President Barack Obama’s global AIDS program is facing criticism for scaling back efforts to put people on HIV drug therapy in order to emphasize HIV prevention and treat other less costly diseases, reports The New York Times.

AIDS advocates say this is a major setback from the progress made through former President George W. Bush’s global AIDS strategy, the President’s Emergency Plan for AIDS Relief (PEPFAR).

“I’m holding my nose as I say this, but I miss George W. Bush,” said AIDS activist Gregg Gonsalves. “On AIDS, he really stepped up. He did a tremendous thing. Now, to have this happen under Obama is really depressing.”

Global AIDS coordinator and chief of PEPFAR, Eric Goosby, MD, denied a decline in the Obama administration’s AIDS efforts, saying more people would receive HIV treatment each year.

According to the article, the program’s “Five Year Strategy,” released December 1 with three supplements handed out December 8, proposes to put 320,000 people on antiretroviral treatment annually for the next five years. This is a significant decrease from PEPFAR’s previous five-year plan, which added 500,000 people each year on average.

The new plan places greater emphasis on preventing HIV, curbing mother-to-child transmission and treating tuberculosis, pneumonia, diarrhea and malaria. The Obama plan did not detail whether it would carry over the more controversial aspects of Bush’s PEPFAR, such as requiring groups to emphasize abstinence.

Fearing these cutbacks, medical schools, public health presidents and deans wrote letters urging the Obama administration to expand global HIV treatment programs until all those living with the virus have access to treatment.