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The Survey to End War and Disease

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

2. How should public money be divided between these two uses?

  • Weapons and military spending
  • Pragmatic clinical trials comparing promising treatments

Pragmatic clinical trials: Your doctor enrolls you. The trial runs through ordinary healthcare instead of a special facility. It costs less. The results go into the scorecard, including the ones where the treatment did nothing.

Why we ask: Disease costs about 13% of global GDP. The destructive economy consumes 11.5% of GDP and grows faster than the productive one138. Military spending creates depreciating assets; weapons become obsolete. Medical research creates appreciating assets; treatments compound. Oxford’s RECOVERY trial tested 6 treatments on 48,000 patients at about $500 (95% CI: $400-$2,500) per patient versus roughly $41,000 (95% CI: $20,000-$120,000) for a conventional Phase III trial. That is a cost reduction of about 82x (90% CI: 21.4x-195x). It was run during a pandemic by terrified people, which raises questions about what the non-terrified system has been doing with its time. After WW2, the US cut military spending by 87.6% in two years and stumbled into the largest economic boom in its history. This survey asks about 1%.

Prediction: Most people allocate more than the 0.17% that goes to clinical trials today. In US polling, 57% supported cutting the military budget by 10% to fund health and other domestic needs139.

If the median allocation gives trials at least 1 percentage point more than today’s share: That is a global mandate for the 1% reallocation: $27.2 billion per year for pragmatic trials, a 12.3x (90% CI: 4.92x-50.8x) increase in trial capacity, and a timeline drop from 443 years (90% CI: 255 years-841 years) to 36 years (90% CI: 8.15 years-106 years). Even after discounting for the chance it never happens politically, the reallocation would cost $0.177 (90% CI: $0.03-$2.92) per healthy year of life saved140. Vaccinating a child costs $30. A bed net costs $89 (95% CI: $78-$100).

Evidence and calculations: Allocation Impact Analysis140

3. Most promising treatments are never tested, because no company can profit from testing them. Should patients be allowed to fund and join trials of treatments for their own disease?

Why we ask: 95% of diseases have zero FDA-approved treatments101. There is a queue to not die, and at current speed it is 443 years (90% CI: 255 years-841 years) long. A trial needs money. If no company can patent the treatment, no company pays, and it stays on a shelf.

Prediction: No direct polling exists. Access to unapproved treatments polls between 54% and 90% depending on framing. Patient funding raises equity concerns those polls did not test.

If a majority of humanity says yes: Regulators can permit patient-funded trials without political risk. Treatments with no patent value get tested.

Evidence and calculations: Appendix: Calculations137

4. If government action kills or injures your family, should you have the same right to sue as if a corporation did it?

Why we ask: Since 1900, governments have spent $170 trillion on the capacity to kill people and used it to kill 310 million of them, including 102 million children, who likely did not deserve it. The chance of dying from terrorism is 1 in 30 million4. The chance of dying from disease is 100%. Governments built the security apparatus around the first number. If a company made this trade, you could sue. Sovereign immunity means that when a government does it, you mostly cannot141.

Prediction: In adjacent US polling, 63% favor ending qualified immunity for government officials142 and 66% favor giving civilians the power to sue officers for misconduct143. The equal-treatment framing in this question has not been directly polled.

If a majority of humanity says yes: A global consensus removes the belief that sustains immunity: that everyone else accepts it. It becomes possible to propose a court for harm caused by states.

Evidence and calculations: Appendix: Calculations144

5. Should governments be required to measure how long people live in good health and what they actually earn, and to test which policies improve those numbers?

Why we ask: Governments measure how much money they spend. They do not measure whether it worked. Two outcomes would tell them: how long people live in good health, and what they actually earn.

Prediction: In US polling, 91% of voters agree that data and evidence should be a top influence in government policy, bipartisan145. The specific two-metric measurement mandate has not been polled.

If a majority of humanity says yes: Ten thousand jurisdictions have already tried different policies and written down what happened. The Optimal Policy Generator uses causal inference to figure out which policies improved the two numbers and which ones did not, then produces recommendations for any jurisdiction: enact, replace, repeal, or keep146. The Optimal Budget Generator does the same for spending levels147. The recommendations and the votes are both public.

Evidence and calculations: Optimal Policy Generator146

Why counting matters

A majority can exist and not know it exists. Pluralistic ignorance148: eight billion people waiting for permission to want what they already want. The condition holds until somebody counts.

Erica Chenoweth studied every major nonviolent campaign of the last century and found that none had ever failed after achieving 3.5% (95% CI: 1%-10%) sustained participation65. Not one. Humanity discovered the cheat code for upgrading its own civilization.

What happens if all five pass

On the reallocation trajectory, the models project global GDP of $322 trillion (90% CI: $245 trillion-$404 trillion) and average income of $34,972 (90% CI: $26,587-$43,903) in year 20138. If every institution the mandate enables works as modeled, year-20 global GDP is $10.7 quadrillion (90% CI: $3.95 quadrillion-$28 quadrillion) and median after-tax income is $194,130 (90% CI: $70,137-$507,535)138. The second number’s growth assumptions are outside historical precedent.

Costs

A verified response costs $6.5 (90% CI: $4-$9.14): $1.5 (95% CI: $1-$3) for identity verification and processing, $5 (95% CI: $2-$10) for incentives. Organizations that distribute the questions receive compensation per verified response; terms are in the Organization Kit. If the treaty passes, each response corresponds to 2.6 lives saved, at $2.5 (90% CI: $1.12-$4.68) per life.

Appendix: Calculations

The 0.17%. Military spending is 604 (90% CI: 453-888) times government clinical trial spending, so trials receive roughly 1/604 of what weapons receive:

\[ \begin{gathered} Ratio_{mil:gov} \\ = \frac{Spending_{mil}}{Spending_{trials,gov}} \\ = \frac{\$2.72T}{\$4.5B} \\ = 604 \end{gathered} \]

The RECOVERY cost reduction:

\[ \begin{gathered} k_{RECOVERY} \\ = \frac{Cost_{P3,pt}}{Cost_{RECOVERY,pt}} \\ = \frac{\$41K}{\$500} \\ = 82 \end{gathered} \]

Annual funding from a 1% reallocation:

\[ \begin{gathered} Funding_{treaty} \\ = Spending_{mil} \times Reduce_{treaty} \\ = \$2.72T \times 1\% \\ = \$27.2B \end{gathered} \]

The treatment-testing timeline, including the status quo 443-year estimate and the 12.3x (90% CI: 4.92x-50.8x) capacity multiplier it improves on:

\[ \begin{gathered} T_{queue,trial} \\ = \frac{T_{queue,SQ}}{k_{capacity}} \\ = \frac{443}{12.3} \\ = 36 \end{gathered} \]
where:
\[ \begin{gathered} T_{queue,SQ} \\ = \frac{N_{untreated}}{Treatments_{new,ann}} \\ = \frac{6{,}650}{15} \\ = 443 \end{gathered} \]
where:
\[ \begin{gathered} N_{untreated} \\ = N_{rare} \times 0.95 \\ = 7{,}000 \times 0.95 \\ = 6{,}650 \end{gathered} \]
where:
\[ \begin{gathered} k_{capacity} \\ = \frac{N_{fundable,ref}}{Slots_{curr}} \\ = \frac{23.4M}{1.9M} \\ = 12.3 \end{gathered} \]
where:
\[ \begin{gathered} N_{fundable,ref} \\ = \frac{Subsidies_{trial,ref}}{Cost_{pragmatic,pt}} \\ = \frac{\$21.8B}{\$929} \\ = 23.4M \end{gathered} \]
where:
\[ \begin{gathered} Subsidies_{trial,ref} \\ = Funding_{trial,ref} - OPEX_{trial} \\ = \$21.8B - \$40M \\ = \$21.8B \end{gathered} \]
where:
\[ \begin{gathered} OPEX_{trial} \\ = Cost_{platform} + Cost_{staff} + Cost_{infra} \\ + Cost_{regulatory} + Cost_{community} \\ = \$15M + \$10M + \$8M + \$5M + \$2M \\ = \$40M \end{gathered} \]

Cumulative military spending expressed in years of clinical trial funding:

\[ \begin{gathered} Years_{mil \to trials,gov} \\ = \frac{Spending_{mil,cum,fed}}{Spending_{trials,gov}} \\ = \frac{\$170T}{\$4.5B} \\ = 37{,}800 \end{gathered} \]

Source citations for all quantities are in the parameter registry.