STEVE INSKEEP, host:

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There's a category of illnesses in the developing world called neglected diseases, meaning we neglect them. Those are parasitic diseases that do not kill, at least not very quickly. And over the last 20 years, as the fight against AIDS and malaria captured attention and resources, those infections have been overlooked.

NPR's Joanne Silberner reports that international donors are trying to change that in Nigeria and across Africa.

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JOANNE SILBERNER: We are in a plaza in the busy city of Jos in Central Nigeria. A man with a megaphones yells out instructions to people gathered here. Three small goats dart through the waiting crowd. People stand in a line three across to get medicines donated by Glaxo and Merck.

Dr. Abel Eigege, one of the event's organizers, says this medicine will prevent a painful and disfiguring disease.

Dr. ABEL EIGEGE (Health Official): (Unintelligible) is the station where we're treating people for lymphatic filariasis.

SILBERNER: Lymphatic filariasis, a disease transmitted by mosquitoes that breed in the stagnant water that collects in the alleys and side streets of Jos.

Dr. EIGEGE: Our hope is that most of the people will turn out to be treated.

SILBERNER: There are already more people than the health workers can handle quickly.

Dr. EIGEGE: (Unintelligible) and it finishes - the session for today finishes, tomorrow they come back again.

SILBERNER: So many people are coming because the chance to get this kind of medicine hasn't happened very often over the past 20 years. In fact, lymphatic filariasis is one of the group of diseases that have come to be called neglected diseases, even though they infect about a billion people worldwide and even though most of these diseases are easily preventable. For example, only a few pills just once a year will protect these people in Jos from the horribly swollen legs and other symptoms of lymphatic filariasis.

Dabiyak Damulak, health commissioner of this region, says these are neglected diseases because he has other, bigger health problems to worry about.

Mr. DABIYAK DAMULAK (Health Commissioner, Central Nigeria): We tend to focus on the pressing issues and then allocate resources.

SILBERNER: AIDS and malaria are his top concerns. They kill much more often than the so-called neglected diseases. Lymphatic filariasis, schistosomiasis, guinea worm, river blindness, leishmaniasis and more, all are disabling. But if they kill, it's only after years of infection.

These diseases are so prevalent they've become almost a condition of life here. The parasites that cause them breed in the water that people drink and swim in, water that stands in urban ditches and rural ponds and rushes in river gullies in the rainy season.

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SILBERNER: Near the rural town of Nasarawa North, young boys happily splash in a river that most likely contains the parasite that causes schistosomiasis.

Unidentified Man #1: (Speaking foreign language)

Unidentified Man #2: (Speaking foreign language)

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SILBERNER: A health worker gathers the boys and asks them, how many of you have red urine? Blood in the urine is a key symptom of schistosomiasis.

At least half raise their hands. And as they talk further, it turns out many of the children are several years older than they look. They're small, stunted. Studies done in Kenya show that schistosomiasis stunts the growth of children; it causes them to score lower on intelligence tests and wears down the immune system so they get other diseases.

Neglected diseases hurt people economically. In a nearby village, we met nine-year-old Monday Mweke who had guinea worm disease. It's so painful it can keep farmers from working their fields for months at a time. When Monday Mweke was ill he wasn't able to help his mother with family chores.

Unidentified Man #3: (Speaking foreign language)

Unidentified Woman: (Speaking foreign language)

SILBERNER: Monday Mweke is an ambitious boy. He whispers that he wants to have a big job someday.

Unidentified Man #3: (Speaking foreign language)

Unidentified Woman: (Speaking foreign language)

SILBERNER: Did you catch that? He said maybe even governor.

But any ambition, even the most realistic, will be hard for Monday Mweke to achieve if he's ill and in pain. When he had guinea worm, he missed three months of school and ended up staying back a year, adding an extra year of school fees for his parents.

Neglected diseases can also be socially devastating. Health worker John Umaru tells the story of a woman with lymphatic filariasis who was ostracized because of her swollen limbs.

Mr. JOHN UMARU (Health Worker, Nigeria): She couldn't attend her church services. People would be running away from her. Nobody would like to come close and sit with her. If she comes and sit down while somebody is already seated, the person might leave.

SILBERNER: This grotesque deformity provokes irrational fear.

Neglected diseases are finally getting some attention and some money. Hundreds of millions of dollars are coming into developing countries from private donors and government partly because it's become apparent these diseases make people more vulnerable to AIDS and malaria.

But money and free medicine won't solve all of Health Minister Dabiyak Damulak's problems with neglected diseases. He still has to make tough choices. Most grants and most free drug programs require him to come up with matching cash or workers. Damulak cannot keep spending on a neglected disease program when the fires of AIDS and malaria flare up.

Last year he spent three times as much on AIDS and four times as much on malaria as he spent on lymphatic filariasis and schistosomiasis.

Joanne Silberner, NPR News.

INSKEEP: Two hundred million people in developing countries have schistosomiasis. It usually does not kill, but it weakens people already on the edge. And later on ALL THINGS CONSIDERED, NPR's Joanne Silberner will report on a doctor trying to take the measure of that disease in Central Nigeria.

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