(FORTUNE Small Business) – David Green sets up affordable health-care projects in developing countries, but in 2005 he'll tackle something new. The founder and executive director of Project Impact, a Berkeley-based nonprofit, is distributing hearing aids to needy people in the U.S. The World Health Organization estimates that 250 million people worldwide are hearing impaired. Most can't afford treatment, even in the U.S., where Green estimates only 20% receive proper care. "There's a market failure here," he says. His venture will offer at least one solution: Project Impact's high-tech digital device will cost $300 (including fitting and follow-up care), compared with $1,800 for a typical hearing aid sold today.

That price difference is the result of the high-volume, low-margin strategy Green already uses overseas. He says it costs only about $50 to make a digital hearing aid, but patients in the U.S. can receive them only from a licensed audiologist, so the process is more expensive than it needs to be. Green plans to control costs with the help of the Lions Club, which already runs programs for the deaf. Local clubs will identify patients who qualify for assistance and match them up with pro bono audiologists. The patients chip in whatever they can, and the club covers the rest. By 2006 the Lions Club expects 700 Project Impact hearing aids to be distributed each month nationwide.

Green is also getting some financial help for the project. In September he was awarded a prestigious MacArthur fellowship, the $500,000 "genius grant" that is given annually to a handful of Americans. —CHRISTINE Y. CHEN