Anthony S. Fauci

First Person | Anthony S. Fauci Courtesy of NIAID On normal days, he works 14 hours, jogs for lunch, eats dinner with his family after 9, and continues working until bedtime, when he sleeps for about 4 1/2 hours. But normal is long gone for Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. He has bioterrorism worries and SARS on his plate, along with AIDS, which put Fauci's name in the limelight years ago, when gay men demanded being heard, noticed, and respected. It was Fauci, raised in Brooklyn, educated by Jesuits, who said, "Bring them to the table." Fauci, 62, says he's an NIH lifer. "This is very suited to me. When you can have an impact on the public health of this nation, and [consequently] an impact on the public health of the rest of the world, that's what really gives me satisfaction." What were you thinking when you visited the gay bathhouses in the late 1980s? I have gay colleagues and gay friends, but in a straight world, you don't get the feel of the culture. I really needed to see that. I went through the [bathhouses] and said, this is something that is going to require a lot more than saying 'just say no.' You attended two Jesuit-run schools. Are you a man of faith? Broadly and generically, I'm not a regular church attender. I have evolved into less a Roman Catholic religion person [to] someone who tries to keep a degree of spirituality about them. I look upon myself as a humanist. I have faith in the goodness of mankind. When the AIDS epidemic came, I had already evolved into a way of looking at life that was extremely tolerant. Yes, some at the NIH had issues with my approach. It was a good thing I was the boss. [Colleagues and others] were very concerned and disturbed about allowing a reactive gay population a seat at the table to discuss the agenda. But to a person, years later, they said, "You were quite correct." What did you learn from your dad, who was a pharmacist? I got an early exposure to public health. Back then, a pharmacist served the community as the first line of [medical] defense. You're not interested in being the NIH director. I didn't want to get so far removed that I couldn't make my impact on [public health]. That means a lot to me. Also, I run an active lab. If I took on the broad [responsibilities of the] generic NIH, it would take me further away from the lab. Do you still see patients? Twice a week. The vast majority are individuals with HIV, [who are accepted after meeting] detailed, explicit entry criteria. We have multiple protocols. What trends in AIDS are you seeing now? There's been a shift in demo-graphy. Fifty percent of new infections this year are African Americans, 20% Hispanic. Either they live in the inner city, and contracted it through intravenous drug use, or had sexual contact [with a partner who contracted HIV] by drug use. Why isn't the message getting through? You have 40,000 new infections every year; this has reached a plateau over 10 years. They don't know, and don't care. I think we have got to do better with the message. You've worked with Democrats and Republicans. Do you like politics? I like what you can accomplish if you know what you are doing. If you are consistent and honest and let science and the whole aspect of public health guide you, whether you're a Democrat or Republican, they respect you and they come back to you and rely on you. Must you hold your tongue? Not substantially, but there are times when you have to defend a certain position. The most recent [example] is the commitment of the US to helping AIDS-infected people in Africa. I could have gotten on a soap box, [or] you can support the people in the administration and work behind the scenes with them. What is your favorite paper? A 1973 paper was the first demonstration of the induction of remission in a lethal inflammatory disease by the use of cytotoxic agents that were formally used in cancer patients.1 A 1993 paper was a demonstration that HIV actively replicates in lymphoid tissues, even through the asymptomatic phase of HIV.2 What bothers your family and colleagues about you? The fact that I'm an absolutely incorrigible workaholic. My doctor is pissed at me, and I trained him here. My wife ... really understands what I am doing. My girls, we make a point to eat together; they give me a little bit of flak. What is stressful for you? Having thoroughly overlapping things at the same time: being summoned to the Oval Office at 3:00 p.m., and CNN wants you at 3:00 p.m., and you have to meet with your postdoctoral fellows at 3:00 p.m. What's your idea of a good time? Being with my wife and children and eating fried calamari, drinking a glass of wine, and fishing. References 1. A.S. Fauci, S.M. Wolff, "Wegener's granulomatosis: Studies in eighteen patients and a review of the literature," Medicine, 52:535-61, 1973. 2. G. Pantaleo et al., "HIV infection is active and progressive in lymphoid tissue during the clinically latent stage of disease," Nature, 362:355-8, 1993. function sendData() { document.frm.pathName.value = location.pathname; result = false if (document.frm.score[0].checked) result = true; if (document.frm.score[1].checked) result = true; if (document.frm.score[2].checked) result = true; if (document.frm.score[3].checked) result = true; if (document.frm.score[4].checked) result = true; if (!result) alert("Please select") return result; } .myradio{background-color : #94bee5} Please indicate on a 1 - 5 scale how strongly you would recommend this article to your colleagues? Not recommended 1 2 3 4 5 Highly recommended Please register your vote

Anthony S. Fauci

The Scientist Staff

First Person | Anthony S. Fauci

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