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[58] 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.[59] Toms currently works with factories nearby where they perform some of their shoe drops.[60]

Shoes have been given to children in 70 countries worldwide, including the United States, Argentina, Ethiopia, Rwanda, Swaziland, Guatemala, Haiti and South Africa.[45] Toms are sold at more than 500 stores nationwide and internationally, including Neiman Marcus, Nordstrom, and Whole Foods Market, which include shoes made from recycled materials.[46]

The Tom's 'One for One' model has inspired many different companies to adopt similar concepts. Warby Parker, launched in 2010, donates a pair of glasses to someone in need for every pair of glasses it sells. The social business Ruby Cup uses a 'Buy One Give One' model for their menstrual cup venture, benefiting women in Kenya.[61] A Bristol chiropractic center influenced by Mycoskie's Start Something That Matters[62] book started donating £1 to Cherish Uganda for every appointment attended.[63]

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