NEARLY EVERY YEAR since 1969, the District has had the highest rate of infant mortality in the nation; in 1978, the local rate exceeded that of any western nation. The city also has the fourth highest rate in the country for reported cases of tuberculosis, and health officials are certain that many cases simply are not reported. Moreover, the District has the nation's highest rate of cirrhosis of the liver and rates quite high in cases of venereal disease. There is also a woefully small amount of public health care in the poorest sections of town -- and that which exists is often so ineptly managed that people can't get the treatment they need.

The other day, the District government and the U.S. Department of Health, Education and Welfare announced that they will work together to remedy some of these problems. In a joint statement, Mayor Barry and HEW Secretary Califano said that federal officials will be assigned to help the city lower the rate of infant deaths, alcoholism and the like. The District will assign an official to work with HEW to improve conditions at St. Elizabeths Hospital, the federally-owned mental-health institution. HEW and city officals will undertake to reduce the number of errors in public-assistance payments, along with the number of excessive Medicaid payments made to hospitals, pharmacies and physicians.

With this federal help, District officials can get information on the ways other cities have tackled similar health problems. Federal officials also can assist the District in figuring out how to improve the way health-care programs are administered in the local bureaucracy. That examination is long overdue. For the past 10 years, reports critical of the way the Department of Human Resources administers health and hospital programs have piled up in City Hall -- along with recommendations for a separate department of health. Nothing has ever been done to create such an agency; DHR -- the largest and most inefficient of all local agencies -- still has the responsibility for most city-health programs.

During his campaign, Mr. Barry pointed out that DHR was so preoccupied with lawsuits and other troubles that it was unable to give adequate attention to health programs. To remedy this situation, Mr. Barry said, a separate health department would have to be created. That probably is what's needed to give the District's effort to lower the disease death toll the necessary impetus. And the HEW-District partnership is a good, solid step in that direction.