Reversing the AIDS Pandemic

Despite its role as world cop, the US is capable of dramatic acts of kindness. It fed the hungry after World War I. It airlifted supplies to stranded Berliners during the cold war. Today, it provides over 60 percent of international food aid.

President Bush referred to those humanitarian gifts last week when he elaborated on his new AIDS plan for Africa and the Caribbean: $15 billion over five years, $10 billion of that in new funding. A stunning tripling of the US commitment to reversing this modern-day holocaust, the spending plan indeed reflects the American spirit of giving - and deals with an issue of strategic importance as well.

One reason health workers praise the initiative, which focuses on 12 African and two Caribbean countries, is that half of the money is for treatment with low-cost antiretroviral drugs, which up to now have been unaffordable. About 30 million Africans are thought to have the AIDS virus.

But the administration should be commended for not abandoning prevention. A third of the money is to be used this way, including a new emphasis on the use of condoms.

Uganda has shown how prevention efforts can alter behavior. In destigmatizing the disease, and emphasizing abstinence, fidelity, and condom use, it is the only African country to suppress the pandemic, reducing it to 6 percent of the population.

Congress should examine the proposal's proportion of prevention dollars. It should also ask why only $1 billion is slated for the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, which the US helped set up two years ago. That fund is the central clearinghouse for global anti-AIDS efforts. By largely bypassing it, Washington may be adding to the anti-AIDS bureaucracy and undermining the very fund it worked to start.

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