In the raw poverty of the slums of Kolkata—formerly known as Calcutta—visibly malnourished children with bloated stomachs and patchy hair run barefoot over paths in which human and animal waste mix with mud and garbage. Hundreds of dwellings made of straw, mud, tin, and cardboard are squeezed into areas the size of one small city block. In these cramped dwellings, often only an arm-span in width, entire families live with no running water, no electricity, and no furniture.

Today, as the sun rises over the rural villages of South Africa's Eastern Cape Province, community members witness what is becoming a common sight. A motorbike speeds by and its driver readily waves; today he does not stop to chat. He is Mtiteto Mfikile and he has work to do. Meanwhile, a village nurse hears the beep of her cell phone and she too gets to work - an SMS message from a nearby laboratory gives her TB smear results of a patient. She can start appropriate treatment now.

During the 1980s and early 1990s, the Kenyan government struggled with economic decline, high inflation, and rapid population growth. The nation's growing health needs, including those related to HIV/AIDS, placed additional demands on limited government resources. As a result, increasing numbers of Kenyans, especially the poor, were without access to basic health care. To address these problems, the government spearheaded an initiative to improve the quality and scale of its health programs while controlling costs.