Revisiting Guide Dogs and Blindness Prevention

By admin
In early effective altruism it

the example of deciding between donating to fund the training of guide dogs in wealthy countries or to reduce blindness in very poor countries. For example, here’s what Giving What We Can used to say

For example, suppose we want to help those who are blind. We can help blind people in a developed country like

the United States
GPE

by paying to train a guide dog. This is more expensive than most people realize and costs

around $50,000
MONEY

to train a dog and teach its recipient how to make best use of it. In contrast, there are

millions
CARDINAL

of people in developing countries who remain blind for lack of a cheap and safe eye operation. For the same amount of money as training a single guide dog, we could completely cure enough people of Trachoma-induced blindness to prevent a total of

2,600 years
DATE

of blindness.

That writing went up sometime in

2011
DATE

or earlier, and I think it’s where this comparison entered proto-

EA
ORG

, but if you know of earlier usage I’d be curious!

Over time, however, EAs have mostly moved away from this comparison. Instead global poverty EAs are more likely to give comparisons like:

A typical

US
GPE

income vs how much the world’s poorest people live on.

How much the

US
GPE

is willing to pay to save the life of

one
CARDINAL

of its citizens vs how much it costs to save a life where that’s cheapest.

What

the UK National Health Service
ORG

is willing to spend per

Quality-Adjusted Life Year
ORG

(QALY) vs what it costs to provide a similar benefit to someone in a very poor region.

What these have in common is that there are charities working in these areas with strong evidence to support their cost-effectiveness. With GiveDirectly you can send money to people who are living on under $1/day, or with

the Against Malaria Foundation
ORG

you can provide bednets that cut malaria deaths in ~half, at

around $5k
MONEY

per life saved (~$100/QALY).

On the other hand, while GiveWell and other

EA
ORG

groups have looked into vision surgery, there are no high quality evaluations. [

1
CARDINAL

] What do you do if you say something like "while a guide dog costs $X you can restore someone’s sight for $Y << $X" and someone asks where they can donate to make that happen? Much better to give actionable comparisons.

[

1
CARDINAL

] You might think of

Hellen Keller International
ORG

, another GiveWell recommendation, but looking at their cost-effectiveness model, GiveWell is primarily rating it highly for mortality reduction. Looking at their vision benefits writeup and

BOTEC
PERSON

, linked from the cost-effectiveness model, most of the supplementation is going to people who wouldn’t otherwise become blind: yes, it’s

two
CARDINAL

pills for ~$2.70, but if I’m interpreting GiveWell’s rough estimate correctly

only 1:1,100
CARDINAL

people who get the pill would otherwise become blind, and the supplementation isn’t

100%
PERCENT

effective, so it ends up being

about $3k
MONEY

to prevent a case of blindness this way. (more)