# Medical Research Spending: The [\$67.5 billion (95% CI: \$54 billion-\$81 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_med_research_spending) Lie Here is the complete accounting of humanity’s commitment to curing disease. Spoiler: It’s largely an accounting trick. ## The Broad Number vs. The Real Number Governments claim they spend billions on “medical research.” In 2024, the official global total for government medical R&D was approximately **[\$67.5 billion (95% CI: \$54 billion-\$81 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_med_research_spending)**. [![The ‘official’ number for medical research versus the real number after you subtract all the parts that aren’t actually curing diseases. Like restaurant portions, governments describe things generously.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-broad-nu-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-broad-nu-bw-academic.jpg) The ‘official’ number for medical research versus the real number after you subtract all the parts that aren’t actually curing diseases. Like restaurant portions, governments describe things generously. It sounds like a lot. It is a lie. ### The Accounting Trick That \$68 billion figure includes: 1. **Basic Science:** Studying fruit fly genetics and yeast cells (important, but not a cure). 2. **Overhead:** University buildings, admin salaries, and electricity bills (often 40-60% of grants). 3. **Bureaucracy:** Salaries for the people who decide where the money goes. 4. **Epidemiology:** Counting how many people have died (instead of saving them). [![Where the 68 billion goes: basic science, overhead, bureaucracy, and epidemiology. Notice how ‘curing diseases’ is not on this list.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-accounting-trick-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-accounting-trick-bw-academic.jpg) Where the 68 billion goes: basic science, overhead, bureaucracy, and epidemiology. Notice how ‘curing diseases’ is not on this list. ### The Real Number: [\$4.5 billion (95% CI: \$3 billion-\$6 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_government_clinical_trials_spending_annual) When you strip away the overhead and basic science to ask **“How much do governments spend on actually testing cures in humans?”** the number collapses. [![4.5 billion for clinical trials, divided by 8 billion people. That’s about 56 cents per human per year. You spend more on a pack of gum.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-real-num-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-real-num-bw-academic.jpg) 4.5 billion for clinical trials, divided by 8 billion people. That’s about 56 cents per human per year. You spend more on a pack of gum. **Global government spending on interventional clinical trials is only ~[\$4.5 billion (95% CI: \$3 billion-\$6 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_government_clinical_trials_spending_annual) per year.** That is the entire public contribution to testing new medicines for 8 billion people. > **IMPORTANT:** > > In 2024, global military spending reached **[\$2.72 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_military_spending_annual_2024)**. In contrast, global government spending on interventional clinical trials is estimated at **[\$4.5 billion (95% CI: \$3 billion-\$6 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_government_clinical_trials_spending_annual)**. > > [![For every dollar we spend on clinical trials, we spend 604 dollars on the military. We’re very good at killing people and very bad at not killing people. Consistency is important.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-604x-disparity-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-604x-disparity-bw-academic.jpg) > > For every dollar we spend on clinical trials, we spend 604 dollars on the military. We’re very good at killing people and very bad at not killing people. Consistency is important. > > This represents a funding ratio of **[604 (90% CI: 453-888)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-military_to_government_clinical_trials_spending_ratio)**. > > For every \$1 governments spend testing cures, they spend [604 (90% CI: 453-888)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-military_to_government_clinical_trials_spending_ratio) on weapons and military systems. ## The Industry Trap “But doesn’t the pharmaceutical industry fund trials?” Yes. In fact, industry funds **~90%** of all interventional trials. The ratio of Industry to Government spending is **[12.3 (90% CI: 8.23-19.3)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-industry_vs_government_clinical_trials_spending_ratio)**. This creates a fatal incentive structure: 1. **Profit First:** Companies only test drugs that can be patented and sold for high prices. 2. **Me-Too Drugs:** It is safer to make the 12th slightly better antidepressant than to cure Alzheimer’s. 3. **Orphan Diseases:** If a disease doesn’t affect enough rich people, it gets zero funding. 4. **Repurposed Generics:** There is zero profit in proving that a cheap, off-patent drug cures cancer. So nobody funds those trials. **We have outsourced our survival to a business model that requires us to stay sick enough to buy pills, but alive enough to pay for them.** [![The drug industry flowchart: will it make money? No? Don’t cure it. Yes? Cure it. This is why we have seventeen acne medications and zero malaria vaccines. The market has spoken, and it has terrible skin.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-industry-incentive-cycle-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-industry-incentive-cycle-bw-academic.jpg) The drug industry flowchart: will it make money? No? Don’t cure it. Yes? Cure it. This is why we have seventeen acne medications and zero malaria vaccines. The market has spoken, and it has terrible skin. ## Broad R&D Breakdown: The Hall of Shame *Note: These figures refer to the broader “Medical Research” budgets (the [\$67.5 billion (95% CI: \$54 billion-\$81 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_med_research_spending) figure), not the specific clinical trial spending.* ### United States: The Alleged Leader **NIH Budget (2024): \$47.1 billion^([1](../references.llms.md#ref-nih-budget-fy2025))** - **Actual Clinical Trials:** Only ~\$810M - \$5.6B^([2](../references.llms.md#ref-nih-phased-trial-spending-2010-2019)) (depending on definition). - **Administrative Costs:** 31%^([3](../references.llms.md#ref-nih-administrative-costs-31pct)) of the budget. - **Indirect Costs:** Universities take 40-60%^([4](../references.llms.md#ref-university-indirect-costs-40-60pct)) for overhead. [![Where the NIH’s 47.1 billion goes after universities and administrators take their cut. Like watching a cake get sliced, if most of the slices went to people who weren’t hungry.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-united-state-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-united-state-bw-academic.jpg) Where the NIH’s 47.1 billion goes after universities and administrators take their cut. Like watching a cake get sliced, if most of the slices went to people who weren’t hungry. ### China: The Rising Power **Medical Research Spending: ~\$15 billion^([5](../references.llms.md#ref-china-medical-research-spending-15b))** - Prioritizes surveillance technology over medical breakthroughs. - Spends 97x more^([6](../references.llms.md#ref-china-surveillance-vs-medicine-spending)) on domestic security than clinical research. [![China spends 97 dollars on domestic security for every dollar on clinical research. They’re very committed to making sure people stay alive long enough to be monitored.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-china-the-rising-power-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-china-the-rising-power-bw-academic.jpg) China spends 97 dollars on domestic security for every dollar on clinical research. They’re very committed to making sure people stay alive long enough to be monitored. ### European Union **Horizon Europe Health Budget: €1.17 billion/year^([7](../references.llms.md#ref-eu-horizon-health-budget-8-2b))** - Per citizen: Less than the cost of a cup of coffee (\$2.89/year). - Individual countries like Germany (\$6B) and France (\$4B) add to this, but the total remains a fraction of their military budgets. [![The EU health budget per citizen, compared to a cup of coffee. The coffee costs more. At least the coffee keeps you awake while you slowly die of preventable diseases.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-european-union-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-european-union-bw-academic.jpg) The EU health budget per citizen, compared to a cup of coffee. The coffee costs more. At least the coffee keeps you awake while you slowly die of preventable diseases. ### The Rest of the World - **Japan:** \$5 billion^([8](../references.llms.md#ref-japan-medical-research-spending-5b)) (Aging population, zero urgency). - **India:** \$3 billion^([9](../references.llms.md#ref-india-medical-research-spending-1-2b)) (\$2.14 per person). - **Russia:** \$800 million^([10](../references.llms.md#ref-russia-medical-research-spending-800m)) (Spend huge on nukes, pennies on health). [![Medical research spending in Japan, India, and Russia. The differences are significant, like comparing a swimming pool, a bathtub, and a shot glass. All full of water, very different outcomes.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-rest-of-the-world-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-the-rest-of-the-world-bw-academic.jpg) Medical research spending in Japan, India, and Russia. The differences are significant, like comparing a swimming pool, a bathtub, and a shot glass. All full of water, very different outcomes. ## Conclusion: A Species-Wide Failure We are the only species that pays for its own extinction while claiming it cannot afford its own survival. 1. **Global Military Spending:** [\$2.72 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_military_spending_annual_2024) 2. **Pet Food:** \$150 Billion 3. **Video Games:** \$180 Billion 4. **Government Clinical Trials:** [\$4.5 billion (95% CI: \$3 billion-\$6 billion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_government_clinical_trials_spending_annual) **We value our dogs’ dinner 30x more than finding cures for our children.** The solution is the **[1% Treaty](https://manual.warondisease.org/knowledge/solution/1-percent-treaty.html)^([11](../references.llms.md#ref-1-percent-treaty-paper-2025)) ^([12](../references.llms.md#ref-1-pct-treaty-impact-paper-2025))**: shifting just 1% of military spending ([\$27.2 billion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-treaty_annual_funding)) would increase global government clinical trial funding by **600%**. We could run tens of thousands of pragmatic trials annually, breaking the industry monopoly on what gets tested and cured. [![What humanity spends money on: trillions on military, billions on entertainment and pets, and whatever’s left over for not dying. We have our priorities, and they are terrible.](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-spending-com-bw-academic.jpg)](../../assets/images/global-government-medical-research-spending/global-government-medical-research-spending-section-spending-com-bw-academic.jpg) What humanity spends money on: trillions on military, billions on entertainment and pets, and whatever’s left over for not dying. We have our priorities, and they are terrible. 1\. NIH. NIH budget (FY 2025). *NIH* (2024) *The budget total of \$47.7 billion also includes \$1.412 billion derived from PHS Evaluation financing... Additional sources: https://www.nih.gov/about-nih/organization/budget \| https://officeofbudget.od.nih.gov/* . 2\. PMC. NIH phased trial spending for approved drugs 2010-2019. *PMC* *NIH spent \$8.1 billion on phased clinical trials of 387 drugs that were approved between 2010 and 2019. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC10349341/* . 3\. American Action Forum. NIH administrative costs percentage (31%). *American Action Forum: NIH 15* *Indirect costs (facilities & administration): Historically averaged 27-28% of total grant costs FY2023:  \$9B indirect costs out of \$35B total competitive grants (26% of total) Institution-specific rates varied: Harvard 69%, Yale 67%, UPenn 62.5%, MIT 59%, Stanford 55% Average base rate:  52% overhead on direct costs (meaning \$52K overhead per \$100K research grant = 34% of total) February 2025: NIH imposed 15% cap on indirect cost rates for all grants Additional sources: https://www.americanactionforum.org/weekly-checkup/nihs-15-percent-cap-leaner-budgets-stronger-science/ \| https://www.feldesman.com/a-major-fumble-in-research-grants-nih-unilaterally-caps-indirect-costs-at-15-percent-in-open-grants-to-universities-and-research-institutions/* . 4\. AAU. University indirect costs on research grants (40-60%). *AAU* *Universities typically have a negotiated F&A (Facilities & Administrative) rate between 40-60 percent, though many organizations charge indirect rates of over 50% and in some cases over 60%. Additional sources: https://www.aau.edu/key-issues/frequently-asked-questions-about-facilities-and-administrative-fa-costs-federally \| https://research.ucdavis.edu/3-things-to-know-about-indirect-costs-aka-fa/* . 5\. China National Statistics. China’s medical research spending (2024):  \$15 billion. *China National Statistics: R&D 2024* (2024) *Total R&D spending: 3.6 trillion yuan ( \$500B USD, 2024), 2.68% of GDP Basic research: 249.7 billion yuan ( \$35B), 6.91% of total R&D (10.5% increase from 2023) Life sciences is priority area alongside quantum tech, materials science, space China is world’s 2nd largest R&D spender after US (\$784B vs \$723B in 2023) Note: Specific health/medical research breakdown not publicly reported; life sciences receives increasing investment Additional sources: https://www.stats.gov.cn/english/PressRelease/202502/t20250207_1958579.html \| https://www.globaltimes.cn/page/202501/1327442.shtml* . 6\. Nikkei Asia. China spending on surveillance vs. medicine. *Nikkei Asia: China Public Security* *Domestic security/surveillance:  1.45 trillion yuan (2023) Healthcare (public expenditure):  2.24 trillion yuan (2023) Domestic security spending first exceeded military budget in 2010 2017:  \$197B domestic security (\$349B PPP basis), more than double US’s \$165B Note: While healthcare receives more total funding, domestic security spending has tripled in past decade, emphasizing internal stability control Additional sources: https://asia.nikkei.com/static/vdata/infographics/china-spends-more-on-controlling-its-1-dot-4bn-people-than-on-military/ \| https://jamestown.org/program/chinas-domestic-security-spending-analysis-available-data/* . 7\. HRB. Horizon europe health budget (2021-2027): €8.2 billion. *HRB: Horizon Europe Health Information* *Horizon Europe total budget: €95.5 billion (2021-2027) Cluster 1 "Health": €8.246 billion dedicated to health research Alternative figures: €7.7B (some sources) or €8.3B (including Next Generation EU: +€1.1B) Managed by: Health and Digital Executive Agency (HaDEA) Pillars structure: Cluster 1 Health falls under Pillar 2 (Global Challenges) Note: Most consistent official figure is €8.246B for Cluster 1 Health. Variations reflect different components or inclusion of Next Generation EU supplemental funds Additional sources: https://www.hrb.ie/funding/funding-opportunities/eu-funding-support/horizon-europe-information/ \| https://hadea.ec.europa.eu/programmes/horizon-europe/health_en \| https://www.healthncp.net/horizon-europe* . 8\. PMC. Japan medical research spending:  \$5 billion/year. *PMC: Limited Alignment Disease Funding Japan* *Publicly competitive health R&D funding: 344.1B JPY ( \$3B USD) for 32,204 projects in 2015-2016 Japan Agency for Medical Research & Development (AMED):  660B yen ( \$6B USD) funded since establishment Pharmaceutical R&D: 1.43 trillion yen ( \$13B USD) by Japanese pharma companies in FY2022 Total R&D across all fields (FY2022): 20.7 trillion yen (most for natural sciences including health) Note: "\$5B" is reasonable estimate for government health R&D; AMED alone  \$6B total; pharma private R&D much higher ( \$13B) Additional sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7010241/ \| https://www.nature.com/articles/d42473-020-00051-w \| https://pmc.ncbi.nlm.nih.gov/articles/PMC10434904/ \| https://www.statista.com/statistics/1108205/japan-research-and-development-expenses-pharmaceutical-industry/* . 9\. ACS. India medical research spending: \$1.2 billion. *ACS: India Budget Biotech Health* (2021) *Current pharma & MedTech R&D:  \$3 billion (vs US \$50-60B, China \$15-20B) Department of Health Research budget 2025-26: Rs. 3900.69 crores (\$467M USD) Recent budget: Rs 3,201 crore (\$419.2M) Historical health research funding: US \$1,053M (2007-08) → \$1,423M (2011-12), 8.8% annual increase Public health spending:  1.2% of GDP (among lowest globally) Healthcare infrastructure need: \$1.2 trillion (NITI Aayog 2022 report) Note: "\$1.2 billion" may refer to historical 2011-12 figure (\$1.423B). Current: \$3B pharma/MedTech, \$467M govt budget Additional sources: https://cen.acs.org/policy/research-funding/India-prioritizes-new-research-foundation-biotech-and-health-in-new-budget/99/web/2021/03 \| https://nmji.in/mapping-of-health-research-funding-in-india/ \| https://dhr.gov.in/documents/budget-reports* . 10\. Frontiers. Russia medical research spending: \$800 million. *Frontiers: Promoting Biomedical Communication in Russia* (2022) *Agency for Strategic Initiatives (ASI): RUB 800M ( USD \$11M, 2014-2020) for innovation development NTI (National Technology Initiative): RUB 1,578M ( USD \$21.5M, 2019-2020) for pandemic-related healthcare HealthNet roadmap: Focuses on personalized medicine, life expectancy, prevention/treatment Note: "\$800M" appears to be RUB 800M (≈ \$11M USD) for ASI over 6 years, not \$800M USD annually Additional sources: https://www.frontiersin.org/journals/communication/articles/10.3389/fcomm.2022.848578/full \| https://www.who.int/observatories/global-observatory-on-health-research-and-development/resources/databases/databases-on-inputs-to-r-d/funding-flows-for-health-r-d-by-country* . 11\. 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.* 12\. 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.* 13\. Component country budgets. Global government medical research spending (\$67.5B, 2023–2024). *See component country budgets: NIH Budget* . 14\. Applied Clinical Trials. Global government spending on interventional clinical trials:  \$3-6 billion/year. *Applied Clinical Trials* *Estimated range based on NIH ( \$0.8-5.6B), NIHR (\$1.6B total budget), and EU funding ( \$1.3B/year). Roughly 5-10% of global market. Additional sources: https://www.appliedclinicaltrialsonline.com/view/sizing-clinical-research-market \| https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30357-0/fulltext* . 15\. SIPRI. Global military spending (\$2.72T, 2024). *SIPRI* (2025).