WASHINGTON — In a major policy shift, President Bush has decided to allow social service agencies in Africa and the Caribbean to receive U.S. funds under his $15-billion emergency AIDS relief plan even if they promote family planning and provide abortions, White House officials said Friday night.
The only restriction will be that the agencies must use the money for treating people with AIDS, according to a senior administration official who requested anonymity.
"The president views this as a health-care issue," the official said.
"Any agency that provides treatment for AIDS will get the money, as long as none of the funds are used for family planning purposes or for abortions, except in cases of rape, incest or when the life of the mother is in danger," said another senior White House aide, who also spoke under the condition of anonymity.
Nevertheless, Bush's decision is likely to infuriate abortion opponents, who are a solid core of his political constituency.
The decision marks a shift in position for Bush, who just days after taking office issued an order barring any U.S. money to international groups that use their own funds to support abortion -- either through performing surgery, counseling as a family planning option or lobbying foreign governments on abortion policy.
By reinstating the so-called "Mexico City policy" restrictions that his father, former President Bush, as well as President Reagan, had supported before him, Bush reversed the Clinton administration's position on unrestricted family planning aid overseas.
The policy got its name because it was announced by Reagan at a 1984 population conference in Mexico City.
Bush's policy change could be significant because in many African and Caribbean nations, family planning services and AIDS assistance are often provided by a single agency. Thus a ban on funding to such groups could have proved counterproductive if Bush wanted his high-profile initiative to be effective.
When Bush announced his AIDS relief plan for Africa and the Caribbean in his Jan. 28 State of the Union address, he did not get into the details of the initiative.
Some lawmakers this week questioned Secretary of State Colin L. Powell about the funding -- in the context of family planning and abortion services -- during his appearances on Capitol Hill to brief them on the potential war with Iraq.
The AIDS initiative is to be administered by the Department of State, under the Foreign Assistance Act.
Bush's shift on the funding issue emerged Friday as other administration officials began consulting and informing lawmakers about the new policy.
In addition to angering abortion opponents, Bush's move threatens to undermine his otherwise unwavering stance against granting U.S. funds to agencies outside Africa and the Caribbean that promote family planning or provide abortions.
Opponents of his position, such as Sen. Barbara Boxer (D-Calif.), now could seize on Bush's shift to point out the "inconsistency" of continuing to ban aid to some family planning organizations, according to one top Senate Democratic aide.
The White House's rationale, like that of the administrations of his father and Reagan, was that if funds were given to agencies that promote family planning and abortions, even if the money was not used directly for such purposes, the agencies nevertheless would end up with more resources to promote their goals.
In any case, one Democratic congressional staffer for a lawmaker staunchly in favor of abortion rights hailed Bush's change in policy.
"It certainly is a welcome change from their position on family planning funds," he said.
In his State of the Union address, Bush called the AIDS pandemic in Africa and the Caribbean "a severe and urgent crisis," and described his initiative as "a work of mercy beyond all current international efforts."
The White House said the $15 billion in funding over five years would prevent 7 million new infections and treat 2 million HIV-infected people by providing advanced antiretroviral treatment in the poorest, most-afflicted countries.
Bush's initiative also would involve large-scale prevention efforts, including voluntary testing and counseling.
The financial commitment nearly triples U.S. spending in global AIDS assistance.
If approved by Congress, funding will begin with $2 billion in fiscal year 2004, and increase each year thereafter.