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President Bush greeted 4-year-old Baron Mosima Looyios Tantoh of South Africa yesterday during a ceremony calling for a doubling of funding of the US global AIDS program to $30 billion over five years. The child, his HIV-positive mother, Manyonga (left), and Bishop Paul Yowakim of Kenya (center) have all been recipients of US funding for treating AIDS.
President Bush greeted 4-year-old Baron Mosima Looyios Tantoh of South Africa yesterday during a ceremony calling for a doubling of funding of the US global AIDS program to $30 billion over five years. The child, his HIV-positive mother, Manyonga (left), and Bishop Paul Yowakim of Kenya (center) have all been recipients of US funding for treating AIDS. (Mark Wilson/ Getty Images)

With AIDS funding proposal, Bush looks to his legacy

$30 billion plan eyes treatment over five years

WASHINGTON -- Hoping to cement a positive part of his legacy, President Bush yesterday asked Congress to double the funding of the US global AIDS program to $30 billion over five years, which sets goals of helping support AIDS treatment of 2.5 million people.

"This is really a story of the human spirit and the goodness of human hearts," Bush said during a ceremony at the Rose Garden. "Once again, the generosity of the American people is one of the great untold stories of our time. Our citizens are offering comfort to millions who suffer, and restoring hope to those who feel forsaken."

The announcement to further fight what Bush called "this modern-day plague" came a week before a summit of industrialized nation leaders in Germany.

Some analysts said that Bush wanted to use the increase in aid to encourage others to give more in the fight against AIDS, but others suggested the president wanted to also blunt international criticism of the administration's climate-change policies. The White House has rejected large sections of a German-crafted statement on global warming, which includes a goal of halving global warming pollution by 2050.

The Bush administration's global AIDS program, known widely as PEPFAR, "goes in the success column, and the administration is entering its legacy phase, where they want to try to get that column up," said J. Stephen Morrison , director of the Africa program at the Center for Strategic and International Studies , a centrist Washington think-tank.

Morrison said most presidents have used international summits to promote their accomplishments, noting that Bush's announcement signaled that he considers the AIDS initiative one of his biggest successes. Morrison also believed the administration wants to bolster its foreign policy record by aiming to "convert fixable problems, like putting energy to get the relationship with Russia right."

Since taking office, Bush has put a special emphasis on increasing aid to Africa, increasing direct US aid from $ 1.1 billion in 2000 to $4.2 billion in 2006.

Tom Hart, director of government relations for DATA, the Africa advocacy organization founded by rock singer Bono , predicted that by the time Bush leaves office in early 2009 his administration will have increased aid to Africa by at least six times over that of the Clinton administration. Hart said that Bush also will probably surpass his pledge, made at the G8 summit in Gleneagles in 2005, to double US assistance to Africa by 2010. At the time, US aid to Africa amounted to $4.1 billion.

In addition to the AIDS program, other aid programs to Africa include several billion dollars to fight malaria, promote economic development, and provide emergency food.

When President Clinton left office, 20 percent of US overseas assistance went to Africa; after Bush's first four-year term, that figure increased to 25 percent. "It's clearly an historic shift," Hart said.

Bush, who met in the Oval Office yesterday with recipients of PEPFAR programs from Haiti, South Africa, and Kenya, said his motivation was simple: "This investment has yielded the best possible return: Saved lives." After the Rose Garden announcement, the president called to the audience for 4-year-old Baron Mosima Looyios Tantoh of Cape Town, whose HIV-positive mother, Manyonga, stood on the stage.

The boy bounded into Bush's arms, flashed a huge smile, and waved . Bush beamed.

The additional resources the president wants would also set 10-year goals: prevent 12 million new HIV infections and provide care for 12 million people, including 5 million orphans and other vulnerable children. The program's focus area covers 15 countries, including 12 in Africa as well as Haiti, Guyana, and Vietnam.

Mark Dybul , the US global AIDS coordinator, said that the continuation of PEPFAR has been in discussion for the past three years. The timing of the announcement was not related to the G8 meeting, he said, but rather to let other governments and US partners know they could plan for an increased commitment.

"This is about doing the right thing," Dybul said. "The timing is really related to partnerships, knowing that the initial program ends in 2008. The legacy piece [for Bush] is ensuring that life-saving programs continue."

Dybul said the administration hopes Congress will reauthorize an additional five-year commitment to AIDS programs sometime this year.

Rajat Gupta , board chairman of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, said that Bush's announcement was timely because the "programs need to be scaled up and needs to have this longevity."

Gupta, who was part of the Oval Office meeting, said the president's decision to announce the increase before the G8 meeting "is a good thing because the US is challenging the world to increase spending, and I hope others will rise to it."

Some global health experts said they hoped the US administration will now improve upon its record in fighting AIDS.

Barry Bloom , dean of Harvard's School of Public Health, said one key question is whether the AIDS programs can build sustainable health programs in poor countries, and not siphon off talented health professionals to work for international organizations. "These programs must identify not just the patients' needs, but the systems' needs as well," he said.

And Susan Foster , professor of international health at Boston University, hoped that PEPFAR would eliminate specific budget goals to promote abstinence teaching as part of the prevention effort.

"It's not really working," she said. "And it's a little bit insulting to tell adults that they should abstain from sex."

John Donnelly can be reached at donnelly@globe.com

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