On his five nation swing through Africa, President Bush once again revealed the two inescapable truths of his AIDS diplomacy. First, as I noted last May, Bush never hesitates to use AIDS funding to provide air cover in his failing struggle to sway global opinion. And second, even thousands of miles from home, George W. Bush will kowtow to the religious right back in the United States.
Greeted in Africa by banners proclaiming "Thank you for helping fight malaria and HIV," President Bush championed his commitment to doubling to $30 billion the President's Emergency Plan for AIDS Relief (PEPFAR). But as ever, those funds come with strings attached, courtesy of Bush's base.
One-third of all prevention spending under Bush' program must go to abstinence-until-marriage programs. Senate Democrats want to remove that provision, which has been criticized by both the U.S. Institute of Medicine and the Government Accountability Office. Of course, despite the miserable track record of abstinence programs worldwide, President Bush is undeterred and demanded Congress support "what works" in Africa. As the Los Angeles Times reported:

"It is a balanced program. It is an ABC program: abstinence, be faithful, and condoms. It's a program that's been proven effective," he said, speaking at a news conference with Tanzanian President Jakaya Kikwete, an enthusiastic supporter of the effort.
"I understand there's voices on both ends of the political spectrum trying to alter the program," Bush said.
"I would ask Congress to listen to leaders on the continent of Africa...analyze what works, stop the squabbling and get the program reauthorized," he said.

While that battle continues at home, President Bush's AIDS diplomacy provides an excellent distraction from American challenges abroad. As Bush revels in the warm welcome he is receiving in Africa, tensions with Russia are rising in the wake of Kosovo's declaration of independence. Meanwhile, Bush ally Pervez Musharraf awaits election results in Pakistan, a vote delayed by the assassination of Benazir Bhutto.
The pattern by now is familiar one. Last May, Bush tried to deflect criticism of American global warming policy in advance of an imminent G8 summit. Just days before, Bush announced his new proposal for $30 billion in U.S. funding for AIDS programs around the world. In 2003, of course, his problem was the looming Iraq war.
It was U2 frontman Bono who offered President Bush the prospect of a global American public relations triumph in the run-up to the invasion of Iraq by announcing a massive commitment to fighting AIDS:

"Maybe it's smart to just help people with these crushing problems. These drugs are great advertisements for us in the West, for our ingenuity, our technology, our innovation, particularly in the United States. I said that to President Bush. I said, 'Paint them red, white and blue if you want, but these drugs are the best advertisement you are going to get right now, and that might be important right now.'"

Shortly thereafter, President Bush shocked the world by announcing a five-year, $15 billion dollar AIDS program for Africa and the Caribbean in his 2003 State of the Union Address. Later, he would tap First Lady Laura Bush as his global AIDS ambassador.
That aid, of course, came with strings attached. Only $1 billion would go to the UN's Global AIDS Fund. Over $1 billion would be distributed through faith-based organizations, such as Graham's Samaritan's Purse. Worse still, the Bush administration and allies such as Kansas Senator Sam Brownback followed the lead these religious groups in balking at the use of condoms (the "C" in the Ugandan ABC formula of "Abstinence, Be Faithful, Condoms"). As a result, Brazil declined to accept Americans AIDS funding which barred programs involving condoms. Pioneering Ugandan AIDS activist Noerine Kaleeba could only ponder in amazement:

"I have met President Bush twice. He strikes me as a very brilliant, very passionate and very caring person. But when I contrast the President Bush that I have met with the policies and practices that are coming out of the United States, I can't reconcile it."

By now, of course, it is very easy to reconcile the timing and content of Bush's generous AIDS crusade. As the history shows, President Bush opens the purse strings as politics foreign and domestic require. And as ever, Bush's faith-based followers control those purse strings. So even as he tries in his final days in office to cement his legacy as the friend of Africa, George W. Bush is always thinking about his friends - and enemies - back home.