President Bush and some of his die-hard conservative allies are headed for a rare disagreement over his proposal to spend $15 billion to combat the global spread of AIDS, mainly in Africa.
The bill, set for a House vote Thursday, would encourage not only abstinence and fidelity but also the use of condoms -- thus provoking opposition from some who have been among his staunchest political supporters.
As he ardently urged support for the initiative Tuesday, Bush demonstrated a willingness to start exploiting his postwar popularity to get his way with Congress -- a likely harbinger of his approach on other key priorities, including his tax cut plan.
The House vote also will test Bush’s ability to advance his “compassionate conservative” agenda through a skeptical Congress.
The AIDS measure is likely to pass by a sizable margin -- if, as expected, supporters defeat attempts to limit condom distribution.
Few oppose the goal of trying to contain the AIDS pandemic in some of the world’s most severely afflicted countries. Even many antiabortion lawmakers are going along with Bush’s proposal to provide funding to organizations that traditionally support abortion and family planning as long as they do not use the AIDS money to promote such programs.
The proposal to spend $15 billion over five years would be the largest expenditure of U.S. funds to date in response to the AIDS crisis. Most of it will go to programs sponsored by the U.S. Agency for International Development, the Department of Health and Human Services, nongovernmental organizations, faith-based groups and governments in the affected nations.
At what amounted to a White House pep rally for the plan Tuesday, the president called combating AIDS “a moral imperative” and described the disease as “a threat to stability of entire countries and of regions of our world.”
He asked Congress to send him legislation by Memorial Day.
Bush unveiled his global initiative against acquired immune deficiency syndrome in his Jan. 28 State of the Union address. It targets areas around the world hit particularly hard by the human immunodeficiency virus: 12 sub-Saharan nations in Africa (Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia), the Caribbean nation of Haiti and the South American nation of Guyana.
The plan, which would support the distribution of life-prolonging antiretroviral drugs, could prevent 7 million new HIV infections, treat at least 2 million infected people and provide humane care for millions more, according to the White House.
“This is a terrible disease, but it is not a hopeless disease,” Bush said as he praised Uganda’s anti-AIDS efforts, which emphasize the so-called ABC approach (abstinence, being faithful and condoms.)
AIDS activists hailed Bush’s renewed commitment.
“The president is demonstrating very good, solid leadership on this issue. It’s absolutely essential and required and is very much appreciated,” said Kate Carr, president of the Elizabeth Glaser Pediatric AIDS Foundation.
A number of antiabortion lawmakers, such as Sen. Norm Coleman (R-Minn.) and Rep. Christopher H. Smith (R-N.J.), are backing the bill, despite reservations about providing funds to organizations that support abortion.
“The bottom line is, we’re going to do it,” Coleman said Tuesday as he left the White House.
Some GOP lawmakers want to give abstinence a more prominent role in preventing HIV transmission. Others, opposed to the emphasis on condoms, want to grant waivers to groups that do not advocate their use. But the White House and its allies believe they have the votes in the House to defeat such proposed amendments.
“Many of us have real concerns about the lack of abstinence [education] in the bill. Abstinence in Africa has been proven to work,” said House Majority Leader Tom DeLay (R-Texas). But he did not say he would try to scuttle the bill.
Rep. Joseph R. Pitts (R-Pa.) plans to offer an amendment to require that at least one-third of the funding for AIDS prevention be spent on abstinence education. But some conservative Republicans ordinarily inclined to side with Pitts are likely to oppose his amendment because they believe it is a potential “poison pill” that could sink the bill.
In a statement made after Bush’s remarks at the White House, Pitts expressed his concern that nongovernmental organizations will not always abide by the stipulation that money provided for AIDS prevention not be used to promote abortions or family planning.
“What happens when President Bush leaves office -- when someone who may not share his commitment to what works takes office?” Pitts asked.
At the White House, spokesman Ari Fleischer said there will be checks in place to ensure that organizations do not commingle AIDS funds with money allocated for other purposes.
“There’s a series of mechanisms in place, and that deals with the transparency of these organizations,” he said. “They will not be able to do business with the government unless we were satisfied they had transparency in place to know about their use of funds.”
Democrats saw the bill as a rare example of bipartisanship in the GOP-dominated House.
The measure was crafted by Rep. Henry J. Hyde (R-Ill.), chairman of the House International Relations Committee, and Rep. Tom Lantos of San Mateo, the committee’s top Democrat. It cleared 37 to 8 with support from all Democrats and all but eight of the Republicans.
Lantos said Democrats would be united behind the bill when it comes to the floor, and predicted that the House would support it by a ratio of 3 to 1.
After the expected House passage, the Senate will consider the bill. Assuming it is passed there, lawmakers from both houses will meet to reconcile any differences. Senate Majority Leader Bill Frist (R-Tenn.), a physician, has said the legislation is one of his top priorities.
Times staff writer Janet Hook contributed to this report.