Last Updated: 2003-05-16 9:42:32 -0400 (Reuters Health)

WASHINGTON (Reuters Health) - The U.S. Senate authorized early Friday morning a $15 billion aid package for poor nations ravaged by HIV and AIDS, clearing the way for President Bush to sign one of his marquee initiatives into law.

Lawmakers voted to approve a 5-year relief program that passed the House on May 1. President Bush, who called for the bill in his State of the Union address last January, has said he will sign the bill.

The measure authorizes $3 billion in spending per year on HIV prevention and treatment programs in 14 African and Caribbean countries where AIDS has had the deepest impact. It also authorizes $1 billion in U.S. contributions over the next five years to the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

The authorization directs American funds toward programs focusing on abstinence, monogamy and condom use. The approach is widely credited with helping cut HIV transmission rates in Uganda.

Still, controversy persisted in the Senate over how to fit the bill's priorities into American social politics. The bill contains a provision directing one-third of all prevention monies, about seven percent of all U.S. aid, to programs stressing abstinence-only education.

Democrats moved to amend the bill by removing its focus on abstinence programs, which are strongly backed by conservative lawmakers and interest groups. The effort was defeated in one of several near party-line votes by a count of 45-52.

Republicans defeated several other Democratic amendments in an effort to keep the bill free of any alterations that could hinder its path to the White House for the president's signature.

That path had been smoothed earlier this week by Majority Leader Bill Frist, R-Tenn., who put the House-passed bill up for a vote instead of a compromise bill that had endured months of difficult Senate negotiations.

The substitution put some senators, including Frist and Foreign Relations Committee chair Sen. Richard Lugar, R-Ind., in the awkward position of voting against amendments they had supported in years or even weeks past.

"We can't let the perfect be the enemy of what the good is," Frist said.

G.O.P Senators also said that Bush asked them to deliver the bill in advance of the June 1 G-8 economic forum, a meeting of seven of the wealthiest nations in the world plus Russia. White House officials said that the president intends to use the bill to try to convince other wealthy nations to boost their contributions to the Global Fund.

"He wants money from the G-8, he wants commitment from the G-8, he wants somebody in this ball game besides the United States," Lugar said.

Senators rejected a bid by Sen. Richard Durbin, D-Ill., and others to send $1 billion to the Global Fund next year provided that other countries contribute $2 billion. Instead the bill authorizes up to $1 billion in Global Fund contributions but leaves the final number up to the president.

Bush has said that no more than $200 million should go to the fund each year. The U.S. has committed $350 million to the fund for the current fiscal year.

Lawmakers also voted down an amendment requiring U.S.-supported programs to cut costs by purchasing anti-HIV drugs at the lowest available price.

Ambassadors from several sub-Saharan African nations, including Uganda, endorsed the bill Thursday and called for its quick passage.

Many Democrats remained critical of the bill's details, stressing that it focuses funds on 14 African and Caribbean countries and not on Asia and parts eastern Europe, where infection rates are growing rapidly.

Minority Leader Thomas A. Daschle, D-S.D., argued that more U.S. support should go to the Global Fund in an effort to boost HIV treatment and prevention in other regions.

"We must do now in those areas what we did not do soon enough in Africa," he said.

Lawmakers must still agree later this year on actual appropriations levels for AIDS spending. President Bush's budget calls for $1.7 billion in spending out of the $3 billion authorized by Congress.