Thanks for your comment and the paper! I’ve come across this paper before but didn’t read it in detail. I have skimmed the paper again just now, so here are a couple of my ad-hoc thoughts:
The cost-effectiveness of the Goa campaigns seems to be a lot better than my modeled program in India. My CEA is very speculative, so it’s nice to see that a retrospective CEA of this intervention yields a relatively good $-per-averted-DALY result. However, I’m not swayed by the number, since it’s still far from GiveWell’s cost-effectiveness bar of 100$ per averted DALYs. It would also be interesting to have a closer look at the assumptions they make in the CEA. From a brief look at the spreadsheet, they seem to equate one rabies death with ~26 YLL. This is a lot lower than my assumed ~45 DALYs per rabies death in my model (I used Founders Pledge’s moral weights and roughly adapted them to the age distribution of rabies victims; also, virtually all of the DALY burden from rabies comes from YLL). This change alone would probably increase (potentially double?) the cost-effectiveness in the paper you linked but I guess it would still not pass GiveWell’s bar.
Regarding the logistical issues you mention, this aligns with what I discovered in my research. As far as I know, free-roaming dogs have a higher rabies incidence than homestead dogs. But free-roaming dogs are hard to vaccinate with traditional (injectable) vaccines, since these dogs can be very shy and hard to catch. That’s where oral vaccines would come in since you can simply throw a vaccination baits in front of a dog without having to come the dog. Which means that oral vaccine could be a good method to close the vaccination gap beween homestead and free-roaming dogs.
Thanks for your comment and the paper! I’ve come across this paper before but didn’t read it in detail. I have skimmed the paper again just now, so here are a couple of my ad-hoc thoughts:
The cost-effectiveness of the Goa campaigns seems to be a lot better than my modeled program in India. My CEA is very speculative, so it’s nice to see that a retrospective CEA of this intervention yields a relatively good $-per-averted-DALY result. However, I’m not swayed by the number, since it’s still far from GiveWell’s cost-effectiveness bar of 100$ per averted DALYs. It would also be interesting to have a closer look at the assumptions they make in the CEA. From a brief look at the spreadsheet, they seem to equate one rabies death with ~26 YLL. This is a lot lower than my assumed ~45 DALYs per rabies death in my model (I used Founders Pledge’s moral weights and roughly adapted them to the age distribution of rabies victims; also, virtually all of the DALY burden from rabies comes from YLL). This change alone would probably increase (potentially double?) the cost-effectiveness in the paper you linked but I guess it would still not pass GiveWell’s bar.
Regarding the logistical issues you mention, this aligns with what I discovered in my research. As far as I know, free-roaming dogs have a higher rabies incidence than homestead dogs. But free-roaming dogs are hard to vaccinate with traditional (injectable) vaccines, since these dogs can be very shy and hard to catch. That’s where oral vaccines would come in since you can simply throw a vaccination baits in front of a dog without having to come the dog. Which means that oral vaccine could be a good method to close the vaccination gap beween homestead and free-roaming dogs.
Hope this addresses some of the points you made!