This month, Anthony Fauci is stepping down as director of the National Institute of Allergy and Infectious Diseases (NIAID), after more than 38 years in the role and following his parent organization, the National Institutes of Health (NIH). NIH) for 54 years. He has led the institute under seven U.S. presidents and oversaw its research and response to the HIV/AIDS epidemic, the 2014 Ebola outbreak in West Africa, and the COVID-19 pandemic.The 81-year-old doctor and scientist has become a household name during the pandemic, during which he has been revered by some as a trusted source of advice but disparaged by others, including former U.S. President Donald Trump , who found his advice inconsistent and overbearing. On Dec. 11, he was attacked on Twitter Elon Musk, who took over the social media platform in October. Fauci and nature On Musk’s comments, the pandemic and his own legacy.
Looking back at your decades at NIH, in which area of infectious disease have we made the most progress?
One of the most important of these is in the area of HIV. In 1981, when we first became aware of AIDS cases, [it was] A mysterious disease of unknown cause that kills nearly everyone infected. That was one of the darkest times in my career or anyone’s career in infectious disease.We went from the bleak period of not knowing what killed all these mostly young gay men to getting [underlying virus], diagnostic tests, and within a few years an entire array of drugs that, when used in combination, revolutionized the lives of people living with HIV.We have also developed highly effective prevention methods, including pre-exposure prophylaxis and [can treat] Infected people, reduce virus levels below detectable levels, so they don’t spread the virus to anyone else.
Where will we see the next infectious disease revolution?
One of the holy grails of infectious disease research is a safe and effective HIV vaccine. We have made amazing progress in the development of therapies to treat and prevent disease. But so far, we have been unable to find a safe and effective vaccine. So that’s one of the things we look forward to. Another possibility is that, although HIV is difficult to cure in some ways, you can achieve durable suppression or elimination and eradication of the virus without any further treatment. We’re not there yet, but it’s an aspirational goal.
Your ex-boss, former NIH director Francis Collins, lamented the lack of behavioral science research to better understand misinformation On vaccines and other aspects of public health. Do we need to rethink how we incorporate the social sciences into the “hard” biomedical sciences?
Yes, we have. You just do it. It is not difficult to incorporate social science disciplines into the hard science disciplines of developing a vaccine. It is very disturbing that in our country we have 68% of the total population vaccinated against the primary COVID vaccine. Of these, only half received a promotion. Importantly, [despite] Availability of valid BA.4/5 Dual Price Update Booster, only 13% of the eligible population took it. It’s very disturbing and almost embarrassing because we have so little enthusiasm for getting life-saving vaccines.
Beyond vaccine hesitancy, how can behavioral science play a role in pandemic response?
Another aspect that COVID-19 has highlighted is the importance of mental health, and attention to [the pandemic] Impact on society: not only healthcare workers, doctors and nurses, but ordinary people including children. [Their] growth and development have been [shaped] Not just missing school, but the stress of losing grandparents and parents and seeing the normal flow of their childhood disrupted. All of this has a significant negative impact on mental health.
During the COVID-19 pandemic, we have seen governments censor scientists, misrepresent data, and act maliciously in other ways, making international cooperation to prevent a pandemic difficult. How do researchers navigate this tricky line?
It is impossible to answer. The existence of opaque countries or groups is a major obstacle to global public health efforts. I hope all countries in the world realize that we must be fully cooperative, collaborative and transparent in everything we do because there is no such thing as a pandemic, especially an infectious disease that spreads through a virus. Respiratory, that will stay in one country. We have watched with great pain how COVID has spread around the world and has killed nearly 7 million people, which is probably a gross underestimate.
How would you rate the world’s response to the pandemic?
hard to be fair [answer], because when you face such a powerful virus, you will die. But the international community, including the United States, can certainly do better. One success story is the rapid development and deployment of the vaccine. Less successful have been the public health responses. Take this country for example.For decades we have shrunk our public health system [by] Do not replace people who leave, do not keep equipment updated, do not [information] real-time access. We had to go to other countries to get real-time information: UK, Israel, South Africa.And in our reporting system, states don’t have to report to CDC [US Centers for Disease Control and Prevention]—CDC must ask them to participate in the response. This really has to change.
On Sunday, entrepreneur Elon Musk demanded that you be sued, claiming you lied to Congress and funded research that killed millions. How do you respond to these tweets?
I didn’t pay attention to that, Max, I don’t think I need to respond. I don’t tweet. I don’t have a Twitter account. A lot of stuff is just a dumping ground for misinformation and I won’t waste a minute worrying about it.
Do you feel your safety is at risk given Musk’s massive Twitter presence?
Of course there are risks. That’s why I have armed federal agents with me all the time. It fueled a lot of hate from people who didn’t know why they hated – they hated because people like this were tweeting.
At this point, what advice do you have for early career scientists who may be reconsidering their career choices after seeing some vitriol against you and other public health officials during the pandemic?
I would encourage them not to be intimidated, because by going into public service and public health, the degree of satisfaction and contribution you make to society is immeasurable. It’s extraordinary. It overcomes and resists all other bad things. Unfortunately, we are experiencing attacks on public health officials.But the satisfaction and sense of accomplishment you can get [achieve] Great on the field. It will definitely replace everything else.
I know you’re still making plans after leaving your position as director, yes?
Well, I’m going to write and speak, maybe [write] memoir. But I’m certainly not retiring in the classic sense.
This article is reproduced with permission, has been reprinted first published December 13, 2022.