While key ingredients to HealthStore are local entrepreneurs and good training, it seems clear from the interview that the middle management is crucial as well. Without their relationship with MEDS, HealthStore couldn't provide low-cost drugs. Without their relationship with the government, they'd have a hard time operating in the regulatory environment. Both of these relationships are the direct result of good middle-upper management. If HealthStore is to scale, they'll need entrepreneurs as well as local champions with connections to government and civil society to ensure that the model's price points can be maintained and they won't get shut down by regulators.