018 U.S.): $232.2B total ($189.5B civilian, $42.7B military) Civilian costs driven by: Direct healthcare ($66B), unemployment ($42.7B) Military costs driven by: Disability ($17.8B), direct healthcare ($10.1B) Exceeds costs of other mental health conditions (anxiety, depression) War-exposed populations: 2-3X higher rates of anxiety, depression, PTSD; women and children most vulnerable Note: Actual burden $232B, significantly higher than "$100B" claimed Additional sources: https://pubmed.ncbi.nlm.nih.gov/35485933/ | https://news.va.gov/103611/study-national-economic-burden-of-ptsd-staggering/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC9957523/

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178.

AllTrials. Publication rate of clinical trial results. AllTrials: Half of Trials Unreported https://www.alltrials.net/news/half-of-all-trials-unreported/ (2013)

 50.0% of clinical trials never publish results (NHS-funded systematic review, 2010) Schmucker et al (2014): 53% of trials published (analyzing 39 studies, >20,000 trials) Munch et al (2014): 46% of pain treatment trials published Chang et al (2015): 49% of high-risk cardiac device trials published Positive findings: 3X more likely to be published than negative results Antidepressant example: Published literature showed 94% positive trials; FDA analysis showed only 51% positive Additional sources: https://www.alltrials.net/news/half-of-all-trials-unreported/ | https://www.nature.com/articles/nature.2013.14286 | https://pmc.ncbi.nlm.nih.gov/articles/PMC8276556/

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179.

IMF. Reconstruction costs from active conflicts. IMF: Cost of Conflict https://www.imf.org/external/pubs/ft/fandd/2017/12/imus.htm (2017)

Individual conflict examples: Libya, Syria, Yemen  $300B combined (World Bank) Syria alone: $250B-$1T estimates Ukraine: >€500B reconstruction costs Gaza: $18.5B infrastructure damage Global conflict/violence cost: $14.3T/year (2016, includes military spending, security, losses) Note: Specific "$1,875B for 47 conflicts" figure not verified in sources Additional sources: https://www.imf.org/external/pubs/ft/fandd/2017/12/imus.htm | https://www.weforum.org/stories/2018/01/conflict-costs-global-economy-14-trillion-a-year/ | https://fortune.com/2022/04/21/ukraine-reconstruction-cost-rebuild-economists-plan-russia-foot-trillion-bill/

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180.

Initiative, R. RECOVER initiative budget update (>$2.3B). RECOVER Initiative https://recovercovid.org/news/nih-adds-funds-long-covid-research-advances-work-new-clinical-trials (2024).

181.

NIH. NIH RECOVER initiative patient enrollment numbers. NIH: RECOVER Initiative Enrollment https://www.nih.gov/news-events/news-releases/nih-builds-large-nationwide-study-population-tens-thousands-support-research-long-term-effects-covid-19

Enrolled:  30,000 people in ongoing studies and clinical trials Goal: 40,000 adults and children $1.15B effort (including American Rescue Plan Act 2021 support) One of largest, most diverse Long COVID cohorts in world Additional sources: https://www.nih.gov/news-events/news-releases/nih-builds-large-nationwide-study-population-tens-thousands-support-research-long-term-effects-covid-19 | https://recovercovid.org/news/nih-launches-long-covid-clinical-trials-through-recover-initiative-opening-enrollment

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182.

Oren Cass, M. I. RECOVERY trial cost per patient. Oren Cass https://manhattan.institute/article/slow-costly-clinical-trials-drag-down-biomedical-breakthroughs (2023)

The RECOVERY trial, for example, cost only about 500perpatient...Bycontrast, themedianper − patientcostofapivotaltrialforanewtherapeuticisaround41,000. Additional sources: https://manhattan.institute/article/slow-costly-clinical-trials-drag-down-biomedical-breakthroughs

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183.

Oxford, U. of. RECOVERY trial time to first cure. University of Oxford https://www.ox.ac.uk/news/2020-06-16-dexamethasone-reduces-death-hospitalised-patients-severe-respiratory-complications (2020)

100 days to first cure Additional sources: https://www.ox.ac.uk/news/2020-06-16-dexamethasone-reduces-death-hospitalised-patients-severe-respiratory-complications | https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19

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184.

al., N. E. Á. et. RECOVERY trial global lives saved ( 1 million). NHS England: 1 Million Lives Saved https://www.england.nhs.uk/2021/03/covid-treatment-developed-in-the-nhs-saves-a-million-lives/ (2021)

Dexamethasone saved  1 million lives worldwide (NHS England estimate, March 2021, 9 months after discovery). UK alone: 22,000 lives saved. Methodology: Águas et al. Nature Communications 2021 estimated 650,000 lives (range: 240,000-1,400,000) for July-December 2020 alone, based on RECOVERY trial mortality reductions (36% for ventilated, 18% for oxygen-only patients) applied to global COVID hospitalizations. June 2020 announcement: Dexamethasone reduced deaths by up to 1/3 (ventilated patients), 1/5 (oxygen patients). Impact immediate: Adopted into standard care globally within hours of announcement. Additional sources: https://www.england.nhs.uk/2021/03/covid-treatment-developed-in-the-nhs-saves-a-million-lives/ | https://www.nature.com/articles/s41467-021-21134-2 | https://pharmaceutical-journal.com/article/news/steroid-has-saved-the-lives-of-one-million-covid-19-patients-worldwide-figures-show | https://www.recoverytrial.net/news/recovery-trial-celebrates-two-year-anniversary-of-life-saving-dexamethasone-result

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185.

Institute, M. RECOVERY trial 82× cost reduction. Manhattan Institute: Slow Costly Trials https://manhattan.institute/article/slow-costly-clinical-trials-drag-down-biomedical-breakthroughs

RECOVERY trial:  $500 per patient ($20M for 48,000 patients = $417/patient) Typical clinical trial:  $41,000 median per-patient cost Cost reduction:  80-82× cheaper ($41,000 ÷ $500 ≈ 82×) Efficiency: $50 per patient per answer (10 therapeutics tested, 4 effective) Dexamethasone estimated to save >630,000 lives Additional sources: https://manhattan.institute/article/slow-costly-clinical-trials-drag-down-biomedical-breakthroughs | https://pmc.ncbi.nlm.nih.gov/articles/PMC9293394/

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186.

Trial, R. RECOVERY trial cost reduction. RECOVERY Trial https://www.recoverytrial.net/

Oxford RECOVERY trial achieved  $500 per patient cost, compared to traditional Phase III trial costs of $40,000-120,000+ per patient. This represents an 80-100x+ cost reduction. Key strategies: embedding trial protocols within routine hospital care, minimizing overhead by leveraging existing staff/resources and electronic data capture, and focused pragmatic trial designs. Additional sources: https://www.recoverytrial.net/

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187.

Trial, R. RECOVERY trial dexamethasone results. RECOVERY Trial https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19

Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; $p=0.0003$) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; $p=0.0021$) Additional sources: https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19

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188.

News, O. U. RECOVERY trial summary quote. Oxford University News https://www.ox.ac.uk/news/features/recovery-trial-two-years

One trial. Over 47,000 participants. Nearly 200 hospital sites, across six countries. Ten results. Four effective COVID-19 treatments... Through discovering four treatments that effectively reduce deaths from COVID-19, it is certain that the study has saved thousands – if not millions – of lives worldwide. Additional sources: https://www.ox.ac.uk/news/features/recovery-trial-two-years

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189.

ASPE. Refugee lost annual earning potential ($23,400). ASPE: Fiscal Impact of Refugees https://aspe.hhs.gov/reports/fiscal-impact-refugees-asylees

Refugee economic impact: Net positive $123.8B fiscal impact (2005-2019, 15 years) Refugees pay $21K more in taxes than benefits received over first 20 years in U.S. Earnings gap: Refugees work at higher rates than natives but earn less; never reach U.S.-born earning levels Income progression: <5 years in U.S. = $30,500 median; 20+ years = $71,400 (exceeds national $67,100 median) Note: Specific "$23,400 lost earning potential" figure not verified in sources Additional sources: https://aspe.hhs.gov/reports/fiscal-impact-refugees-asylees | https://www.americanimmigrationcouncil.org/sites/default/files/research/05.23_refugee_report_v3_0.pdf | https://www.nber.org/system/files/working_papers/w23498/w23498.pdf

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190.

Forest, W. Milestones in regenerative medicine and tissue engineering. Wake Forest: Record of Firsts https://school.wakehealth.edu/research/institutes-and-centers/wake-forest-institute-for-regenerative-medicine/research/a-record-of-firsts

1999: First 3D-printed organ (bladder) transplanted into human (Wake Forest Institute, still functioning 20+ years later) Windpipes (trachea): 3D-printed windpipe transplants performed; patient received biodegradable 5-year windpipe Blood vessels, skin: Mobile bioprinters can print skin directly onto wounds at patient bedside Tubular organs: Urine conduits engineered and implanted in patients 3D-printed ear implant: World’s first successfully transplanted Current status: Can print flat structures (skin), tubular (blood vessels), hollow non-tubular (bladder); complex life-sized organs 20-30 years away Additional sources: https://school.wakehealth.edu/research/institutes-and-centers/wake-forest-institute-for-regenerative-medicine/research/a-record-of-firsts | https://builtin.com/articles/3d-printed-organs | https://pmc.ncbi.nlm.nih.gov/articles/PMC5313259/

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191.

JAMA. Research to practice gap (17 years). JAMA https://pubmed.ncbi.nlm.nih.gov/37018006/ (2023)

It takes an average of 17 years for new scientific evidence to be implemented into clinical practice. Additional sources: https://pubmed.ncbi.nlm.nih.gov/37018006/

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192.

WHO. Annual deaths from respiratory disease. WHO: COPD Fact Sheet) https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd (2019)

Chronic respiratory diseases: 4.0 million deaths annually (2019) COPD specifically: 3.5 million deaths (2021) - 4th leading cause of death globally Pneumonia: 2.5 million deaths including 672,000 children (2019) Combined respiratory deaths:  6.5 million annually Note: 90% of COPD deaths in those under 70 occur in low- and middle-income countries. COPD affects over 380 million people globally Additional sources: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd | https://www.healthdata.org/research-analysis/library/global-burden-chronic-respiratory-diseases-and-risk-factors-1990-2019

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193.

Congress.gov. Right to try act (2018). Congress.gov https://www.congress.gov/bill/115th-congress/house-bill/2368 (2018)

Right to Try Act (2018) Additional sources: https://www.congress.gov/bill/115th-congress/house-bill/2368 | https://pmc.ncbi.nlm.nih.gov/articles/PMC7416898/

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194.

PMC. Number of patients helped by the u.s. Right to try act. PMC: Understanding Right to Try https://pmc.ncbi.nlm.nih.gov/articles/PMC7416898/ (2024)

2018-2022: Supported access to only 12 products total; 4 products in 2023 Number of people treated: Not publicly reported, "likely only in the hundreds Specific documented cases: 75+ neuroendocrine cancer patients (LU-177); at least 1 ALS patient (NurOwn); 7 glioblastoma patients (Gliovac) Minimal safety reporting: Only annual basis, no requirement to publish results/outcomes Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC7416898/ | https://www.statnews.com/2024/08/02/trump-gave-patients-right-to-try-it-hasnt-helped-them/ | https://www.healio.com/news/hematology-oncology/20200303/right-to-try-a-wellintentioned-but-misguided-law

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195.

SIPRI. Russia’s share of global military spending. SIPRI: 2024 Military Expenditure https://www.sipri.org/media/press-release/2025/unprecedented-rise-global-military-expenditure-european-and-middle-east-spending-surges (2024)

2024: $149B military spending (5.5% of global $2.7T), 3rd largest spender globally 38% increase from 2023; doubled since 2015 7.1% of Russia’s GDP, 19% of all Russian government spending Top 5 spenders (US, China, Russia, Germany, India): $1,635T combined (60% of global) Note: Russia accounts for  5.5% of global military spending, not 10% Additional sources: https://www.sipri.org/media/press-release/2025/unprecedented-rise-global-military-expenditure-european-and-middle-east-spending-surges | https://www.sipri.org/sites/default/files/2025-04/2504_fs_milex_2024.pdf

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196.

Dawkins, R. The selfish gene quote. Richard Dawkins https://en.wikipedia.org/wiki/The_Selfish_Gene (1976)

We are survival machines, robot vehicles blindly programmed to preserve the selfish molecules known as genes. Additional sources: https://en.wikipedia.org/wiki/The_Selfish_Gene

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197.

Institute, S. I. P. R. Trends in world military expenditure, 2023. (2024).

198.

WHO. Smallpox eradicated. WHO https://www.who.int/health-topics/smallpox

Following a successful global eradication campaign, the World Health Assembly officially declared the world free of smallpox in 1980. Additional sources: https://www.who.int/health-topics/smallpox

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199.

CSIS. Smallpox eradication ROI. CSIS https://www.csis.org/analysis/smallpox-eradication-model-global-cooperation.

200.

Finance, Y. George soros’s 1992 bet against the british pound. Yahoo Finance: British Pounding https://finance.yahoo.com/news/british-pounding-george-soros-made-160033593.html

Black Wednesday (September 16, 1992): Soros assembled $10 billion short position against British pound Increased position from $1.5B to $10B that morning; bought German marks while selling pounds Profit: Over £1 billion ($1-1.5 billion) in single day UK Treasury cost: £3.3 billion; Bank of England spent $29 billion trying to defend pound Pound fell 15% vs. German mark, 25% vs. dollar; UK forced to exit European Exchange Rate Mechanism Earned Soros title "the man who broke the Bank of England Additional sources: https://finance.yahoo.com/news/british-pounding-george-soros-made-160033593.html | https://en.wikipedia.org/wiki/Black_Wednesday | https://www.thebalancemoney.com/black-wednesday-george-soros-bet-against-britain-1978944

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201.

UK, H. The south sea bubble of 1720. Historic UK: South Sea Bubble https://www.historic-uk.com/HistoryUK/HistoryofEngland/South-Sea-Bubble/

South Sea Company founded 1711 as public-private partnership to consolidate national debt Granted monopoly (Asiento de Negros) to supply African slaves to South America (1713) Stock price explosion: £128 (Jan 1720) → £175 (Feb) → £330 (Mar) → £550 (May) → £1,000 (Aug) Reality: No realistic prospect of trade; Company never realized significant profit from monopoly Collapse: By September market crashed; December shares down to £124 Called world’s first financial crash, first Ponzi scheme, classic "group think" speculation mania Story disconnected from actual (negligible) profits Additional sources: https://www.historic-uk.com/HistoryUK/HistoryofEngland/South-Sea-Bubble/ | https://en.wikipedia.org/wiki/South_Sea_Company | https://www.britannica.com/money/South-Sea-Bubble

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202.

PMC. Standard medical research ROI ($20k-$100k/QALY). PMC: Cost-effectiveness Thresholds Used by Study Authors https://pmc.ncbi.nlm.nih.gov/articles/PMC10114019/ (1990)

Typical cost-effectiveness thresholds for medical interventions in rich countries range from $50,000 to $150,000 per QALY. The Institute for Clinical and Economic Review (ICER) uses a $100,000-$150,000/QALY threshold for value-based pricing. Between 1990-2021, authors increasingly cited $100,000 (47% by 2020-21) or $150,000 (24% by 2020-21) per QALY as benchmarks for cost-effectiveness. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC10114019/ | https://icer.org/our-approach/methods-process/cost-effectiveness-the-qaly-and-the-evlyg/

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203.

Lancet, T. Statins for high-risk patients cost per QALY. The Lancet https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(24

Standard statin was cost-effective across all categories with incremental cost per QALY from £280 to £8530, with higher intensity statin cost-effective at higher cardiovascular risks and higher LDL-C levels. Additional sources: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(24

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204.

GAO. Annual cost of u.s. Sugar subsidies. GAO: Sugar Program https://www.gao.gov/products/gao-24-106144

Consumer costs: $2.5-3.5 billion per year (GAO estimate) Net economic cost:  $1 billion per year 2022: US consumers paid 2X world price for sugar Program costs $3-4 billion/year but no federal budget impact (costs passed directly to consumers via higher prices) Employment impact: 10,000-20,000 manufacturing jobs lost annually in sugar-reliant industries (confectionery, etc.) Multiple studies confirm: Sweetener Users Association ($2.9-3.5B), AEI ($2.4B consumer cost), Beghin & Elobeid ($2.9-3.5B consumer surplus) Additional sources: https://www.gao.gov/products/gao-24-106144 | https://www.heritage.org/agriculture/report/the-us-sugar-program-bad-consumers-bad-agriculture-and-bad-america | https://www.aei.org/articles/the-u-s-spends-4-billion-a-year-subsidizing-stalinist-style-domestic-sugar-production/

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205.

WHO. Global suicide deaths vs. Combat deaths. WHO https://www.who.int/publications/i/item/9789240110069 (2021)

Suicide deaths: 727,000 annually (2021), over 700,000 per year on average One person dies by suicide every 40 seconds 3rd leading cause of death among 15-29 year olds globally 73% of suicides occur in low- and middle-income countries Combat deaths:  89,000 annually (significantly lower than suicide) Note: Link between suicide and mental disorders (depression, alcohol use) is well-established. With timely, evidence-based interventions, suicides can be prevented Additional sources: https://www.who.int/publications/i/item/9789240110069 | https://www.who.int/news-room/fact-sheets/detail/suicide

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206.

Bank, W. Swiss military budget as percentage of GDP. World Bank: Military Expenditure https://data.worldbank.org/indicator/MS.MIL.XPND.GD.ZS?locations=CH

2023: 0.70272% of GDP (World Bank) 2024: CHF 5.95 billion official military spending When including militia system costs:  1% GDP (CHF 8.75B) Comparison: Near bottom in Europe; only Ireland, Malta, Moldova spend less (excluding microstates with no armies) Additional sources: https://data.worldbank.org/indicator/MS.MIL.XPND.GD.ZS?locations=CH | https://www.avenir-suisse.ch/en/blog-defence-spending-switzerland-is-in-better-shape-than-it-seems/ | https://tradingeconomics.com/switzerland/military-expenditure-percent-of-gdp-wb-data.html

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207.

Bank, W. Switzerland vs. US GDP per capita comparison. World Bank: Switzerland GDP Per Capita https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=CH

2024 GDP per capita (PPP-adjusted): Switzerland $93,819 vs United States $75,492 Switzerland’s GDP per capita 24% higher than US when adjusted for purchasing power parity Nominal 2024: Switzerland $103,670 vs US $85,810 Additional sources: https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=CH | https://tradingeconomics.com/switzerland/gdp-per-capita-ppp | https://www.theglobaleconomy.com/USA/gdp_per_capita_ppp/

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208.

Tracker, K. H. S. Switzerland vs. US life expectancy comparison. KFF Health System Tracker: Life Expectancy Comparison https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/

Switzerland: 84 years | United States: 78.4 years (2023) U.S. has lowest life expectancy among comparable developed countries (average: 82.5 years) Gap driven by preventable causes: cardiovascular disease, drug overdoses, firearm violence, motor vehicle crashes Note: U.S. spends nearly twice as much on healthcare per person as comparable countries despite lower life expectancy. The disadvantage began in 1950s and has worsened over past 4 decades Additional sources: https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/

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209.

Wikipedia. Switzerland’s last military conflict. Wikipedia: Sonderbund War https://en.wikipedia.org/wiki/Sonderbund_War (2019)

Sonderbund War (November 3-29, 1847): Last armed conflict on Swiss soil Civil war between 7 Catholic cantons vs. federal government over centralization Duration: 26 days; Casualties: 93 deaths total (60 federal, 33 Sonderbund), 510 wounded Federal army (100,000) led by General Guillaume Henri Dufour defeated Sonderbund forces Resulted in emergence of Switzerland as federal state; entered period of peace lasting to present Battle of Gisikon: Last battle Swiss ever fought Additional sources: https://en.wikipedia.org/wiki/Sonderbund_War | https://militaryhistorynow.com/2019/02/27/charm-offensive-switzerlands-polite-war-of-1847/ | https://www.zeit-fragen.ch/en/archives/2018/no-1-10-january-2018/the-sonderbund-war-the-last-armed-conflict-on-swiss-soil

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210.

Treasury. Troubled asset relief program (TARP) of 2008. Treasury: TARP About https://home.treasury.gov/data/troubled-assets-relief-program/about-tarp

Authorized: $700 billion (later reduced to $475 billion by Dodd-Frank) Actual disbursed: $443.5 billion to stabilize financial institutions Bank rescue: $236 billion to 707 financial institutions in 48 states Breakdown: $250B banking, $82B auto industry, $70B AIG, $46B foreclosure programs Net lifetime cost: $31.1 billion (after repayments, sales, dividends, interest); most attributable to foreclosure programs Passed October 3, 2008 (signed by President Bush); Emergency Economic Stabilization Act Additional sources: https://home.treasury.gov/data/troubled-assets-relief-program/about-tarp | https://en.wikipedia.org/wiki/Troubled_Asset_Relief_Program | https://www.propublica.org/article/the-bailout-was-11-years-ago-were-still-tracking-every-penny

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211.

FDA. Thalidomide caused thousands of birth defects. FDA https://www.fda.gov/about-fda/fda-history-exhibits/frances-oldham-kelsey-medical-reviewer-famous-averting-public-health-tragedy

it resulted in thousands of horrific congenital disabilities. Additional sources: https://www.fda.gov/about-fda/fda-history-exhibits/frances-oldham-kelsey-medical-reviewer-famous-averting-public-health-tragedy | https://www.smithsonianmag.com/science-nature/woman-who-stood-between-america-and-epidemic-birth-defects-180963165/

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212.

FDA. FDA dr. Kelsey prevented widespread thalidomide birth defects in the US. FDA: Frances Oldham Kelsey https://www.fda.gov/about-fda/fda-history-exhibits/frances-oldham-kelsey-medical-reviewer-famous-averting-public-health-tragedy

Dr. Frances Kelsey (FDA reviewer) resisted pressure to approve thalidomide September 1960-November 1961 Worldwide:  8,000 infants born with missing/malformed limbs; 5,000-7,000 perished in utero United States: 17 confirmed phocomelia cases + 9 likely cases (vs.  8,000 worldwide) Kelsey insisted on hard evidence, refused to be browbeaten; repeatedly requested more information every 60 days Merrell complained to her bosses, calling her "petty bureaucrat" - she persisted Recognition: President’s Award for Distinguished Federal Civilian Service (JFK, 1962) Led to 1962 Kefauver-Harris Amendments requiring drugs prove both safety AND effectiveness Additional sources: https://www.fda.gov/about-fda/fda-history-exhibits/frances-oldham-kelsey-medical-reviewer-famous-averting-public-health-tragedy | https://www.uchicagomedicine.org/forefront/biological-sciences-articles/courageous-physician-scientist-saved-the-us-from-a-birth-defects-catastrophe | https://www.smithsonianmag.com/science-nature/woman-who-stood-between-america-and-epidemic-birth-defects-180963165/

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213.

UNDP. Tobacco control ROI. UNDP https://www.undp.org/asia-pacific/blog/how-raising-tobacco-taxes-can-save-lives-and-cut-poverty-across-asia-pacific-0

In our study of six Asia-Pacific countries, we found that for every unit of local currency invested in increasing tobacco taxes, the countries would gain between 20 and 1,057 units in return over 15 years. That’s a remarkable return on investment ratio of between 20:1 and 1,057:1. Additional sources: https://www.undp.org/asia-pacific/blog/how-raising-tobacco-taxes-can-save-lives-and-cut-poverty-across-asia-pacific-0

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214.

Investor, A. Top performing private equity & hedge funds. Alternatives Investor https://alternativesinvestor.com/top-performing-private-equity-funds-2016-2019 (2021)

Top-performing private equity funds, such as Spectrum’s VIII-A Program, have achieved net IRRs as high as 98.91% for a single vintage year (2017). Renaissance Technologies’ Medallion Fund is famed for achieving an average annualized gross return of  66%, and a net return of  39%, from 1988 to 2021. Additional sources: https://alternativesinvestor.com/top-performing-private-equity-funds-2016-2019 | https://www.traderslog.com/top-hedge-funds

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215.

SIPRI, C. breakdown calculated using. Total military and war costs: $11.4 trillion.

Direct costs: $7,655B (Military $2.7T + Human casualties $2,446B + Infrastructure $1,875B + Trade disruption $616B) Indirect costs: $3,700B (Refugees $1,680B + Diplomatic $800B + Environmental $420B + Opportunity costs $320B + PTSD $232B + Lost human capital $300B) Total: $11,355.1 billion annually Per capita: $1,419/year; $113,500 over 80-year lifetime Updated from previous $9.9T estimate due to corrected combat deaths (89K → 233,600 per 2024 ACLED data)

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216.

Moore, Z., T. J. & Drug Administration, 2015.-2017. _JAMA. I. Medicine_. Traditional trial cost per patient. Moore https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295430/ (2020)

The median cost of a pivotal trial was estimated to be 19million...themediancostperpatientwas41,413. Additional sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295430/

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217.

NCBI, F. S. via. Trial costs, FDA study. FDA Study via NCBI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248200/

Overall, the 138 clinical trials had an estimated median (IQR) cost of 19.0million(12.2 million-33.1million)...Theclinicaltrialscostamedian(IQR)of41,117 (31, 802−82,362) per patient. Additional sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248200/

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218.

WHO. Annual deaths from tuberculosis. WHO https://www.who.int/news-room/fact-sheets/detail/tuberculosis (2024)

Tuberculosis | 1.3 million Additional sources: https://www.who.int/news-room/fact-sheets/detail/tuberculosis | https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024

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219.

Study of Drug Development, T. C. for the. Tufts center drug development cost estimate 2021. (2021)

Total cost to develop a new drug estimated at $2.6 billion as of 2021, nearly a 3-fold increase from $802 million in 2003 (inflation-adjusted).

220.

UNESCO. UNESCO cost for universal education coverage. UNESCO https://news.un.org/en/story/2023/04/1135697 (2023)

The largest financing gap is in sub-Saharan Africa: $70 billion per year. An additional $77 billion is needed annually for African countries to reach their national education targets and provide quality education for all. Additional sources: https://news.un.org/en/story/2023/04/1135697 | https://unesdoc.unesco.org/ark:/48223/pf0000192186

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221.

UNHCR. UNHCR forcibly displaced people 2023. UNHCR https://www.unhcr.org/global-trends-report-2023 (2023)

At the end of 2023, 117.3 million people worldwide were forcibly displaced. Additional sources: https://www.unhcr.org/global-trends-report-2023

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222.

CGDev. UNHCR average refugee support cost. CGDev https://www.cgdev.org/blog/costs-hosting-refugees-oecd-countries-and-why-uk-outlier (2024)

The average cost of supporting a refugee is $1,384 per year. This represents total host country costs (housing, healthcare, education, security). OECD countries average $6,100 per refugee (mean 2022-2023), with developing countries spending $700-1,000. Global weighted average of  $1,384 is reasonable given that 75-85% of refugees are in low/middle-income countries. Additional sources: https://www.cgdev.org/blog/costs-hosting-refugees-oecd-countries-and-why-uk-outlier | https://www.unhcr.org/sites/default/files/2024-11/UNHCR-WB-global-cost-of-refugee-inclusion-in-host-country-health-systems.pdf

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223.

Cryptopolitan. Uniswap labs treasury size. Cryptopolitan https://www.cryptopolitan.com/uniswap-dao-governance-attacks-2025/ (2025)

Uniswap is the largest DAO, holding $5.4B in its treasury as of early 2025. The DAO manages a $5.4 billion treasury, far surpassing the Ethereum Foundation’s $919 million. Additional sources: https://www.cryptopolitan.com/uniswap-dao-governance-attacks-2025/ | https://blockchainreporter.net/top-15-daos-ranked-by-treasury-size-mantle-uniswap-optimism-lead-the-pack

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224.

Research, P. US clinical trials market size 2024. Precedence Research https://www.precedenceresearch.com/us-clinical-trials-market

The U.S. clinical trials market was estimated at $45.07 billion in 2024, representing approximately 54% of the global market. Additional sources: https://www.precedenceresearch.com/us-clinical-trials-market

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225.

Group, C. F. Thickness of US currency. Certified Financial Group https://financialgroup.com/2021/10/21/what-does-one-trillion-dollars-look-like/ (2021)

All U.S. paper currency measures 0.0043 inches thick. A trillion dollars in $100 bills would be just over 678.66 miles tall. If we stacked $11.4 trillion in $100 bills, the stack would be approximately 7,737 miles tall. Additional sources: https://financialgroup.com/2021/10/21/what-does-one-trillion-dollars-look-like/ | https://lasvegassun.com/news/2011/jul/16/putting-debt-physical-perspective/

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226.

SIPRI. US/EU combined share of global military spending. SIPRI https://www.sipri.org/publications/2025/sipri-fact-sheets/trends-world-military-expenditure-2024 (2024)

Total military spending by NATO members amounted to $1,506 billion, or 55% of global military expenditure in 2024. The USA spent $997 billion (37% of world spending), European NATO members spent $454 billion. Additional sources: https://www.sipri.org/publications/2025/sipri-fact-sheets/trends-world-military-expenditure-2024

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227.

NEA. U.s. Federal government spending on the arts. NEA https://www.arts.gov/news/press-releases/2023/statement-national-endowment-arts-chair-maria-rosario-jackson-presidents-fiscal-year-2024-budget (2024)

The National Endowment for the Arts received an appropriation of $207.0 million for FY2024, with actual spending reaching $220 million. Additional sources: https://www.arts.gov/news/press-releases/2023/statement-national-endowment-arts-chair-maria-rosario-jackson-presidents-fiscal-year-2024-budget | https://www.usaspending.gov/agency/national-endowment-for-the-arts

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228.

USASpending.gov. U.s. Federal government spending on education. USASpending.gov https://www.usaspending.gov/agency/department-of-education (2024)

The Department of Education spent $268.4 billion in fiscal year (FY) 2024. About $80 billion consisted of discretionary appropriations that Congress allocates annually. Additional sources: https://www.usaspending.gov/agency/department-of-education | https://www.ed.gov/sites/ed/files/about/overview/budget/budget24/summary/24summary.pdf

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229.

CMS. U.s. Federal government spending on healthcare. CMS https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet (2024)

Healthcare: $1.5 trillion (for not dying, but slowly) Additional sources: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet

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230.

NASA. U.s. Government use of prize and bounty programs. NASA https://www.nasa.gov/news-release/nasa-and-x-prize-announce-winners-of-lunar-lander-challenge/

NASA’s Centennial Challenge, initiated in 2005, has paid out more than $7.6 million. The Ansari XPRIZE demonstrated significant leverage: $10 million was awarded to the winner, but more than $100 million was invested in new technologies in pursuit of the prize. NASA launched its own incentive scheme in 2005 called Centennial Challenges. Additional sources: https://www.nasa.gov/news-release/nasa-and-x-prize-announce-winners-of-lunar-lander-challenge/ | https://www.xprize.org/past-challenges | https://www.herox.com/blog/985-prize-challenges-governments-secret-weapon-for-inn

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231.

Defense, D. of. U.s. Military budget. Department of Defense https://www.military.gov/Spotlights/FY2024-Defense-Budget/ (2024)

The fiscal year 2024 (FY2024) military budget was signed into law on December 22, 2023 at $841.4 billion. The Fiscal Year 2024 Defense Appropriations Act provides $831.781 billion in total funding. Additional sources: https://www.defense.gov/Spotlights/FY2024-Defense-Budget/ | https://www.congress.gov/crs-product/R47582

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232.

Treasury, U. U.s. National debt. US Treasury https://fiscaldata.treasury.gov/americas-finance-guide/national-debt/

The gross national debt of the United States reached $36 trillion in November 2024, and has now reached $38 trillion as of late October 2025. Additional sources: https://fiscaldata.treasury.gov/americas-finance-guide/national-debt/ | https://www.crfb.org/press-releases/gross-national-debt-reaches-36-trillion

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233.

Wikipedia. US GDP growth rate post-WWII. Wikipedia https://en.wikipedia.org/wiki/Post–World_War_II_economic_expansion

US GDP increased from $228 billion in 1945 to just under $1.7 trillion in 1975. Average real GDP growth from 1950 to 1980 was around 4.1% annually, compared to 3.1% from 1981 to 2008. Additional sources: https://en.wikipedia.org/wiki/Post–World_War_II_economic_expansion | https://www.stlouisfed.org/timely-topics/house-prices-homeownership-rise

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234.

Fed, St. L. US home ownership rate increase post-WWII. St. Louis Fed https://www.stlouisfed.org/timely-topics/house-prices-homeownership-rise

The homeownership rate increased nearly 20 percentage points between 1940 and 1960, from 43.6% to 61.9%, the largest change in American homeownership in the past 100 years. Additional sources: https://www.stlouisfed.org/timely-topics/house-prices-homeownership-rise | https://www.census.gov/data/tables/time-series/dec/coh-owner.html

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235.

Wikipedia. US military spending reduction after WWII. Wikipedia https://en.wikipedia.org/wiki/Demobilization_of_United_States_Armed_Forces_after_World_War_II (2020)

Peaking at over $81 billion in 1945, the U.S. military budget plummeted to approximately $13 billion by 1948, representing an 84% decrease. The number of personnel was reduced almost 90%, from more than 12 million to about 1.5 million between mid-1945 and mid-1947. Defense spending exceeded 41 percent of GDP in 1945. After World War II, the US reduced military spending to 7.2 percent of GDP by 1948. Defense spending doubled from the 1948 low to 15 percent at the height of the Korean War in 1953. Additional sources: https://en.wikipedia.org/wiki/Demobilization_of_United_States_Armed_Forces_after_World_War_II | https://www.americanprogress.org/article/a-historical-perspective-on-military-budgets/ | https://www.stlouisfed.org/on-the-economy/2020/february/war-highest-military-spending-measured | https://www.usgovernmentspending.com/defense_spending_history

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236.

Foundation, T. Length of the u.s. Tax code. Tax Foundation https://taxfoundation.org/blog/how-many-words-are-tax-code/ (2024)

The Internal Revenue Code comprises 6,871 pages. When including federal tax regulations, federal tax laws and regulations together total over 10 million words (IRC: 2,412,000 words; regulations: 7,655,000 words). Additional sources: https://taxfoundation.org/blog/how-many-words-are-tax-code/ | https://www.ntu.org/foundation/detail/tax-complexity-2024-it-takes-americans-billions-of-hours-to-do-their-taxes

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237.

Bureau, U. C. Number of registered or eligible voters in the u.s. US Census Bureau https://www.census.gov/newsroom/press-releases/2025/2024-presidential-election-voting-registration-tables.html (2024)

73.6% (or 174 million people) of the citizen voting-age population was registered to vote in 2024 (Census Bureau). More than 211 million citizens were active registered voters (86.6% of citizen voting age population) according to the Election Assistance Commission. Additional sources: https://www.census.gov/newsroom/press-releases/2025/2024-presidential-election-voting-registration-tables.html | https://www.eac.gov/news/2025/06/30/us-election-assistance-commission-releases-2024-election-administration-and-voting

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238.

1, C. from. Value captured by 1% treaty of $27+ billion annually.

A 1% treaty redirects 1% of global military spending ($2.7T × 1% = $27.2B) to pragmatic clinical trials, with 10% of this flow (2.7B annually) distributed to VICTORY Incentive Alignment Bondholders as returns.

239.

VA. Veteran healthcare cost projections. VA https://department.va.gov/wp-content/uploads/2025/06/2026-Budget-in-Brief.pdf (2026)

VA budget: $441.3B requested for FY 2026 (10% increase). Disability compensation: $165.6B in FY 2024 for 6.7M veterans. PACT Act projected to increase spending by $300B between 2022-2031. Costs under Toxic Exposures Fund: $20B (2024), $30.4B (2025), $52.6B (2026). Additional sources: https://department.va.gov/wp-content/uploads/2025/06/2026-Budget-in-Brief.pdf | https://www.cbo.gov/publication/45615 | https://www.legion.org/information-center/news/veterans-healthcare/2025/june/va-budget-tops-400-billion-for-2025-from-higher-spending-on-mandated-benefits-medical-care

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240.

Graham, D. (FDA). |. L. Vioxx cardiovascular deaths (rofecoxib). PMC: FDA incapable of protecting against another Vioxx https://pmc.ncbi.nlm.nih.gov/articles/PMC534432/ (2007)

Graham testimony (2004): 88,000-139,000 U.S. heart attacks/strokes from Vioxx; up to 55,000 deaths (40% fatality rate) Lancet study estimate: 88,000 Americans had heart attacks from Vioxx; 38,000 died FDA memo (2004): Vioxx contributed to  27,785 heart attacks and sudden cardiac deaths (1999-2003) High-dose Vioxx: Tripled risk of heart attacks and sudden cardiac death Prescriptions: 92.8 million U.S. prescriptions 1999-2003 Withdrawn: September 30, 2004 after APPROVE trial showed cardiovascular risks Note: Vioxx case demonstrates failure of passive post-market surveillance (FAERS) to detect safety signals in time. Voluntary reporting missed cardiovascular risks for years despite millions of prescriptions Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC534432/ | https://www.npr.org/2007/11/10/5470430/timeline-the-rise-and-fall-of-vioxx | https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05

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241.

CNBC. Warren buffett’s career average investment return. CNBC https://www.cnbc.com/2025/05/05/warren-buffetts-return-tally-after-60-years-5502284percent.html (2025)

Berkshire’s compounded annual return from 1965 through 2024 was 19.9%, nearly double the 10.4% recorded by the S&P 500. Berkshire shares skyrocketed 5,502,284% compared to the S&P 500’s 39,054% rise during that period. Additional sources: https://www.cnbc.com/2025/05/05/warren-buffetts-return-tally-after-60-years-5502284percent.html | https://www.slickcharts.com/berkshire-hathaway/returns

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242.

University, U. Number of armed conflicts since 1945. Uppsala University https://ucdp.uu.se/

The AKUF dataset documents 218 wars and violent conflicts since 1945. The Uppsala Conflict Data Program (UCDP) recorded 40 armed conflicts in 2014 (highest since 1999, with 11 defined as wars). Peak year 1991 saw 51 active conflicts. Additional sources: https://ucdp.uu.se/ | https://en.wikipedia.org/wiki/Uppsala_Conflict_Data_Program

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243.

Science/AAAS. Estimated annual cost of repeating failed experiments due to non-publication of results. Science/AAAS https://www.science.org/content/article/study-claims-28-billion-year-spent-irreproducible-biomedical-research (2020)

Up to 50.0% of published preclinical research is irreproducible, with an estimated annual cost of $28 billion in the U.S. alone. This is based on $56B annual spending on preclinical research × 50.0% irreproducibility rate. Main causes: reagents/materials (36%), study design (28%), data analysis (25%), protocols (11%). Additional sources: https://www.science.org/content/article/study-claims-28-billion-year-spent-irreproducible-biomedical-research | https://www.idbs.com/2020/11/replicating-science-28-billion-is-wasted-every-year-in-the-us-alone/

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244.

Forum, W. E. & Public Health, H. S. of. WEF/harvard NCD cost ($47T, 2011-2030). World Economic Forum and Harvard School of Public Health https://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf (2011)

The cumulative output loss due to non-communicable diseases (NCDs) under a ’business as usual’ scenario is estimated to be US47trillion.Thislossrepresents75%ofglobalGDPin2010(US 63 trillion). Additional sources: https://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf

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245.

Trust, W. Wellcome trust endowment size. Wellcome Trust https://cms.wellcome.org/sites/default/files/2024-01/Wellcome-Trust-Annual-Report-and-Financial-Statements-2023.pdf (2023)

$38B Additional sources: https://cms.wellcome.org/sites/default/files/2024-01/Wellcome-Trust-Annual-Report-and-Financial-Statements-2023.pdf

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246.

World’s Resources, S. the. War spending vs WHO budget. Share the World’s Resources https://sharing.org/information-centre/news/world-health-organisations-annual-budget-equivalent-global-military/

The WHO’s annual budget of US$2.1 billion is equivalent to global military expenditure every eight hours. WHO Director-General noted that US$2.1 billion is the price of one stealth bomber. A 1% increase in military spending results in a 0.62% decrease in health spending globally. Additional sources: https://sharing.org/information-centre/news/world-health-organisations-annual-budget-equivalent-global-military/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC9174441/

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247.

Organization, W. H. World Health Organization https://www.who.int/activities/choosing-interventions-that-are-cost-effective-(who-choice

In the CHOICE project, we have used a threshold of three times GDP per capita for an intervention to be considered ’cost-effective’ and a threshold of one times GDP per capita to be considered ’very cost-effective’. Additional sources: https://www.who.int/activities/choosing-interventions-that-are-cost-effective-(who-choice

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248.

Based on WHO Global Health Estimates showing 55 million annual deaths / 365 days = 150, 000. per day |. W. 150,000 deaths per day from all causes. Based on WHO Global Health Estimates showing  55 million annual deaths / 365 days =  150 https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death (2024)

Approximately 150,000 people die every day worldwide. The majority of these deaths (over 100,000) are from non-communicable diseases including cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. Additional sources: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

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249.

Journal, G. P. World bank cost to eradicate extreme poverty. Global Policy Journal https://www.globalpolicyjournal.com/blog/25/07/2024/new-estimates-cost-ending-poverty (2024)

Jeffrey Sachs estimated $175 billion per year for 20 years (less than 1% of combined income of richest countries). Recent UNU-WIDER research: $70B/year for extreme poverty ($2.15/day threshold) or $325B/year for absolute poverty ($3.65/day). This is only 0.1-0.6% of OECD high-income countries’ GNI. Additional sources: https://www.globalpolicyjournal.com/blog/25/07/2024/new-estimates-cost-ending-poverty | https://borgenproject.org/how-much-does-it-cost-to-end-poverty/

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250.

Bank, W. World bank trade disruption cost from conflict. World Bank https://www.worldbank.org/en/topic/trade/publication/trading-away-from-conflict

Estimated $616B annual cost from conflict-related trade disruption. World Bank research shows civil war costs an average developing country 30 years of GDP growth, with 20 years needed for trade to return to pre-war levels. Trade disputes analysis shows tariff escalation could reduce global exports by up to $674 billion. Additional sources: https://www.worldbank.org/en/topic/trade/publication/trading-away-from-conflict | https://www.nber.org/papers/w11565 | http://blogs.worldbank.org/en/trade/impacts-global-trade-and-income-current-trade-disputes

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251.

American Scientists, F. of. World nuclear forces. Federation of American Scientists https://fas.org/issues/nuclear-weapons/status-world-nuclear-forces/ (2024)

As of early 2025, we estimate that the world’s nine nuclear-armed states possess a combined total of approximately 12,241 nuclear warheads. Additional sources: https://fas.org/issues/nuclear-weapons/status-world-nuclear-forces/

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252.

Foundation, W. Worldcoin identity verification scale. World Foundation https://world.org/blog/announcements/world-year-two (2025)

World Network now spans 160 countries and more than 14 million verified unique humans using iris biometric scanning, demonstrating feasibility of global-scale biometric verification. Additional sources: https://world.org/blog/announcements/world-year-two

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253.

American Scientists, F. of. Cost of world war II in today’s dollars. Federation of American Scientists https://fas.org/publication/costs_of_war/

WWII cost $4 trillion (today’s dollars). Additional sources: https://fas.org/publication/costs_of_war/ | https://online.norwich.edu/online/about/resource-library/cost-us-wars-then-and-now

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254.

Treasury, U. S. WWII war bonds. U.S. Treasury https://en.wikipedia.org/wiki/War_bond.

255.

Prize, N. Discovery of induced pluripotent stem cells (yamanaka factors). Nobel Prize https://www.nobelprize.org/prizes/medicine/2012/press-release/ (2012)

In 2006, Shinya Yamanaka and Kazutoshi Takahashi showed that introducing four specific genes (Myc, Oct3/4, Sox2, Klf4), known as Yamanaka factors, could convert somatic cells into pluripotent stem cells. Yamanaka was awarded the 2012 Nobel Prize with Sir John Gurdon for the discovery that mature cells can be reprogrammed to become pluripotent. Additional sources: https://www.nobelprize.org/prizes/medicine/2012/press-release/ | https://en.wikipedia.org/wiki/Induced_pluripotent_stem_cell

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256.

ACS. ZINC-22 database (billions of compounds). ACS https://pubs.acs.org/doi/10.1021/acs.jcim.2c01253

ZINC-22 contains tens of billions of purchasable virtual molecules for drug discovery. Additional sources: https://pubs.acs.org/doi/10.1021/acs.jcim.2c01253

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