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MELISSA BLOCK, host: From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

MICHELE NORRIS, host: And I'm Michele Norris. The Horn of Africa is in the grip of its worst drought in decades. Already, tens of thousands of children have died. The toll is likely to keep rising unless international aid groups can ramp up their operations in Somalia and neighboring Kenya and Ethiopia.

As NPR's Michele Kelemen reports, these groups have gotten some good news in recent days, but many obstacles remain.

MICHELE KELEMEN: Lawless Somalia is a dangerous place for aid workers. Much of the country is run by the al-Shabaab, which the US considers a terrorist organization. That group pulled out of Mogadishu last week, a move welcomed by a top White House official, Gayle Smith.

GAYLE SMITH: The move of al-Shabaab out of Mogadishu is a good sign. It's too early to tell whether it is a good and lasting sign, but it does offer the possibility of getting more assistance in through Mogadishu and to assist people there.

KELEMEN: United Nations officials say that 100,000 Somalis have fled to the capitol in search of food and shelter, and Valerie Amos, who runs the UN's Office for the Coordination of Humanitarian Affairs, says UN agencies are providing help, but moving in cautiously.

VALERIE AMOS: The refugee agencies managed to get three plane loads of supplies into Mogadishu in the last few days, but I do think it's important that we all remember that there are still about 2.2 million people in the south and center who require aid and support.

KELEMEN: Al-Shabaab controls south and central Somalia and those are the areas worst hit by the famine. The US government recently agreed to ease its restrictions on private American relief groups that want to deliver supplies to parts of Somalia run by the Islamist militant group.

DONALD STEINBERG: We're not going to play got you with our partners in that area.

KELEMEN: That's Donald Steinberg of the US Agency for International Development who says the US won't prosecute aid groups if some aid inadvertently falls into the hands of al-Shabaab.

STEINBERG: When you move food in, there are going to be, we understand, the possibilities for diversion, possibilities for payment requirements, et cetera.

KELEMEN: Private relief groups lobbied hard for that sort of flexibility and are still trying to make sure these new regulations cover everyone hoping to bring emergency relief supplies to Somalia. Aid groups have had other challenges trying to raise awareness and funds.

Sam Worthington, who runs InterAction, an umbrella organization of 190 humanitarian groups, says the response to the drought has been disappointing.

SAM WORTHINGTON: Hunger is a silent killer. It results in a child's withering away. It is not as dramatic as a tsunami or an earthquake and as a result is a harder message to get to the American public.

KELEMEN: And to Congress, which is focused mainly on budget cuts these days, including to foreign assistance programs. Donald Steinberg of the US Aid Agency says this year, the government has given more than $500 million in aid for the Horn of Africa, but these funds could soon dry up.

STEINBERG: If we do see the kinds of cuts in food assistance that are identified in merging legislation in Congress, it will have a significant impact.

KELEMEN: And most aid experts fear that the worst is yet to come in the drought-ravaging Somalia and neighboring countries. Michele Kelemen, NPR News, Washington.

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