President Bush yesterday signed into law a $15 billion program to prevent and treat AIDS in poor countries in Africa and the Caribbean that have been devastated by the epidemic.

The program, first introduced by the White House four months ago, is designed to triple U.S. investment in international AIDS assistance during the next five years. It requires that a substantial portion of the prevention money be spent to encourage sexual abstinence outside marriage -- an approach favored by conservatives but viewed as largely ineffective by public health specialists. The administration had leaned hard on Congress to enact the legislation this month, hoping it would give the president leverage in urging the leaders of seven other major industrialized nations to increase their international AIDS funding when he meets with them in France next week.

But Congressional Democrats portray the White House's commitment to the program, and to international public health in general, as hollow. They have begun to make the case that, even as Bush gave the AIDS initiative a prominent spot in his State of the Union address, he proposed cutting other international public health and relief programs.

While they were delighted by the new law, several AIDS activists suggested that the administration's commitment to easing the epidemic within this country is shaky. They said the White House has recommended funding cuts for the Ryan White CARE Act, and that federal aid to state programs that subsidize HIV therapies has not kept pace with demand.

The law envisions $3 billion a year in subsidies through 2008, but it remains uncertain how much will actually be spent. The congressional appropriations process for next year is in the early stages, and members of both parties have cautioned that it may be difficult to fit that sum within the tight limits on foreign aid that Republicans have approved.

In his remarks at the signing, Bush sought to link the AIDS initiative to several of the largest humanitarian steps taken in 20th century America. He called the initiative "the largest, single up-front commitment in history for an international public health initiative involving a single disease."

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