Cape Town: In her Aids-scarred South African township, Sweetness Mzolisa leads a chorus of praise for George W. Bush that echoes to the deserts of Namibia, the hills of Rwanda and the villages of Ethiopia.

Like countless Africans, Mzolisa looks forward to Barack Obama becoming America's first black president tomorrow.

But - like countless Africans - Mzolisa says she will always be grateful to Bush for his war on Aids, which has helped to treat more than 2 million Africans, supported 10 million more, and revitalised the global fight against the disease.

"It has done a lot for the people of South Africa, for the whole of the African continent," says Mzolisa, a feisty mother of seven. "It has changed so many people's lives, saved so many people's lives."

Mzolisa, 44, was diagnosed with the Aids virus in 1999 and formed a women's support group to "share the pain".

In 2004 she received a US grant to set up office in a shipping container and start a soup kitchen from the group's vegetable garden.

She stretches her $10,000 (Dh36,700) in annual funding to train staff to look after bedridden AIDS victims, feed and clothe orphans, and do stigma-busting work at schools and taxi ranks.

Hundreds of similar small grass-roots projects are being funded by the President's Emergency Plan for Aids Relief, or PEPFAR, alongside higher-profile charities and big state clinics.

Bush launched the $15-billion plan in 2003 to expand prevention, treatment and support programmes in 15 hard-hit countries, 12 of them African, which account for more than half the world's estimated 33 million Aids infections.

The initiative tied in with a World Health Organization campaign to put 3 million people on Aids drugs by 2005 - a goal it says was reached in 2007.

Congress last year passed legislation more than tripling the budget to $48 billion over the next five years, with Republicans and Democrats alike hailing the programme as a remarkable success.

But the task remains enormous. Of the more than 1.5 million Africans who died of Aids in 2007 (the US death toll from the disease is under 15,000), fewer than one-third had access to treatment, and new infections continued to outstrip those receiving life-prolonging drugs.

In most African countries, life expectancy has dropped dramatically, and only a few, like Botswana, have started to turn the corner again.

And with no end in sight to the global financial crisis, there are fears about whether all the funding approved by Congress will be delivered.

There continue to be detractors who say the US administration should have channelled the money through the UN" that it has placed too much emphasis on faith-based groups and abstinence" that it has trampled on women's health by shunning anything associated with abortions" that it has concentrated on Aids treatment at the expense of prevention" and that it has diverted attention away from bigger killers like pneumonia and diarrhea.

Helen Epstein, an Aids expert who has consulted for the UN and the World Bank, says both the UN and PEPFAR have failed disastrously on prevention by preaching abstinence until marriage and failing to recognize that in some African cultures it is the norm to have several simultaneous long-term relationships.

She says the money would be better spent on strengthening African health care systems rather than focusing on a single disease.

Johanna Hanefeld at the London School of Hygiene and Tropical Medicine says her research in Zambia indicated that the UN Global Fund to Fight Aids, TB and Malaria was more effective in using HIV programmes as a lever to improve health care and staff training, rather than scattering cash among many non-governmental groups, faith-based or other.

Mark Dybul, the US global Aids coordinator who is informally known as the PEPFAR ambassador, dismisses criticism that the funding is too narrowly focused.

"In Africa you can't tackle development goals unless you tackle HIV/Aids," he says, citing the devastation wreaked on professions like nursing and teaching.

Besides PEPFAR, Bush has launched a five-year, $1.2 billion initiative to cut malaria deaths in 15 African nations by half.

Dybul also says it is unfair to accuse the US of overemphasising abstinence because PEPFAR is a major supplier of condoms to the targeted African countries.

For instance, PEPFAR figures show 60 million condoms going to Zambia, 40 million to Rwanda, 145 million to Ethiopia in the past five years.et.