There are many organisations currently engaged in the development of `low cost' medical equipment `designed' for developing countries. These organisations include NGOs, academic institutions, not for profit organisations, charities, foundations and spinout companies using funds from the not for profit, charity sector to pump prime commercial companies. This paper will discuss the implications from the ethical, safety and cost effective perspectives of these activities. The paper is intended to be provocative, not to pass judgement on these activities but because the authors believe that important issues are being overlooked. However, it appears that there are a number of misleading activities under this heading that are resulting in the less than optimal use of available funding and in the displacement of existing relevant commercial activities. This has led to a situation where inappropriate medical devices are being sent to resource poor areas of the world.