A manual for ending war and disease using financial incentives, pragmatic trials, and the radical assumption that humans respond to money. Spoiler: they do. 10.7 billion lives at stake.

A drug passes every safety test your species invented. It won't hurt you. Everyone agrees. You still can't have it for another 8.2 years. There is, however, no waiting list for dying. No one blocks that. The testing costs 44.1x more than proven alternatives and excludes 86.1% of the patients who'll actually take it. For every 1 unit of harm prevented, the system creates 3,389 through denied access. Here's how to fix it.

You type in what's wrong with you, see what worked for everyone else, and try it. The outcomes get recorded automatically. We've had this for millennia. Your decentralized FDA is the same thing, built with technology you already have. It's an open protocol that connects treatments to patients, records what actually happens, and publishes the results. Consumer Reports, but for not dying. It cuts trial costs from $41,000 to $929, expands capacity from 1.9 million patients/year to 23.4 million patients/year, and replaces your 40-page drug inserts with Outcome Labels that tell you what actually happened to real humans who took the pill.

A planet had every tool needed to cure disease and chose to build weapons instead. They went extinct. Their last words were 'but the economy.' This is a bedtime story for civilizations that can't do math.

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.

After proving a drug is safe, the FDA requires 8.2 years to prove it works before patients can access it. We estimate this delay cost 102 million deaths among people waiting for approved drugs (1962-2024). The human cost in death and disability of blocking good drugs is 3,389 higher than the cost of approving bad ones.

Three counts of negligent mass homicide against the governments of Earth. The body count, the bill, and the only remedy that works on actual humans.

You cannot prove you won't suffer forever. You cannot prove you won't be pleasant forever. Both probabilities are greater than zero, both outcomes are infinite, and the cost of nudging the odds is one share of a military contractor. When the stakes are infinite, any finite action is rational. It is Pascal's Wager with the bugs fixed.

Since 1900, your governments printed $170 trillion out of nothing and spent it murdering 310 million and destroying many valuable things those people spent their entire lives building. If you had required donations to fund all wars since 1900 and outlawed funding them through printing money, none of this death and destruction would have happened and you would be 23.2x richer today from the compound effects of productive instead of destructive spending.

There are 9.5 million possible drug-disease combinations. You've tested 32,500. That's like searching for your keys in 0.34% of your house and declaring them lost. The other 99.7% is sitting right there, untested, because the molecules weren't profitable enough to bother.