Ambassador Dr. Mark Dybul, coordinator of the United States Global AIDS program, asserted the Bush administration's commitment to fighting AIDS in undeveloped countries and dismissed some beliefs that the administration is unsympathetic or religion-oriented regarding AIDS funds during an appearance at the Commonwealth Club of California last week.

Dybul, who is openly gay, also gave a nod to the bipartisan support of the program and acknowledged the continuing generosity of the American people when it comes to foreign aid.

The plan, known as the President's Emergency Plan for AIDS Relief, is the largest commitment by any country to help combat the HIV/AIDS epidemic in foreign countries. The U.S. has allocated $15 billion in funds for PEPFAR and has committed to a multifaceted approach.

During his April 27 appearance, in which Dybul was questioned by Dr. Paul Volberding, chief of medical service at the San Francisco Veterans Affairs Medical Center and a longtime AIDS physician and researcher, Dybul said AIDS is the "black death of our time," and stressed the importance of international AIDS relief as not only a humanitarian effort, but also as an investment in the security of the U.S.

"The continent of Africa, and other regions, floundering in destruction and despair because of HIV/AIDS and poverty are a global risk to peace, freedom, and prosperity and so pose a risk to the interest of the United States," he said.

He described PEPFAR aid as a holistic approach to combating the disease, saying that this program is different than others because it's based on a "philosophy rooted in a handshake rather than a handout. It is a philosophy rooted in partnership between people."

In countries where AIDS infection is so high economies have been stunted, PEPFAR aid goes toward prevention of HIV transmission for pregnant mothers, addressing gender inequalities and aid for orphans in addition to AIDS medications.

One controversial aspect of PEPFAR is that it encourages ABC as part of its program: Abstain, Be faithful, Condom use. A recent study by the World Health Organization found that circumcision cuts down on the spread of HIV, but Dybul said PEPFAR wouldn't be changing the meaning of the "C" in ABC anytime soon. While the U.S. supports circumcision, other countries do not have the medical infrastructure ready to support circumcision on a grand scale.

He addressed the perception, at least among many in San Francisco, where the president is very unpopular, that the administration is not as concerned about AIDS, particularly in the LGBT community. Dybul noted that in sub-Saharan Africa, where the majority of PEPFAR programs are located, 90 percent of AIDS transmissions come from heterosexual relations. In those locations, funding often goes to organizations that serve heterosexuals, particularly focusing on young women, who are increasingly accounting for transmission of the disease. He said PEPFAR does support programs for men who have sex with men, especially in Asian and Latin American countries where MSM transmission is more of an issue.

While responding to questions from the audience, Dybul stated numerous times that the U.S. needs more help from the international community and from developed countries in particular. He noted that the U.S. donates more to combat AIDS than the combined donations of all other countries, but declined to comment on donations as a percentage of the gross domestic product. He did note that the program's success thus far is thanks, in large part, to the generosity of the American people.

"In San Francisco, 20-some years ago, in the darkest hour of this city when the pall of HIV/AIDS was over this city, the community came together to care for each other with compassion and generosity," he said. "Compassion and generosity and the coming together in adversity is not a characteristic uniquely of Americans, but it is absolutely a part of the character of the American people."

Dybul made headlines last fall when Secretary of State Condoleezza Rice swore him in. His partner, Jason Claire, held the Bible on which Dybul took the oath of office and first lady Laura Bush attended the ceremony.