In the two months since the harsh realities of SARS-CoV-2 and COVID-19 have come into sharp focus, Americans have become increasingly familiar with a man who has been quietly serving the people since the days when Ronald Reagan was up for re-election. For many, Dr. Anthony Fauci is the national voice of reason in a sea of dubious information. He has arguably become the most trustworthy person the government has to offer in the face of this pandemic.
Officially, Dr. Fauci is the Director of the National Institute of Allergy and Infectious Diseases (NIAID), a position he was appointed to in 1984. He has worked under six presidents, advising them on every outbreak from the HIV/AIDS epidemic up through Zika and Ebola. Now, he is part of the White House’s coronavirus task force.
At 79 years old, he still works 18-hour days, sticking it to infectious diseases with one hand, and smoothing the feathers of the American people with the other. Dr. Fauci certainly feels like the right person at the right time. So how did he get to this point?
A Doctor Grows in Brooklyn
Anthony Stephen Fauci was basically born into the medical profession. He grew up in Brooklyn, New York, in an apartment above the Fauci family pharmacy. As a teenager, he commuted by subway and bus to the prestigious Regis High School on the Upper East Side, and spent his evenings and weekends delivering prescriptions around Brooklyn by bicycle.
Fauci was the captain of the Regis basketball team and thought about trying to go on, but at 5’7″, figured he didn’t have much of a shot. Interestingly, his family didn’t push him toward science or medicine, at least not in so many words. He had grown up around artists from his mother’s side, and decided that becoming a doctor would put him at the intersection of science and humanities.
After high school, Fauci collected an interesting set of pre-med undergraduate credits steeped in classical studies before enrolling at Cornell Medical College. He graduated in 1966, and was given his choice of required military service, including the Public Health Service. Dr. Fauci was assigned to the National Institutes of Health (NIH), and has remained there ever since.
A Spoonful of Chemotherapy
In 1972, Dr. Fauci was promoted to senior researcher at the National Institute of Allergy and Infectious Diseases (NIAID), a division of the NIH. He kicked off his research by studying chronic fevers at the molecular level particular to vasculitis, a disease that causes blood vessels to become inflamed. Some types of vasculitis are caused by an overactive immune system, and the body attacks the blood vessels by mistake.
During this time, Dr. Fauci frequently observed patients at the nearby National Cancer Institute. The immunosuppressive reactions they had from chemotherapy gave him an idea. If chemotherapy drugs suppress the immune system, then extremely low doses of them could be the answer to vasculitis. It worked. Dr. Fauci effectively cured vasculitis, and this discovery led to good progress in the fight against more common diseases like lupus and rheumatoid arthritis.
Crusade Against AIDS
By the early 1980s, many doctors and scientists thought there were no more large-scale infectious diseases left to fight, at least in the first world. And then, seemingly out of nowhere, the HIV/AIDS epidemic showed up and proved them all wrong.
In 1981, Dr. Fauci read a report from the CDC about five otherwise healthy gay men who had contracted a form of pneumonia normally reserved for immuno-compromised persons. When a second, more alarming report came in a month later, he dropped what he was doing to fight what he felt was a serious emerging epidemic. His mentors were disappointed and thought he was wasting his career.
Fauci wrote a paper trying to get the medical community to take notice of the virus, and got it published after a few attempts. Meanwhile, he began making progress in the lab by studying B cells, which help produce antibodies. His lab figured out that the B cells of HIV patients become hyperactive, and this turned out to be a defining feature of HIV/AIDS.
In 1984, Dr. Fauci was made director of the NIAID. As the epidemic progressed over the next few years, he became the face of the governmental response, appearing almost daily to discuss the mounting public health crisis.
People wanted him to answer for the government’s lackadaisical response, but he wasn’t in a position to get drugs approved or even accepted into trials. Many thought his cautious scientific approach to the crisis was cold-hearted and detached. Dr. Fauci has said that it was a dark period for him because for the first time in his career, he wasn’t saving anybody.
Fauci decided to take a more humanistic approach, and spent time with leaders and members of the gay communities in New York and San Francisco to better understand where they were coming from. Soon, he created a division within the NIH focused on HIV/AIDS.
Platform for Pandemic Preparedness
Dr. Fauci continues to fight AIDS in between global pandemics and coming up with ways to cure fatal rheumatological diseases. He has received many awards and accolades, including 30 honorary doctorates and a Presidential Medal of Freedom from George W. Bush.
For the last 15 years, Dr. Fauci has been trying to garner interest in developing a platform vaccine — a kind of ready-made base that would work against an entire class of viruses. With these in place, developing vaccines tailored to specific viruses like SARS-CoV-2 could happen much more quickly. Unfortunately, getting to that point would require radical, top-down changes in the way that vaccines are developed. This kind of revolution would cost billions and take years, but could save countless lives. Maybe it’s time to get started.