The devastating AIDS pandemic is one of the major themes of President Bush's five-nation African trip this week. In his State of the Union address, Bush pledged $15 billion over five years to fight AIDS in poor nations, mainly in Africa. Yet while the plan was endorsed by Congress in May, the money must be approved each year. The administration is seeking only $1.7 billion for the next fiscal year, and congressional aides say finding much more money will be difficult given the rapidly growing U.S. deficit.

Critics complain that over the last two decades the United States and other wealthy nations did little to stem the pandemic as it spread across the globe. Now the disease is out of control, and experts say that wealthy countries need to spend at least $10.5 billion a year to have any impact on its spread in the developing world. Last year, foreign donors spent only $2.8 billion.

Some are angry that conservative groups pressured Congress to earmark at least one-third of the prevention money for abstinence programs "which we know don't work," said Sandra Thurman, AIDS chief in the Clinton administration.

But Dr. Joseph O'Neill, the Bush dministration's AIDS czar, said the $15 billion pledge came from Bush's belief that "the United States, even though we've done a lot, could do a lot more and take real leadership on this and encourage others to follow us."

AIDS activists agree it is time for wealthy European and Asian nations to increase their commitments to fighting AIDS, and that countries affected by the disease must also work to save themselves.

In Senegal, Bush will find a nation largely untouched by HIV, thanks in part to the foresight of government leaders who started prevention programs before AIDS became epidemic there. Uganda's massive AIDS campaign has reduced adult infection rates from 18 percent in 1995 to 5 percent in 2001. But Bush's other hosts will present a more dismal picture. Facing utter devastation, Botswana has adopted one of the world's most aggressive AIDS programs, promising free AIDS medicine to all its infected people.

Though late in coming, the new U.S. leadership on AIDS funding is welcome, said Save the Children CEO Charlie MacCormack. "[But] even if we respond properly now, the worst of the pandemic is still ahead of us," he said.

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