The major mission of Toms is that a business, rather than a charity, would help their impact last longer. In his speech at the Second Annual Clinton Global Initiative Mycoskie states that his initial motivation was a disease called podoconiosis—a debilitating and disfiguring disease which causes one's feet to swell along with many other health implications. Also known as "Mossy Foot", podoconiosis is a form of elephantiasis that affects the lymphatic system of the lower legs. The disease is a soil-transmitted disease caused by walking in silica-rich soil. Toms currently works with factories nearby where they perform some of their shoe drops.
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The Tom's 'One for One' model has inspired many different companies to adopt similar concepts. Warby Parker, launched in 2010, donates a pair of glasses to someone in need for every pair of glasses it sells. The social business Ruby Cup uses a 'Buy One Give One' model for their menstrual cup venture, benefiting women in Kenya. A Bristol chiropractic center influenced by Mycoskie's Start Something That Matters book started donating £1 to Cherish Uganda for every appointment attended.
A story by LA Weekly priced the manufacturing cost of a pair of Toms Shoes at $3.50-$5.00 in U.S. dollars, and noted that the children's shoes given out by the company were among the cheapest to make, which is not necessarily apparent to consumers. According to garment-industry author Kelsey Timmerman, many people he spoke to in Ethiopia were critical of the company, saying that they felt it exploited the idea of Ethiopian poverty as a marketing tool. An Argentina-based shoemaker agreed, saying that the imagery used by the company was manipulative.