The 1% Treaty: Harnessing Greed to Eradicate Disease

Abstract: 6. 65k diseases (95% CI: 5. 70k diseases-8. 24k diseases) diseases have 0 FDA-approved treatments. At current trial capacity (15 diseases/year (95% CI: 8 diseases/year-30 diseases/year) new first treatments/year), exploring the therapeutic search space takes ~443 years (95% CI: 324 years-712 years). Redirect 1% of military spending (27. 2B/year) to pragmatic clinical trials. Trial capacity jumps 12. 3x (95% CI: 4. 19x-61. 3x). Search space explored in ~36 years (95% CI: 11. 6 years-77. 2 years) instead of centuries. Average treatment reaches patients 212 years (95% CI: 135 years-355 years) sooner. Timeline shift saves 10. 7B deaths (95% CI: 7. 39B deaths-16. 2B deaths), valued at 84. 8 quadrillion (95% CI: 62. 4 quadrillion-97. 3 quadrillion). Cost-effectiveness: 0. 0018 (95% CI: 0. 0007-0. 0041) /DALY, 50. 3kx (95% CI: 23. 7kx-111. 7kx) better than bed nets. Even at 1% (95% CI: 0. 1%-10%) probability of treaty adoption, risk-adjusted cost-effectiveness remains superior to the best existing global health interventions. Incentive Alignment Bonds address political feasibility by tying legislators' career incentives to a public voting scorecard.