The mission of Aravind is “Eliminate needless blindness, providing compassionate & high quality eye care to all”. However, providing health care for all can be expensive: in Europe represents 9% of the GDP and could rise to 20% in a few years. As the alternatives are worsening the quality of health care, or improving it efficiency, please identify the operational keys to cost efficiency at Aravind, and discuss how these can be applied to other health care providers.