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Purpose:

This page explains what an IMPALA implementation costs: how we count costs, what a standard ward package includes and what it costs, which costs are one-off and which recur, why costs vary between projects, and how these figures relate to the Rethink Priorities Report cost-effectiveness assessment.

How to use this page:

• Section 1 explains why the price of IMPALA is the right cost to use in cost-effectiveness calculations.
• Sections 2 and 3 show what a standard ward implementation includes and costs. Open 3.1 for the five-year total, context-specific costs and optional add-ons.
• Sections 4 and 5 explain why costs vary and which costs may fall with scale.
• Section 6 explains how these figures relate to the Rethink Priorities assessment and the published cost-effectiveness study.

This page was last updated: October 6, 2026

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1. Understanding intervention costs within our operating model

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In traditional cost-effectiveness calculations for NGO programmes, the programme costs include the organisation's overhead. Funders pay for the whole operation, so the whole operation is counted. GOAL 3 works differently. We sell a product at a price, margin and volume designed to sustain the organisation and, over time, repay the development of the product. The commercial price is therefore set to cover our overhead and investments at scale, and it is this price we use as the cost in our cost-effectiveness calculations. Until GOAL 3 reaches break-even, the shortfall is carried by investors, not by philanthropic funders.

This is possible because GOAL 3 is structured as a business. The initial development was paid for by investments, in-kind support, and subsidies (~US$9.9 million, see section 2.1 of Hybrid model explained ). The sales price is set at a level at which we believe IMPALA can be sold and sustained at sufficient scale for GOAL 3 to become profitable. The risk of development and of reaching break-even is therefore carried by investors rather than philanthropic capital, on the assumption that investors are repaid through returns once GOAL 3 is profitable.

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2. An IMPALA implementation

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An IMPALA implementation should not be understood as a one-off purchase of medical devices. It combines the physical system with the service model needed to make the system useful, maintained, and embedded in daily clinical care. This distinction matters because many medical equipment donations fail when equipment is delivered without the surrounding implementation model (Perry & Malkin, 2011): staff are not trained, devices are not maintained, and spare parts are unavailable. GOAL 3 therefore prices implementation as a complete package rather than as isolated hardware.

A standard ward implementation has three core elements:

1. Bedside IMPALA monitors;
2. The IMPALA Platform: software, a local server, local Wi-Fi network, central patient overview, tablets, and dashboards;
3. Implementation and long-term support: an installation week and a three-month implementation period, during which GOAL 3 supports training and onboarding, adapts the implementation to hospital workflows and preferences, and follows up through remote check-ins after approximately one week, four weeks, and three months. After this period, IMPALA Care provides ongoing support through quarterly remote check-ins and remote troubleshooting.

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3. Costs of a standard implementation

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The standard package for one ward is 10 IMPALA monitors and one local server. The one-off investment is US$24,850, with installation, implementation, onboarding, and training included in the package price. The line items below are a breakdown of what sits inside the package, not additions to it:

After the implementation period, the IMPALA Annual Platform & Support Fee covers the ongoing support that long-term sustainability depends on: US$500 per server plus US$150 per connected monitor, thus US$2,000 per year for the standard 10-monitor ward. This includes software access and regular updates, remote support and troubleshooting, quarterly check-ins, adoption monitoring, e-learning modules, champion engagement, participation in country-level support communities, and a replacement allowance for sensors and probes.

3.1. One-off costs versus recurring costs

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4. Why costs may differ by country or project

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The standard package is a reliable baseline, but final costs vary with context: import duties, taxes, transport and travel; hospital size and the number, type, and location of wards; the number of monitors required; local availability of biomedical technicians and the maturity of implementation partners; data and reporting requirements; and whether the implementation is a one-site project or part of a larger scale-up in which hospitals, government, NGOs, or funders share costs. A small single-ward implementation carries relatively higher costs because travel, installation, and training are spread across fewer monitors and patients; a larger country programme reduces average costs by spreading training, logistics, support, and project management over more hospitals.

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5. Which costs may decrease with scale?

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Several cost categories are expected to become more efficient as GOAL 3 scales:

• Manufacturing and procurement costs may decrease with larger production volumes;
• Training costs per hospital may decrease as materials, e-learning, and champion models become more standardised;
• Travel costs per site may decrease when local teams and distributors take on more implementation work;
• Support costs may decrease as country-level service structures mature;
• Project management costs per hospital may decrease when implementations are bundled into national or regional programmes;
• Adoption support may become more efficient as local champions and peer-learning networks become stronger.

Not all costs should be expected to disappear, however: software support, maintenance, troubleshooting, refresher training, data review, and replacement accessories remain essential to long-term quality and sustainability.

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6. How these figures relate to the Rethink Priorities assessment

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Rethink Priorities' independent cost-effectiveness assessment (October 2026) uses the same price list, but a different configuration of it: monitors with a 2-year warranty and the all-inclusive service fee of US$365 per device per year with a 30% five-year contract discount, coming to US$21,850 one-off plus US$2,811 per year, annualised over a 7-year lifetime to approximately US$6,100 per ward per year. This is the same configuration used in the published cost-effectiveness study (Ben et al., 2026); RP retained it to stay consistent with that study and describes its cost assumptions as deliberately conservative, taking the maximum expected cost of each line item and assuming no scale effects beyond the contract discount.

The difference with the current commercial model is packaging, not price level: the extended warranty moved into the hardware price and the recurring fee became a leaner platform and support fee with optional add-ons. Over five years the two configurations differ by roughly 3% (US$34,850 versus US$35,905, excluding taxes and transport). RP also models taxes at a central 5% of equipment cost (10% in its low case), reflecting that most implementations are exempt, whereas this notion page quotes the fuller VAT range that applies when exemptions are not available. For an in-depth explanation, please see Rethink Priorities Report

For the clinical and cost-effectiveness evidence this configuration is grounded in, including the cost-per-life-saved and cost-per-DALY-averted estimates from Ben et al. (2026), see Evidence Summary Dashboard — C13: cost-effectiveness and C11: mortality and DALY impact on Notion.