San Francisco Chronicle - July 2, 2008

At issue is one of Washington's unrivalled foreign policy successes: a bipartisan plan to expand global AIDS care and treatment. The initiative, by far the biggest by any nation, is stalled in the Senate though it easily won House approval earlier this year and has the backing of President Bush.

This humanitarian program was launched by the White House in 2003 and focused on 15 counties, mostly in sub-Saharan Africa, with $15 billion in aid. The program may well be one of the president's most impressive - and least noted - accomplishments. Nearly two million receive anti-retroviral drugs. Prevention efforts are credited with forestalling infection of seven million more.

AIDS remains a worldwide horror with some 33 million infected with the HIV virus that causes the disease. Since 1981, more than 20 million have died from AIDS. But before the 15-nation program was launched, fewer than 100,000 were receiving life-prolonging drugs while prevention and education were haphazard.

The renewed initiative, if it survives, will build on the first five years of work. It steers 55 percent of the money into direct and measurable treatment but it allows a freer hand at the country-level to craft new programs, a feature supported by a federal study by the Government Accountability Office. What works in Vietnam may not serve as well in South Africa, two of the recipient countries.

This far-flung operation has performed well and it's time to go wide-screen. When the White House proposed a $30 billion budget for the next five years, the House raised the number to $50 billion. The president now supports the new number.

The budget boost riled GOP conservatives, who feel the price tag is too high. No question, it's a large number. But it builds on AIDS-fighting programs and includes two new targets, tuberculosis and malaria. These diseases are endemic in the same countries afflicted with the virus that causes AIDS. Going after one devastating infection gives health experts a chance at tamping down two other killers.

The bill includes compromises that explain why it's collected widespread support. Abstinence programs, dear to the heart of religious right, will be maintained though to a lesser degree, as AIDS workers prefer. Liberals accepted changes to minimize family planning groups, disliked by anti-abortion groups.

There is also a proviso that would cancel a ban on admitting immigrants infected with HIV into the United States, canceling a barrier that few other major nations impose. Such a change would return the decision on controlling disease at the border to health experts, not politicians who imposed the ban in the early days of AIDS threat. One local note: the late Cong. Tom Lantos, D-San Mateo, played a key role in resolving disputes around the House version, making the bill another memorial to his Capitol career.

The Senate should act without delay to complete its version and speed along a broadly-supported package. Adding urgency is a G-8 summit of the world's major countries later this month. President Bush needs approval of this global AIDS program to press other national leaders to follow the U.S. lead. An important battle against AIDS still needs fighting, and this country should continue to lead the charge.

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