WASHINGTON - President Bush said the $15 billion global AIDS bill he signed on Tuesday is the "moral duty" of the United States to act against a disease that has killed more than 20 million people worldwide.
"We believe in the value and dignity of every human life," Bush said, likening the AIDS initiative to U.S. relief and rebuilding efforts in Europe during World War II.
"We are the nation of the Marshall Plan, the Berlin airlift and the Peace Corps and now we are the nation of the emergency plan for AIDS relief," Bush said at the State Department, where representatives of 25 nations gathered for a ceremony at which he signed the five-year plan designed to help prevent and treat AIDS, especially in more than a dozen African and Caribbean nations.
If fully implemented, the legislation is supposed to prevent 7 million new infections, care for 10 million HIV-infected people and AIDS orphans and provide anti-retroviral therapy for 2 million.
Signing the bill gives Bush more leverage to press other wealthy nations to work harder against the killer disease as he prepares for a European summit. The president had urged Congress to get the bill to his desk before he traveled to the June 1-3 "Group of Eight" summit in Evian, France, where he is expected to use it to solicit other countries to contribute more to the cause.
The G-8 comprises the leaders of the world's seven richest countries - the United States, Japan, Germany, France, Britain, Italy and Canada - plus Russia.
"I will challenge our partners and our friends to follow our lead and to make a similar commitment made by the United States of America so we can save even more lives," Bush said of his trip to Europe. "I will remind them that time is not on our side."
Dr. Peter Piot, who directs a joint United Nations program on HIV/AIDS, praised the legislation, saying resources directed to scientifically proven interventions can dramatically reduce deaths, even where the epidemic is most severe.
"For the first time there is a concerted global effort to close the treatment gap that denies life-saving HIV medicines to 95 percent of the people living with AIDS around the world," Piot said.
But he said that even with the new U.S. money, spending is shy of the resources needed to address the problem.
"There is still a long way to go," Piot said. "AIDS will be defeated when responsibility for addressing it is fully shared - with every nation working to meet the financial and leadership challenges presented by this global epidemic."
Said Jose Zuniga, president of the International Association of Physicians in AIDS Care: "Other wealthy nations - specifically G-8 member nations - must follow suit with similar funding increases."
The new AIDS package, which Congress completed last week, recommends that 55 percent of direct aid go to treatment programs, 20 percent to prevention, 15 percent to palliative care and 10 percent to children orphaned by the disease. It also would allow, but not require, the administration to contribute up to $1 billion in 2004 to the international Global Fund to Fight AIDS, Tuberculosis and Malaria.
"This is a whole new day in the fight against this epidemic," said Mark Isaac, vice president of the Elizabeth Glaser Pediatric AIDS Foundation. The foundation fights HIV and AIDS and other serious and life-threatening diseases affecting children.
To appease conservatives, the measure says one-third of the money going toward prevention be set aside for projects that promote abstinence - an issue that was prominent in the final congressional debate. The bill says religious groups will not lose funding because they oppose certain preventive methods, such as condom distribution.
Supporters of the legislation said Uganda has been successful in lowering infection rates with its "ABC" program of "Abstinence, Be Faithful and Condom use when appropriate." Others say it is a mistake to focus on any one strategy when local customs vary widely.
"We were speaking to the first lady of Uganda the day the bill was being considered in the Senate," Isaac said. "And she was quite firm in saying that people in the countries most affected are the most knowledgeable about what kind of prevention works best locally. We need to give them a full range of options."
While the legislation nearly triples current U.S. contributions to AIDS programs, Congress still must approve actual spending levels in its annual budget appropriations process. The bill calls for spending $3 billion a year, but the administration is seeking only $1.7 billion in fiscal 2004, $2 billion if related programs for malaria and tuberculosis are included.
"The president moved with great speed, but now Congress has to move with the same speed and dispatch," Isaac said.