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Bush, activists hold differing views on progress against AIDS

WASHINGTON—President Bush will observe World AIDS Day on Thursday by touting his administration's efforts to combat the deadly disease, but some public health officials and AIDS activists argue that the president has little to brag about.

Bush, in remarks at the White House, will maintain that he's kept his promise by combating AIDS globally through the President's Emergency Plan for AIDS Relief, a five-year, $15 billion program aimed at providing treatment and prevention help to countries hit hardest by the disease.

"The theme of World AIDS Day is `Keeping the Promise,' and President Bush has kept his promise," said Mark Dybul, the White House's deputy global AIDS coordinator and chief medical officer. "The president has been leading; the Congress has been in lockstep."

The administration appears to be on target in year three of its emergency AIDS plan, having dispersed $2.4 billion in 2004, $2.8 billion in 2005 and $3.2 billion for 2006.

But activists complain that the White House is lagging when it comes to donations to the Global Fund to fight AIDS, Tuberculosis and Malaria, as well as for the contribution Bush promised during July's Group of Eight summit to come as "close as possible to universal access to treatment to all who need it by 2010."

The pledge—signed by Bush and leaders from Russia, Canada, Great Britain, Italy, Japan, France and Germany—called for most work toward that goal to be conducted through the global fund.

Activists say America is balking at its pledge because it's not doing enough to help the global fund bridge a more than $3 billion funding gap that's expected after 2007. If the gap isn't filled, the fund won't have the resources to award new grants to fight the HIV/AIDS pandemic, according to a report in November from the Congressional Research Service, a nonpartisan research arm of Congress.

The United States, which contributed $459 million to the fund in 2004 and pledged $414 million for 2005, accounts for one-third of the fund's finances. Activists say that's not enough.

"What we need here is for the U.S. to take the leadership that President Bush appears to want to take on AIDS," said Joia Mukhrejee, the medical director for Partners in Health, a nonprofit program that coordinates AIDS and women's-health programs. "The idea of one-third is like falling to the back of the pack instead of leading the pack, and it's eroding the global fund."

White House officials dismissed the activists' complaints, saying Bush hasn't reneged on the G-8 commitment.

"I'm bewildered how they can suggest a country can be behind a commitment it made months ago," said Trent Duffy, a White House spokesman. "We will deliver on the commitments the president made during the G-8, like he's met for the rest of the AIDS programs."

Activists also complain that U.S. money for HIV/AIDS comes with strings attached. In his 2004 State of the Union address, Bush called for increased emphasis on sexual-abstinence education as a way to reduce HIV/AIDS in the United States.

Jodi Jacobson, the executive director of the Center for Health and Gender Equity, and other activists say that approach has made its way into international HIV/AIDS programs, to the detriment of other prevention programs.

Several African nations that are receiving U.S. assistance are practicing a program called ABC: Abstinence, Being Faithful and Condoms. Jacobson said the abstinence emphasis wasn't balanced and didn't take married couples into account. The highest rates of new AIDS/HIV infections are among married women, she said.

White House aide Dybul said the countries that received the emergency HIV/AIDS money—not the United States—decided which prevention programs to pursue.

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(c) 2005, Knight Ridder/Tribune Information Services.

GRAPHIC (from KRT Graphics, 202-383-6064): 20051129 AIDS update

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