Laura Bush: Into Africa with billions to spend

by Mark Silva

First Lady Laura Bush flies to Africa today for a five-day, four-nation tour aimed at showcasing an unprecedented U.S. commitment to the battle against AIDS and malaria.

The first lady will land in Dakar, Senegal, this evening, and spend just a few hours there in the morning in a meeting with the president and tours of facilities offering relief for AIDS patients before heading on to Mozambique, Zambia and Mali in a swift, continent-crossing tour.

The Tribune is traveling with Mrs. Bush, and will report here in the Swamp and in the newspaper on her journey. For starters, here is the story about the African journey.

Also listen to the first lady's interview with NPR.

For all the billions of dollars of U.S. aid committed, it is not without controversy. The Republican-run Congress has required that one-third of AIDS-prevention funding is spent on the teaching of abstience. In practice, because 20 percent of the $15 billion that the U.S. has committed during the first five years is dedicated to prevention, this means that about 7 percent of the overall funding has gone to abstinence.

In some nations, such as Uganda, this focus on abstinence has paralleled the national plan for disease prevention. In others, such as Senegal, where sex-workers are responsible for a lot of HIV transmission, promoting abstinence has not been part of the U.S. strategy.

The first lady boarded her plane at Andrews Air Force Base this morning. Photo by Silva

First lady to tout aid on Africa visit
She aims to build on U.S. AIDS,
malaria, education efforts

By Mark Silva
Washington Bureau

June 25, 2007

WASHINGTON -- Many small children die each day and adults succumb to avoidable illness in the far corners of Africa where First Lady Laura Bush will spend this week promoting an unprecedented U.S. campaign against AIDS and malaria and offering the promise of education.

At a time when the Bush administration is seeking a doubling of the U.S. commitment to a global battle against AIDS -- asking Congress to add $30 billion over the next five years -- the first lady will attempt a sales pitch to Americans in a five-day, four-nation African tour with a display of what U.S. aid can accomplish.

With this, her third trip to Africa, Laura Bush carries a certain cachet, wearing the popular face of an unpopular administration. Yet for a president dealing with war and terrorism, the African agenda represents perhaps the greatest single initiative that he can claim as a legacy-staking achievement.

Since early in his presidency, Bush has committed tens of billions of dollars to the fight against AIDS and malaria in Africa -- part of more than $100 billion committed to AIDS at home and worldwide. The U.S. and other nations also have forgiven billions of dollars of debt among some of the most impoverished nations -- money that, in turn, some have invested in immunization and education.

It's not only a war on disease. With a delivery of five scholarships for girls in Senegal at the start of her trip, the first lady will launch a program promising 555,000 scholarships for elementary schools by 2010 in a region where education and preventing the spread of HIV from mother to child are integral to averting a crisis for the next generation.

Still, a flood of foreign aid has made only a dent against endemic disease on a continent where an estimated 30 million people are infected with HIV and more than 1 million children die of malaria each year. Critics question some of the tactics employed in this battle, with Congress insisting that a share of the money devoted to AIDS prevention be spent on teaching abstinence.

Yet the commitment lends hope to relief advocates that this isn't a passing campaign.

Malaria's devastating toll

More than 85 percent of the global death toll caused by malaria occurs in sub-Saharan Africa, with most victims younger than 5. In most of the nations Laura Bush will visit this week -- including Mozambique, Zambia and Mali -- 1 in 10 children die in infancy. In Senegal, the infant mortality rate is 6 percent.

In June 2005 the president pledged $1.2 billion for a fight against malaria in 15 African nations over five years, and congressional funding is on track. It started at $30 million the first year, and Congress authorized $388 million this year. By 2010, the Malaria Initiative is seeking a $500 million annual budget.

The strategy of disease prevention includes indoor spraying and distribution of insecticide-treated mosquito nets. It has started in three countries -- Angola, Tanzania and Uganda -- with the spraying of 415,000 homes and distribution of 855,000 nets the first year. The treatment included more than 1 million diagnostic tests and 1.3 million doses of medicine as well as the training of 8,344 health-care workers in the delivery of treatments.

In January 2003, with his State of the Union address, the president proposed an Emergency Plan for AIDS Relief and called on Congress to commit $15 billion over five years -- targeting a dozen African nations, but also the Caribbean, particularly Haiti. Congress has exceeded the $15 billion by $3.3 billion. And now Bush has called on Congress to commit $30 billion more for the next five years.

The House has approved $6.3 billion for the coming year, which puts Congress on track to slightly exceed that $30 billion, with Senate action expected this summer.

"If Congress approves ... we will have committed $48.3 billion to the fight against AIDS over a 10-year period," said Jimmy Kolker, deputy U.S. global AIDS coordinator. "It's already an unprecedented program. There has never been a fight against a single disease of that magnitude before."

With more than 1 million people being treated for HIV, the goal is to double that by next year and eventually treat 5 million, while averting 12 million new infections.

Commitment 'extraordinary'

"You have to give this administration a lot of credit on Africa," said Princeton Lyman, senior fellow for Africa studies at the Council on Foreign Relations and a former ambassador to African nations and senior State Department official under Presidents Bill Clinton, George H.W. Bush and Ronald Reagan.

"I am not a great fan of this administration ... but [Bush's African aid] is a substantial increase, where aid to Africa under the Clinton administration was rather flat," he said. "The AIDS commitment is rather extraordinary, and there is no question that it has galvanized resources more than anything before it."

Yet advocates say money for education is still lacking.

"The first lady has been an eloquent spokesman for education, but the administration has never embraced ideas for big and bold change, the way they rightly have done for AIDS," said Gene Sperling, director of the Center for Universal Education and a former economic adviser to Clinton.

With an estimated $10 billion needed to make school generally accessible to children in countries where girls in particular don't finish grade school, he said international donations have totaled about $2.5 billion.

"The scholarships have certainly helped some girls. But there is really little sense in the world that the U.S. has helped any African nation take a big step forward on education," Sperling said.

"The president deserves credit for helping break a political mold in the U.S. response to AIDS," said Tom Hart, director of governmental relations for Debt AIDS Trade Africa. "The disease is still outpacing us, but there is a political sea change in Washington in attitudes toward Africa. This president has absolutely contributed to that."

In Africa this week, the first lady will attempt to tell small stories about big change.

After she arrives in Senegal late Monday, her first stop on Tuesday is the Fann Hospital in Dakar, where gardens are growing vegetables for AIDS and HIV patients.

On Wednesday her stops in Maputo, Mozambique, will include a home where mosquito spraying is under way and a pediatric day hospital. In Lusaka, Zambia, on Wednesday and Thursday, she will visit a school where the first of many PlayPumps have been installed -- part of a program financed by the Case Foundation in which pumps powered by the activity of children on playgrounds deliver clean water from wells.

In Bamako, Mali, on Friday, Bush will visit the Nelson Mandela Public School, where USAID funding is supporting the education of girls and training of teachers.

"I want the American people to know what they're doing," Laura Bush said last week. "This is American taxpayer money. This is what Americans are doing in Africa."