President Obama and the first lady visited a hospital in Accra, Ghana, during their July 2009 trip to Africa. Michelle Obama will return to the continent for her first solo trip abroad on Sunday. (Haraz N. Ghanbari/AP)

First lady Michelle Obama’s upcoming five-day goodwill tour to sub-Saharan Africa, designed to highlight HIV/AIDS projects and inspire young adults there, is billed by the White House as an important next step in the administration’s outreach to the continent.

But the trip also has resurrected criticism among a vocal subset of Africa advocates — including President Obama supporters — who say they are disappointed that the first American president with African roots has not personally focused more on the region.

Critics cite changes to a HIV/AIDS program advanced during the Bush administration, the relatively limited time Obama has spent on the continent as president and their belief that Africa has become less significant in U.S. foreign policy.

Expectations for American engagement with Africa soared when Obama took office, with advocates citing his previous travels to his father’s homeland of Kenya and attention paid to African nations while he was a senator. But while Obama has talked about his “family members who live in villages” and told an Africa-focused Web site that he is “probably as knowledgeable about African history as anybody who’s occupied my office,” he has made just one presidential visit to sub-Saharan Africa.

On that 24-hour visit to Ghana in 2009, Obama spoke to the country’s parliament about his father growing up herding goats in a tiny village and outlined his approach to foreign assistance on the continent.

“The true sign of success is not whether we are a source of perpetual aid that helps people scrape by — it’s whether we are partners in building the capacity for transformational change,” he said.

Yet the big challenges facing the continent — poverty, government corruption, threats of extremism, and AIDS — have not drawn the White House attention that Mwiza Munthali, public outreach director of TransAfrica Forum, had hoped for.

U.S. officials, said Munthali, “are not seeing Africa as a big priority. There has been some ambivalence.”

Sebastian Spio-Garbrah, a Ghanaian who runs a New York investment and research firm specializing in Africa, pointed to what he said was the irony in the shared disappointment. “We really said if a black man became president, it would change the world, but we are basically back at the same level we were before,” he said. “The bulk of the policy is still the legacy of the Clinton and Bush years. The Obama legacy toward Africa is still yet to be seen.”

White House officials disagreed, saying that the administration has laid out clear priorities in Africa: supporting democratic regimes, decreasing hunger and developing the $63 billion Global Health Initiative. That program seeks to integrate the Bush administration’s focus on AIDS with a wider approach to public health issues.

Ben Rhodes, deputy national security adviser, noted that Obama met with the leaders of Nigeria and Gabon this month, and last year hosted a large group of handpicked young adults from the continent for a White House forum.

“We have looked for ways for him to continue to speak to the African people directly,” Rhodes said.

While Obama’s schedule has prevented him from traveling the continent more, Rhodes said, the president delivered audio messages urging a peaceful democratic transition in Ivory Coast and an end to violence in Sudan, which recently divided into northern and southern jurisdictions with U.S. backing.

The biggest criticism has come from supporters of the PEPFAR program (the President’s Emergency Plan for AIDS Relief) started by President Bush, which dramatically scaled up distribution of anti-retroviral treatment in developing countries.

Under Obama, the program has seen its smallest increases, and treatment programs at some organizations in sub-Saharan Africa have been unable to grow.

A letter to Obama from the Treatment Action Campaign, a South African group that advocates for HIV/AIDS patients, accused the administration of backing away from its commitment to treat the epidemic.

“It is a shame,” Fazila Farouk, a social activist in Johannesburg, said in a phone interview. “We have had to fight huge battles to get the government here to acknowledge the crisis we face and the importance of making universal access to anti-retroviral drugs.” She said she wants to ask Obama: “How can you do this?”

Rhodes said the controversy reflects a difference of opinion on how to best tackle the crisis. The administration has opted to put more emphasis on HIV prevention, along with maintaining funding for treatment.

“Our analysis,” he said, was that the treatment program was necessary “but what was going to make the game-changing difference in the long run is building on African public health care.”

Rep. Donald M. Payne (D-N.J.), a solid Obama supporter and longtime advocate for African nations in Congress, has said the president was initially slow to develop a policy toward Africa, but Payne is now satisfied.

“Part of the difficulty is getting the deficit hawks in Congress to understand the importance of foreign assistance,” he said.

Tony Fratto, a spokesman in the Bush White House, said it has always been difficult to get congressional support, but “at one point we were spending four times more in Africa than we had ever spent before.”

For Obama, the U.S.-Africa relationship has been fraught with its own political challenges. Among them has been the false claim that Obama was born in Kenya.

Even among those who did not make that claim, the tendency to associate Obama with Africa has elevated expectations.

“Shortly after President Obama came into office, in Africa and on the street . . . there was this emphasis on the fact that the first African American president” has African roots, said John Campbell, a former U.S. ambassador to Nigeria who also served in South Africa. “There was the sense that, somehow or another, that was going to change things, and it didn’t, of course. Not dramatically. . . . There is remarkable continuity in U.S. policy toward Africa” from one administration to the next.