A sifter lies idle at Quality Chemicals Industries. Millions of tablets of the highest quality ACT could be produced each day, enough to easily fulfill Uganda's needs and generate a surplus available for export.

In 2002, the World Health Organization set up an international list of pre-qualified manufacturers of drugs to treat malaria, HIV, tuberculosis and reproductive health drugs, based on internationally recognized standards of quality. Those companies listed are considered acceptable for procurement by United Nations agencies and, by association, governments and NGOs. This offers patients greater protection against defective treatments, but it also means that a manufacturer's ability to sell drugs is limited until they receive WHO approval.

Oversight is essential and WHO tries to "fast track" deserving companies. This will help many who are in need, but inevitably it will be too late for some. Past and current abuses have made these WHO guidelines essential, but the same regulations have also resulted in higher costs and have limited distribution. As long as people put profit ahead of moral responsibility, these strict controls are a necessary tradeoff for quality assurance.