San Francisco Chronicle - November 19, 2004

But it's not working as smoothly as that. Foot-dragging by Washington, by far the biggest check-writer to the Global Fund to Fight AIDS, Tuberculosis and Malaria, nearly shut down a long list of projects.

What's going on is typical of a political sideshow that undercuts the war on AIDS. The infighting imperils the fragile existence of dozens of countries depleted by the uphill fight against the disease. The jockeying also delivers a blow to the image of the United States, the one country with the money and medicine to make a difference.

For the record, the White House hasn't ignored AIDS.

President Bush is on track to spend $15 billion on care and prevention in 15 countries where results can be studied carefully.

It's a big-budget plan that comes with strings. It relies partly on a message that abstinence can stem AIDS and a rule that all drugs used honor American patents. These rules are deal-killers for some countries that want a free hand to distribute condoms and cheaper generic drugs made in defiance of U.S. copyright laws.

Alongside this plan is the Global Fund, founded by the United Nations, which collects an average of $1 billion a year from rich countries to distribute in about 120 countries.

Grudgingly, the White House has participated, kicking in the bare minimum while closely watching to see if it operates efficiently. As Health and Human Services Secretary Tommy Thompson argued at the fund's meeting in Tanzania this week, the fund should take extra time to organize and collect more money. Urgent aid must be balanced with fiscal prudence, he said.

But with African presidents, one by one, pleading for quicker action, these arguments rang hollow. A backstage compromise was struck to keep the international fund in business.

The fund will delay but not cancel its next round of grants. Washington relented, though the level of its financial support will hinge on what other countries give.

On one level, the result is a tiny victory in a huge war against AIDS and the divisive rivalries it provokes. It's also a paradigm for a suspicious American foreign policy that distrusts alliances and prefers calling all the shots.

But a united front, as with terrorism or any other international challenge, is the only way to stop AIDS. Nearly 40 million have died in the last two decades. It kills some 3 million per year, mostly in southern Africa but now spreading to central Europe and Asia. India and China, the world's biggest countries, are notably unprepared and directly in the path of the virus.

Against this backdrop, the competitive feelings on display this week are inexcusable. Both approaches -- Washington's strict plan and the wider international effort -- have a place on the AIDS battlefront. It's time to end a pointless rivalry.

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