Ok, noted. But then if people just want to skim the post in seconds (especially those who may not be so interested in the first place) do you think maybe headings or infographics would be more appropriate? What would you recommend?
To the Fred Hollows Foundation? Will they not assert that they first do not operate in India and their services are needed where they operate, plus they are not an investing company? This is why funders are a better audience to decide? Especially considering the innovativeness of EAs? Nevertheless noted.
To answer:
Extent of FHF support from EA: FHF is a TLYCS recommended charity. The cost of treating a cataract surgery versus that of training a guide dog for blind people is a commonly cited example in EA. The revenue of FHF was $650m in 2019. I am not finding any funding from Open Philanthropy/Good Ventures but I think in EA Brazil they selected a cataract organization as one of the 3 non-GW ones and in the Philippines they seem to have also tried to find charities that do similar work to GW organizations, and include The Fred Hollows Foundation on their list. Other local effective donation organizations may include FHF. So, I would suggest that people are at least thinking, if not donating.
Cost-effectiveness analyses: From the TLYCS page, which cites a World Bank and a GiveWell resource, the cost of one surgery is $100 and prevents 1–30 years of blindness and, in addition, 1–30 years of low vision. Based on GW’s analysis, the disability weight of blindness is 0.2. IHME cites 0.187 (range 0.124–0.26) for blindness (e. g. row 209 (original resource)) and 0.031 for moderate vision impairment (e. g. row 207). Assuming 15.5 years of blindness and of low vision prevented, that is 15.5*(0.187+0.031)=3.379 DALYs averted per $100. Assuming a life of 70 years, 100⁄3.379*70=$2,072/statistical life saved. That is competitive with AMF, which cites about $3,500 per statistical life saved but not with e. g. DMI which should avert malaria for $600. This is neglecting that some people may experience negative quality life (below death) so the assumption of full life quality (1.00) does not make sense – if life is saved, then that can be adding suffering (but if blindness is averted, that may reduce suffering).
Why has Aravind not expanded (uncertain): Yes, perhaps the scalability has issues or it is just the limited motivation to expand, also given the possible preference for keeping respect to a founder by not being too competitive, also due to the developing country and personal mission-driven company context. Limited access to credit or low efficiency and professionalism of local financial markets may be another expansion barrier. According to The Fortune at the Bottom of the Pyramid (inspiration for this post), the organization seemed organized regarding training doctors and delegating work to differently skilled personnel to keep costs low. But that is almost 20 years ago, so maybe competitors implemented similar approach or the real cost of providing a free cataract surgery to a patient increased due to a decreasing cost of other treatments.
TLYCS moves relatively little money compared to GiveWell, and cataract surgery rarely comes up on the Forum. That’s where my point came from. (Note that my explanation is meant to be a guess at why AECS hasn’t gotten much attention, not an argument that it shouldn’t get much attention.)
My rough summary of GiveWell’s cataract research (as of 2018): it seems cost-competitive with other work, but there’s a lot of uncertainty around cost-effectiveness estimates and they’ve struggled to find orgs that meet their standards for monitoring and evaluation.
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Do you think maybe headings or infographics would be more appropriate?
I don’t think infographics are necessary, or even headings in a short post like this. I just think removing most or all of the bold text would help. (There are other things I’d edit to make some sentences more clear, but I don’t have time to talk about them — as I recommend below, reading your post out loud might help you see what is or isn’t clear.)
Bold text tells us to stop and really focus on something, but if that happens three times in a given sentence, it breaks up how people typically read. It might help to read your post aloud, but raise your voice for all the bold text and see if the result feels natural.
Ok, noted. But then if people just want to skim the post in seconds (especially those who may not be so interested in the first place) do you think maybe headings or infographics would be more appropriate? What would you recommend?
To the Fred Hollows Foundation? Will they not assert that they first do not operate in India and their services are needed where they operate, plus they are not an investing company? This is why funders are a better audience to decide? Especially considering the innovativeness of EAs? Nevertheless noted.
To answer:
Extent of FHF support from EA: FHF is a TLYCS recommended charity. The cost of treating a cataract surgery versus that of training a guide dog for blind people is a commonly cited example in EA. The revenue of FHF was $650m in 2019. I am not finding any funding from Open Philanthropy/Good Ventures but I think in EA Brazil they selected a cataract organization as one of the 3 non-GW ones and in the Philippines they seem to have also tried to find charities that do similar work to GW organizations, and include The Fred Hollows Foundation on their list. Other local effective donation organizations may include FHF. So, I would suggest that people are at least thinking, if not donating.
Cost-effectiveness analyses: From the TLYCS page, which cites a World Bank and a GiveWell resource, the cost of one surgery is $100 and prevents 1–30 years of blindness and, in addition, 1–30 years of low vision. Based on GW’s analysis, the disability weight of blindness is 0.2. IHME cites 0.187 (range 0.124–0.26) for blindness (e. g. row 209 (original resource)) and 0.031 for moderate vision impairment (e. g. row 207). Assuming 15.5 years of blindness and of low vision prevented, that is 15.5*(0.187+0.031)=3.379 DALYs averted per $100. Assuming a life of 70 years, 100⁄3.379*70=$2,072/statistical life saved. That is competitive with AMF, which cites about $3,500 per statistical life saved but not with e. g. DMI which should avert malaria for $600. This is neglecting that some people may experience negative quality life (below death) so the assumption of full life quality (1.00) does not make sense – if life is saved, then that can be adding suffering (but if blindness is averted, that may reduce suffering).
Why has Aravind not expanded (uncertain): Yes, perhaps the scalability has issues or it is just the limited motivation to expand, also given the possible preference for keeping respect to a founder by not being too competitive, also due to the developing country and personal mission-driven company context. Limited access to credit or low efficiency and professionalism of local financial markets may be another expansion barrier. According to The Fortune at the Bottom of the Pyramid (inspiration for this post), the organization seemed organized regarding training doctors and delegating work to differently skilled personnel to keep costs low. But that is almost 20 years ago, so maybe competitors implemented similar approach or the real cost of providing a free cataract surgery to a patient increased due to a decreasing cost of other treatments.
TLYCS moves relatively little money compared to GiveWell, and cataract surgery rarely comes up on the Forum. That’s where my point came from. (Note that my explanation is meant to be a guess at why AECS hasn’t gotten much attention, not an argument that it shouldn’t get much attention.)
My rough summary of GiveWell’s cataract research (as of 2018): it seems cost-competitive with other work, but there’s a lot of uncertainty around cost-effectiveness estimates and they’ve struggled to find orgs that meet their standards for monitoring and evaluation.
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I don’t think infographics are necessary, or even headings in a short post like this. I just think removing most or all of the bold text would help. (There are other things I’d edit to make some sentences more clear, but I don’t have time to talk about them — as I recommend below, reading your post out loud might help you see what is or isn’t clear.)
Bold text tells us to stop and really focus on something, but if that happens three times in a given sentence, it breaks up how people typically read. It might help to read your post aloud, but raise your voice for all the bold text and see if the result feels natural.
Oh, that is interesting. I see that TLYCS moves a few million $/year, GW more than a hundred million.
Yes. It is interesting that TLYCS specifies a 10× greater cost-effectiveness than GW estimates in its updated report.
OK, thank you for the tip!