PATNA, India — Munia Devi lies limp in a hospital bed as a bilious yellow liquid drips into her thin arm.
The drug she is receiving can be toxic, but it is her best hope for curing a disease that kills as many as an estimated half-million people worldwide each year, almost all of them poor like Devi.
Devi will need 15 of these treatments at a total cost of roughly $500 to vanquish visceral leishmaniasis, known here as kala azar or black fever.
Soon, however, all that might change. A cheap, effective drug — shelved decades ago by a large pharmaceutical company because it was unlikely to make a profit — is on the verge of winning final approval from the Indian government.
Behind this development is a small charity based in San Francisco, the Institute for OneWorld Health, which is trying to bridge the chasm between the world's poor, who need medical miracles but cannot pay for them, and the pharmaceutical companies that must show a profit to stay in business.
If the drug, paromomycin, is approved, which is expected this fall, it will be the first time a charity has succeeded in ushering a drug through medical trials and into the market. A course of treatment with paromomycin, which has shown almost no side effects during trials, is expected to cost just $10. And experts say it has the potential to virtually eliminate the disease.
The idea of a nonprofit drug company struck many as folly when Dr. Victoria Hale, a former Genentech executive and Food and Drug Administration official, was founding OneWorld Health in 2001. So she and her husband started the project using their own money, though they have since won support from the Bill and Melinda Gates foundation, among others.
Hale hopes to stamp out black fever eventually, a goal many doctors regard as impossible. "The last disease we truly eradicated was smallpox," Hale said. "There's no urgency to eradicating diseases any more. Why not?"