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MICHELE NORRIS, host:

The president's emergency plan for AIDS relief is widely considered President Bush's greatest success. It provides treatment for more than one-and-a-half million people in Africa, the Caribbean and Vietnam. Despite bipartisan support, however, a Senate vote on the bill that authorizes funding is still being blocked by one man, and that man is Oklahoma Republican Tom Coburn.

NPR's Brenda Wilson reports.

BRENDA WILSON: There are several things Senator Coburn and six other senators object to in the global AIDS reauthorization bill. They don't like the increase in funding from 15 to $50 billion over the next five years. They insist that 55 percent of the money be spent on HIV/AIDS treatment, and they don't want to include a provision that would cover treatment for other diseases.

Allen Moore is a Senior Fellow at the Global Health Council who worked on the first AIDS bill as a Republican staff member.

Mr. ALLEN MOORE (Senior Fellow, Global Health Council): There are conservatives who sometimes really do just want to kill bills. That's not how I see what Senator Coburn is up to. I may not agree with his tactics, but he is standing in front of the bill saying I like this program, and I want to keep what I see as the heart of it intact and not see it frittered away or modified.

WILSON: Frittered away, Coburn has complained, on prevention programs that do not emphasize abstinence. Instead, Coburn wants a guarantee that at least 55 percent of the money is spent on treatment, Moore says.

Mr. MOORE: And treatment not only means giving drugs to people who need them. It really means tracking people who are found to be HIV positive through the period of literally years - five, six, seven, eight years - before they actually need the drugs.

WILSON: But Paul Zeitz of the Global AIDS Alliance, a non-profit group that represents AIDS advocates and service providers, is worried that Coburn's demands could undo legislation that was brokered through delicate negotiations.

Mr. PAUL ZEITZ (Global AIDS Alliance): There is a broad bipartisan consensus in support of the major aspects of the bill. Folks on either side of the aisle now have to show flexibility and move towards a compromise so that the bill can be passed and signed into law before President Bush goes to the G8.

WILSON: Those G8 leaders of Western governments plan to meet in early July in Japan. The US contributes nearly half of the funding for AIDS treatment. Zietz says to increase pressure on other countries to do more, President Bush needs a signed bill in hand.

Mr. ZEITZ: It would be a real setback for the United States government -and that includes the Congress and the administration - if he goes empty-handed.

WILSON: AIDS workers in developing countries, he says, have learned that simply handing out pills is not enough. They're going to have to do a lot more - train health workers and treat other diseases like tuberculosis.

Mr. ZEITZ: Most people that die from AIDS die from co-infection with tuberculosis. We've already seen that if TB isn't advanced, then there are the emergence of mutated strains, like the extremely drug resistant strain that's circulating in southern Africa right now.

WILSON: Senate Majority Leader Harry Reid has given Republicans and Democrats until Tuesday to reach a compromise. But there's another group that was sidelined in this fight that is in no rush to see the bill authorized. Katie Porter of Population Action International says family planning was sacrificed to get conservatives to support this bill.

Ms. KATIE PORTER (Population Action International): If we are trying to prevent the most number of infections among men and women, these individuals need access to family planning. They need access to the very services that would prevent an infection. They need the education and the consulting that goes around that. For me, that's not something that you can negotiate away.

WILSON: Some people watching the process are worried that even if Coburn lifts his hold and these issues get ironed out in the final bill, they'll pop up again when the administration writes the rules to implement the legislation. Brenda Wilson, NPR News.

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