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Moreover , such technology already exists and will in time make a real impact on medical practice . To add to this , in 2003 the Institute for Economic Research in the University of Costa Rica , published a report stating that the PSA system had no real impact on the improvement of environmental services being paid for , it was concentrated in few landowners ’ hands , and it didn ’ t contribute to eradicating rural poverty . If we can facilitate and discover levels of co-operation which can benefit us all then we will make a real impact on the economic landscape . For very poor people in rural areas , free or heavily subsidised nets and an organised free supply of insecticide will be required to achieve the high coverage rates necessary for a real impact on malaria . Deeply affected by this context of vulnerability , and with the determination to fully play their role as humanitarian organizations , the national societies ( NSs ) of Central Africa are striving to develop community - based programmes that are likely to create a real impact on the lives of vulnerable people . Lack of good health care has a real impact on people 's lives .