In Washington, a Bush administration official Wednesday updated Congress on the latest U.S. efforts to combat AIDS in Africa. Republican Senator Lamar Alexander of Tennessee, chairman of the Foreign Relations' African Affairs subcommittee, opened a hearing on the scourge of AIDS in Africa with sobering statistics. "[Of the] over 40 million people infected with HIV around the world, three-fourths, 30 million of them, are in the 48 African countries south of the Sahara desert," he said. "The figures are staggering."

President Bush last year pledged $15 billion for the global fight against AIDS. The State Department's coordinator in the effort to combat the deadly disease, Randall Tobias, told the panel the first installment of the funding $350 million was released earlier this year.

"With this first round of funds, an additional 50,000 people living with HIV/AIDS in the 14 focus countries are beginning to receive anti-retroviral treatment, which will nearly double the number of people who are currently receiving treatment in sub-Saharan Africa," he said. "Today activities have been approved for treatment in Kenya, Nigeria and Zambia, and patients are receiving treatment in South Africa and Uganda because of the emergency plan."

While welcoming efforts to expand treatment for those infected with HIV and AIDS, Senator Russ Feingold, a Wisconsin Democrat, urged the Bush administration to focus more on policies aimed at prevention. He acknowledged that that would require challenging some cultural taboos.

"We can all obviously agree that women and girls are especially vulnerable to HIV/AIDS because they are often not in a position to make choices that can keep them healthy," said the senator. "Women may not be able to negotiate condom use with their husbands. These issues are difficult to talk about, but they are very real. No plan to roll back the epidemic can succeed without addressing these issues."

Mr. Tobias agreed, underscoring that it is a delicate matter. "What we are talking about here more than anything is changing cultures and influencing the change in behavior," he added. "Among other things, that is going to take some extraordinary diplomatic effort if you will to get that done and we are going to need a lot of innovative and creative work here."

Mr. Tobias said the administration is considering such an effort and would be making some decisions in the next 90 days.