By a voice vote early today, the Senate gave President Bush the $15 billion he sought to fight global AIDS and prod the rest of the world to follow America's lead. Senate Majority Leader Bill Frist (R-Tenn.), a doctor, hailed passage of the five-year plan as "the first major step in reversing this greatest of humanitarian challenges of the 21st century."

At the urging of the White House, the Senate defeated all but one attempt to amend the measure passed previously by the House. In a statement, Bush said he looked forward to signing the legislation as soon as possible. Frist and other GOP leaders said it is imperative to get the bill to the president quickly so he can go to the June 1-3 summit of world leaders in France with evidence of US determination to fight AIDS and bring relief to the 42 million people with HIV. Dr. Peter Piot, head of UNAIDS, said the move would "send a strong message that the global fight against AIDS should be a top priority at this meeting."

The legislation, though unprecedented in scope, only authorizes the spending of $15 billion over five years. Congress must still approve real spending levels in its annual budget appropriations.

The bill specifically targets 12 sub-Saharan nations in Africa, plus Haiti and Guyana. It recommends 55 percent of the money for treatment; 20 percent for prevention; 15 percent for palliative care; and 10 percent for AIDS orphans. It would allow, but not require, the administration to contribute up to $1 billion in 2004 to the Global Fund to Fight AIDS, TB and Malaria. It also establishes the position of coordinator for HIV/AIDS at the State Department. House conservatives were able to amend the bill to ensure that 33 percent of all prevention funding will go to abstinence programs, and that Catholic and other religious groups will not be denied funding because they oppose condom distribution.

Sen. Joseph Biden of Delaware, the top Democrat on the Foreign Relations Committee, worked with the White House to secure an increase in debt relief funding for poor countries with AIDS. Sen. Rick Santorum (R-Pa.) said House GOP leaders were agreeable to the change and would reapprove the bill Tuesday.

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