This case describes the evolution of Rural Health Care Foundation (RHCF), which provides primary healthcare services to the economically underprivileged in rural India, its various alliances with non-governmental organizations (NGOs) and for-profit organizations. RHCF centers attract large number of patients every day from as far away as 100 km, due to low charges (INR 40, which is less than 1 USD, for consultation and a week's supply of medicine) and availability of reliable doctors. The case discusses the scale up challenges RHCF is facing to expand their centers to other locations as well as to provide other services within each center. The case also highlights the role various alliances, between NGOs and for profit organizations, play in delivering healthcare services to the bottom of the pyramid, especially those living in rural localities and can neither access nor afford proper medical facilities.

Describes the leadership dilemmas facing the top management team of a leading Indian pharmaceutical company--the first in its industry to be listed on the NYSE. Much admired for its impressive growth, Dr. Reddy's stands at a crossroad. How much emphasis should it place on the legacy business of active pharmaceutical ingredients and generics that have brought the company its current stature, and how much should it focus on future business like specialty pharmaceuticals and discovering new chemical entities? The two represent different business models and straddling the strategy, organization, and human resources demands of each one is the challenge for Dr. Reddy's top team.