More War on AIDS

Mr. Bush proposes to double America's commitment.

THOSE WHO questioned President Bush's commitment to fight the pernicious progression of HIV and AIDS around the world should be doubters no more. Not only did he meet his pledge of $15 billion over five years, he also called on Congress last week to reauthorize the President's Emergency Plan for AIDS Relief (PEPFAR) for another five years -- long after he's vacated the Oval Office. This is one foreign policy initiative that should get Congress's swift approval.

When Mr. Bush announced his emergency plan for AIDS during his 2003 State of the Union address, he stunned the world's AIDS community. After all, up until then, the U.S. had contributed only $840 million to combating this global scourge. The $15 billion was the largest pledge ever by any nation to fight a single disease. But that was a pledge. The reality is that by the end of fiscal 2008, when PEPFAR is slated to end, the U.S. will have spent $18.3 billion. Treatment has been provided for 1.1 million people in 15 focus countries, which are home to about half the world's AIDS population, most of it in Africa. By the end of fiscal 2013, PEPFAR, working with national governments, will have committed $48.3 billion over 10 years and 2.5 million people will be receiving treatment such as anti-retroviral medication, if Congress funds Bush's latest initiative.

That's a drop in an ever-deepening bucket of AIDS cases around the world. According to UNAIDS, 39.5 million people were living with HIV and AIDS in 2006. That's up 2.6 million cases since 2004. Two-thirds of all infected adults and children live in sub-Saharan Africa -- 24.7 million, up 1.1 million since 2004. And the estimated number of people contracting the disease with no cure rose to 4.3 million in 2006, up 400,000 since 2004.

The administration has been criticized for what a small portion of the money is being spent on (abstinence programs) and for what none of it is being spent on (needle-exchange programs). While PEPFAR seeks to implement comprehensive prevention measures -- the U.S. is the largest distributor of condoms in the world -- the continuing prohibition against needle-exchange programs appears to be grounded in head-in-the-sand logic. But Mr. Bush is right to push undauntedly to do what the United States can in the fight against AIDS.