Health care workers in East Africa are cautiously welcoming U.S. President George W. Bush's call to triple U.S. spending on AIDS treatment and prevention in the continent over the next five years.

Regional health care workers describe President Bush's Tuesday announcement as a surprise.

Chris Ouma is a Kenya-based doctor with the non-governmental organization, Action Aid. He says he is delighted with the prospect of receiving much-needed funds to fight AIDS, but he predicts much of the money will not be made available until several issues are resolved.

"Is it cash into programs for community projects in Africa or does this involve training for medical staff? There are issues that raise questions. But generally, I think it is something we must welcome," he said.

In his State of the Union address Tuesday, President Bush asked Congress to commit $15 billion over five years for the treatment and prevention of AIDS in Africa and the Caribbean.

The president says the initiative could prevent as many as seven million new infections and provide care for 10 million AIDS sufferers and children orphaned by the disease. He says some of the money could go toward supplying life-extending drugs to some two million people infected with HIV, the virus that causes AIDS.

There is no cure for AIDS, but a cocktail of costly drugs has been proven to be effective in controlling the disease. For years, AIDS activists have complained that such drugs have been financially out of reach for most people. The activists have also been critical of what they say has been a lackluster response by the United States to the global epidemic.

Stephen Lewis is the U.N.'s special envoy for HIV/AIDS in Africa. Speaking in Johannesburg on Wednesday, he said those involved in the fight against AIDS had been seeking more money than President Bush offered Tuesday. Still, Mr. Lewis welcomed the president's decision to devote billions more dollars to the fight against AIDS.

"The president's announcement is a significant announcement. It gives leverage to activists everywhere to keep the pressure on. It opens the floodgates of hope," he said.

Mr. Bush's new AIDS initiative targets 12 countries in Africa, where more than 35 million people are HIV positive.

Five of those countries, Ethiopia, Rwanda, Kenya, Tanzania and Uganda, are in East Africa. Over the past decade, the disease has left millions of children in the region infected or orphaned. It has also taken a fearsome toll on East African economies and education systems.

In Kenya, where 2.5 million people out of a population 30 million are infected, the government estimates the AIDS epidemic has contributed to at least a 15 percent drop in the country's economic productivity and output since the late 1990s.

In neighboring Uganda, a high rate of infection among teachers has emptied numerous classrooms. A World Bank report says HIV is prevalent among teachers because they tend to be relatively affluent and have the means to have multiple partners. HIV in Africa is spread mainly through heterosexual contact.

Dr. Ouma and other health-care workers say they hope the U.S. pledge to fight AIDS will earmark sufficient funds to set up a comprehensive AIDS education program in each country.

They say they believe widespread knowledge about the disease will ultimately be the best cure for Africa's biggest scourge.