The $15-billion President Bush wants to spend treating AIDS in Africa and the Caribbean could have a significant impact. And there is no time to waste.

In his State of the Union speech, President Bush surprised the world by committing the United States to an aggressive assault on the AIDS pandemic. Bush promised a tripling of spending toward the care and treatment of AIDS patients in Africa and the Caribbean. It was a sign that there is still something left of Bush's compassion agenda -- something we have seen far too little of since he took office.

The tone of Bush's speech differed sharply from his administration's earlier statements on AIDS in Africa, which had lacked a sense of humanitarian urgency. Early in his administration, officials suggested that providing antiretrovirals was a wasted effort and less important than funding prevention. This time Bush made a point of highlighting the need to provide life-prolonging drugs, which he proposes distributing to 2-million HIV-infected people.

If approved by Congress, the $15-billion Bush asks for over the next five years could have a significant impact on containing the transmission of the disease, treating the nearly 30-million HIV-positive Africans, and providing services to the millions of AIDS orphans. The move would give hope to a continent whose future has been decimated by a disease that takes men and women at the prime of their productivity.

But there is no reason to wait until the beginning of fiscal 2003 to start delivering on this promise. Overseas AIDS spending for this year is currently being debated in conference committee. The Senate has authorized $225-million more than the House. Rep. C.W. Bill Young, R-Largo, as chairman of the House Appropriations Committee, has a great deal of influence over whether the more generous Senate allocation is adopted. Young should push for the earlier phase-in of resources. In 2002, 3.1-million people died of AIDS. There is no reason to wait. The will of the president is clearly to provide help as soon as possible.

Yet, even with this infusion of funding from the United States, there will be logistical problems in getting real help to the sick and needy. In places where the epidemic is at its worst, such as South Africa and Botswana, even if antiretrovirals are made available, the medical infrastructure is generally not in place to distribute the medicine. There may be some institutional resistance, too. In the past, South Africa's president, Thabo Mbeki, has irresponsibly interfered with efforts to help stem the epidemic. Finally, South Africa has a national program to prevent mother-to-child transmission of HIV.

In Botswana, where more than a third of all working-age adults have been infected, HIV/AIDS is considered so taboo that only a handful of people admit to having the disease. It will be a challenge to get people to come forward for testing.

But Bush's plan goes far in addressing these barriers. It includes recruiting specialized doctors and nurses, using central hospitals and also satellite clinics that will provide education, testing and drug distribution to the farthest corners of each country. Local healers will be enlisted to assist the effort -- a way to help gain the trust of the local population. And people will be more encouraged to get tested because knowing one's status will no longer be simply a death sentence. Those who test positive will now have the chance to receive the AIDS drugs that will keep them alive.

Bush's proposal is a serious effort that matches the severity of the crisis. If the money comes through, the United States will be at the forefront of donor nations responding to this humanitarian disaster, and Bush will have chosen the right way to lead -- by example.

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