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A $50-billion bill to fight AIDS and other diseases in Africa and elsewhere gives us reason to cheer.

April 04, 2008

President Bush is going partway toward atoning for his sins in the Middle East by rebuilding Africa. His leadership in fighting disease and poverty on the continent culminated Wednesday with a breathtaking gesture from the House of Representatives, which took the president's generous proposal to spend $30 billion over five years fighting AIDS, malaria and tuberculosis around the world and upped it by $20 billion.

The $50-billion reauthorization for the president's anti-disease program, which is also expected to pass in the Senate, marks a dramatic shift in the United States' attitude toward foreign aid. This country has supported big international disease-eradication projects in the past, notably when it led a World Health Organization crusade against malaria in the late 1950s, but never with such an enormous financial commitment. We'd like to think this reflects a realization that saving lives and rebuilding economies destroyed by disease is a better way to enhance global security and stability than dropping bombs on people.

The bill does come with a few flaws. The most controversial aspect of the president's program when it was launched in 2003 was a requirement that 33% of the money for AIDS prevention had to be spent on abstinence-only programs, a bone tossed out to win the support of the religious right. The House bill scraps that requirement, only to replace it with a rule that may be nearly as bad. Now, if a program spends less than half of its budget for preventing sexual transmission on abstinence efforts, it has to send a report to Congress justifying the decision. That could have a chilling effect on programs that would rather spend the money on condoms but don't want to risk having their funds cut off by conservative lawmakers.

There are conflicting studies on the effectiveness of abstinence programs in places like Uganda, but it's clear that health experts in the field are better judges of the best way to prevent AIDS in a given country than Congress. The Senate should scrap the reporting requirement.

Such quibbles aside -- and there are other details in the bill attracting the ire of the fractious public health community -- the House bill gives Americans a good reason to be deeply proud of their country, a feeling many war-weary patriots haven't experienced in a while.

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