President Bush's visit to Africa is partly devoted to observing the continent's AIDS crisis. Sub-Sarahan Africa has three-fourths of the world's 40 million HIV infections. The president is seeking billions of dollars from Congress to help the hardest hit African nations and some in the Caribbean combat the pandemic. But many HIV activists and international aid advocates question his commitment to the problem.
President Bush's itinerary takes him to AIDS clinics in Uganda and Nigeria on Friday and Saturday.
It will be his first direct view of a problem he wants to alleviate with $15 billion in spending over the next five years. In a recent speech to an organization that promotes U.S.-African trade, Mr. Bush said the money would prevent seven-million new HIV infections, treat two million people with life-extending drugs, and care for 10 million patients and AIDS orphans.
"This is one of the largest public health projects in history," said Mr. Bush. "America is proud to be a part of this cause, and we are absolutely determined to see it through until we have turned the tide against AIDS in Africa."
Mr. Bush has also proposed providing $5 billion more over three years to African and other countries that move toward democracy and promote the health and education of their people.
But many skeptics mistrust the President's intentions, which he outlined in a speech to Congress in January. They recall an election campaign statement three years ago in which he ranked Africa behind most of the rest of the world on his list of foreign policy priorities.
Columbia University economist Jeffrey Sachs, an advisor to the United Nations Secretary-General, says U.S. aid to Africa is negligible and that Mr. Bush's policies have made little difference to what he calls a neglected continent.
"Millions of people have died on the president's watch," says Mr. Sachs. "So far this administration has racked up [has made] one good speech and maybe is going to start racking up [start having] some accomplishments, but the fact of the matter is that until the speech, basically the administration's position vis-ŕ-vis Africa was that it was letting it die."
But others point out that President Bush has changed his mind about African issues since coming into office. A Washington Post article says his increased focus on the continent reflects the growing influence of aid groups, religious organizations, entrepreneurs who want to do more business with Africa, black legislators, and his black national security advisor, Condoleezza Rice.
Ms. Rice told reporters recently that President Bush wants to reconcile Africa and the United States in part as a result of America's role in African slavery.
"The president is going to talk about and acknowledge what slavery has meant to Africa and has meant to America," she says. "He's going to look forward to the tremendous contributions that we have made and he is going to look forward to how to help Africa finally realize its potential."
But as Mr. Bush tours Africa, a U.S. House of Representatives subcommittee is expected to vote to give him less money for his AIDS program this year than he is asking. Although Congress is controlled by the president's party, lawmakers cite national budget deficits as one of the reasons for a lower appropriation. However, Condoleezza Rice says the government is fighting for the full amount.
"The message to Congress is that the president requested funding at the levels that he thought necessary to get the job done," she says. "We are actively, all of us, actively engaging with the Congress to try and get full funding."
Yet even if President Bush's AIDS request were fully funded, the United Nations AIDS Program says it and promises of more European help are only half of what is needed by 2005 to fight the pandemic effectively. The head of the French National AIDS Research Agency, Dr. Michel Kazatchkine, acknowledges that global AIDS spending has increased nine-fold since 1996, but he says it is insufficient.
"In the next two or three years, we will see much more commitment, but I fully agree with all the experts of course and particularly with Jeff Sachs, that we are very, very far from having currently the resources that we would need to have an impact on the epidemic in the short term," says Dr. Kazatchkine.
President Bush's sub-Saharan African trip is unlikely to cause him to pledge more AIDS money than he already has. But South African AIDS activist Millie Katana says she hopes it hardens his commitment to accomplish what he has promised.
"I really hope this visit is not for the president to look good but to act good," says Ms. Katana.