June 24, 2004 Bush Backs Condom Use to Prevent Spread of AIDS By DAVID E. SANGER and DONALD G. McNEIL Jr.
PHILADELPHIA, June 23 - President Bush said on Wednesday for the first time that the United States should "learn from the experience" of countries like Uganda in fighting AIDS and embraced the use of condoms to prevent its spread, a sensitive issue among conservative groups that have fought the adoption of any strategy that does not focus on abstinence.
Announcing some modest changes to government financing for antiretroviral drugs in front of a church-affiliated group here, Mr. Bush also argued for sexual abstinence. But in his comments, he appeared to be offering something to both sides in the debate: his base of social conservatives as well as moderates in crucial election states like Pennsylvania, who have argued that Mr. Bush has been too slow to embrace effective methods of preventing AIDS.
"We can learn from the experiences of other countries when it comes to a good program to prevent the spread of AIDS, like the nation of Uganda," Mr. Bush said. "They've started what they call the A.B.C. approach to prevention of this deadly disease. That stands for: Abstain, be faithful in marriage, and, when appropriate, use condoms."
The approach was working and was a "practical, balanced and moral message," Mr. Bush said.
He was quick to add that "in addition to other kinds of prevention, we need to tell our children that abstinence is the only certain way to avoid contracting H.I.V."
As audience members shouted "Yes!" in response to his words, he said, "It works every time."
Cries of "Every time!" and "That's for sure!" answered from the pews.
Uganda has used the A.B.C. approach for years, but it did not originate there, as it is a mnemonic used by AIDS educators in many English-speaking countries. But Uganda's success in driving down new infection rates has drawn attention.
Mr. Bush had several agendas at work on Wednesday. He has visited Pennsylvania more than two dozen times, and Senator Arlen Specter, a Pennsylvania Republican who narrowly won a primary fight with Mr. Bush's help, accompanied the president here on Air Force One.
Asked about Mr. Bush's chances of carrying the state in November, Mr. Specter said, "It's tight, it's tight," but he asserted that Mr. Bush had improved his standing among black voters in the state.
The program that the president visited here on his way to a private lunch with supporters in a wealthy corner of the suburb of Villanova is the charitable operation of the Greater Exodus Baptist Church. The pastor, the Rev. Herbert H. Lusk II, a former professional football player for the Philadelphia Eagles, is a longtime supporter of the president. The charitable organization, People for People Inc., has received about $1 million in federal money to help low-income families. Mr. Bush used the event to urge Congress to speed financing of his plan to spend $15 billion over five years to fight AIDS. He also announced that Vietnam would be added to the list of 15 countries receiving the money, making it the first Asian nation on the list. One of his political aides noted recently at the funeral of former President Ronald Reagan that Mr. Bush "has no intention of letting this issue get ignored," as critics said Mr. Reagan had done.
In addition, the administration said it was moving $20 million into a program to obtain drugs for AIDS patients in 10 states that lack money for therapy. The waiting lists for treatment are longest in three of those states, Alabama, Colorado and South Carolina, said Tommy G. Thompson, secretary of health and human services.
Nonetheless, some activist groups have accused the Bush administration of doing too little. The fight against AIDS needs at least $30 billion over five years, they say, and the money could be spent more quickly. They also accuse the administration of wasting taxpayer dollars on expensive brand-name drugs from big pharmaceutical companies with powerful lobbies.
Senator John Kerry, the presumptive Democratic nominee for president, issued a statement on Wednesday saying: "It is long past time for empty rhetoric on this issue. It is time for real resources and a real commitment that is based on science - not politics - to fight this epidemic."
The administration argues that its critics have oversimplified the problems of getting safe drugs to AIDS patients. It has said it will buy whichever drugs are cheapest that have been shown to work. But it says it has refused to simply accept all the generic AIDS drugs that the World Health Organization has approved, and it said last month that it would set up a process whereby makers of generic drugs could apply for approval from the Food and Drug Administration. Mr. Bush has mentioned condom use at least once before, last July, in Entebbe, Uganda. But mentioning it in a domestic context is quite different.
"I can't believe the president actually used the C-word," said Amy Coen, the president of Population Action International, which has long backed birth control and AIDS prevention in underdeveloped countries. "That's not one that comes easily to him. But it's one thing to use the word and another thing to actually fund it."
A study by the group in 2002 showed that underdeveloped countries need 10 billion condoms a year and were getting only 2.5 billion.
In fact, although neither the Bush nor the Clinton administration advertised it, the United States has long been the world's largest supplier of condoms to such countries.
In 1990, through the Agency for International Development, it donated 800 million condoms to poor countries. That dropped to a low of 186 million in 1999, in the Clinton administration, then rose to 458 million last year and is on track to reach 550 million this year, said Dr. E. Anne Peterson, the agency's assistant administrator for global health.
"We've more than doubled condom availability during this administration, primarily for H.I.V.-AIDS," Dr. Peterson said. "Before, it was a mix of family planning and AIDS, but the big increase is for AIDS prevention."
Groups that have consistently criticized Mr. Bush's AIDS policy seemed nonplused. No one on a 1 p.m. telephone news conference held to denounce the speech had listened to it.
But Mark Isaac, policy director for the Elizabeth Glaser Pediatric AIDS Foundation, said later in an interview that backing a combination of condoms, abstinence and fidelity was "a science-based approach, and for that reason is to be applauded."
Donald G. McNeil Jr. reported from New York for this article.