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Most economic development programs that aim to reach the poorest households have not been designed using a sustainable business approach. Instead, these programs have been developed as grants and charity-driven projects. While there is a role for grant-driven programs, organizations can also make sustainable business decisions to extend outreach to poorer populations in the medium to long term. This paper investigates the “double” (financial and social) bottom line implications for two microfinance institutions that have added product lines to serve very poor households: Fonkoze of Haiti and The Small Enterprise Foundation (SEF) of South Africa.