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You know we have a real race problem in America when The New York Times, in the second paragraph of its story on the severity of AIDS infection in the African-American community, writes that a just-released report "provides a startling new perspective" on the epidemic.

Where have y’all been?

The report, by the Black AIDS Institute, is old news. The problem is that the news media has been so dazzled by the show of support for people living with HIV in Africa by President Bush and other conservatives that it doesn’t ask the question I always ask when I hear Bush talk oh-so-compassionately-conservative about AIDS in Africa: "What about us here in the U.S.A?"

The answer: We’ve been dying.

The report, "Left Behind: Black America: Neglected Priority in the Global AIDS Epidemic," notes that AIDS is the leading cause of death among Black women between 25-34 years and the second leading cause of death in Black men between 35-44 years of age.  There are about 600,000 African Americans living with HIV in the U.S. today, and another 30,000 are infected each year, the report says. If the U.S. African-American population were a separate country, it would rank 16th in the world in the number of people with HIV, and ninth among the 15 countries targeted by the President’s Emergency Plan For AIDS Relief.

President Bush made a show Wednesday of signing a bill that wouild over five years commit $48 billion to PEPFAR. The transcript of the signing ceremony was filled with platitudes — "With this legislation, America is showing its tremendous regard for the dignity and worth of every human being" — but betrayed no indication that AIDS was anything other than a distant problem for a distant people.

Meanwhile, the Bush administration has actually proposed cutting funding for HIV programs targeted at the African-American community, according to a report by the Kaiser Family Foundation. The Minority HIV/AIDS Initiative was funded at just under $400 million in 2006 and peaked last year at $402 million; the current budget request for fiscal year 2009 is $387 million, a 4 percent cut. The total domestic HIV/AIDS budget in that period would increase from $15.9 billion to a proposed $18.2 billion. Given inflation, that’s just slightly better than level funding in real terms. Spending on the global AIDS initiative, meanwhile, is set to increase from $3.2 billion in fiscal 2006 to $5.9 billion in fiscal 2009, an 84 percent increase. The share of U.S. AIDS spending that goes overseas has grown from 17 percent of the budget to 25 percent.

The bottom line: The Bush administration, and its enablers in Congress, have chosen to make black Americans losers in an AIDS-funding musical-chairs game.

But we shouldn’t be surprised. Back in 1984, in the vice-presidential debate between John Edwards and Dick Cheney, moderator Gwen Ifill asked both candidates a pointed question about the fact that "Black women between the ages of 25 and 44 are 13 times more likely to die of the disease than their counterparts." Cheney admitted, "I had not heard those numbers with respect to African American women. I was not aware that it was that severe an epidemic there." Edwards was hardly better, dodging the question to make a point about health care generally. Ifil, clearly dissatisfied with the non-answers, nonetheless said, "OK, we’ll move on." And move on we did.

That moment is recaptured in another Black AIDS Institute report, "We Demand Accountability," released late last year to push the issue of AIDS in the African-American community into the 2008 presidential debate. The report includes a four-point platform: Reduce the rate of HIV infection among black people by half within five years, increase the number of black people who know their HIV status by 50 percent in that period, ensure that all people living with HIV have access to appropriate care, and eliminate the stigma associated with HIV infection.

There is a fifth agenda item that is implicit in all of this: Eliminating the disparities in health care in this country that exist based on race. The even more outrageous story in the "Left Behind" report is this:

Standing on its own, Black America would constitute the world’s 35th most populous country and its 28th largest economy. Yet although Blacks in the U.S. reside in the most economically powerful country on Earth, they do not benefit equally from the fruits of America’s affluence. Black America would rank 105th among the world’s countries in life expectancy and 88th in infant mortality; Blacks in the U.S. have a lower life expectancy than Algeria or the Dominican Republic, and the infant mortality rate in Black America is twice that of Cuba’s. More than one-fifth of Black Americans lack health coverage, and nearly one in four live in poverty—patterns that differentiate Blacks in the U.S. from all other high-income countries. On every major health, social and economic indicator, Blacks in the U.S. score significantly more poorly than whites.

On Tuesday, the U.S. House of Representatives passed by a voice vote a resolution apologizing for slavery. I hope you will forgive me for not rushing to accept the apology. I would have a lot more heartfelt gratitude for a Congress and a White House that was resolved, together with every element of the African-American community, to erase once and for all the conditions that allow the length and quality of lives to be determined by skin color — whether because of HIV infection or any other reason. I’d like to hear an apology for all of the times in which we’ve allowed people in the White House and Capitol Hill to pat themselves on the back for making a show of caring about "poor people" in Africa and Asia while showing their backside to people of color in their midst.

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