Philanthropy vs. Blindness: What's the Latest?

If ever there were a problem that might seem tailor-made for philanthropy, it's fighting blindness. Losing sight is a horrifying fate for anyone to contemplate, and it's not surprising that blindness has motivated some deep-pocketed donors for at least a century. Over the past few decades, significant gains have been made in this area. In the United States, for example, the Foundation Fighting Blindness—co-founded by venture capitalist Gordon Gund in 1971—has raised over $600 million to fund research advances to prevent and cure retinal degenerative diseases that affect more than 10 million Americans. Worldwide, a range of efforts have sought to bring poor countries affordable cataract surgery. Cataracts are the main cause of blindness for half of the 40 million or so people who cannot see. Millions of people can see today because of these efforts.

This fight would seem eminently winnable, given that the World Health Organization estimates that 80 percent of blindness is avoidable, meaning it can be either prevented or reversed. Spurred on by that hopeful fact, the WHO galvanized a plan in 1999 called Vision 2020, a global initiative to prevent avoidable blindness, with a coalition that includes a number of foundations and top nonprofits. That milestone is now just three years away, and much work remains.

As usual, one key obstacle to faster progress has been funding. Never mind that the world's 2,500 billionaires now have assets of around $7.6 trillion—there's just never enough private or public money to fight blindness. Today's wealthy spend a fortune on luxuries even as millions of their fellow human beings cannot see. As a practical matter, reducing blindness has to compete with a bunch of other global health priorities, starting with diseases that actually kill people, like malaria and HIV/AIDS.

In addition, there aren't nearly as many major funders focused on preventing blindness as you might think. Very few of the largest U.S. foundations have made this a priority.

The Gates Foundation has patched in and out of this issue over the past 18 years, spending tens of millions fighting neglected tropical diseases that cause blindness, including large grants in the past to the Carter Center, the Task Force for Global Health, and Johns Hopkins University. But blindness hasn't been a big priority lately, at least compared to the foundation's investments in other areas.

Recently, the MacArthur Foundation announced that two of its eight semi-finalists for a special $100 million grant were organizations fighting blindness: Himalayan Cataract and the Carter Center. The fact these two made it into the top tier out of 2,000 proposals underscores the potential for big new money to make a huge impact (which is the goal of Mac's 100&Change competition).

While MacArthur's entry into the blindness space could be a game-changer, the Conrad N. Hilton Foundation stands out as one of the steadier big funders here. In particular, it's worked tirelessly to eliminate trachoma, a major cause of blindness. Trachoma is a result of repeated chlamydia trachomatis infections in the eyes. The infection, which typically starts in infancy or childhood, causes the eyelid to turn inward, resulting in corneal scarring caused by the eyelashes rubbing on the eyeball. Trachoma is incredibly painful, and if left untreated, leads to irreversible blindness. The debilitating disease is endemic in some of the poorest countries in the world.

Hilton uses the World Health Organization’s (WHO) “SAFE strategy” (surgery, antibiotics, facial cleanliness, and environmental improvement) approach to eliminating blinding trachoma in Mali, Niger, and Tanzania. The foundation has played a crucial role in eliminating the disease in Ghana, which achieved its elimination targets in 2014. While this is a major success, Hilton isn’t celebrating just yet. The foundation still has blinding trachoma in its sights and just awarded millions in grants to eliminate the disease.

Hilton made a total of $11.725 million in grants to three organizations that know more than a little bit about trachoma and avoidable blindness.

At just under $6 million, Helen Keller International received the largest award in this round. Established over 100 years ago, Helen Keller International has been on the front lines of the global trachoma battle since the 1950s, and has over 120 programs across Africa and Asia. Using the WHO's SAFE strategy as well, Helen Keller administered more than 80.5 million integrated neglected tropical disease (NTD) treatments in six African countries in 2016.

Coming in a close second behind Helen Keller International, the Carter Center received a $5.1 million grant from Hilton. The Carter Center has been a leader for over 30 years in the war against NTDs such as guinea worm, river blindness and trachoma. Since 1999, Carter has implemented the SAFE strategy in Mali and Niger. The Carter Center has facilitated thousands of surgeries and administered more than 500 million doses of antibiotics through its mass drug administration programs. Carter has also backed the construction of nearly 220,000 latrines in Mali and Niger. Better water, sanitation, and hygiene plays a critical role in preventing the spread of trachoma.

The final grant in this round was awarded to Sightsavers, which received $650,000. Sightsavers is a U.K.-based organization that has been working to eliminate avoidable blindness for six decades in over 30 countries around the world. Over the years, the group has supported more than 575 million treatments for blinding and potentially blinding conditions, and backed over 8 million surgeries to restore sight. Caroline Harper, CEO of Sightsavers, called Hilton’s donation “vital” to meeting the WHO target for eliminating blinding trachoma by 2020.

Helen Keller International and the Carter Center are using the Hilton grants for trachoma prevention and elimination programs in Mali and Niger. Sightsavers is using its donation from Hilton to back its work in Mali. Both countries are within reach of their trachoma elimination targets.

The Hilton Foundation’s $11.725 million in grants certainly provides a nice boost toward eliminating trachoma in Mali and Niger, and the leveraging power of those funds could help both countries reach the elimination finish line. Hilton’s latest trachoma grants require a dollar-for-dollar match by 2020 from each organization. Meaning, the foundation is effectively mounting a three-year, $23.45 million trachoma eradication campaign.