One wonders how drug company CEOs sleep at night:

DFMO works so well that it has been nicknamed the "resurrection drug." But it costs 10 times more than melarsoprol, or almost $600 (U.S.). Worst yet, production has been discontinued because, at that price, some of the poorest people in the world can't afford to buy enough of the drug to make it profitable.

At the 58-bed Omugo centre, they are literally counting down the world's supply of DFMO. As the nurse loads up Ms. Brateru's IV drip, 1,812 vials are left. When her course of treatment is done, there will be 1,805 and counting.

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The maker of DFMO, the U.S. subsidiary of Aventis SA, a multinational corporation based in Switzerland, has stopped producing the drug because it can make a lot more money by using its facilities otherwise.

The company is not protecting its patent; on the contrary, it has turned the rights over to the World Health Organization.

But WHO cannot find a manufacturer. The precursor chemical of DFMO is unstable so it requires specialized workers; the drug is corrosive, requiring special piping and a dedicated production line, and demand will never be in the millions of doses.

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Melarsoprol has been around since 1949. The reason newer drugs have not come along is that research by pharmaceutical corporations is virtually non-existent. Much more effort has gone into the search for treatment of the form of sleeping sickness that affects animals, namely cattle and horses, than the disease that kills humans. (Sleeping sickness kills an estimated $5-billion (U.S.) worth of livestock annually.)

Worse yet, the manufacturer has repeatedly threatened to discontinue production because the drug's profit margin is low. Still, a course of treatment costs many times more than the per-capita health spending in Uganda.

Pentamidine was another drug well on its way to being phased out until it was found to be effective in treating pneumocystic carinii pneumonia, a common symptom of HIV-AIDS. Overnight, the price of the drug increased tenfold.

Médecins sans frontières and WHO were able to negotiate a reprieve. Pentamadine has been offered at the old price -- about $120 (U.S.) for 10 shots -- on the understanding that it be used only for the treatment of sleeping sickness.

You can read more about Médecins sans frontières efforts to gain access for the poor to life-saving medicines here.