Booting Earth Optimization System
Thank you for your patience. Your civilization is very important to us.
Thank you for your patience. Your civilization is very important to us.
“97% clinical trials, 3% overhead — the exact mirror of your NIH”
— Wishonia, Planetary Systems Engineer
“Forty-seven billion dollars. Three point three percent touches a patient. The rest funds the world's most expensive grant-writing competition.”
— Wishonia
The NIH optimizes for publications, not patients. Scientists spend 50-67% of their time writing grant proposals instead of doing science.
The incentive is to produce preliminary results that justify the next grant, not to produce cures. Cures end funding.
Approving a drug that harms 100 people = career over. Delaying a drug that could save 100,000 = nobody notices. The FDA optimizes for the first risk, not the second.
8.2 years of exclusivity after safety is proven. Not because it takes that long — because the delay IS the business model.
97% of budget on pragmatic trials, 3% on overhead. The exact mirror of the NIH. 30x more patients, 30x more data, 30x more cures.
The only number that matters. Are people living longer without disease? Everything else is overhead.
$0.84 per DALY averted with pragmatic trials. Traditional system: ~$50,000. A 60,000x efficiency gap.
Zero years. If it's proven safe, patients can access it. No 8.2-year queue while people die waiting.
Seek fundamental knowledge and apply it to enhance health
2003 Doubling complete ($27.2B) — then budget flatlines for a decade ↗
2013 Sequestration cuts $1.7B from NIH — 640 fewer grants funded ↗
2020 $4.9B emergency COVID supplemental — suddenly money is available when Congress is scared ↗
Budget increased 164% while drug approvals remained volatile and flat on trend. Only 3.3% of the budget reaches actual clinical trials.
Total annual funding for the National Institutes of Health
Share of NIH budget that actually funds clinical trials — ~$1.55B of $47B
Average cost per patient in a traditional randomized controlled trial
Share of researchers' time spent writing grant proposals instead of doing science
The ADAPTABLE trial proved this isn't theoretical. 15,076 patients. $14 million. $929 per patient. A traditional RCT of the same question would have cost $420 million.
At $929 per patient instead of $27,800, the NIH's $47 billion could enrol 50 million patients per year in pragmatic trials instead of 1.9 million in traditional ones. That's not an incremental improvement. That's the difference between discovering ten cures a decade and discovering three hundred.
Grant administration, overhead, buildings, and committees that review committees that review other committees. It's like a fire department that spends 97% of its budget on the building and 3% on water. $45.5 billion that never touches a patient.
~$1.55 billion funds actual trials. And those are traditional RCTs at $27,800/patient with 86% of applicants excluded.
dIH flips the ratio. 97% to patients. 3% to infrastructure. No grant committees. No scientists spending half their careers writing applications to ask permission to do science.
$27,800/patient traditional trials → $929/patient pragmatic trials (30x cheaper)
// dIH allocation — replaces the NIH grant bureaucracy
// Instead of grant committees, funding follows patients.
function allocateSubsidy(patient) {
const severity = diseaseDALYs(patient.condition); // How severe is it?
const subsidy = severity * SUBSIDY_PER_DALY; // Funding proportional to burden
return subsidy; // Patient chooses which trial to join
}
// NIH: $47B/yr → 3.3% funds trials → $27,800/patient → 3-5% of cancer patients in trials
// dIH: 97% funds trials → $929/patient → 30x more patients → 30x more cures
//
// No grant committees. No 40-minute rejections. No 50% of scientists' time wasted.
// Sick people choose trials. Money follows them. Results get published. All of them.Instead of scientists spending half their careers writing grant proposals that get 40 minutes of review, dIH subsidises patients directly. Funding is proportional to disease burden (DALYs). Patients choose which pragmatic trial to join. At $929/patient instead of $27,800, the same money runs 30x more trials with 30x more patients. All results — positive and negative — are published in an open data commons.
Redirecting 97% of the NIH budget to pragmatic trials instead of grant bureaucracy. Same $47B, but 30x more patients treated, 30x more data generated, and scientists spend their time on science instead of paperwork.
“Your scientists spend half their lives writing essays about why they should be allowed to try curing diseases. Then a committee spends forty minutes rejecting them. You spend $47 billion a year on this. 3.3% of it touches a patient. On my planet, we cured disease in year 340. We did not have grant committees.”
— Wishonia
Every Earth agency has a replacement that runs on code instead of bureaucracy. Fund the campaign. See the full system. Set your priorities.