Bush Concludes Africa Trip With Stop in Nigeria; Sees Effects of HIV/AIDS in Person

President Bush on Saturday ended his five-day, five-country trip through Africa with a visit to Nigeria, where he met with people living with HIV/AIDS and talked to health officials, the Los Angeles Times reports. Bush attended a round-table discussion with medical personnel at Nigeria's National Hospital in Abuja and also met with women who have benefited from programs to prevent mother-to-child HIV transmission. Bush said, "[I]t's one thing to hear about the ravages of AIDS [in Africa] or to read about them, [but it's] another thing to see them firsthand" (Chen, Los Angeles Times, 7/13). The West African nation of Nigeria so far has "been spared the kinds of infection levels that have rocked" other African countries, particularly in sub-Saharan Africa, but advocates are concerned about the effect the disease could have in West Africa (Agence France-Presse, 7/12). According to a CIA study released last year, AIDS in Nigeria threatens the country's national security and interferes with its role as a peacekeeper in the region, according to Long Island Newsday (Mulugeta, Long Island Newsday, 7/13). Bush praised Nigerian President Olusegun Obasanjo for his efforts to curb the spread of HIV in the country, saying, "I appreciate your honesty and openness and forthrightness when it comes to battling the pandemic of AIDS. You're truly an international leader on this issue" (Agence France-Presse, 7/12). Bush added, "You have to have the desire to say, 'Let's get after it and whip that disease.' It sounds to us that Nigeria has got that focus" (Long Island Newsday, 7/13).

Funding
Bush on Saturday also pledged to push Congress to fully fund his global AIDS initiative, the New York Times reports. Bush said, "The House of Representatives and the United States Senate must fully fund this initiative, for the good of the people on this continent of Africa" (Stevenson, New York Times, 7/13). During the trip, Bush promoted the five-year, $15 billion AIDS initiative (HR 1298), which he signed into law in May. The initiative seeks to prevent seven million new HIV infections, provide care for 10 million people living with the disease and provide treatment to two million HIV-positive people (Kaiser Daily HIV/AIDS Report, 7/9). The House Appropriations subcommittee on foreign operations on Thursday approved $17.1 billion in fiscal year 2004 foreign assistance, including $1.27 billion to fight AIDS internationally, which is $86 million more than Bush requested and a 40% increase over the amount approved for FY 2003. The subcommittee also substantially restructured the AIDS plan, reducing funds controlled by a newly appointed AIDS coordinator and increasing the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. In addition, the full House on Thursday approved a bill (HB 6470) to provide funding for labor, education and health programs, including $644 million for foreign AIDS research and prevention and $155 million for combating other infectious diseases, such as tuberculosis. As a result, total funding for global AIDS is now a little more than $2 billion for FY 2004. In a separate action, the Senate approved 78-18 a nonbinding resolution calling for $3 billion in FY 2004 to fight AIDS overseas, even if the amount exceeds the ceiling mandated in Congress' annual budget resolution (Kaiser Daily HIV/AIDS Report, 7/11).

Bush Responds to House Action
Bush said in his weekly radio address on Saturday, "This week, a committee of the House of Representatives took an important step to fund the first year of this effort. I ask the Senate to move quickly, as well. And I urge the entire Congress to fully fund my request for the emergency plan for AIDS relief, so that America can help turn the tide against AIDS in Africa" (White House release, 7/12). Bush in Nigeria said, "[C]urrent efforts to fight the disease [throughout the continent] are simply not equal to the need. More than four million people require immediate drug treatment, and just 1% of them are receiving the medicine they require," adding, "Africa has the will to fight AIDS, but it needs the resources as well" (Thomma, Knight Ridder/Charlotte Observer, 7/13). National Security Adviser Condoleezza Rice, who traveled with Bush in Africa, said, "We'll work with what we get, but the president believes very strongly in the full funding of this [global AIDS initiative]" (AP/Baltimore Sun, 7/12).

Uganda
Bush on Friday visited Uganda, lauding President Yoweri Museveni for his efforts to "remove the stigma of AIDS" and for "aggressively pursuing" a treatment program that includes antiretroviral therapy, the New York Times reports (Stevenson, New York Times, 7/12). Uganda has had success in lowering its HIV prevalence by employing the "ABC" HIV prevention model -- abstinence, be faithful, use condoms. Bush has cited Uganda's program as a model for his AIDS initiative. During his four-hour visit to Uganda, Bush met with Museveni and visited TASO, an AIDS support organization and clinic (Kaiser Daily HIV/AIDS Report, 7/11). Bush said at the clinic, "You know, I believe God has called us into action. I believe we have a responsibility. My country has got a responsibility" (Donnelly, Boston Globe, 7/13). Bush added, "You have worldwide influence here because you've provided a model of care for Uganda. Life by life, village by village, Uganda is showing that AIDS can be defeated across Africa" (New York Times, 7/12). Bush said that AIDS "does its worst harm in an atmosphere of secrecy and unreasoning fear." He said, "The president of Uganda speaks the truth. And therefore you're overcoming the stigma of the disease, and you're lifting despair" (Superville, AP/Philadelphia Inquirer, 7/12).

More Work
However, Uganda still has much work to do in the fight against AIDS, as only 4,500 people of the 1.5 million living with HIV/AIDS in the country receive antiretroviral drugs, the Washington Post reports. Michael Etukoit, manager of TASO, said, "Can you imagine counseling someone for 10 years, and you keep counseling them, and then what next? What do you tell them? Our dream is that all clients could be on drugs that people in the rest of the world can afford" (Wax/Milbank, Washington Post, 7/12). Liliane Mworeko of Uganda's National Forum of People Living With HIV/AIDS said that the ABC model stigmatizes people living with the disease and called for Museveni to provide more HIV/AIDS drugs to patients, Uganda's Monitor/AllAfrica.com reports. "When they talk about ABC, we are looked at as people who did not abstain, were not faithful and failed to use a condom," she said, adding that Museveni "should know that you can't talk about prevention without treatment" (Bakyawa, Monitor/AllAfrica.com, 7/11).

Reaction
Bush said of his trip through Africa, "[I] have seen the rich culture and resources of Africa as well as the continuing challenges of Africa. With greater opportunity, the peoples of Africa will build their own future of hope. And the United States will help this vast continent of possibilities to reach its full potential" (Kemper, Chicago Tribune, 7/13). However, some advocates expressed concern that Bush will not be able to deliver on his pledges. E.O. Otioto, a former Nigerian government official who attended Bush's speech there, said, "We look at the kind of things Bush has talked about, the $15 billion for AIDS, and we see a commitment beyond the usual talk. Will he come through? Everybody is waiting, hoping. If he performs, he will skyrocket. If he doesn't, it spells danger" (Milbank, Washington Post, 7/13). Monique Luse of the Washington, D.C.-based advocacy organization Africa Action said that Bush has "misled both Americans and Africans into believing that he really is going to promote peace and stability and fight AIDS, and that has not been what any of his policies have actually done because they're all underfunded." She added, "People can say words but words don't fight AIDS." Paul Zeitz, executive director of the Global AIDS Alliance, said that Bush's trip to Africa "created a lot of dialogue and policy debate about what's actually happening (and) what needs to happen, and that's beneficial" (Boyd, Globe and Mail, 7/12).

Media Coverage
The following NPR programs reported on Bush's trip to Africa:

• NPR's "All Things Considered": NPR's Robert Siegel interviews Ted Dange, Africa specialist at the Congressional Research Service, about the significance of Bush's trip (Siegel, "All Things Considered," NPR, 7/11). The full segment is available online in RealPlayer.
  
• NPR's "All Things Considered": The segment reports on Bush's visit to an AIDS clinic in Uganda (Gonyea, "All Things Considered," NPR, 7/11). The full segment is available online in RealPlayer.
  
• NPR's "All Things Considered": The segment reports on questions over the sources of funding for Bush's AIDS initiative and some lawmakers' statements that Bush has yet to request "the full amount he's promised" from Congress. The segment includes comments from Reps. Jim Kolbe (R-Ariz.) and Nita Lowey (D-N.Y.) and Zeitz (Rovner, "All Things Considered," NPR, 7/12). The full segment is available online in RealPlayer.