Working with our implementing partner, the Seva Foundation, we provide medically underserved people in Asia, Africa, and Latin America basic eye care and sight-restoring surgery. Most blindness is reversible. Cataracts, the leading cause of vision loss, are treatable through a simple 15-minute procedure delivered for only ~$50 in the developing world, making it one of the most cost-effective life-changing medical interventions. These surgeries, performed free by teams of local specialists often trained by Seva or with Seva’s support, take place at temporary eye camps, clinics, and hospitals. Each time the bandages are removed the day following surgery and a formerly blind person can see again, it is a small miracle. And often, the blind person is looking at a child or grandchild who has been responsible for the care of his or her relative. Not only can the person with renewed sight resume a productive life, but the caregiver can return to school or work. Thus, each procedure changes the lives of at least two people.

We know of no philanthropic investment that achieves a greater life-changing impact per dollar than cataract surgeries. With this starting point, we considered the handful of experienced nonprofits active globally in delivering this medical service. Seva appealed to us because, for 35 years, they have been building in-country capacity—the only way to address the prevalence of blindness and impaired vision in the developing world at scale and on a sustained basis—and then leveraging that local capability to fund free care to the poorest people. They asserted that they could consistently deliver cataract surgeries for ~$50 across diverse geographies. Our detailed cost-buildup showed that their actual numbers were even better, about $47 per adult surgery (though somewhat higher for pediatric surgeries because they require general anesthetic). Our site visits to observe their work in Cambodia, Guatemala, India, Myanmar, Nepal, and Peru give us confidence that they maintain program fidelity, strong cost management and reporting, and respectful interactions with both local medical providers and, most importantly, patients served.