The annual Human Development Report normally concerns itself with the Third World, but the 2005 edition scrutinises inequalities in health provision inside the US as part of a survey of how inequality worldwide is retarding the eradication of poverty.

    It reveals that the infant mortality rate has been rising in the US for the past five years - and is now the same as Malaysia. America's black children are twice as likely as whites to die before their first birthday.

    Although the US leads the world in healthcare spending - per head of population it spends twice what other rich OECD nations spend on average, 13 per cent of its national income - this high level goes disproportionately on the care of white Americans. It has not been targeted to eradicate large disparities in infant death rates based on race, wealth and state of residence.