This case introduces David Green, a social entrepreneur with the mission of making advanced medical technology affordable and available to those in the third world. It describes the growth and success of projects to develop, manufacture and distribute low-cost hearing aids and other basic medical technology in India, and presents a direct contrast to the traditional maximum profit model of the medical industry. After achieving success with Aurolab, established in 1992 to provide intra-ocular lenses to eye care facilities such as the Aravind Eye Hospital, Green directed his energies toward the problem of hearing loss in the third world, another area with the potential to make a big impact. By producing a hearing aid available at US $51 instead of the industry average of US $1,600, Green could open up an entirely new market, turning the usual low volume, high margin model of the hearing aid industry on its head. Project Impact is the non-profit organization founded by Green in 2000 to manage and raise funds for his Affordable Hearing Aid Project (AHAP) in India. The case analyzes challenges such as scaling and financial sustainability faced by the AHAP and Project Impact' strategic options for the future in a changing competitive landscape.