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REMARKS BY:	DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:		Congressional Black Caucus, Washington, D.C.
DATE:		September 16, 1999

And when times are good - as they are now - our innate sense of fairness leads us to find the shadow that's cast on the far side of the tree. We always need to light that shadow, to eliminate pockets of failure wherever we find them, and to make sure that no one in this land of plenty is left behind. That's why we're in the fight of our lives to protect the lives and health of African Americans.

By almost any measure, health outcomes for African Americans fall short of the general population. This is an enormous challenge - to both our public health system, and our conscience. And it is compounded by the fact that racial health disparities are often caused by a complex mix of factors, including education and cultural tradition, as well as economic status.

But no matter how deep and tangled the root of the problem - we must tear it up from the ground.

So let me be clear. This Administration - with great public health leaders like Surgeon General David Satcher, Drs. Jeff Koplan at CDC and Earl Fox at HRSA, and Sandy Thurman - will not give up until - in the words of Dr. King - we live out the true meaning of our creed.

That creed says we are all created equal - and we are all owed an equal chance at good health and long life.

There are no more vocal advocates for African American health than the Congressional Black Caucus. You've been holding our feet to the fire for a long time. So perhaps even now you're thinking: Calling for an equal chance at good health is a great ideal - but where's the money to pay for it? You're right. Improving the health of African Americans and other minorities will not come cheap. That's why the President has requested an unprecedented $4.2 billion for minority health in the next fiscal year.

Nowhere is the gap in health outcomes for African Americans more apparent - and more tragic - than HIV/AIDS. Just last month, the CDC announced that AIDS deaths have continued to decline overall, although not as sharply they did between 1995 and 1997. More alarming, the CDC revealed that almost half of all AIDS deaths were African American, and AIDS remains the leading killer of African American men, 25 to 44 - and the second leading killer of African American women in the same age group.

Some of the reasons are well known: Too few African Americans are being encouraged to get tested. The cost of treatment is high. The regimen of pills is difficult to follow. And prevention messages have not been targeted enough - or accepted enough - in the African American community. But let me be clear: These obstacles will not deter us from doing the right thing.

That's why HIV/AIDS is one of six areas in which we're working to eliminate the gap between minorities and the general population. I'll mention the others shortly. But to make sure we're successful with HIV/AIDS, we're expanding our $156 million dollar partnership with the Congressional Black Caucus. This year we're requesting a full $171 million.

But more important, we working to get these funds into the hands of frontline leaders and African American health organizations without delay. That way we can build on the progress we've already made. In particular, we're going all out on outreach - helping individuals and groups that have never been helped before, in localities that have never had a seat at the table before.

We even have Crisis Response Teams that are targeting minority communities with a high concentration of HIV. The teams only come in at the request of political and health leaders at the community level - and include experts trained to meet the specific needs of each community. So in every way possible - our strategy is not top down. It's bottom up. It's about funding your projects. Implementing your ideas. And supporting your constituents.

Our CBC partnership is just one piece of a much larger effort against HIV/AIDS. The Substance Abuse and Mental Health Services Administration is now funding - to the tune of $39 million dollars - comprehensive substance abuse prevention and treatment programs for African Americans and Hispanics with HIV/AIDS - or at risk for the disease. And today, I'm pleased to announce that our Health Resources and Services Administration has awarded an additional $4 million dollars in planning grants under Ryan White. These funds will help public and private organizations improve HIV/AIDS care for African Americans in rural and underserved areas.

While HIV/AIDS in African American communities is a top public health priority for this Administration - we have set our sights on a much bigger target. As I mentioned, last year the President announced a commitment to eliminate racial and ethnic health disparities in six critical areas by the year 2010, and he backed up that commitment with $400 million over five years.

With that money - and lots of teamwork - we hope to not only eliminate disparities in HIV/AIDS, but to have a winning scorecard that shows: Cancer screenings - no disparity. Diabetes - no disparity. Cardiovascular disease - no disparity. And immunization rates - no disparity.

Our commitment to eliminate major health disparities does not tell the full story of what we're doing to improve health and extend life for African American families. As you know, a large percentage of America's ten million uninsured children are African American. CHIP - our Children's Health Insurance Program - is up and running in every state. It will insure up to half of this country's uninsured children, and is a down payment on insuring them all.

We're also engaged in a major outreach campaign to find and sign up children for Medicaid. One of the places we're finding CHIP and Medicaid eligible children is in our expanded Head Start and Early Head Start programs. Head Start is not just about education. For many children, Head Start is their first contact ever with the public health system.

As the CBC knows all too well, we can't have a successful public health agenda - that protects African Americans - without help from Congress. That's why just last week, the President called on Congress to give all Americans a strong Patient Bill of Rights, strong privacy protection for their medical records, strong incentives to help the disabled succeed in the workplace, and a Medicare program that is modernized and ready for the 21st century. That means extending the life of the Trust Fund another 25 years, and including a prescription drug program that is voluntary, dependable and affordable.

Opponents of the President's plan say that it's not needed. Well here are the facts: Seventy-five percent of Medicare beneficiaries do not have dependable private sector coverage, and one-third - that's 13 million people - have no coverage at all. By the way, half of those 13 million have incomes below 150 percent of poverty.

So we have our work cut out for us. We need to work day and night to close racial and ethnic health disparities, to improve treatment and prevention services in minority communities, to fund programs on the local level so that the people who best understand the community are making the decisions, and to continue the historic partnership between the Congressional Black Caucus and this Administration.

We will win this fight - because it is just. Because we are committed. And because this is a cause where the fruits of victory will benefit not only African Americans - but all Americans. Thank you.