Dr. Anthony Fauci introduced his new memoir, “On Call: A Doctor’s Journey in Public Service,” which reflects on his decades of public service and his role in combating major epidemics at a Nov. 6 Georgetown University event.
Fauci, former director of the National Institute of Allergy and Infectious Diseases (NIAID) and current distinguished professor at Georgetown University School of Medicine and the McCourt School of Public Policy, spoke about the evolving relationship between medicine and society to preview his book. The event was led by Emily Mendenhall, the director of the science, technology, and international affairs (STIA) program.
At the event, Fauci analyzed how the HIV/AIDS epidemic, which began in 1981, became an important story in the history of patient advocacy. At the time, clinical trials were the only avenue for HIV patients to access therapy.
With the FDA approval process taking years and clinically ill patients often projected to have less than a year to live, advocacy from the LGBTQ+ community demanded faster access to therapies.
Fauci said listening to the LGBTQ+ community when addressing the AIDS crisis was one of the greatest decisions in his career.
“I started to listen to what they were saying, put aside the theatrics and the disruptive behavior, and what they were saying made absolutely perfect sense,” Fauci said at the event. “What that opened up was a relationship with the activist community that ultimately led to what we call the parallel track, which was the first foray into compassionate use of drugs, which means that you can do the clinical trial with all of the pristine aspects of it, inclusion and exclusion criteria, but in parallel, you can get the drug to be available to people outside of the clinical trial, so long as they do informed consent, so with all of the disruptions that were done.”
Lizzy Kim (SOH ’28), a human science student who attended the event, said she was inspired by Fauci’s empathy for the advocates and by his role in the parallel track.
“I was very impressed by Dr. Fauci’s ability to rewrite the narrative of health care access, publicly speaking against the FDA’s rigid and impractical practices in entry, exclusion criteria and clinical trial cases in the midst of an HIV epidemic causing thousands of deaths by the month,” Kim wrote to The Hoya.
In 1996, triple-drug therapy was introduced in the United States, transforming HIV care and allowing patients to live relatively normal lives.
However, most infections occurred in sub-Saharan Africa, and Fauci said it was an injustice that life-saving drugs were inaccessible to certain populations due to geography.
“People in the United States, Canada, Australia and the European Union had accessibility to drugs that were completely life-saving, but 67% of all the infections were in sub-Saharan Africa,” Fauci said. “So in my multiple trips to Africa, I became very taken up by the unfairness of the disparity, where the African physicians in the year 2001-2002 were like Tony Fauci in 1983,” Fauci said.
To tackle this issue, Fauci and former President George W. Bush created the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003, a global initiative led by the United States to address HIV/AIDS epidemics in other countries. Since then, PEPFAR has invested over $120 billion in 50 countries, providing lifesaving opportunities to 25 million people.
Fauci said PEPFAR is facing federal cuts, which could be detrimental for both developing countries and the United States.
“The PEPFAR program is now under siege, and they’re trying to cut it, which I think would be a really bad mistake, not only a bad humanitarian mistake, but a bad mistake for our country, which is one of the most important manifestations of what we call soft power in the world, where the countries totally respect us for what we’ve done in the developing world,” Fauci said. “It would be terrible to lose that.”
Fauci also addressed the COVID-19 pandemic, saying he felt a public responsibility to be open with the U.S. public about scientific developments, even if it meant contradicting the president.
“I have a great deal of respect for the presidency of the United States, no matter who is in the office, but I just feel I have a responsibility as a physician and as a scientist to the American public, and when you have a responsibility for the American public, you have to tell the truth,” Fauci said.
Fauci said ultimately, after leading the NIAID, conducting research and working in public policy, his primary identity is as a physician.
“When I asked myself who I am, I’m fundamentally a physician,” Fauci said. “When you look at global health, the entire population is your patient in a metaphorical way, so you have to have a responsibility for the general public, which is the reason why you do the research or you get involved in policy decisions to make advances to benefit the general public.”
