NEWS

He first became known to the biomedical community and to AIDS patients through his HIV research in the early 1980s. Today he is known to millions across the US as the man who explains the science behind bioterrorism. Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, talked to Nature Medicine . Anthony Fauci

Those who know him will know that can and can’t be done because the authori- be developed within three to five years, Anthony Fauci is a man brimming with en- ties depend very strongly on our word.” Fauci is more cautious, most probably be- ergy and enthusiasm for his work. His im- The charismatic Fauci has also been se- cause of the verbal attacks from the AIDS mense level of personal drive enabled him lected to be the current science face of the community he suffered in the early 1980s to work 20-hour days during the weeks nation. As such, he appears regularly on and sharp criticism from some public when the anthrax scare was at its peak, television explaining the infectivity of health researchers over his refusal to fund when 5 people died. bioterrorism pathogens. This takes up an studies of VaxGen’s controversial vaccine, Things have calmed down since then, enormous amount of his time, but he ac- AIDSVAX in 1995. relatively speaking, and Fauci’s daily cepts the role out of a sense of duty. “I owe “If you’re talking about a vaccine that’s schedule is back to normal. “I get up at it to the public to articulate these issues to truly useful and will have a substantial im- 4:30 a.m., come into work around 6:30 them. They’ve invested a lot of money in pact on the epidemic it’s going to be more a.m. and balance my meetings with my my institute—$2.5 billion is a lot of re- than three years. The most you can hope postdocs and lab staff with my administra- sponsibility. With the anxiety that’s run- for by then might be a vaccine to protect tive duties. I like to go through research ning through society I feel it’s my against disease progression rather than in- data every day. I run around the bucolic responsibility to explain what’s going on.” fection.” Fauci is involved in work on both landscape of the NIH at lunchtime then zip Fauci, who was born in Brooklyn and ob- kinds of vaccine. His institute is supporting on through the rest of the day, leaving tained his M.D. from Columbia University, Phase II trials of a prophylactic canarypox around 9:00 p.m.,” he tells me without is filled with a sense of vaccine in collaboration drawing breath. public duty from his for- with Aventis Pasteur. Already working as a senior investigator mative years. Growing Antibody and cytotoxic at the United States National Institutes of up, his family’s philoso- T lymphocyte data will Health (NIH), he became the director of phy was based on what be analyzed over the the National Institute of Allergy and one could do for other next few months to Infectious Diseases (NIAID) in 1984, not people and his strict determine whether the long after he redirected his immunology Jesuit schooling in- vaccine can progress © 2002 Nature Publishing Group http://medicine.nature.com Group Publishing Nature 2002 © lab to study HIV. “Back in the early years of stilled a sense of public to Phase III studies. the AIDS epidemic I was quite alone in that responsibility into him. Meanwhile, his labora- I recognized that this was going to be a “I’ve chosen public ser- tory has recently pub- major public health problem. I wrote about vice as my career but in lished primate data on a that in Editorials at the time—1982. Many the arena of health and vaccine to prevent dis- of my colleagues thought I was crazy to science. As researchers, ease progression ( Nature change direction in my lab, it was even be- we all have the com- Med . 7, 1225; 2001). fore the virus was discovered.” mon goals of uncover- His devotion to bench- Facing the nation One new aspect to his present day rou- ing the unknown in work is one of the main tine is that Fauci is now one of four close science and using that reasons why he has hith- advisors to the secretary of Health and for the benefit of man- erto refused to take over Human Services, Tommy Thompson. As kind. I do this, and an official component the directorship of the NIH when it has such, he can be called to see Thompson at of what I do is public service, which is the been available, as it is now. He has stressed any moment and, as a minimum, joins reason I have stayed at the NIH for a num- his desire to continue working on the him on a conference call every day. “We’ve ber of years, and not taken any one of the frontline in his field of expertise—infec- assumed a role that transcends the research far more lucrative offers I’ve had.” tious diseases—and to carry on leading role that I have, and the regulatory role So how does the bioterrorism crisis com- NIAID. But as his political persuasion is that the FDA [US Food and Drug pare with the AIDS epidemic? “When I more in line with the current Republican Administration] person has, et cetera . We started to talk about AIDS to the public and Administration than the former regime, advise the Secretary of Health on how to the government it was very different be- would he accept the post now? His official handle the current bioterrorism situation. cause I was trying hard to get them inter- comment is “no comment.” However, for When you get the call, you have to go to ested in something that I knew was going those who know Fauci, this is more affir- the crisis room and start figuring out what to evolve into a major problem. I had to mative than the flat denials he has issued you’re going to do. It’s just like a wartime drum up interest and funding. So I wasn’t in the past. So perhaps if the roles of NIH heightened alert,” he says. having to respond to the concerns of an and NIAID director were somehow com- He has spent recent weeks drawing up a entire nation as I do now, it was quite the bined he would agree to take the job. Only plan for increased expenditure on bioter- opposite.” Tony Fauci would have the energy for such rorism research at the NIAID (see page 6). Unlike some outspoken scientists in the a dual role. “We have to precisely understand what field who claim that an AIDS vaccine will Karen Birmingham, London

10 NATURE MEDICINE • VOLUME 8 • NUMBER 1 • JANUARY 2002