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After the Glittering AIDS Bill
President Bush signed into law on Wednesday an important bill that authorizes greatly increased American spending to fight AIDS, tuberculosis and malaria around the world. Although the money is more than he had originally wanted, the president willingly accepted the higher numbers. He can be justifiably proud of his administration's leadership in ramping up its commitments to the global effort to control AIDS over the past five years and in proposing to do more in the next five.
The only hitch is whether the money will actually materialize in the form of appropriations. The signs in Congress are not good.
The authorizing measure calls for $48 billion to be spent over the next five years - mostly for AIDS, with a significant portion for the other two diseases as well. That implies appropriations of roughly $9 billion to $10 billion a year. But advocacy groups say the amounts emerging from Congressional appropriations committees for fiscal year 2009 will be little more than half of that. If Congress can't come closer to the authorized amount, the global AIDS bill may turn out to be, as one leading advocate put it, "more rhetoric than reality."
Meanwhile, an advocacy group for black Americans has come up with a startling insight into the AIDS epidemic in this country by contrasting it with the global epidemic. The Black AIDS Institute makes a persuasive case that the epidemic among black Americans is comparable to the epidemics in many of the countries that the administration is trying to help, either in terms of the number of people infected with H.I.V., the virus that causes AIDS, (more than 500,000 in this country) or the routes of transmission. In some American cities, prevalence rates among blacks approach those in the most heavily affected countries in Africa.
The administration has not shown the same zeal to control this domestic tragedy that it has shown in the global campaign. Surely we should be doing as much to prevent the spread of the AIDS virus in our own communities as we are trying to do abroad.

The Bush legacy_-
In global battle against AIDS, millions saved
August 1, 2008

President Bush cemented his own legacy this week, signing into law a dramatic expansion of his already unprecedented effort against AIDS in Africa and other desperate regions. His program is saving literally millions of lives, and it will stand as his greatest bipartisan foreign policy achievement. Approved with lopsided majorities by the House in April and the Senate last month, Bush signed the bill on Wednesday. It authorizes spending $48 billion over the next five years to fight AIDS, tuberculosis and malaria - the three diseases of poverty - in the areas of the world that most need help. The $48 billion represents a more than threefold expansion of the program that Bush first announced in his State of the Union address in 2003 and was approved by Congress later that year.
At the time, the Bush initiative was overshadowed in the headlines by the nation's focus on Iraq and the economy, despite the fact that the original $15 billion initiative was the largest commitment ever by any nation for a global battle against a single disease.
Five years later, the new initiative is again overshadowed, and again by the focus on the economy and Iraq.
And - for Bush, at least - that is a shame.
In 2003, just 50,000 of the millions of people infected with the AIDS virus in all of sub-Saharan Africa were receiving life-saving antiretroviral drugs. Today, 1.7 million Africans are receiving the drugs, and the program is supporting care for nearly 7 million, including 2.7 million children orphaned by AIDS. In Haiti, one of the poorest nations on the planet, barely 100 people were receiving the drugs in 2003; now 13,000 are treated.
With less than six months remaining in the Bush presidency, the rest of his legacy remains at best cloudy. But the impressive results of his battle against the scourge of AIDS cannot be denied. Its impact, in real lives saved, will be felt for many years to come.

AIDS bill sets unclear treatment target
WASHINGTON (AP) - The global AIDS bill signed by President Bush on Wednesday sets a goal of treating more than the 2 million-patient target set in 2003, but how much more isn't clear.
In signing the bill, President Bush said, "With this funding, we will support treatment for at least 3 million people." However, the bill itself doesn't set a specific target.
Early versions of the bill that passed the House specified a target of treating at least 3 million people by 2013, but that number was removed in the final version that Bush signed. Instead, the bill now says U.S. policy is to increase the number of people receiving anti-retroviral treatment beyond the original goal of 2 million.
The $48 billion measure renews the President's Emergency Plan for AIDS Relief, which is set to expire in September. The program has been credited by Republicans and Democrats alike with saving millions of lives in Africa alone.
The State Department said 1.7 million people had received treatment as of March 31 and the original bill's 2 million-person goal will be reached by December.
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