WASHINGTON — The Senate on Wednesday approved a $48-billion program to treat and prevent AIDS, malaria and tuberculosis, tripling the amount set aside in landmark legislation first passed five years ago.
The legislation, approved 80 to 16, came after an impassioned debate that had stalled for weeks over objections by conservatives about the bill's cost, the role of abstinence education and control over how money is spent.
Most Senate Republicans joined Democrats in backing the measure, which had the support of the White House. President Bush called for the 2003 initiative in his State of the Union speech that year, and favored renewal of the program this year. In Congress, the effort was seen as an important U.S. foreign policy initiative.
"It's one of the strongest ways the U.S. has made an impact on a number of countries where our diplomacy hasn't been effective in the past," said Sen. Richard G. Lugar (R-Ind.), adding that the measure is aimed at "the alleviation of extraordinary suffering on Earth."
The bill, known as the President's Emergency Plan for AIDS Relief, sets an ambitious five-year goal of helping prevent 7 million HIV infections and caring for 10 million people who have HIV or AIDS.
The program supports lifesaving antiretroviral treatment for more than 1.7 million people living with HIV or AIDS in 15 countries in sub-Saharan Africa, Asia and the Caribbean. When Bush called for the program, only 50,000 people in sub-Saharan Africa received treatment, the White House said.
With Bush's approval ratings at home and abroad at record lows, the AIDS program could provide a cornerstone to salvage part of his foreign policy legacy.
"I have been extremely critical of President Bush's foreign policy," said Sen. Joseph R. Biden Jr. (D-Del.), chairman of the Senate Foreign Relations Committee. "But I must say, the president of the United States has led us to this incredible moment."
Advocates of AIDS prevention and treatment praised the measure, but they also expressed concern over provisions that increase the amount of money required to go toward abstinence education.
A report last year by the federally funded Institute of Medicine recommended elimination of the requirement.
"Some of its mandates aren't grounded in evidence, and politics is put ahead of science," Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, said in an interview from South Africa, where he is attending meetings on HIV prevention research.
