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GOAL 3 works through a hybrid structure: a Social Enterprise and a Foundation working alongside each other but governed independently. Both entities serve the same mission, but they have different roles, sources of funding, and responsibilities. GOAL 3 was started in 2019 as a Social Enterprise, and in 2023 the GOAL 3 Foundation followed. This page explains the reasoning behind GOAL 3's hybrid structure to clarify why IMPALA is delivered through both entities and how the two coordinate in practice.
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GOAL 3 started from a vision of "fair and accessible healthcare for everyone" with the mission "to empower health workers at places where it is needed the most." The means to achieve that is IMPALA, which is progressively proving an effective solution to this vision and mission through our ongoing research. The overall strategy behind this vision is to scale IMPALA by bringing it to more places, and to expand it by adding and improving functionality.
GOAL 3 started as a Social Enterprise because we believe a business model with local revenue is fundamental to ensure scalable, sustainable success across different settings, without dependency on philanthropy. Moreover, a local business model is important to ensure local ownership and keeps GOAL 3 accountable towards users and the organisations that will sustain and pay for the solution in the long term. It has also been essential for attracting the investment and subsidies needed to develop and validate IMPALA.
However, business logic alone would not get us to where we need to be to achieve our mission. Many of the places where IMPALA is needed most, and where it could have the greatest impact, do not have the means to buy it. The GOAL 3 Foundation was started to make sure GOAL 3 can reach these places too, not as an opportunistic response if the chance arises, but as an important part of the strategy from the start. At the same time, a purely philanthropic model alone would struggle to provide the operational continuity that a medical technology platform requires.
At high level the roles and responsibilities are:
These two entities do more than serve different purposes: success on one side reinforces success on the other. If GOAL 3 succeeds as a Social Enterprise, it can reach economies of scale, invest in the platform, and increase value for existing and new users while improving accessibility in under-resourced settings. At the same time, if the Foundation succeeds in securing funding at scale, it helps the Social Enterprise bring down costs and improve its products and services, increasing the chances of sustainable success for both.
Figure 12: Why a hybrid model is needed for our innovation
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The inspiration for IMPALA as a platform comes from technology companies like Google, which used their enormous scale to put game-changing software such as Google Maps in the hands of almost everyone, even in the hardest-to-reach places. With a large enough user base, development costs are spread so thin that price stops being a barrier.
Healthcare is, of course, a very different sector, but GOAL 3 follows the same logic: build a global platform in which economies of scale, product expansion, and business efficiency progressively drive down costs and increase value, so that IMPALA reaches more and more people. Succeeding at this takes significant investment, reliable and growing revenue streams, and a constant focus on efficiency and scale. This ambition has shaped how GOAL 3 is organised and which funding fits it. It requires GOAL 3 to build scalable models from the start: achieving efficiency by productising its solutions and services, building frameworks that can be repeated across hospitals and countries, and treating financial sustainability as a design requirement rather than a future ambition. Reaching scale is itself a requirement for success, since only scale allows GOAL 3 to become sustainable and to reduce costs far enough to enable further expansion.
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A purely commercial model would create a different problem: many of the facilities with the greatest clinical need would not be able to afford IMPALA. The Foundation is therefore needed to help remove financial and structural barriers that the market alone will not solve. This applies at facility level within a country (some facilities are able to afford it, while others may not be) but also at country level (some countries have more favourable business conditions for GOAL 3 to enter, while others may be more difficult). The Foundation can help overcome these barriers at scale and sustainably. Philanthropy acts as a subsidy to increase accessibility, while local contributions reinforce ownership and ensure the right decision-makers are involved for long-term continuity.
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Philanthropic funding is intended to act as a catalyst rather than a permanent replacement for local health-system financing. Where possible, hospitals, national or local governments, NGOs, and other partners contribute financially. Over time, a growing share of recurring costs should be covered through domestic financing mechanisms, including national or subnational health budgets, hospital operating budgets, public or social health insurance where applicable, and service agreements with public health authorities. Other locally mobilised funding may include hospital-generated revenues, local corporate social responsibility (CSR) contributions, domestic philanthropy, faith-based or private-sector health financing, and co-financing from local NGOs or implementation partners.
The right financing mix will differ by country and local contexts. Some governments may be able to procure systems directly. Others may need a temporary partial subsidy, while facilities in the most constrained settings may require a larger philanthropic contribution. The objective is therefore not to apply a single financing model, but to use philanthropic capital strategically to bridge affordability gaps and support a gradual transition towards locally anchored and sustainable financing where feasible.
All in all, the Social Enterprise and the Foundation are not pursuing separate missions. They are two mechanisms serving the same goal: improving the quality of care for patients in under-resourced health systems. Together, they address two common failures in global health innovation:
GOAL 3’s hybrid structure is designed to avoid both outcomes. It combines professional product and service delivery with a transparent mechanism for equitable access and catalytic financing.
As mentioned, the GOAL 3 Social Enterprise and the GOAL 3 Foundation work towards the same overall goal: helping health workers provide better care by making IMPALA available, reliable, and sustainable in under-resourced health systems. The distinct roles of both entities are summarised in Figure 13.
In many projects, both entities are involved, but they do not play the same role. For example, a hospital may be interested in implementing IMPALA but unable to finance the full cost. The Social Enterprise first assesses what the implementation would require and prepares the operational plan and budget. This includes the equipment, technical infrastructure, training, implementation support, and long-term service needed for the project. The contribution that can be made by the hospital, government, NGO, or another partner is then established. Where a funding gap remains, the Foundation assesses whether philanthropic support is justified. This assessment considers the clinical need, expected impact, local ownership, available co-financing, implementation readiness, and whether the project would be likely to proceed without the subsidy. This is done using a standardised questionnaire that GOAL 3's account manager completes with the hospital. The GOAL 3 Foundation team then reviews it with the account manager until the hospital's situation is clear.
Overall, this creates a structure where philanthropic funding can then focus on the settings, projects, and transition points where it remains most needed, as seen in Figure 14.
Figure 14: The structure of GOAL 3.
Figure 13: Explaining the different roles of both entities.
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The collaboration between GOAL 3 Foundation and GOAL 3 Social Enterprise can take different forms depending on the needs and financial capacity of a hospital or government. In most cases, the Foundation helps overcome the initial investment barrier, while the hospital or government contributes what it can and, where possible, takes responsibility for the recurring service costs. GOAL 3 Social Enterprise is responsible for supplying, implementing, and servicing the IMPALA System.
The following cases illustrate how this model works in practice.
| Case | Country | Scale | Upfront costs covered by | Recurring service costs covered by |
|---|---|---|---|---|
| 5.1 Government collaboration | Malawi | 10 public hospitals, ~100 monitors | The Life You Can Save & Founders Pledge, via GOAL 3 Foundation (~US$300,000) | Government of Malawi (~US$40,000 in total per year) |
| 5.2 IMPALA-Ubumwe | Rwanda | 5 public hospitals, 80 monitors | Philanthropic funding raised by GOAL 3 Foundation (US$150,000) | Hospitals (~US$2,000–3,000 per hospital per year) |
| 5.3 Mission hospitals | Malawi | 6 hospitals so far, 8–25 monitors each | Philanthropic funding per hospital (~US$20,000–40,000) | Hospitals (~US$1,500–4,000 per year) |
| 5.4 Breathing for Babies | Tanzania | 8 hospitals | Contribute Foundation (~US$330,000, including research) | Hospitals (~US$2,000-4,000 per year) |
Philanthropy stepped in when development funding stalled; the government covers recurring costs.
A Foundation-led initiative with the Ministry of Health to expand beyond the research hospitals.
A hospital-by-hospital model with the Christian Health Association of Malawi.
Adding IMPALA to an existing CPAP programme and research study.