Naina Dhingra is the Director of International Policy at Advocates for Youth and serves on the Developed Country NGO Board Delegation of the Global Fund.

I remember the night of January 28, 2003 well. For days prior, there had been a flurry of emails speculating that President Bush might perhaps mention global AIDS and that he just might announce a major new U.S. government initiative to tackle the pandemic in his State of the Union. At the time, I was a college AIDS activist with the Student Global AIDS Campaign (SGAC) at George Washington (GW) University and a member of the International Youth Leadership Council with Advocates for Youth. I lived and breathed the global AIDS movement. SGAC had formed just a few months earlier on the passion and commitments of a small group of students from Harvard, GW, University of Maryland, Yale, and several other universities. We were young, inspired, and believed that we could change the world.

That night, several of us eagerly tuned in to hear what the President had to say. After what seemed like hours of endless applause, the moment we had all been waiting for happened. The President of the United States began to discuss AIDS in Africa in his State of the Union. It was the first time that this international health crisis received this level of attention by a President. While President Clinton has become a leader on global AIDS post presidency, his actions while in office were disappointing, and he certainly never made mention of the pandemic during a State of the Union address.

Bush began by discussing the challenges of AIDS in Africa and the costs of anti-retroviral medicines. He then shocked the American public by saying, "Tonight I propose the Emergency Plan for AIDS Relief—a work of mercy beyond all current international efforts to help the people of Africa. This comprehensive plan will prevent 7 million new AIDS infections, treat at least 2 million people with life-extending drugs, and provide humane care for millions of people suffering from AIDS, and for children orphaned by AIDS." He then asked Congress to commit $15 billion over the next five years to meet the goals.

For a moment, I forgot that this was the same President who had reinstated the global gag rule and de-funded UNFPA. How was it possible for this President to show so much compassion for those affected by AIDS and not realize that the very same people were equally affected by the ideological policies restricting family planning resources? I barely had a moment for reflection though as every cell phone in the room began ringing. We were in awe, not just at what Bush had just said, but at what we saw as the power of a community movement.

For months prior to the State of the Union, a small group of NGOs including activist organizations like Health GAP and progressive faith-based organizations had been lobbying the Administration to launch a major Presidential AIDS Initiative. Inside and outside strategies were used that included high level meetings with senior Administration officials as well as constant badgering of those same officials at public events and in the media. We demanded that the U.S. government do more on global AIDS. While there were certainly other factors that contributed to the decision for President Bush to include global AIDS in the State of the Union, both known and unknown, we were convinced in the power of the people.

It would be several months before we realized that the plan wasn't going to live up to all of our hopes and dreams. The same ideological battles that gave rise to the domestic abstinence-only funding spree by Congress, took over this initiative. Conservative faith-based organizations received special treatment and money was prioritized for abstinence-until-marriage programs that made many of us seriously question if PEPFAR would ever happen.

But here we are—four years later. The American public now expects an annual update on PEPFAR recognizing it as one of the President's monumental initiatives. HIV/AIDS was once again highlighted as one of the eight major policy initiatives in the 2007 State of the Union. While PEPFAR has made dramatic achievements in the rapid scale up of putting HIV+ people on life-extending anti-retrovirals, the American people should hold their applause. PEPFAR's ideological policies, including the abstinence-until-marriage earmark and the prostitution loyalty oath, dramatically hinder the effectiveness of prevention programs targeting women and girls. While the United States, through PEPFAR, is certainly the largest bi-lateral donor to global AIDS, it is known for its "go it alone" approach and for bullying countries to accept its conservative policies.

In 2003, Bush said, "This nation can lead the world in sparing innocent people from a plague of nature." We certainly have the capacity and the responsibility. Now it is up to the new Congress to ensure that we truly have the will.