His plan targets women and children in 14 nations in Africa and the Caribbean. It needs Congress' OK.

WASHINGTON - Unveiling the latest in a series of recent international efforts to fight AIDS more aggressively, President Bush presented a $500 million plan yesterday to save 146,000 newborns a year in Africa and the Caribbean.

"The global devastation of HIV/AIDS staggers the imagination and shocks the conscience," Bush said. "The disease has already killed 20 million people, and it's poised to kill at least 40 million more."

Critics called the proposal "grossly underfinanced."

Worldwide, more than two million women carrying the AIDS virus give birth each year, and 90 percent of those pass it on to their young in pregnancy, childbirth or nursing. Bush chose this front in the war on AIDS, and singled out 12 African and two Caribbean nations for his initiative.

If Congress approves the spending, this would open another line of attack on the deadly illness. The United Nations is asking countries around the world to donate $10 billion a year to its AIDS fund.

The United States would pay for the drugs, such as nevirapine, which blocks transmission of HIV to unborn children. A second component of the program would improve health-care delivery systems in the targeted countries.

The White House is tapping $200 million that both houses of Congress recently approved for global AIDS programs for the first installment of the $500 million proposal. Bush has requested nearly $1.1 billion for the worldwide AIDS fight for the fiscal year beginning Oct. 1.

Government health experts estimate that Bush's new program will prevent the spread of HIV to 146,000 of the 720,000 children who are born to infected mothers every year.

The nations Bush targeted are Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Rwanda, South Africa, Uganda, Guyana and Haiti. In 2003, the program would expand to Namibia, Nigeria, Tanzania and Zambia. White House officials said those countries were targeted because they have widespread AIDS problems and the infrastructure to accommodate U.S. efforts.

Congress must approve any increase in spending on AIDS relief abroad. Senate Majority Leader Tom Daschle (D., S.D.) said that he welcomed Bush's proposal and that Congress might boost spending on it.

The Bush administration's concern about AIDS in Africa gained elevated attention during the recent journey there by Treasury Secretary Paul H. O'Neill and Irish rock star Bono of the band U2, but White House aides said work on the initiative had begun before that.

Critics derided Bush's proposal as a paltry effort compared to the AIDS problem.

Act Up and other AIDS activist groups want the United States to contribute more to the United Nations-backed Global Fund to Fight AIDS, Tuberculosis and Malaria. The United States has pledged $500 million to that fund.

"The bodies won't stop piling up until Bush commits $2.5 billion in new money for HIV that prioritizes getting medicine into the hands of people with AIDS," said Asia Russell, an official with the AIDS advocacy group Health GAP.

The Global AIDS Alliance branded Bush's plan "grossly underfinanced." But Marc Isaac, director of public policy for the Elizabeth Glaser Pediatric AIDS Foundation, called the focus on mothers and babies "appropriate and farsighted."