WASHINGTON - President Bush plans to sign a bill next week that commits the United States to spending about $40 billion over the next five years to fight AIDS overseas, a major expansion of what many consider his most successful foreign policy initiative.
The legislation also extends an implicit pledge that has little precedent in the history of U.S. foreign assistance: to continue purchasing lifesaving drugs for millions of individual people in developing countries for an indefinite period of time.
Foreign aid for health care has traditionally been used to put up buildings, buy equipment and train workers. Direct medical care of individuals was limited to one-time interventions such as vaccinations, emergency treatment after natural disasters, and curative treatments of limited duration for diseases such as tuberculosis or leprosy.