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economic harm, structural inequity, and pharmaceutical
exclusion.

We need a new oath—one that doesn’t just promise safety
for the patient, but justice for the system.
This chapter proposes three new pillars for biologic
medicine: durability, equity, and locality.

1. Durable by Design: A Rejection of Planned
Obsolescence

Too many biologics today are engineered for chronic
dependence, not sustained recovery. They are:

• Dosed repeatedly for life.
• Prone to triggering immune rejection over time.
• Followed by ever-more expensive second- and
third-line therapies.

This creates a cycle of pharmaceutical escalation:

• The body adapts.
• The drug fades.
• The system profits.

But this cycle is not just biologically unsustainable—it’s
ethically corrosive. It imposes psychological fatigue,
financial hardship, and immune instability on patients who
are trying to heal.

Durable biologics—those that induce long-term immune
harmony—change the equation.

They:

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