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REMARKS BY:	DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:		National Conference on African Americans and AIDS, Washington, D.C.
DATE:		February 24, 2000

I've known Phill for many years. And I can tell you that he's a bridge over troubled waters when it comes to HIV/AIDS. He began building coalitions in the African American community before most people even understood what we were up against.

Phill and others like him remind me of something Maya Angelou once said, "If you're for the right thing then you do it without thinking." That's why I'm gratified that so many community-based organizations, service providers, and caregivers are here today - because working on the frontlines of AIDS is perhaps the toughest job of all. It is a commitment that should give one pause before taking it on. But despite the enormous difficulties of fighting this disease, many of you have accepted the challenge of doing the right thing.

I'm proud to say that this Administration has been committed from the start to attack the HIV/AIDS epidemic. And we've made remarkable progress on many fronts. Overall funding for AIDS-related programs has increased by 131 percent. And we've nearly tripled funding for the Ryan White CARE Act.

New anti-retroviral treatments have brought a decline in AIDS incidence and deaths among all risk groups. Mother-to-child HIV transmissions have decreased dramatically. New treatment guidelines are giving health professionals much needed guidance in the care of individuals with HIV and AIDS.

And strong partnerships with the community - the kind that the Surgeon General's Leadership Campaign on AIDS is producing - has resulted in a tremendous increase in community leadership by the African American community.

Fraternities, sororities, civic organizations, business, and a host of other institutions have stepped up to the plate to educate and provide support where we need it most - at the grassroots level.

But we shouldn't kid ourselves for a minute. Progress against AIDS in the African American community still lags far behind the majority population. Imagine America for a moment as a small village where 12 percent of the population is African American. In our village, an estimated 1 in 50 African American men and 1 in 160 African American women are infected with HIV. And if you're an African American woman, you're almost 20 times more likely to have AIDS than a white woman living next door. That's far too many.

There are at least two more facts that can't be ignored. AIDS - a completely preventable disease - is now the second leading cause of death for African American women in their most productive years of life, and the leading cause of death for men of the same age. This is absolutely unacceptable.

Let me say here that as HHS Secretary, the opportunity to quote comedian Chris Rock doesn't come very often. But in one of his standup routines, he asked a question that really goes to the heart of why this conference is important. He said, "Why should I pay taxes? I won't get the money until I'm 65. Meanwhile the average black man [in America] dies at 54. Hypertension, high blood pressure, something will get you." He just as easily could have put AIDS at the top of the hit list, followed by cancer, heart disease, and stroke.

But as you know, the threat of AIDS is hardly confined to America. There are an estimated 42 million AIDS cases worldwide. The virus has tightened its death grip on Africa in particular. As one UNAIDS worker said: "People have gone into the coffin-making business - that is something you can see without being an epidemiologist." Africa may be ground zero for the epidemic, but this room is ground zero for a solution.

We will not - and cannot rest until we eliminate all health disparities among racial and ethnic groups in America - including AIDS. As you know, the sheer number of AIDS cases among African American men and other minorities has surpassed whites. In 1989, that number was only 31 percent. By 1998, it had risen to 52 percent. We understand some of the reasons behind these statistics . . .

Too few African Americans are getting tested. Or getting access to care. The cost of treatment is high. The regimen of pills is difficult to follow. And prevention messages have not been targeted enough - or become accepted enough - in the African American community. Let me be clear: These obstacles will not deter us from doing the right thing. That's why this Administration - with great public health leaders like Surgeon General David Satcher, Dr. Eric Goosby, Drs. Jeff Koplan and Earl Fox at HRSA, Dr. Helene Gayle, Dr. Tony Fauci, and Sandy Thurman, . . .With our powerful allies in Congress like Rep. Maxine Waters and the Congressional Black Caucus . . . And most important, with members of the African American community . . .

We will - as my friend Maxine Waters puts it - " take our individual power and pool it."

That's why the Administration's strategy against AIDS will continue to be guided by three principles: First, put the money in communities. Second, prevent the spread of AIDS. And third, eliminate the barriers to care.

Let me talk briefly about all three. Principle One: Put the money where it will do the most good - in communities. Our strategy isn't about telling you what to do. It's about putting the decision-making and resources where they belong, in communities where real people live and work.

That's why we've made the commitment to listen and learn from you. For example, our CBC initiative has been extremely successful in helping to get resources into the hands of frontline leaders and African American health organizations without delay. And if we listen closely, we can hear the sounds of hard work and moral conviction rewarded. Those sounds are the budget victory for AIDS that the Congressional Black Caucus helped us win in 1999 and 2000.

But before we can throw confetti, this year Congress must pass our total AIDS budget of 9.2 billion dollars. That's an 8.4 percent increase above last year. We've also requested 276 million dollars to specifically fight HIV/AIDS in racial and ethnic communities. The purpose of these funds is to build on progress that's already been made by hundreds of community-based organizations.

We're also helping individuals and groups that have never been helped before, in localities that have never been invited to sit at the table before. We even have Crisis Response Teams that are targeting minority communities with a high concentration of HIV. The teams come in at the request of political and health leaders at the community level - and will include experts trained to meet the specific needs of each community.Everyday - in every possible way - our strategy is not top down. It's bottom up.

Our CBC partnership is just one part of a much larger fight against HIV/AIDS. I want to be clear: Wiping out AIDS the way we wiped out smallpox is a top priority for everyone in this Administration. We will accept nothing less than total victory - and our budget reflects that. From HRSA to CDC to NIH - every agency's AIDS-fighting budget has increased to reflect our focus on prevention, care, and treatment.

Which brings me to the second guiding principle, which I can sum up in three words: Prevention. Prevention. Prevention. Stopping this disease before it starts is the best way to fight HIV/AIDS. That's why our budget proposes to spend an additional 75 million dollars to help get the word out about how to prevent the spread of this disease.

CDC will direct 40 million dollars of the new funds to local communities to provide additional technical assistance to minority populations.

We're increasing our support for substance abuse prevention and treatment programs for African Americans and Hispanics with HIV/AIDS - or those who are at risk for the disease. And we're telling communities what we know about effective needle exchange programs so that they can use this information to reduce the transmission of HIV. But as you know, our efforts to fight HIV/AIDS can not be focused entirely on prevention.

Which brings me to my third principle: We must treat those with the disease by improving access and eliminating the barriers to care. Nearly all of the problems associated with HIV/AIDS are compounded by a crisis of access. Today, more than 46 million Americans have no health insurance. Too many of them are children. And far too many of them are minorities.

That's one reason we created the State Children's Health Insurance Program, and why the President has proposed allowing parents to enroll in the same SCHIP programs as their children. And it's also why we're expanding our Medicaid outreach efforts.

But we know we must do better.

That's why I'm proud to announce today that we've approved Maine's Medicaid demonstration plan to launch an early drug intervention and treatment program for individuals who are HIV positive, but who don't yet show signs of AIDS, and who aren't already eligible for Medicaid. Maine is the first state to offer a plan to enroll low-income people with HIV in the Medicaid program earlier than they would be enrolled under current Medicaid rules.

But it's not just a question of health insurance. Once we've identified those individuals at high risk for HIV/AIDS, we must provide creative testing opportunities in a non-judgmental atmosphere. And then get people who test positive into a seamless system of medical care.

But even the most innovative drug therapies and comprehensive care are destined to fail unless we eliminate the stigma of this disease. The importance of eliminating the stigma of AIDS cannot be overstated. Fear and ignorance only compound an already complex set of circumstances. As Dr. Satcher has reminded all of us, "together we must work together to bring an end to the stigma associated with HIV/AIDS because it carries negative perceptions and stereotypes of HIV positive individuals that get in the way of testing and care."

We must come to grips with the fact that homophobia is rampant in some communities and institutions. These negative attitudes only drive people underground into hiding places, and inhibit them from protecting themselves and others.

History will ultimately judge how we handle this crisis. We've reached the point in this public health crisis where we're informed enough to do something. If we don't do what we can, then we are all complicit in the outcome. But together we can do the right thing. We can end this epidemic here and around the world by acting in good conscience and in a universal spirit of brotherhood and sisterhood.

Unlike so many other diseases, AIDS is preventable. But the responsibility for ending AIDS goes beyond anything that government can do alone.

Overcoming the barriers to prevention and care, eliminating the stigma of AIDS, teaching communities what they must do to protect themselves; these challenges will require a kaleidoscope of partnerships in all sizes, shapes and colors.

We need community-based organizations and service providers to hold our feet to the fire. We also need national organizations like the Urban League and the NAACP to continue speaking out about what AIDS is doing to African American communities. And we need men and women everywhere: Sororities and social groups, churches and care givers, parents and students, artists and intellectuals, educators and entertainers, doctors and nurses, and business leaders to join the fight.

We need - and this is very important - for every African American man, woman, and child to be counted in the 2000 Census.

Let me close by quoting my friend Phill Wilson, who said, "It's not real until they're talking about it on street corners and in barbershops." This is about real life. It's about our friends, our neighbors, our families, our cousins, nieces, and nephews.

It's about Reggie, James, Steven, and Tony . . .

I would like to leave you with an invitation and a challenge. I invite each of you to continue doing the right things to fight this epidemic. And I invite you to recruit others to the battle. I not only invite - I challenge - everyone here to continue to work closely with us to build upon our successes. The health of America as a whole is no better than the least healthy among us. That is our message to our sisters and brothers in the African American community. It is a message of hope. Thank you.