Bill opponents said it was simply too expensive, and that there were pressing needs at home that need to be addressed.
The bill would discard a current requirement criticized by some Democrats and AIDS activists that a third of all HIV prevention funds be spent on sexual abstinence education. It instead calls for "balanced funding" for abstinence, fidelity and condom programs.
There are 33 million people worldwide infected with HIV, the virus that causes AIDS, with two-thirds of them in sub-Saharan Africa, according to U.N. estimates.
Rep. Ileana Ros-Lehtinen, a Florida Republican, said the bill would save millions of lives around the world and help maintain stability in a key region of the world.
"The program that we are authorizing today ... is now recognized as perhaps the most successful foreign assistance program of the United States of America since the Marshall Plan," Ros-Lehtinen said, referring to the costly U.S. plan to rebuild Europe after World War II.
Bush sees his efforts against AIDS and malaria as foreign policy successes in a presidency dominated by the unpopular war in Iraq. During a trip to Africa in February, Bush was given a hero's welcome in part for U.S. AIDS and malaria programs.
The White House calls the anti-AIDS initiative the largest commitment ever by any nation for an international health initiative dedicated to a single disease.
New Jersey Democratic Rep. Donald Payne said the initiative will go down as Bush's single most important achievement.
But opponents said it costs too much. "It is terrible that millions of Africans are suffering AIDS. But we cannot afford such totally irrational generosity. This is benevolence gone wild," said California Republican Rep. Dana Rohrabacher.
"We can't take care of our own veterans when they come home from the war. We can't take care of our elderly. We have people who can't take care of their own health needs and are at risk of losing their homes," Rohrabacher added. "We have big hearts. But we need to use our brains."
