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.
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."
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.