The U.S. Senate, fending off opposition from some conservative Republicans, voted on Wednesday to spend $48 billion to fight AIDS worldwide over the next five years.
By a vote of 80-16, the Senate passed the legislation and ended weeks of delays orchestrated by some Republicans who thought the measure spent too much and objected to other provisions.
"In 2003, President Bush and this Congress launched the largest public health program in the history of the world," said Senate Foreign Relations Committee Chairman Joseph Biden, a Delaware Democrat, who pushed the legislation. "It is saving lives, millions of them."
The House of Representatives passed its version of the bill on April 2. The House and Senate will have to work out their differences to craft a final version.
"With passage of today's bill we are one step closer to ensuring that this excellent program continues to help those in need. I encourage the full Congress to move quickly to send me final legislation that I can sign," President George W. Bush said in a statement.
Bush had requested $30 billion over five years but has indicated he would go along with the higher spending.
Backers of the legislation hope it will encourage other wealthy countries to boost their global AIDS funding.
Twelve African nations, which have been suffering from a rapid spread of the human immunodeficiency virus (HIV) that causes AIDS, would benefit most from the added U.S. money.
The program, initiated in 2003 with $15 billion for the first five years, also would help fight AIDS, malaria and tuberculosis in Vietnam, Haiti and Guyana.
Some health groups criticized the bill for placing too many constraints on the money. For example, they argued there would be more progress on halting AIDS by liberalizing rules on what overseas health organizations can do to counsel prostitutes.
Besides the funding level, some Republicans objected to a Senate provision lifting a ban in place since 1987 on admitting HIV-positive visitors to the United States.
"Our government still treats individuals with HIV/AIDS as modern day lepers, categorically banning these individuals from entering into the U.S.," said Sen. Gordon Smith, an Oregon Republican. "To fully embrace our global leadership on HIV/AIDS, we must remove our unwelcome mat and overturn this ridiculous ban."
A conservative challenge to lifting the ban never materialized, as Sen. Jeff Sessions, an Alabama Republican, decided not to offer such an amendment.
"This bill will expand American leadership on global health and foster hope around the world," said Paul Zeitz, executive director of the Global AIDS Alliance.
The President's Emergency Plan for AIDS Relief now supplies HIV drugs to 1.73 million people worldwide, mostly in sub-Saharan Africa, up from the 50,000 or so treated in 2003.
With expanded funding, 12 million people would be targeted for disease prevention and an estimated 3 million to 5 million victims of HIV, malaria and tuberculosis could be treated.