# The 1% Treaty

A Treaty for the Reallocation of 1% of Military Expenditures Toward Biomedical Research and the Prevention of Human Suffering and Death

Author

Affiliation

Mike P. Sinn

Institute for Accelerated Medicine

Abstract

Your public servants used [\$170 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-cumulative_military_spending_fed_era) of their salary to murder approximately [310 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_deaths_since_1900) humans over the last century of their employment. The murdered included 930,000 doctors, 310,000 scientists, 620,000 engineers, 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. They spend [604](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-military_to_government_clinical_trials_spending_ratio) dollars on the capacity for orphan manufacturing for every one dollar spent on the trials that might cure what is actually going to kill their citizens. Someone you love is, at this moment, suffering from a disease because the treatment that would help them exists untested on a shelf, because the money that would have tested it was busy turning into a missile.

This treaty requires the undersigned nations to be 1% more rational. Each signatory redirects exactly one percent of its military budget to pragmatic clinical trials, perpetual [Incentive Alignment Bond](https://manual.warondisease.org/knowledge/appendix/incentive-alignment-bonds-paper.html)^([1](../references.llms.md#ref-iab-paper-2025)) returns, and a Political Incentive Fund that scores legislators on compliance. Every nation cuts equally, so no country gets weaker. Trial capacity scales [12.3x (90% CI: 4.92x-50.8x)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_multiplier). The backlog of [6,650](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-diseases_without_effective_treatment) untreated diseases drops from [443 years (90% CI: 255 years-841 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-status_quo_queue_clearance_years) to [36 years (90% CI: 8.15 years-106 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_queue_clearance_years). Treatments arrive [212](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_plus_efficacy_lag_years) years sooner. [10.7 billion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_plus_efficacy_lag_lives_saved) preventable deaths averted, valued at [\$7.53 quadrillion (90% CI: \$3.08 quadrillion-\$12.8 quadrillion)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_plus_efficacy_lag_economic_value).

The percentage can go up. It never goes down. The Treaty is the settlement offer for the liability established in [Humanity v. Government](https://manual.warondisease.org/knowledge/appendix/humanity-v-government.html), adjudicated through the [Court of Humanity](https://manual.warondisease.org/knowledge/solution/court-of-humanity.html)^([2](../references.llms.md#ref-court-of-humanity-paper-2025)), with the economic case quantified in [1% Treaty Impact](https://manual.warondisease.org/knowledge/economics/1-pct-treaty-impact.html)^([3](../references.llms.md#ref-1-pct-treaty-impact-paper-2025)).

WHEREAS, humanity pays governments approximately [\$36.5 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_government_expense_annual) per year^([4](../references.llms.md#ref-world-bank-government-expense-pct-gdp)) for the service of promoting the general welfare, defined as the median health and wealth of the citizenry;

WHEREAS, the citizenry would like to actually receive this service at some point;

WHEREAS, these public servants instead used [\$170 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-cumulative_military_spending_fed_era) of their salary to murder approximately [310 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_deaths_since_1900) humans^([5](../references.llms.md#ref-lost-human-capital-war-cost)) over the last century of their employment;

WHEREAS, these murdered humans included 930,000 doctors, 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^([5](../references.llms.md#ref-lost-human-capital-war-cost));

WHEREAS, this seems counterproductive;

WHEREAS, murdering [310 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-war_deaths_since_1900) of your employers is the opposite of promoting their welfare, and would be grounds for termination in any other employment contract humans have ever signed;

WHEREAS, had your governments not spent [\$170 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-cumulative_military_spending_fed_era) murdering those people and destroying everything they spent their entire lives building, the average human alive today 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)^([5](../references.llms.md#ref-lost-human-capital-war-cost)). Dead scientists do not discover things and exploded cities are very expensive to fix;

WHEREAS, the governments of Earth have been hitting each other for roughly 10,000 years because the other one hit them last;

WHEREAS, this is the conflict resolution strategy of four-year-olds except four-year-olds eventually get tired and take a nap, and these governments have failed to apply naps to foreign policy;

WHEREAS, the governments of Earth possess nuclear weapons sufficient to end civilization [122](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-nuclear_winter_overkill_factor) times but have not cured Alzheimer’s once (which is particularly wasteful given we only have one civilization to destroy);

WHEREAS, your employees spend [\$2.72 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_military_spending_annual_2024) a year on their capacity for mass murder, which is enough to buy [850](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-bullets_per_person_annual) bullets for every man, woman, and child every year, even though it would require at most 2 bullets per person to murder everyone;

WHEREAS, governments spend [604](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-military_to_government_clinical_trials_spending_ratio) dollars on the capacity for orphan manufacturing for every one dollar spent on the trials that might cure what is actually going to kill their citizens;

WHEREAS, the Department of “Defense” has “misplaced” [\$2.46 trillion](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-pentagon_unaccounted_funds), failed seven consecutive audits trying to find it^([6](../references.llms.md#ref-pentagon-unaccounted-2-5t)), and then requested additional trillions without explanation or apology (Not to belabor the point, but that money could have funded [547](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-pentagon_unaccounted_clinical_trial_years) years of clinical trials at current funding levels, possibly saving billions of lives and preventing quadrillions of hours of suffering, so we would appreciate it if you would have them be more careful in the future);

WHEREAS, pre-WW2 U.S. military spending was [96.7%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-us_1939_military_spending_pct_lower_than_current) lower than today’s peacetime budget, even after adjusting for inflation^([7](../references.llms.md#ref-us-military-spending-historical-constant-dollars)). The U.S. still won World War II, then cut military spending [87.6%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-post_ww2_military_cut_pct) in two years^([8](../references.llms.md#ref-us-post-wwii-military-spending-cut)) and produced the fastest growth in median standard of living in history.

WHEREAS, unless the human genome has significantly degraded in the two generations since, a one percent improvement in resource allocation should be manageable;

WHEREAS, global military spending has been growing [2.76%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_military_spending_real_cagr_20yr) a year for twenty years^([9](../references.llms.md#ref-sipri-milex-2024)). If no one tells it to stop, every human alive will pay about [\$402,488 (90% CI: \$352,459-\$456,139)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-global_war_cost_lifetime_per_person_baseline) over their lifetime^([3](../references.llms.md#ref-1-pct-treaty-impact-paper-2025)) (mostly funding explosions in countries they cannot find on a map). A one percent cut tells it to stop. That saves the average person about [\$290,052 (90% CI: \$253,999-\$328,716)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-peace_dividend_lifetime_per_person) ([the peace dividend](../../knowledge/economics/peace-dividend.llms.md));

WHEREAS, [diseases kill more people than all wars combined](../../knowledge/problem/cost-of-disease.llms.md)^([10](../references.llms.md#ref-pandemics-vs-wars)) and, unlike wars, do not even have the decency to be quick about it;

WHEREAS, your chance of dying in a terrorist attack is approximately 1 in [30 million](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-annual_terrorism_death_risk_denominator), and your chance of dying of a disease is approximately 100%, and your current budget does not reflect this;

WHEREAS, only 15 diseases get their first effective treatment each year^([11](../references.llms.md#ref-diseases-getting-first-treatment-annually)), while [6,650 diseases (90% CI: 5,700 diseases-8,232 diseases)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-diseases_without_effective_treatment) are still waiting;

WHEREAS, at this rate, it takes [443](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-status_quo_queue_clearance_years) years to find treatments for all diseases, which is important because you will personally be dead within 80 years (which I mention not to be rude but because you seem weirdly calm about this);

WHEREAS, there are 9,500 known safe treatments which have never been tested for [99.7% (90% CI: 99%-100%)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-unexplored_ratio) of their potential uses;

WHEREAS, [pragmatic clinical trials built into ordinary healthcare](https://papers.acceleratedmedicine.org/dfda-protocol.html) cost [\$929 (95% CI: \$97-\$3,000)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_pragmatic_trial_cost_per_patient) per patient instead of the usual [\$41,000 (95% CI: \$20,000-\$120,000)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-traditional_phase3_cost_per_patient), which makes them [44.1](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_cost_reduction_factor) times cheaper, which means [12.3](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_multiplier) times as many patients can join, which drops the wait from [443 years (90% CI: 255 years-841 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-status_quo_queue_clearance_years) to [36 years (90% CI: 8.15 years-106 years)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_queue_clearance_years), which means treatments arrive [204](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_treatment_acceleration_years) years sooner on average.

WHEREAS, discovering treatments centuries sooner is [projected](https://manual.warondisease.org/knowledge/economics/1-pct-treaty-impact.html) to prevent approximately [10.7 billion deaths (90% CI: 6.24 billion deaths-20.3 billion deaths)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_plus_efficacy_lag_lives_saved) and [1.93 quadrillion hours (90% CI: 1.04 quadrillion hours-3.75 quadrillion hours)](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dfda_trial_capacity_plus_efficacy_lag_suffering_hours) of human suffering^([3](../references.llms.md#ref-1-pct-treaty-impact-paper-2025)), which are not metaphors and refer to specific future humans with specific future plans for next Tuesday;

WHEREAS, someone you love is, at this moment, suffering from a disease because the treatment that would help them exists untested on a shelf, because the money that would have tested it 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;

WHEREAS, this is suboptimal;

NOW, THEREFORE, the undersigned nations agree to be 1% more rational, as follows:

**Article I**: Each signatory shall redirect exactly 1% of its annual military budget to **the 1% Treaty Fund**, split as follows: [80%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dih_treasury_medical_research_pct) to [pragmatic clinical trials](https://papers.acceleratedmedicine.org/dfda-protocol.html); 10% to perpetual returns on [Incentive Alignment Bonds](https://manual.warondisease.org/knowledge/appendix/incentive-alignment-bonds-paper.html)^([1](../references.llms.md#ref-iab-paper-2025)); and 10% to a [Political Incentive Fund](../../knowledge/solution/aligning-incentives.llms.md) that supports campaigns of legislators who vote to implement and expand this Treaty. The [80%](../../knowledge/appendix/parameters-and-calculations.llms.md#sec-dih_treasury_medical_research_pct) cures the diseases. The other 20% make sure nobody quietly cancels the part that cures the diseases.

**Article II**: Transfers shall be automatic, immediate, and irrevocable. The money moves on the first of every month, the way your mortgage does, except nobody has to call and yell at anyone.

**Article III**: The percentage can go up. It never goes down. When the treaty works, a mandatory review raises it. Because Article I allocates in percentages, not fixed dollars, every increase enlarges the bondholder payouts and the Political Incentive Fund in lockstep. This produces something your species has never had before: a class of wealthy humans whose bank accounts grow every time a war ends, a disease is eradicated, or a child who would have died gets to grow up and have opinions about things. For the first time in human history, the absence of war and disease will be more profitable than their existence.

**Article IV**: Compliance shall be verified by public ledger and independent audits. Relabeling a submarine as “humanitarian infrastructure” will be noticed, because submarines are large and loud and do not fit in the humanitarian infrastructure drawer. Non-compliant parties shall be given a stern talking to; their compliant political opponents shall be funded via the Political Incentive Fund, which rewards legislators by recorded vote on two axes: (a) Treaty implementation and expansion, and (b) honoring [Court of Humanity](https://manual.warondisease.org/knowledge/solution/court-of-humanity.html)^([2](../references.llms.md#ref-court-of-humanity-paper-2025)) judgments against their government. Compliant votes earn campaign support for those seeking reelection, post-office appointments for those retiring. Non-compliant votes earn the same thing for their opponents. No funds pass directly to any legislator; all disbursements route through [a scoring algorithm](../../knowledge/legal/election-law.llms.md), which is apparently the only legal way to train a senator. The NRA already perfected this technology; this Treaty plagiarizes it, substituting “not dying from diseases” for “guns.”

**Article V**: Citizens of any signatory nation may sue their own government in its own courts for non-compliance with this Treaty. Where domestic courts decline jurisdiction or invoke [sovereign immunity](https://manual.warondisease.org/knowledge/solution/court-of-humanity.html)^([2](../references.llms.md#ref-court-of-humanity-paper-2025)), citizens may bring the same claim in [the Court of Humanity](https://manual.warondisease.org/knowledge/solution/court-of-humanity.html), whose jurisdiction derives from human rather than sovereign consent and whose judgments are enforced through capital markets rather than coercion.

**Article VI**: Holders of Article I [Incentive Alignment Bonds](https://manual.warondisease.org/knowledge/appendix/incentive-alignment-bonds-paper.html) may sue any signatory’s government in its own courts for non-payment. Billionaires have lawyers the way other humans have socks. This Treaty points those lawyers at the one thing billionaires and dying people both want, which is the treaty to keep working.

**Article VII**: Withdrawal requires unanimous consent of all parties plus 10-year notice. Ten years is enough time for the bondholders to sue, the Political Incentive Fund to replace whoever is trying to leave, and the voters to notice that the party attempting withdrawal is the one that wants the diseases back.

**Article VIII**: This treaty supersedes all conflicting domestic law. Including the subsection your legislature added at 2 a.m. last session specifically to make sure this couldn’t happen.

**Article IX**: This Treaty enters into force upon signature by two states. War has killed humans for as long as there have been humans to kill. Disease has been killing them longer. Its founding signatories will be responsible for the largest reduction in human suffering and the largest increase in human prosperity in the history of planet Earth.

IN WITNESS WHEREOF, the undersigned, being of sound mind (debatable) and tired of watching their loved ones die of preventable diseases, have executed this Treaty.

Signed this day, \_\_\_\_\_\_\_\_\_\_\_\_, in the year of our ongoing confusion.

------------------------------------------------------------------------

\[Nation Name\] “We choose life, I guess”

------------------------------------------------------------------------

*P.S. - Yes, this includes space weapons. Nice try.*

*P.P.S. - “Cyber weapons” too. We saw you thinking it.*

1\.

Sinn, M. P. *Incentive Alignment Bonds: Making Public Goods Financially and Politically Profitable*. <https://manual.warondisease.org/knowledge/appendix/incentive-alignment-bonds-paper.html> (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.*

2\.

Sinn, M. P. *The Court of Humanity*. <https://manual.warondisease.org/knowledge/solution/court-of-humanity.html> (2025) doi:[10.5281/zenodo.20075681](https://doi.org/10.5281/zenodo.20075681)

*A decentralized court where 8 billion humans are the jury, sovereign immunity is a choice nobody chose, and  \$104 quadrillion in unliquidated wrongful-death exposure makes the 1% Treaty the most generous settlement offer in legal history.*

3\.

Sinn, M. P. *The 1% Treaty: An Incentive-Compatible Approach to Ending War and Disease*. <https://manual.warondisease.org/knowledge/economics/1-pct-treaty-impact.html> (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.*

4\.

World Bank. [Expense (% of GDP) - world](https://data.worldbank.org/indicator/GC.XPN.TOTL.GD.ZS?locations=1W). (2024).

5\.

Think by Numbers. Lost human capital due to war (\$270B annually). *Think by Numbers* <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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6\.

The Commune. 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 $4.1 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/*

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7\.

Manuel, D. U.s. Defense spending history: 100 years of military budgets. *DaveManuel.com* <https://www.davemanuel.com/us-defense-spending-history-military-budget-data.php> (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.*

8\.

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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9\.

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).

10\.

Our World in Data. 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*

.

11\.

Calculated from Orphanet Journal of Rare Diseases (2024). Diseases getting first effective treatment each year. *Calculated from Orphanet Journal of Rare Diseases (2024)* <https://ojrd.biomedcentral.com/articles/10.1186/s13023-024-03398-1> (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.*

12\.

Cato Institute. 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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13\.

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

14\.

NIH Common Fund. 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/*

.

15\.

FDA Study via NCBI. 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 \$19.0 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/*

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