U.S. President Bush's AIDS Plan, Defying Some Political Supporters, Includes Condoms and Generic Drugs

The Bush administration's new AIDS initiative may cost the president political capital with important interest groups. Many Christian conservatives, an important constituency, believe condoms promote promiscuity. Anthony Fauci, a senior National Institutes of Health official, said that while condom distribution would be part of the prevention component of the program, so would education about abstinence.

As recently as November 2002, administration negotiators urged the World Trade Organization to confine generic drugs to domestic markets, and to ban their export. Western pharmaceutical companies with AIDS drug patents have been major contributors to the Republican Party.

Sandra Thurman, the Clinton administration's top AIDS official and now head of the International AIDS Trust, called the plan "inspiring and clearly heartfelt" and said it "can save millions of lives."

Salih Booker of Africa Action also welcomed the policy change but was not overly optimistic. He cited Bush's failure to make good on an earlier pledge to spend $500 million to prevent mother-to-child transmission, a plan that now appears to be wrapped into the new one.

"They have become very good at the soft rhetoric, but not at the hard policy," Booker said. He worried about a lack of specifics regarding how and when the funds would be distributed, and voiced concern that only 12 African nations -- the other two are Haiti and Guyana -- would be helped. "Why leave out Malawi and Zimbabwe?" he asked. "It can't be successful because borders are porous."

Fauci said much of the implementation would be left up to regional authorities, thus explaining the plan's lack of specifics. He noted that the template would be Uganda's successful "network model," a central clinic directing satellites, one of the few systems reaching rural Africans.

Dr. Peter Mugyenyi, head of the Ugandan program, said he hoped to see Bush's offer, which delighted him, matched by European and Arab nations. In that case, he said, "we would see a real assault on AIDS."

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