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Bush touts African AIDS triumphs

The president starts his five-nation tour Tuesday in Senegal, which has Africa's lowest HIV infection rate.

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Senegal is not one of the countries specifically targeted for Bush's new AIDS funding, since that money will go to Africa's hardest hit nations, along with parts of the Caribbean. But Mr. Lewis says there is growing consensus that targeting high-risk groups, like Senegal's sex workers, is one of the most effective ways to combat the disease.

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Uganda is the country most often associated with stemming the tide of AIDS in Africa.

In the early 1990s, the Great Lakes nation was facing an HIV-infection rate of 14 percent, one of the highest in the region. Today that rate has fallen to around 8 percent, due largely to an aggressive information campaign.

Mr. Museveni, the country's rebel-turned-president, was one of the first African leaders to speak openly about the disease. His administration launched awareness campaigns and the continent's first voluntary counseling and testing centers. Many Ugandans say the government's attention helped change attitudes and, ultimately, behavior.

"One of the things that has helped has been the openness, and that people from the highest level of the political structure, including the president, are talking about AIDS," says Christine Oryema-Lalobo, program manager of the Hope for African Children Initiative in Uganda, sponsored by CARE and five other international humanitarian organizations. "We don't get it right all the time, but at least we're talking about it."

Meanwhile Botswana, with an HIV infection rate estimated at 38 percent, the highest in the world, is an unlikely candidate for AIDS success stories. For a long time, the Southern African nation, like many other countries, ignored the epidemic while cases soared.

But facing the reality that large numbers of Africans, particularly young people of child-bearing age, were HIV-positive, much of the debate on AIDS has shifted from prevention to treatment.

Botswana, a diamond-producing nation with a tiny population, has been the first to offer universal treatment. Last year, it launched the continent's first free antiretroviral program.

"You can't avoid the issue of treatment any more. There are 30 million infected people and a minimum of 6 million who would qualify for treatment," says Mr. Lewis. "What we've also discovered is that treatment not only keeps people alive, it restores hope."

More than 50 percent of the US's new AIDS money - which will go both to the UN's Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and to 14 of the world's most affected countries - is earmarked for prevention and treatment, including antiretrovirals.

But critics question whether the pledge will be fully funded since the president only asked for about $1.5 billion in next year's budget, rather than the $3 billion that was expected in order to meet his five-year, $15 billion target. They also complain that instead of contributing all the money to the Global Fund, they are complicating things by sending funds directly to the countries.

"They're phasing the money in very slowly and undermining the Global Fund," says Paul Zeitz, head of Global AIDS Alliance, a nonprofit group based in Washington. "There are 25 million people who have already died, 3 million dying each year, and 8,000 a day. You don't go slow. We're already way behind on this."