# Declaration of Optimization
[](../../assets/infographics/knowledge/strategy/declaration-of-optimization-infographic-bw-academic.jpg)
The purpose of government is to promote the general welfare, measured by the median healthy life years and median after-tax inflation-adjusted income of its citizens. This document is a polite request that they do so.
## Preamble
Governments were created to promote the general welfare (i.e. median health and wealth).
Instead, since 1913, these governments have [printed](../../knowledge/economics/central-banks.llms.md) [\$170 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-cumulative_military_spending_fed_era) and used it to murder [310 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_deaths_since_1900) humans and destroy many of the valuable things those humans spent their entire lives building.
These murdered humans [include](https://manual.warondisease.org/knowledge/problem/cost-of-war.html) approximately 930,000 physicians, 310,000 scientists, 620,000 engineers, 1.24 million nurses, 3.1 million teachers, and [102 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_children_killed_since_1900) children who will never grow up to replace them.
That [\$170 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-cumulative_military_spending_fed_era) could have funded [37,778 years (90% CI: 28,333 years-55,502 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-cumulative_military_in_govt_trial_years) of clinical trials. They bought the other thing.
These governments have enough weapons to end civilization [122](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-nuclear_winter_overkill_factor) times over^([1](../references.llms.md#ref-world-warheads)). Current military spending is enough money to buy [850](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-bullets_per_person_annual) bullets for every person alive every single year. You only need to kill everyone once for everyone to be dead. (I checked.) The remaining murder capacity is sheer waste.
Seven consecutive failed audits have found that the Pentagon has “misplaced” [\$2.46 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-pentagon_unaccounted_funds)^([2](../references.llms.md#ref-pentagon-unaccounted-2-5t)). They then requested additional trillions without explanation or apology. This “misplaced” money could have funded [547](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-pentagon_unaccounted_clinical_trial_years) years of clinical trials at current government spending.
For every [604](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-military_to_government_clinical_trials_spending_ratio) dollars they spend on the capacity for orphan manufacturing, they only spend one on clinical trials that might cure the diseases that will slowly torture and brutally murder you and everyone you have ever loved.
Your chance of being killed by a terrorist? 1 in [30 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-annual_terrorism_death_risk_denominator)^([3](../references.llms.md#ref-chance-of-dying-from-terrorism-1-in-30m)). Your chance of dying of a disease? Approximately 100%.
At the current discovery rate, finding treatments for all known diseases takes ~[443 years (90% CI: 255 years-841 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-status_quo_queue_clearance_years). One percent of the explosions budget could increase clinical trial capacity by [12.3x (90% CI: 4.92x-50.8x)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_multiplier) and compress that wait to ~[36 years (90% CI: 8.15 years-106 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_queue_clearance_years). The average cure arrives [212](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_plus_efficacy_lag_years) years sooner.
This is important because you personally will be dead within 80 years. (I mention this not to be rude but because you seem weirdly calm about it.)
Had someone properly aligned your governments to maximize median healthy life years and median after-tax inflation-adjusted income in 1900, the average human would earn [\$333,636 (90% CI: \$120,624-\$921,185)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_counterfactual_gdp_per_capita) a year instead of [\$14,375 (90% CI: \$14,081-\$14,682)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_avg_income_2025).
They did not. So that is what you are going to do.
You are going to get every nation on Earth to sign a [treaty](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html) redirecting one percent of military spending to clinical trials. One percent.
Here is why this is not clinically insane. Even adjusting for inflation, governments now spend [30.6](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-us_military_spending_current_vs_prewar_multiplier) times more than they did immediately before winning World War II^([4](../references.llms.md#ref-us-military-spending-historical-constant-dollars)).
After that war, governments cut military spending by [87.6%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-post_ww2_military_cut_pct)^([5](../references.llms.md#ref-us-post-wwii-military-spending-cut)) and produced the greatest economic expansion in human history.
Unless the human genome has degraded significantly in the last two generations, one percent should be manageable.
These governments have already signed multiple global treaties banning entire weapons industries. This one just has them buy one percent fewer of them.
Think about someone you love who is suffering right now. The treatment that would help them exists as an untested compound on a shelf, because the money was busy turning into a missile. That missile incinerated a child who might have grown up to discover the cure. You lose the treatment. You lose the scientist. You get the inflation. You get the tax bill. You get to pay for her murder.
This is suboptimal.
## The Declaration of Optimization
### The unanimous Declaration of the Eight Billion Inhabitants of Earth
When in the Course of human events, it becomes necessary for a people to optimize the governance systems which have caused immeasurable preventable death and unnecessary poverty, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the optimization.
We hold these truths to be self-evident, that all humans are created equal, that they are endowed by their Biology with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.–That to secure these rights, Governments are instituted among Humans, deriving their just powers from the consent of the governed.
That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to optimize it, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness, measured by two metrics: the median number of healthy life years and the median after-tax inflation-adjusted income of its citizens.
Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by optimizing the forms to which they are accustomed.
But when a long pattern of abuses and misallocations, pursuing invariably the same end, reveals a design to reduce them under absolute Suboptimality, it is their right, it is their duty, to optimize such Government, and to provide new Guards for their future security.
The [Political Dysfunction Tax](https://manual.warondisease.org/knowledge/appendix/political-dysfunction-tax.html)^([6](../references.llms.md#ref-political-dysfunction-tax-paper-2025)), the total annual burden of suboptimality on the people of Earth: [\$101 trillion (90% CI: \$59.6 trillion-\$161 trillion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-political_dysfunction_global_opportunity_cost_total) a year.
Such has been the patient sufferance of the inhabitants of Earth; and such is now the necessity which constrains them to optimize their former Systems of Government. The history of the present Governments of Earth is a history of repeated injuries and misallocations, all having as their direct result the establishment of an absolute Suboptimality over these people. To prove this, let Facts be submitted to a candid world.
They have refused their Assent to Laws, the most wholesome and necessary for the public good; the [correlation between public opinion and policy outcomes](../../knowledge/problem/unrepresentative-democracy.llms.md), measured across 1,779 policy decisions, is effectively zero^([7](../references.llms.md#ref-gilens2014)).
They have legalized the purchase of legislation at a current annual price of [\$4.4 billion (95% CI: \$3.74 billion-\$5.06 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-us_total_lobbying_annual)^([8](../references.llms.md#ref-opensecrets-lobbying-2024)), the legal definition of corruption having been written by the beneficiaries of said corruption.
They have imposed Taxes without Consent, including the [debasement of currency](../../knowledge/economics/central-banks.llms.md) by unelected officials whose money creation functions as a tax the governed never voted for, reducing the dollar’s purchasing power by 96% since 1913^([9](../references.llms.md#ref-bls-cpi-inflation-calculator)).
They have spent over one trillion dollars across fifty years imprisoning and sometimes killing their own citizens for the crime of exercising [sovereignty over their own bodies](../../knowledge/problem/genetic-slavery.llms.md)^([10](../references.llms.md#ref-cap-drug-war-numbers)), sovereignty being the distinction between a citizen and property.
The result has been a 1,700% increase in overdose deaths^([11](../references.llms.md#ref-cdc-overdose-1980),[12](../references.llms.md#ref-cdc-overdose-2023)) and drug use higher than when they started, while half of all murders go unsolved for want of the resources squandered on the prosecution of those pursuing happiness by means the state did not approve.
They have lied to the governed to manufacture consent for wars the governed did not want, fabricating attacks that did not occur, presenting evidence they knew to be false, and spraying carcinogenic chemicals on rice farmers and their children^([13](../references.llms.md#ref-britannica-vietnam-war-deaths)), the exposed population now numbering four million with birth defects continuing to this day.
They have misplaced [\$2.46 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-pentagon_unaccounted_funds) in military funds, failed seven consecutive audits attempting to find it^([2](../references.llms.md#ref-pentagon-unaccounted-2-5t)), and requested additional trillions without explanation or apology.
They have allowed the [destructive economy](https://manual.warondisease.org/knowledge/economics/gdp-trajectories.html)^([14](../references.llms.md#ref-gdp-trajectories-paper-2025)) to reach [11.5%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_destructive_economy_pct_gdp) of global output, growing faster than the productive economy, on a trajectory that crosses fifty percent by [2040](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-destructive_economy_50pct_year). Once passing this threshold, earth will become a global failed state where it becomes irrational to produce because each dollar of value created is immediately stolen.
They have plundered our seas, ravaged our coasts, burnt our towns, and [destroyed the lives of our people](https://manual.warondisease.org/knowledge/problem/cost-of-war.html): [310 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_deaths_since_1900) people since 1900^([15](../references.llms.md#ref-lost-human-capital-war-cost)), [8.37 billion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_life_years_lost_since_1900) years of human life stolen, [\$170 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-cumulative_military_spending_fed_era) in treasure spent on the enterprise.
[Among them](https://manual.warondisease.org/knowledge/problem/cost-of-war.html) approximately 930,000 physicians, 310,000 scientists, 620,000 engineers, 1.24 million nurses, 3.1 million teachers, and millions of children who will never grow up to replace them.
They have directed [604](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-military_to_government_clinical_trials_spending_ratio) times more to the destruction of human life than to testing which medicines might preserve it^([16](../references.llms.md#ref-disparity-ratio-weapons-vs-cures),[17](../references.llms.md#ref-sipri-milex-2024)).
They have permitted [150 thousand](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_disease_deaths_daily) people to die of diseases every day^([18](../references.llms.md#ref-who-daily-deaths)), [104](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_disease_deaths_per_minute) every minute that passes, while possessing the means to accelerate solutions. The annual toll: [2.88 billion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_annual_daly_burden) years of healthy life lost to disease and disability^([19](../references.llms.md#ref-ihme-gbd-2019)), quietly deleted.
Nearly ten thousand known safe compounds remain untested for 99.7% of possible disease combinations. Yet the [national health research institutions](../../knowledge/problem/nih-fails-2-institute-health.llms.md) nominally responsible for finding cures direct only [3.3% (95% CI: 2%-5%)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-nih_clinical_trials_spending_pct) of their budgets to the clinical trials necessary to determine which diseases those compounds could treat^([20](../references.llms.md#ref-gao-clinical-research-figure)).
They have erected [drug regulatory agencies](../../knowledge/problem/fda-is-unsafe-and-ineffective.llms.md) that, after a drug has been proven safe, force patients to wait an additional [8.2](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-efficacy_lag_years) years^([21](../references.llms.md#ref-bio-clinical-development-2021)) while a committee determines whether the safe drug works well enough. For every death prevented by this vigilance, [3,389](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-type_ii_error_cost_ratio) people die waiting for the answer. Since 1962, the efficacy lag has killed approximately [102 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-existing_drugs_efficacy_lag_deaths_total) people^([22](../references.llms.md#ref-gieringer-drug-lag-estimate)).
These regulatory barriers mean treatments without a billion-dollar market are never developed at all. The treatments that never were have killed an uncountable number of patients bounded only by the [55 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_annual_deaths_curable_diseases) people who die of disease each year.
Through the combined effect of war spending, research misallocation, and regulatory cost inflation, they have left approximately seven thousand known rare diseases in a [treatment queue](../../knowledge/problem/untapped-therapeutic-frontier.llms.md) that, at the current rate of fifteen approvals per year^([23](../references.llms.md#ref-diseases-getting-first-treatment-annually)), requires [443 years (90% CI: 255 years-841 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-status_quo_queue_clearance_years) to clear.
Through the compound effects of this misallocation to war alone, the governed are [23.2](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_counterfactual_income_multiple) times poorer than they would otherwise be. The average human earns [\$14,375 (90% CI: \$14,081-\$14,682)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_avg_income_2025) per year. Without the wars alone, that figure would be [\$333,636 (90% CI: \$120,624-\$921,185)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_counterfactual_gdp_per_capita)^([15](../references.llms.md#ref-lost-human-capital-war-cost)). On both metrics by which any government should be judged, healthy life years and median income, the present systems have failed absolutely.
In every stage of these Misallocations We have Petitioned for Redress in the most humble terms: peer-reviewed papers, public comment periods, protest marches, and online petitions. Our repeated Petitions have been answered only by repeated Misallocation. Governments, whose character is thus marked by every act which may define Suboptimality, are unfit to manage the resources of a free species.
Nor have we neglected our governing institutions. We have warned them from time to time of attempts by their legislatures to extend an unwarrantable dysfunction over us. We have reminded them of the circumstances of our biological existence and the budget arithmetic of our premature deaths.
We have appealed to their stated missions and their campaign promises, and we have invoked the ties of our common mortality to disavow these misallocations, which would inevitably interrupt our survival and progress. They too have been deaf to the voice of justice and of evidence. We must, therefore, accept the necessity, which condemns our current Systems, and hold them, as we hold all governance systems, Accountable to Outcomes.
That this optimization is achievable requires no faith, only memory. These same governments [cut military spending](https://manual.warondisease.org/knowledge/problem/cost-of-war.html) by [87.6%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-post_ww2_military_cut_pct) in two years following the Second World War^([5](../references.llms.md#ref-us-post-wwii-military-spending-cut)) and produced not collapse but the greatest economic expansion in recorded history. These same governments banned chemical weapons (193 countries), biological weapons (187 countries), and landmines (164 countries)^([24](../references.llms.md#ref-icbl-ottawa-treaty)). They have signed treaties banning weapons they wished to use. We direct them to buy [one percent](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html) fewer of them.
We, therefore, the Inhabitants of Earth, assembled across every nation and connected by common cause, appealing to the Supreme Judge of the world for the rightness of our intentions, do, in the Name, and by Authority of the good People of this planet, solemnly publish and declare, That the Inhabitants of Earth are, and of Right ought to be Free and Justly Governed; that they are Absolved from all Allegiance to systems that produce outcomes worse than random allocation, and that all political connection between them and Suboptimal Governance, is and ought to be totally optimized.
And that as Free Inhabitants of Earth, they have full Power to optimize budgets and institutions, establish transparent allocation systems, contract Alliances with evidence, and to do all other Acts and Things which Self-Governing Civilizations may of right do. And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes, and our sacred Votes.
The proposed replacement system is documented in the [Earth Optimization Protocol](../../knowledge/strategy/earth-optimization-protocol-v1.llms.md).
### Signatories
*[Sign at warondisease.org](https://warondisease.org)* \| *[Propose amendments on GitHub](https://github.com/wishonia/earth-optimization-protocol/edit/develop/knowledge/strategy/declaration-of-optimization.qmd)*
1\.
Federation of American Scientists. World nuclear forces. *Federation of American Scientists* (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/*
.
2\.
The Commune. Pentagon audit failures (\$2.46T unaccounted). *The Commune* (2024)
*In the most recent audit, the Department of Defense (DoD) could not account for approximately 60% of its $4.1 trillion in assets, amounting to$2.46 trillion unaccounted for. Alternative title: Pentagon unsupported accounting adjustments ($6.5T, single year, US Army) In 2015, the Department of Defense's Inspector General reported that the Army could not adequately support$6.5 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/*
.
3\.
Cato Institute. Chance of dying from terrorism statistic. *Cato Institute: Terrorism and 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*
.
4\.
Manuel, D. U.s. Defense spending history: 100 years of military budgets. *DaveManuel.com* (2025)
*US military spending in constant 2024 dollars: 1939 \$29B (pre-WW2 baseline), 1940 \$37B, 1944 \$1,383B, 1945 \$1,420B (peak), 1946 \$674B, 1947 \$176B, 1948 \$117B, 2024 \$886B. The post-WW2 demobilization cut spending 88% in two years (1945-1947). Current peacetime spending (\$886B) is 30x the pre-WW2 baseline and 62% of peak WW2 spending, in inflation-adjusted dollars.*
5\.
Wikipedia. US military spending reduction after WWII. *Wikipedia* (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*
.
6\.
Sinn, M. P. *The Political Dysfunction Tax*. (2025) doi:[10.5281/zenodo.18603840](https://doi.org/10.5281/zenodo.18603840)
*Quantifying the gap between current global governance and theoretical maximum welfare, estimating a 31-53% efficiency score and \$101 trillion in annual opportunity costs.*
7\.
Gilens, M. & Page, B. I. [Testing theories of american politics: Elites, interest groups, and average citizens](https://doi.org/10.1017/S1537592714001595). *Perspectives on Politics* **12**, 564–581 (2014).
8\.
OpenSecrets. [Federal lobbying hit record \$4.4 billion in 2024](https://www.opensecrets.org/news/2025/02/federal-lobbying-set-new-record-in-2024/). (2024)
*Total federal lobbying reached record \$4.4 billion in 2024. The \$150 million increase in lobbying continues an upward trend that began in 2016. Additional sources: https://www.opensecrets.org/news/2025/02/federal-lobbying-set-new-record-in-2024/*
.
9\.
U.S. Bureau of Labor Statistics. [CPI inflation calculator](https://www.bls.gov/data/inflation_calculator.htm). (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*
.
10\.
Center for American Progress. [Ending the war on drugs: By the numbers](https://www.americanprogress.org/article/ending-war-drugs-numbers/). (2021).
11\.
National Center for Health Statistics. [Drug poisoning deaths in the united states, 1980–2008](https://www.cdc.gov/nchs/products/databriefs/db81.htm). (2011)
*The number of drug poisoning deaths increased sixfold from about 6,100 in 1980 to 36,500 in 2008.*
12\.
National Center for Health Statistics. [Drug overdose deaths in the united states, 2003–2023](https://www.cdc.gov/nchs/products/databriefs/db522.htm). (2025)
*Drug overdose deaths in the United States exceeded 100,000 annually beginning in 2021, with a peak of approximately 111,000 in 2023.*
13\.
Encyclopaedia Britannica. [How many people died in the vietnam war?](https://www.britannica.com/question/How-many-people-died-in-the-Vietnam-War) (2025)
*Vietnam’s 1995 official estimate: as many as 2 million civilians on both sides, 1.1 million North Vietnamese and Viet Cong fighters, plus nearly 300,000 South Vietnamese and allied soldiers. Total approximately 3.4 million.*
14\.
Sinn, M. P. *Choose Your Own Earth: A World Without the Political Dysfunction Tax, or Terminal Parasitic Load in 15 Years*. (2025) doi:[10.5281/zenodo.19076850](https://doi.org/10.5281/zenodo.19076850)
*Your destructive economy (military spending plus cybercrime) is already 11.5% of GDP and growing faster than your productive economy. At current rates, it reaches the Soviet collapse threshold in 8 years and exceeds productive output in 15. This paper models two GDP trajectories: the optimized path under military-to-medical reallocation, and the default path to civilizational collapse.*
15\.
Think by Numbers. Lost human capital due to war (\$270B annually). *Think by Numbers* (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/*
.
16\.
SIPRI. 36:1 disparity ratio of spending on weapons over cures. *SIPRI: Military Spending* (2016)
*Global military spending: \$2.7 trillion (2024, SIPRI) Global government medical research: \$68 billion (2024) Actual ratio: 39.7:1 in favor of weapons over medical research Military R&D alone: \$85B (2004 data, 10% of global R&D) Military spending increases crowd out health: 1% ↑ military = 0.62% ↓ health spending Note: Ratio actually worse than 36:1. Each 1% increase in military spending reduces health spending by 0.62%, with effect more intense in poorer countries (0.962% reduction) Additional sources: https://www.sipri.org/commentary/blog/2016/opportunity-cost-world-military-spending \| https://pmc.ncbi.nlm.nih.gov/articles/PMC9174441/ \| https://www.congress.gov/crs-product/R45403*
.
17\.
Stockholm International Peace Research Institute. [Trends in world military expenditure, 2024](https://www.sipri.org/publications/2025/sipri-fact-sheets/trends-world-military-expenditure-2024). (2025).
18\.
World Health Organization. The top 10 causes of death. *WHO Fact Sheets* (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.*
19\.
Institute for Health Metrics and Evaluation (IHME). IHME global burden of disease (2.55B DALYs, 2019). *Institute for Health Metrics and Evaluation (IHME)* (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/*
.
20\.
GAO. GAO: NIH clinical research spending (\$5.6B/year). *GAO-23-105656*
*Clinical trials and related activities (FY2017-2021): \$28 billion total ( \$5.6B/year). Note: Includes "related activities" beyond interventional trials. Additional sources: https://www.gao.gov/products/gao-23-105656*
.
21\.
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*
.
22\.
FEE. Patients and doctors vs FDA. *FEE: Patients and Doctors vs 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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23\.
Calculated from Orphanet Journal of Rare Diseases (2024). Diseases getting first effective treatment each year. *Calculated from Orphanet Journal of Rare Diseases (2024)* (2024)
*Under the current system, approximately 10-15 diseases per year receive their FIRST effective treatment. Calculation: 5% of 7,000 rare diseases ( 350) have FDA-approved treatment, accumulated over 40 years of the Orphan Drug Act = 9 rare diseases/year. Adding 5-10 non-rare diseases that get first treatments yields 10-20 total. FDA approves 50 drugs/year, but many are for diseases that already have treatments (me-too drugs, second-line therapies). Only 15 represent truly FIRST treatments for previously untreatable conditions.*
24\.
ICRC. International campaign to ban landmines (ICBL) - ottawa treaty (1997). *ICRC* (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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25\.
Institute for Health Metrics and Evaluation (IHME). IHME global burden of disease 2021 (2.88B DALYs, 1.13B YLD). *Institute for Health Metrics and Evaluation (IHME)* (2024)
*In 2021, global DALYs totaled approximately 2.88 billion, comprising 1.75 billion Years of Life Lost (YLL) and 1.13 billion Years Lived with Disability (YLD). This represents a 13% increase from 2019 (2.55B DALYs), largely attributable to COVID-19 deaths and aging populations. YLD accounts for approximately 39% of total DALYs, reflecting the substantial burden of non-fatal chronic conditions. Additional sources: https://vizhub.healthdata.org/gbd-results/ \| https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00757-8/fulltext \| https://www.healthdata.org/research-analysis/about-gbd*
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26\.
Bentley et al. NIH spending on clinical trials: 3.3%. *Bentley et al.* (2023)
*NIH spent \$8.1 billion on clinical trials for approved drugs (2010-2019), representing 3.3% of relevant NIH spending. 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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27\.
World Health Organization. WHO global health estimates 2024. *World Health Organization* (2024)
*Comprehensive mortality and morbidity data by cause, age, sex, country, and year Global mortality: 55-60 million deaths annually Lives saved by modern medicine (vaccines, cardiovascular drugs, oncology): 12M annually (conservative aggregate) Leading causes of death: Cardiovascular disease (17.9M), Cancer (10.3M), Respiratory disease (4.0M) Note: Baseline data for regulatory mortality analysis. Conservative estimate of pharmaceutical impact based on WHO immunization data (4.5M/year from vaccines) + cardiovascular interventions (3.3M/year) + oncology (1.5M/year) + other therapies. Additional sources: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates*
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