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How to Not Build Most of It

Keywords

war-on-disease, 1-percent-treaty, medical-research, public-health, peace-dividend, decentralized-trials, dfda, dih, victory-bonds, health-economics, cost-benefit-analysis, clinical-trials, drug-development, regulatory-reform, military-spending, peace-economics, decentralized-governance, wishocracy, blockchain-governance, impact-investing

The infrastructure for a dFDA136,137 won’t cost billions to build. Because you’re not building most of it.

Here’s the plan: build the foundation (core API and data standards), pay bounties for critical features nobody wants to build first, and let everyone else build everything else for free. This is how WordPress, Linux, and every successful open platform works. You build the rails, not every train.

The Open Platform Model

The most successful software platforms share a pattern: a small core team builds the foundation, then thousands of outside developers build specialized tools on top of it.

Linux started as one person in Finland writing a kernel. Today it runs most of the internet, every Android phone, and the world’s fastest supercomputers. The core team is still tiny. The contributor network is massive. WordPress works the same way: a small core, 60,000+ plugins built by other people.

Open-source platform models aren’t theoretical. They’re a multi-trillion-dollar economic reality138. WordPress, Linux, Android, and Chrome were all built this way. Combined value: trillions. Combined cost to build the cores: billions. The math is not subtle.

A dFDA follows the same structure:

  • Core infrastructure: APIs, data standards, identity, and consent management. You build this.
  • Everything else: Trial matching tools, analysis dashboards, EHR connectors, patient-facing apps. Developers (companies, academics, individuals with too much free time) build these.

Bounties: Paying for Results, Not Promises

An open platform mostly builds itself, but sometimes you need specific features that nobody’s volunteering to create. That’s where bounties come in.

The traditional approach is grants: “Here’s money. Build something. Let us know how it goes.” The bounty approach inverts this: “Build this specific thing. If it works, you get paid. If it doesn’t, you don’t.” One of these wastes less money. The distinction is left as an exercise for the reader.

The “Right to Trial & FDA Upgrade Act” mandates a public bounty and prize program for exactly this reason. What it funds:

  • Critical features: Essential tools nobody’s building yet. Post a bounty, pay on delivery.
  • Security reporting: Pay hackers to find vulnerabilities and report them instead of exploiting them. Cheaper than getting hacked.
  • High-value integrations: Connectors to major EHR systems and national health registries. Everyone benefits, nobody wants to go first. Bounties fix the coordination problem.
  • Major prizes: Big money for big achievements. Want a breakthrough component? Offer $1M to whoever builds it best.

This Already Works

Governments already use bounties and prizes139 to solve complex problems, and they consistently outperform traditional procurement:

  • XPRIZE: Private-sector space travel
  • NASA Centennial Challenges: Lunar lander, space robotics
  • Department of Defense bug bounties: Cybersecurity

All succeeded. All cost less than the traditional “hire a contractor and hope” approach.

Apply the same model to medical research infrastructure, and you get a global network of tools built by people who actually want them to work, at a fraction of what centralized development would cost. The alternative is continuing to build everything from scratch, slowly, expensively, and badly. Which is also an option, if you prefer tradition to results.