Project Impact: Making Medical Technology & Services Affordable & Sustainable

David Green founded Project Impact, is a MacArthur Fellow, an Ashoka Fellow and is recognized by the Schwab Foundation as a leading social entrepreneur. David has been the prime mover in three successful technology transfers, which have had a significant impact in the fields of blindness prevention and amelioration of hearing impairment. In 1992, David, in collaboration with Seva Foundation and Aravind Eye Hospital, directed the establishment of Aurolab ( India), the first non-profit manufacturing facility in a developing country to produce affordable intraocular lenses (IOLs) to ameliorate cataract which is the main cause of blindness. Aurolab is now one of the largest manufacturers of IOLs in the world, with sales of 700,000+ units per year (8% of the world market share) to 86 countries and has fulfilled its promise to make affordable high quality IOLs available to programs serving the poor. Aurolab's selling price is $4 per lens, compared to over $100 in the US.

In conjunction with Seva, Aurolab and Mr. Rolf Spingler, and other donors, David also established suture (wound closure product) manufacturing at Aurolab in 1998. Aurolab has reduced the selling price of ophthalmic suture from $200 per box of suture to $30.

Project Impact’s present initiative is to design, produce and distribute a digitally programmable hearing aid. Production commenced in February 2003 at Aurolab. Hearing aids usually sell for $1500 per unit. The Project Impact hearing aids are sold for prices ranging from $0 to $200. The manufacturing cost is $50.

Project Impact, through the efforts of biomedical engineer Joel Segre, is also presently engaged in a transfer of technology and know how to Aurolab for the manufacture of a foldable intraocular lens.

Aurolab also produces pharmaceuticals and eyeglasses and has CE Mark Certification for hearing aids, suture and IOLs, fulfilling the same regulatory requirements medical companies must fulfill for selling products in Europe. The suture and hearing aid also have US FDA approval. Aurolab is financially sustainable from sales revenues and as a non-profit, cycles it’s profit into expanding and improving it’s ability to serve the underserved with affordable medical products.

In addition to establishing medical manufacturing, through his work with Seva Foundation and others, David has developed high-volume, quality eye care programs that are affordable to the poor and self-sustaining from user fees.  He helped develop Aravind Eye Hospital in Madurai, India, which performs 220,000 surgeries per year, making it the largest eye care program in the world.  65% of the care is provided free of charge or below cost, yet the hospital is able to attain 50% profit margin. For Lumbini Eye Hospital in Nepal, he worked with Seva to develop a system of financing from user fees to enable the hospital to be self-sustaining. The hospital now provides sight-restoring surgery each year to 30,000 patients (20 percent at no cost and the majority at cost); is now self-sustaining with substantial savings and has a 35% profit margin.  David Also worked with Al Noor Foundation to create a sustainable eye care program that is now one of the largest in Egypt. David has assisted in replicating this cost recovery model in Malawi, Guatemala, El Salvador, Tibet, Tanzania and Kenya and has assisted the Lions Aravind Institute for Community Ophthalmology to build their capacity to transform over 150 programs in India and abroad to increase service volume, improve quality and become self sustaining.