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."
Students attending colleges across the United States have created TOMS campus clubs. As of March 20, 2014, 281 campus clubs existed in the United States with another dozen located in Canada. By comparison, another nonprofit organization known as Lions Club International was established in 1917 and is known for working to ending the cause of blindness, reports 400 Lions’ campus clubs in 42 countries.
Toms markets shoes using an espadrille design and a one for one business model — where with one purchase of a pair of shoes, the company also gives one pair to a child without shoes. With eyewear purchases, part of the profit is used to save or restore eyesight for those in developing countries. The company launched TOMS Roasting Co. in 2014, and with each purchase of TOMS Roasting Co. coffee, the company works with other organizations, referred to as "giving partners", to provide 140 liters of safe water, equal to a one week supply, to a person in need. In 2015, TOMS Bag Collection was launched to help contribute to advancements in maternal health. Purchases of TOMS Bags help provide training for skilled birth attendants and distribute birth kits containing items that help women practice safe childbirth.