Newsday
February 1, 2003

Stung and surprised by criticism of his $15 billion proposal for prevention and treatment of HIV/AIDS in Africa and the Caribbean, President George W. Bush Friday asked Americans to reach out with compassion to those with the disease, and expressed support for the Global Fund to Fight AIDS, Malaria and Tuberculosis.

"We have a chance to achieve a more compassionate world for every citizen," Bush said in a White House ceremony. "America believes deeply that everybody has worth, everybody matters, everybody was created by the Almighty, and we're going to act on that belief."

AIDS activists have criticized the proposal raised in Bush's State of the Union address Tuesday - $15 billion over five years for anti-HIV efforts overseas - because it targets only 14 nations and largely bypasses the Global Fund, which funds proposals submitted by governments and agencies working in poor countries. The fund was established in 2001 at the urging of UN Secretary-General Kofi Annan.

The fund announced Friday in Geneva approval of its second round of grants, awarding $866 million to programs in 60 nations to provide anti-HIV drugs to 270,000 people, tuberculosis treatment for 2 million and antimalarial drugs for 16 million. But that means the Global Fund is now out of money, with another $6 billion worth of requests under review, director Dr. Richard Feacham said in an interview.

Only $200 million of Bush's proposal would go to the Global Fund each year - a decrease over this year's $380 million allotment. The fund "is being starved under the president's proposal," said Asia Russell of the Philadelphia-based AIDS activist group Global Access Project, speaking at the Geneva briefing.

U.S. Secretary of Health and Human Services Tommy Thompson Friday was elected chairman of the fund, a move Russell said "is hard to swallow. It's sending a message to donors that if you flatline your contribution to the Global Fund, you get a pat on the back."

Columbia University economist Jeffrey Sachs, who advocates spending more than $10 billion a year on global HIV/AIDS - $2 billion to $3 billion from the United States - labeled the Thompson announcement "bizarre." Sachs charged that Bush's proposal is saying that "if American money was going to go for something, it needed to be under American control."

Bush sought to counter such criticism Friday. Flanked by UN officials, Thompson and federal public health officials, Bush said, "I've been asked whether or not we're committed to the Global AIDS Fund. Well, first of all, I wouldn't put Tommy [Thompson] as the head of it if we weren't."

"It's more than money we bring," Bush noted. "We bring expertise and compassion and love and the desire to develop a comprehensive system ... for diagnosis and treatment and prevention."

Bush also announced Friday his intention to ask Congress for $16 billion for domestic HIV prevention and treatment programs - a 7-percent increase primarily for the rising costs of anti-HIV medicines for uninsured Americans. He also ordered the FDA to grant rapid approval to a new saliva-based HIV test which manufacturer OraSure Technologies says provides a 99.6 percent accurate diagnosis within 30 minutes.

Bush's announcement, coinciding with word that the Global AIDS fund has run dry, led to pleas for European nations and the United States step up their donations. "Europe has been no champion of this process by any means," Sachs said, acknowledging that the European Union has yet to come through with money for the fund. Bush's $15-billion commitment to fight the disease, even though most of it bypasses the fund, "should be a wake-up call to the EU," he said.