The rhetoric surrounding President Bush’s tour of Africa has certainly been inspirational, but is marked by a common and unfortunate omission. Amid a sea of hopeful images of economic growth, educational opportunity, and life-saving healthcare, the President – like so many other global leaders these days– has displayed an inability to recognize perhaps the most important background factor linking health, wealth, and education in the developing world. The factor I am referring to is the scourge of the neglected tropical diseases (NTDs), a hidden pandemic of the world’s poorest.

Though not killers on the scale of HIV/AIDS and malaria, the NTDs – a group of infections with names like ’schistosomiasis,’ ‘onchocerciasis,’ and ‘lymphatic filariasis’ that are a mouthful even for those of us who have made a career of fighting them – cause more disability and premature death in Africa than either malaria or tuberculosis, according to the World Health Organization. As a group, the NTDs are the most common infections of the world’s at least one billion poorest inhabitants, affecting 500 million in Africa (compared to 30 million for HIV). Simply put, no progress can be made in development without addressing these infections as well as the “big three” (HIV/AIDS, tuberculosis, and malaria) which so preoccupy politicians.

Even if you have traveled in the countries hardest hit by NTDs, you may not be familiar with them. They are hidden infections that thrive in the poorest rural and urban populations, often causing grotesquely swollen limbs, distended bellies full of worms, blindness, and mental retardation, all of which lead to severe social stigmatization. They leave adults unable to work, keep kids out of school, add to rates of infant death and low birth weight, and can speed up transmission of the HIV virus, all at alarming rates.

There is good news, however. A package of medications to treat seven of the most common NTDs is available for only 50 cents per person per year - an almost negligible price compared to treatment costs for other major infectious diseases (for example, $400 - 1200 per year to treat a case of HIV). Given this low cost and the hugely positive impacts of treatment, providing medication for NTDs is one of the single most cost-effective investments we can make with our international aid dollars.

While the President’s commitment to African health and development is admirable, we must be careful not to focus solely on the “big three” to the exclusion of other equally devastating diseases. Control of NTDs is within our grasp, and if we truly wish to invest in the future of African development, we must take action now.

For more information on NTDs or to join the fight, please visit the Global Network for Neglected Tropical Diseases.

-Professor David Molyneux, Director of the Lymphatic Filariasis Support Centre based at the Liverpool School of Tropical Medicine and current President of the Royal Society of Tropical Medicine and Hygiene