In a packed auditorium at Seattle’s Fred Hutchinson Cancer Center, Dr. Anthony Fauci led a conversation Tuesday afternoon about the county’s deep division over COVID-19, its involvement in early HIV/AIDS research and the role of public health in the future.
Fauci, chief medical adviser to the president and director of the National Institute of Allergy and Infectious Diseases, was in town to accept the 2022 Hutch Honorary Award at the Mariners’ game on Tuesday.
The Hutch Award is usually given to a major league basketball player who embodies the spirit of Fred Hutchinson, a pitcher who died of cancer in 1964. It has only been given as an honorary award once before, to the former President Jimmy Carter in 2016.
But before his ceremonial first release, Fauci spoke with Dr. Hutch’s Larry Corey, a professor in the Division of Vaccines and Infectious Diseases, on the history of public health and ongoing obstacles.
Early research on HIV/AIDS
While Fauci has emerged as perhaps America’s best-known source of information on COVID, he was an immunologist when he first read about HIV in 1981, Corey noted. That report changed the course of Fauci’s career.
“I completely turned around the direction of my lab, which was very successful in studying inflammatory disease in the role of immunosuppression,” said Fauci, settled into a brown leather armchair. “Everyone thought I was crazy.”
When he became director of the National Institute of Allergy and Infectious Diseases, Fauci wanted federal funding. But he faced reluctance from former President Ronald Reagan, who “never mentioned the word AIDS until his second term,” Fauci said.
As treatments were approved and health institutions built distribution networks, the fight against the epidemic changed. Richer countries could more easily access expensive treatments, while poorer countries continued to face the worst of the disease.
In 2002, Fauci asked former President George W. Bush to increase federal spending to about $15 billion over five years in order to treat millions of people.
“I wasn’t sure he would accept it,” he said. “Then finally, right before the State of the Union address [in 2003], his team called me at the White House. He announced it without telling anyone.”
The funding launched the President’s Emergency Plan for AIDS Relief, which allowed the federal government to grant full or interim approval of drugs to treat HIV and AIDS more quickly. The program is still valid.
Fauci said he remembered some of the stigma surrounding HIV as the monkeypox virus spreads around the world, disproportionately infecting men who have sex with men.
In addition, he said, the challenge of responsibly implementing tools and drugs remains a burden on the country’s healthcare system.
While Fauci acknowledged that the country continues to battle the COVID pandemic, he expressed deep disappointment and concern about Americans’ divided view of the disease.
“We are in a very difficult situation,” he said. “A third of the people in our country are vaccinated and probably reinforced. How can that be when you have a disease that has killed a million Americans and are hesitant to use life-saving interventions?
“What world do we live in?” it continued.
The response has changed the way he thinks about Americans’ willingness to accept science, he said.
“If we knew in the first few weeks what we know now, we would have done everything differently,” Fauci said, suggesting that masking and social distancing policies should have been implemented even earlier. “But the country would not have accepted what we were saying.”
Fauci also expressed uncertainty about how best to address long-term health disparity issues, including the spread and treatment of COVID.
“The social determinants of health are rooted in institutional racism that dates back to slavery,” he said. “And that’s it. Our original sin of slavery only happens because of the opportunities people have.”
“The Fauci Effect”
As the conversation drew to a close, Corey brought up the “Fauci effect,” a term coined in the late 2020s when medical schools saw a record number of applications. Admissions officials largely attributed the trend to examples of medical workers and public health figures as role models.
When asked, Fauci avoided taking too much credit, saying the effect is less about him and more about what he symbolizes, which he sees as a stable source of information in the “age of the normalization of lies.” .
“Don’t accept the normal blatant distortions of truth and reality,” he said. “Once you do, nothing counts. The truth means nothing.”
His visit to the Hutch ended with a brief Q&A with a group of high school students from the center’s summer internship and learning programs. For them, he had a few words of advice: Stay on track and don’t let intimidation keep you off the field.