The company's shoe distribution partners have focused on distributing shoes in areas where health and social benefits of the shoes would be the highest. For example, in Ethiopia the shoes are intended to help prevent a soil-borne disease that attacks the lymphatic system and which largely affected women and children. Toms sunglasses are sold with the One for One model, however it does not necessarily provide glasses only to those in developing countries. The One for One model includes putting money toward medical treatment, eye surgeries and prescription glasses. Toms works with the Seva Foundation among other partners to accomplish this. The first countries that Toms implemented its program were Nepal, Cambodia and Tibet. The original three designs, according to Leigh Grogan, were "The stripe on the temples represents the buyer; the stripe on the tips represents the person whose sight is being helped, and the middle stripe represents Toms, which brings the two together."
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.
Blake Mycoskie visited Argentina in 2002 while competing in the second season of The Amazing Race with his sister. He returned on vacation in January 2006, and noticed that the local polo players were wearing alpargatas, a simple canvas slip-on shoe that he began to wear himself and which are the model for the original line of Toms Shoes. They are made from canvas or cotton fabric with rope soles, but Toms makes theirs with rubber soles. Mycoskie said that when he was doing volunteer work in the outskirts of Buenos Aires, he noticed that many of the children were running through the streets with no shoes on. He decided to develop a type of alpargata for the North American market, with the goal to provide a new pair of shoes free of charge to youth of Argentina and other developing nations for every pair sold. According to Mycoskie, Bill Gates encouraged him by saying that the lack of shoes was a major contributor to diseases in children.