President Bush signed the U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003 on Tuesday. This bill, which Bush lauded as “a great mission of rescue,” authorizes up to $15 billion over the next five years to fight AIDS abroad.

According to the Joint United Nations Program on HIV/AIDS’ (UNAIDS) AIDS Epidemic Update 2002 (www.unaids.org), best current projections suggest that an additional 45 million people will become infected with HIV in 126 low- and middle-income countries (currently with concentrated or generalized epidemics) between 2002 and 2010 — unless the world succeeds in mounting an expanded global prevention effort.

Dr. Peter Piot, executive director of UNAIDS, praised Bush’s efforts, but said that all countries have a shared responsibility to fight the disease. “With today’s bill signing, the world moves an important step closer to supporting a response that begins to match the magnitude of the challenge,” he said. “But there is still a long way to go. AIDS will only be defeated when responsibility for addressing it is fully shared — with every nation working to meet the financial and leadership challenges presented by this global epidemic.”

Other countries need to commit. The $15 billion the United States is supposed to provide over five years is not enough to cover the full cost of AIDS treatment and prevention. Dr. Catherine Hankins, chief science adviser for UNAIDS, said the “bare bones” costs per year of AIDS programs will reach $15 billion by 2007.

Now we are left to prove that U.S. commitment is real. Even though the legislation authorizes $3 billion to be spent per year, Congress still has to approve the money in its annual budget appropriation. There is no guarantee the entire amount will be given each year.

Even more questions arise about the application of these funds. The new package recommends 20 percent of direct U.S. aid go to prevention programs. To appease conservatives, one-third of that will be set aside for projects that promote abstinence. The bill also provides for religious groups to reject any AIDS-fighting strategy to which they object, such as condom distribution.

While abstinence is the only real way to prevent the spread of AIDS, it is unrealistic to expect abstinence-only programs to be effective when countries’ local customs vary widely.

Uganda has had much success in lowering infection rates with what has become known as the “ABC” model — Abstain, and if you can’t abstain, Be faithful; if you can’t be faithful, use a Condom. This model has promoted monogamy and raised the average age at which young people first have sex while also promoting the use of safe sex.

All of these things go a long way toward fighting AIDS. If countries with the ability to provide funding work together to provide the resources to fight AIDS with a multi-faceted approach to prevention, we just might be able to beat it.

Editorial Board: Nicole Paseka, Amy Schierbrock, Alicia Ebaugh, Ayrel Clark, Lucas Grundmeier