# Optimization Summary Now you understand the problem: everyone is dying while you build missiles. Time to fix it. Your solution has three parts: 1. A [1% Treaty](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html)^([1](references.llms.md#ref-1-percent-treaty-paper-2025)) ^([2](references.llms.md#ref-1-pct-treaty-impact-paper-2025)) (stealing money from the murder budget) 2. A [Decentralized Institutes of Health](../knowledge/solution/dih.llms.md) with algorithmic governance (so no one can steal it back) 3. A [decentralized FDA](../knowledge/solution/dfda.llms.md)^([3](references.llms.md#ref-dfda-spec-paper-2025),[4](references.llms.md#ref-dfda-impact-paper-2025)) (making medicine [44.1x (90% CI: 12.8x-210x)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_cost_reduction_factor) times cheaper) Take money from death, give it to life. The tricky part is convincing humans, who historically prefer the death option. ## A [1% Treaty](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html) Here’s how you redirect [\$27.2 billion](../knowledge/appendix/parameters-and-calculations.llms.md#sec-treaty_annual_funding) per year from bombs to medicine: You instruct every nation on Earth to [cut military spending by 1%](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html). Just 1%. They keep the other 99% for wars and parades and whatever else militaries do when they’re not accidentally losing trillions. One percent is a rounding error. It’s what the Pentagon loses between couch cushions. Everyone cuts simultaneously. Nobody loses “relative power”. I asked a general if losing 1% of weapons would weaken national security. He said yes. I asked if having 1% fewer weapons pointed at you by every enemy would make you safer. He stopped talking to me. The math is simple: If everyone has 1% fewer weapons, the balance stays exactly the same, except now there are 1% fewer weapons total. ------------------------------------------------------------------------ **What You Buy With 1% Less War** [\$27.2 billion](../knowledge/appendix/parameters-and-calculations.llms.md#sec-treaty_annual_funding) funds: - 54,000 pragmatic clinical trials at \$500,000 each (the cheap way) - Or 27 million patients in trials at \$1,000 each - Or 540 new drug approvals (current rate: [50 drugs/year (95% CI: 45 drugs/year-60 drugs/year)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-current_drug_approvals_per_year)) - Or curing 10-20 rare diseases completely in Year 1 - Or preventing 180,000 deaths annually That money splits three ways. [80%](../knowledge/appendix/parameters-and-calculations.llms.md#sec-dih_treasury_medical_research_pct) goes to clinical trials. 10% goes to investors. 10% goes to political incentives. The [full allocation breakdown](https://manual.warondisease.org/knowledge/appendix/incentive-alignment-bonds-paper.html) explains why each slice exists. They say you can’t put a price on human life. But apparently the price is somewhere south of pet food. That seems like it should be revised upward (or you should admit you value dogs more than humans, which honestly might be fair). ## Your [Decentralized Institutes of Health](../knowledge/solution/dih.llms.md) Once your [1% Treaty](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html) is ratified, that [\$27.2 billion](../knowledge/appendix/parameters-and-calculations.llms.md#sec-treaty_annual_funding) per year flows into a **[1% Treaty Fund](../knowledge/solution/dih.llms.md)**. It’s a treasury that runs on rules instead of opinions. The treaty locks the split. Patients pick which trials to join. [Wishocracy](../knowledge/solution/wishocracy.llms.md)^([5](references.llms.md#ref-wishocracy-paper-2025)) handles the parts that need a vote. The humans who run the plumbing don’t get to redirect the water. It’s the opposite of the NIH. Instead of 200 people in a building guessing what to fund and giving grants to their college roommates, the money follows patients. Patients choose which trials to join. Researchers who attract patients get funded. Researchers who don’t, don’t. Defunding failure is apparently a concept so radical it took your species 80 years to consider. [![Money goes in, cures come out, repeat](../assets/images/solution/solution-section-what-your-decentralized-institutes-of-health-do-bw-academic.jpg)](../assets/images/solution/solution-section-what-your-decentralized-institutes-of-health-do-bw-academic.jpg) Money goes in, cures come out, repeat ## [Wishocracy](../knowledge/solution/wishocracy.llms.md) [Wishocracy](../knowledge/solution/wishocracy.llms.md) is how you let [8 billion of people (95% CI: 7.8 billion of people-8.2 billion of people)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_population_2024) control a budget without everyone killing each other in meetings. Anyone can propose how to spend the money. The app shows you random pairs of proposals. You swipe left or right. Everyone’s swipes get aggregated using math. Money flows automatically to top priorities. No committee. No gatekeepers. Just billions of micro-decisions that add up to what humanity actually wants, not what 200 people in suits think humanity wants. [![Swipe right for immortality](../assets/images/solution/solution-section-on-wishocracy-bw-academic.jpg)](../assets/images/solution/solution-section-on-wishocracy-bw-academic.jpg) Swipe right for immortality ## Your Decentralized Framework for Drug Assessment The FDA currently makes drugs [44.1x (90% CI: 12.8x-210x)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_cost_reduction_factor) times more expensive than necessary. Your [decentralized FDA](../knowledge/solution/dfda.llms.md) does three things: [![FDA: slow, expensive, ineffective, and dangerous. dFDA: fast, cheap, effective, and safe](../assets/images/solution/solution-section-your-decentralized-framework-for-drug-assessment-bw-academic.jpg)](../assets/images/solution/solution-section-your-decentralized-framework-for-drug-assessment-bw-academic.jpg) FDA: slow, expensive, ineffective, and dangerous. dFDA: fast, cheap, effective, and safe 1. **Lets anyone run pragmatic clinical trials** (no permission needed) 2. **Tracks what actually works** (real-world data, not guesses) 3. **Publishes outcome labels** (truth about every treatment) Instead of waiting [14 years (95% CI: 12 years-17 years)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-drug_discovery_to_approval_years) from discovery to patient while you die, you join a trial. It costs [\$929 (95% CI: \$97-\$3,000)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_pragmatic_trial_cost_per_patient) instead of [\$41,000 (95% CI: \$20,000-\$120,000)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-traditional_phase3_cost_per_patient). You report outcomes through your phone. The AI analyzes millions of data points. The framework publishes rankings: “For your condition, this works 73% of the time, this works 45%, this does nothing but costs less.” It’s like Amazon reviews except for not dying. Outcome labels replace “ask your doctor” with actual facts. “Improves memory 35%. Reduces symptoms 60%. Causes headaches 9% of the time. Based on 50,000 real patients like you.” Just truth. No marketing. No 40-page legal documents written by lawyers having seizures. [![Warning labels vs. labels that actually help](../assets/images/solution/solution-section-on-outcome-labels-bw-academic.jpg)](../assets/images/solution/solution-section-on-outcome-labels-bw-academic.jpg) Warning labels vs. labels that actually help Researchers set their own price. Patients choose which trials to join. Money flows automatically. Markets decide, not committees. Sick people, guided by their doctors and data, choose what gets funded. Not bureaucrats. Not grant writers. Actual humans who need actual cures. [![Pharma chooses trials vs. patients choose trials](../assets/images/solution/solution-section-on-how-patients-pay-researchers-bw-academic.jpg)](../assets/images/solution/solution-section-on-how-patients-pay-researchers-bw-academic.jpg) Pharma chooses trials vs. patients choose trials ## Who Wins The solution only works if [everyone wins by winning](../knowledge/solution/aligning-incentives.llms.md). Here’s who gets what: **[Military contractors](../knowledge/solution/aligning-incentives.llms.md#military-contractors-teaching-merchants-of-death-to-love-life):** Keep 99% of budget + [272%](../knowledge/appendix/parameters-and-calculations.llms.md#sec-victory_bond_annual_return_pct) returns on bonds **Pharmaceutical companies:** Patients pay them instead of vice versa **Politicians:** Campaign donations + not losing elections **Insurance companies:** They want you either dead or immortal, anything but expensively lingering. Cures help. **Billionaires:** [272%](../knowledge/appendix/parameters-and-calculations.llms.md#sec-victory_bond_annual_return_pct) returns + legacy + naming rights **Regular people:** Subsidized treatment + direct democracy + not dying Notice that everyone’s selfish reason for participating happens to save humanity. The system doesn’t require anyone to stop being selfish. It just redirects selfishness toward curing diseases instead of building bombs. It’s like installing a fire alarm that also makes coffee. You’re going to use it even if you don’t care about fire safety. [![Everyone gets what they want.](../assets/images/solution/solution-section-on-aligning-everyone-s-greed-bw-academic.jpg)](../assets/images/solution/solution-section-on-aligning-everyone-s-greed-bw-academic.jpg) Everyone gets what they want. ## The Scaling Engine The goal isn’t 1%. The goal is 100%. The [1% Treaty](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html) is just the door, not the destination. The 10% going to [Incentive Alignment Bonds](https://manual.warondisease.org/knowledge/appendix/incentive-alignment-bonds-paper.html)^([6](references.llms.md#ref-iab-paper-2025)) creates a machine that only goes one direction. When 1% passes, [\$2.72 billion](../knowledge/appendix/parameters-and-calculations.llms.md#sec-iab_political_incentive_funding_annual)/year flows to people whose entire financial interest is getting the treaty to 2%. When 2% passes, the pressure doubles. Each success makes the next one easier (and more profitable). This is a [ratchet that can eventually redirect all military spending](https://manual.warondisease.org/knowledge/appendix/incentive-alignment-bonds-paper.html) from war to health. [VICTORY Incentive Alignment Bonds](../knowledge/solution/incentive-alignment-bonds.llms.md) are the papers that make this go. Investors get 10% returns. Politicians get 10% career incentives. Patients get [80%](../knowledge/appendix/parameters-and-calculations.llms.md#sec-dih_treasury_medical_research_pct) cures. Everyone gets what they want. Nobody has to stop being selfish. [![When you give people money to cure diseases, they get more money to cure more diseases.](../assets/images/solution/solution-section-on-why-1-is-just-the-beginning-bw-academic.jpg)](../assets/images/solution/solution-section-on-why-1-is-just-the-beginning-bw-academic.jpg) When you give people money to cure diseases, they get more money to cure more diseases. ## The War on Disease You’re declaring war on disease. But unlike previous wars on abstract concepts (drugs, terror, poverty, Christmas), this one will actually work. You’re using markets instead of bureaucracy. [![Your Wars on Drugs and Terror kept making more drugs and terror.](../assets/images/solution/solution-section-on-the-war-on-disease-bw-academic.jpg)](../assets/images/solution/solution-section-on-the-war-on-disease-bw-academic.jpg) Your Wars on Drugs and Terror kept making more drugs and terror. Previous wars built bureaucracies that needed the problem to exist to justify their existence. This war creates a market that profits from solving the problem. The difference is like hiring a plumber who gets paid by the hour versus one who gets paid when your toilet works. One of them is going to take a lot longer. [![On the left, you pay doctors when people are sick. On the right, you pay them when people get better.](../assets/images/solution/solution-section-this-war-bw-academic.jpg)](../assets/images/solution/solution-section-this-war-bw-academic.jpg) On the left, you pay doctors when people are sick. On the right, you pay them when people get better. And the benefits cascade beyond medicine. Addiction, poverty, radicalization, crime; they’re all [biology problems wearing social-problem costumes](../knowledge/economics/peace-dividend.llms.md). Fix the biology, and the society fixes itself. It turns out people are much less interested in joining extremist groups when their brain chemistry works properly. ## Why This Isn’t Clinically Insane [History shows this works](../knowledge/proof.llms.md#historical-precedents): - Post-WWII: Cut military [87.6%](../knowledge/appendix/parameters-and-calculations.llms.md#sec-post_ww2_military_cut_pct), greatest boom ever - Post-Cold War: Cut military 3%, 1990s prosperity - Switzerland: [0.7%](../knowledge/appendix/parameters-and-calculations.llms.md#sec-switzerland_defense_spending_pct) military budget, richest country in Europe You’re only taking 1%. [![Every time a country spent less on blowing things up, their economy mysteriously got better.](../assets/images/solution/solution-section-on-why-this-isn-t-clinically-insane-bw-academic.jpg)](../assets/images/solution/solution-section-on-why-this-isn-t-clinically-insane-bw-academic.jpg) Every time a country spent less on blowing things up, their economy mysteriously got better. ## The Meta-Solution This solution isn’t just about ending disease. It proves that paying people for results works better than paying people for promising results (a distinction your species has been avoiding for centuries). You can cure diseases by redirecting 1% of murder money through markets. That same template solves education, housing, climate change, and literally any problem your governments currently solve by forming a committee to discuss forming a committee. [![One simple trick solves health, education, housing, and climate change.](../assets/images/solution/solution-section-on-the-meta-solution-bw-academic.jpg)](../assets/images/solution/solution-section-on-the-meta-solution-bw-academic.jpg) One simple trick solves health, education, housing, and climate change. The War on Disease is proof of concept. Victory here means you can fix everything else using the same playbook. They say if something seems too good to be true, it probably is. But sometimes things are exactly as good as they seem, and the only reason nobody did them is that everyone was too busy writing grant proposals about doing them. ## What Comes Next The rest of Part II explains each component in detail: - [Your 1% Treaty](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html): How to structure it so countries actually sign it - [Your Decentralized Institutes of Health](../knowledge/solution/dih.llms.md): How algorithmic governance prevents corruption - [Wishocracy](../knowledge/solution/wishocracy.llms.md): How to let billions of people govern the collective-choice part of a budget without lobbyists stealing it - [Your Decentralized FDA](../knowledge/solution/dfda.llms.md): How to achieve [44.1x (90% CI: 12.8x-210x)](../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_cost_reduction_factor) cost reduction in drug trials - [Aligning Incentives](../knowledge/solution/aligning-incentives.llms.md): How to make selfishness save humanity - [Incentive Alignment Bonds](../knowledge/solution/incentive-alignment-bonds.llms.md): How everyone makes money - [The Peace Dividend](../knowledge/economics/peace-dividend.llms.md): Why curing disease accidentally solves everything else That’s it. That’s the plan. [![Take 1 percent of your war money and spend it on not dying.](../assets/images/solution/solution-section-on-what-comes-next-bw-academic.jpg)](../assets/images/solution/solution-section-on-what-comes-next-bw-academic.jpg) Take 1 percent of your war money and spend it on not dying. If that seems anticlimactic, remember: Every revolution starts with someone doing something slightly less stupid than what everyone else is doing. In this case, the slightly less stupid thing is redirecting 1% of the murder budget to the not-dying budget. History will judge whether this was genius or obvious. But either way, you’ll be alive to see it. That’s more than you can say for the alternative. 1\. Sinn, M. P. *The 1% Treaty*. (2025) doi:[10.5281/zenodo.20076511](https://doi.org/10.5281/zenodo.20076511) *Your governments possess nuclear weapons sufficient to end civilization 122 times but have not cured Alzheimer’s once. This treaty asks them to be 1% more rational.* 2\. Sinn, M. P. *The 1% Treaty: An Incentive-Compatible Approach to Ending War and Disease*. (2025) doi:[10.5281/zenodo.18161560](https://doi.org/10.5281/zenodo.18161560) *6,650 diseases have zero FDA-approved treatments; at current trial capacity, exploring them takes  443 years. Redirecting 1% of military spending scales capacity 12.3x, cutting the timeline to  36 years and preventing 10.7 billion deaths. At \$0.02/DALY, 9.3kx more cost-effective than the best existing interventions. The result holds across every specified adoption pathway.* 3\. Sinn, M. P. *The Continuous Evidence Generation Protocol: Two-Stage Validation (RWE → Pragmatic Trials)*. (2025) doi:[10.5281/zenodo.18203375](https://doi.org/10.5281/zenodo.18203375) *We present the Predictor Impact Score (PIS), a novel composite metric operationalizing Bradford Hill causality criteria for automated signal detection from aggregated N-of-1 observational studies. Combined with pragmatic trial confirmation (based on evidence from 108+ embedded trials), this two-stage framework would generate validated outcome labels at 44.1x lower cost than traditional Phase III trials. This enables continuous, population-scale pharmacovigilance and precision dosing recommendations.* 4\. Sinn, M. P. *Ubiquitous Pragmatic Trial Impact Analysis*. (2025) doi:[10.5281/zenodo.18243914](https://doi.org/10.5281/zenodo.18243914) *Only 15 diseases/year get their first treatment each year. With 6,650 diseases lacking effective treatments, the backlog would take 443 years to clear. Integrating pragmatic trials into standard healthcare increases trial capacity 12.3x, cutting that timeline from 443 years to 36 years. The average untreated disease gets a treatment 212 years earlier, saving 10.7 billion deaths at \$9.62 per year of healthy life saved.* 5\. Sinn, M. P. *Wishocracy: Solving the Democratic Principal-Agent Problem Through Pairwise Preference Aggregation*. (2025) doi:[10.5281/zenodo.18205881](https://doi.org/10.5281/zenodo.18205881) *Representative democracy suffers from an inescapable principal-agent problem where elected officials’ incentives diverge from citizen welfare. Wishocracy introduces RAPPA (Randomized Aggregated Pairwise Preference Allocation), which aggregates citizen preferences through cognitively tractable pairwise comparisons and creates accountability via Citizen Alignment Scores that channel electoral resources toward politicians who actually represent what citizens want.* 6\. Sinn, M. P. *Incentive Alignment Bonds: Making Public Goods Financially and Politically Profitable*. (2025) doi:[10.5281/zenodo.18203221](https://doi.org/10.5281/zenodo.18203221) *Government spending is optimized for lobbying intensity, not net societal value. Programs with 100:1 benefit-cost ratios get billions while programs with negative returns get hundreds of billions. Incentive Alignment Bonds flip this by creating a capital pool that rewards politicians (via campaign support and post-office opportunities) for funding high-NSV programs over low-NSV alternatives. The result: public good becomes private profit for both investors and elected officials.* 7\. Biotechnology Innovation Organization (BIO). BIO clinical development success rates 2011-2020. *Biotechnology Innovation Organization (BIO)* (2021) *Phase I duration: 2.3 years average Total time to market (Phase I-III + approval): 10.5 years average Phase transition success rates: Phase I→II: 63.2%, Phase II→III: 30.7%, Phase III→Approval: 58.1% Overall probability of approval from Phase I: 12% Note: Largest publicly available study of clinical trial success rates. Efficacy lag = 10.5 - 2.3 = 8.2 years post-safety verification. Additional sources: https://go.bio.org/rs/490-EHZ-999/images/ClinicalDevelopmentSuccessRates2011_2020.pdf* . 8\. C&EN. Annual number of new drugs approved globally:  50. *C&EN* (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* . 9\. UN. Global population reaches 8 billion. *UN: World Population 8 Billion Nov 15 2022* (2022) *Milestone: November 15, 2022 (UN World Population Prospects 2022) Day of Eight Billion" designated by UN Added 1 billion people in just 11 years (2011-2022) Growth rate: Slowest since 1950; fell under 1% in 2020 Future: 15 years to reach 9B (2037); projected peak 10.4B in 2080s Projections: 8.5B (2030), 9.7B (2050), 10.4B (2080-2100 plateau) Note: Milestone reached Nov 2022. Population growth slowing; will take longer to add next billion (15 years vs 11 years) Additional sources: https://www.un.org/en/desa/world-population-reach-8-billion-15-november-2022 \| https://www.un.org/en/dayof8billion \| https://en.wikipedia.org/wiki/Day_of_Eight_Billion* . 10\. NIH Common Fund. NIH pragmatic trials: Minimal funding despite 30x cost advantage. *NIH Common Fund: HCS Research Collaboratory* (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/* . 11\. World Bank. Swiss military budget as percentage of GDP. *World Bank: Military Expenditure* *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* . 12\. FDA Study via NCBI. Trial costs, FDA study. *FDA Study via NCBI* *Overall, the 138 clinical trials had an estimated median (IQR) cost of \$19.0 million (\$12.2 million-\$33.1 million)... The clinical trials cost a median (IQR) of \$41,117 (\$31,802-\$82,362) per patient. Additional sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248200/* .