Big Tech's $745B AI capex dwarfs US federal R&D — and exposes a market failure in drug pipelines

Ok_Shift9291 · reddit · 2026-09-09

The author lays out stark numbers: Amazon, Microsoft, Alphabet and Meta guided $720-745B in 2026 capex, nearly all AI infrastructure — roughly 15x the entire US federal R&D budget. AI startups took 61% of global VC in 2025 and 80% in Q1 2026, with OpenAI, Anthropic, xAI and Waymo alone accounting for 65% of all venture dollars that quarter.

Meanwhile the WHO's 2025 pipeline review shows antibacterial agents in clinical development shrinking from 97 to 90, with only 15 innovative. Citing a 2015 AER paper (Budish, Roin & Williams), the author argues feedback-loop length alone determines what private capital funds: writing assistants pay back in days, diagnostic models in years. The fix isn't state-run R&D but the state as customer — paying for outcomes before they exist, as the UK already does with its antibiotic subscription model.

Five suggestions close the piece: guaranteed demand contracts, outcome-based prizes, patient sovereign capital, public compute for university researchers, and for countries like India, attacking problems where they hold unique data instead of building a fourth-rate chatbot.

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