Laudatio for Dr. Anthony Fauci on the occasion of his being awarded the 2013 Robert Koch Gold Medal
Peter Palese
Icahn School of Medicine at Mount Sinai, New York
It is a great privilege to introduce this year’s Robert Koch Gold Medal winner, Dr. Anthony Stephen Fauci. Tony Fauci was born about 100 years after Robert Koch, yet there are remarkable parallels in their lives. Robert Koch worked on a variety of topics including anthrax, cholera and tuberculosis. Tony Fauci has been working on a variety of topics including anthrax, cholera and tuberculosis, and if Robert Koch were alive today he would have added HIV, SARS and influenza to his portfolio as Tony Fauci did. Robert Koch went oversees to Africa and India to study cholera. Tony Fauci realized that some of the greatest needs for intervention were in Africa and other low income countries. And finally, Robert Koch used his talents to persuade emperors, kings and politicians to recognize the strength of science in his quest to bring cures to humankind and that is one of Tony Fauci’s great talents as well – his ability to talk to presidents, politicians and scientists alike to convey the strength of science in improving the health of us all. Tony Fauci is a true New Yorker who was born in Brooklyn to a family of Italian immigrants. His father was a hardworking pharmacist and the entire family was involved in running this business. Tony was a top student in elementary school, he graduated top of his class from Regis High School in Manhattan and he was top of his class in college (Holy Cross in Worcester, Massachusetts). Along the way the Jesuits taught him Latin, Old Greek and French and instilled in him, what Tony calls, “Precision of thought, economy of expression and intellectual discipline.” This education propelled him to be first in his medical school class at Cornell University Medical College in New York; graduating number one at Cornell is no small feat. He stayed on for his internship and residency at The New York Hospital-Cornell Medical Center - arguably the best hospital in the country both then and now - and shortly thereafter was a Chief Resident at The New York Hospital (1970-71).
Tony fulfilled his military obligation as a “Yellow Beret” at the National Institutes of Health (NIH) starting in 1968 and he has been there ever since (except for the short stint as Chief Resident at The New York Hospital). He started out his career working on a rare disease which was at the time called Wegener’s granulomatosis. By understanding the mechanism of the disease (in essence its pathophysiology), he designed a treatment. Tony Fauci understood that the autoimmune component - a major cause of the symptoms - could be inhibited by administering an immunosupressive drug, cyclophosphamide. This was a major medical breakthrough for treating these patients. This was precisely the way Tony Fauci would address other important challenges in the future.
In the summer of 1981, he learned about another rare disease, a “curiosity disease.” Only about 100 people were affected by the disease and the median survival appeared to be short (6-8 months). Being an immunologist, Tony Fauci and his colleagues looked for the mechanism of the disease now known as HIV/AIDS. His 1988 Science publication on the pathogenesis of HIV was the most cited paper in all of Medicine in 1989. His 1993 Nature publication on HIV in lymphoid tissues was the most cited paper in AIDS research in 1993-95. This understanding of the functional defect of CD4+ T cells in HIV-infected individuals provided the rationale for using anti-retroviral therapy --- and the rest is history. We now have more than 25 drugs for HIV and patients have a much longer life expectancy. A young HIV-infected patient may continue living for 50 years.
Tony Fauci not only continued his research, changing the outlook for HIV- infected patients, but he’s also responsible for three remarkable initiatives. First, he designed the “parallel track” which allowed HIV patients to obtain access to drugs that were restricted by the FDA to specific clinical trials. Dr. Fauci successfully pushed this program through, and one might say pushing against the FDA. Second, he lent his prestige and unwavering energy to the PEPFAR program (President’s Emergency Plan For AIDS Relief). This program was underwritten by George W. Bush with about $15 billion and saved or extended the lives of millions of patients, most in Africa and other low income countries. Neither President Bush nor Dr. Fauci have been given the appropriate credit they very much deserve for this initiative. A third public health campaign was also largely organized by Dr. Fauci; his efforts were aimed at ensuring biomedical security of the civilian population of the United States. This was in response to the anthrax attacks in the U.S. and included measures to protect not only against anthrax, but also against smallpox, Ebola virus and weaponized microbes. Tony Fauci again showed his evidence-based (medicine) approach to this complex problem.
It was not enough for Tony Fauci to lay the foundations for the “parallel track,” PEPFAR and the biodefense program; in his function as the Director of the National Institute of Allergy and Infectious Diseases (NIAID) he is also instrumental in providing direction for the malaria, tuberculosis and pandemic influenza programs. Again, Tony Fauci has brought to these tasks his foresight, tireless dedication and most importantly, his common sense.
Tony Fauci has a wonderful scientific record (more than 1,000 papers), he is a member of the National Academy of Sciences, the Institute of Medicine, he has received some 40 honorary doctorates and he was honored with the Lasker Award for Public Service in 2007. He is also a recipient of the highest civilian honor in the United States, the Presidential Medal of Freedom. He shares this award with Neil Armstrong, the first man on the moon, with Frank Sinatra and with Walt Disney, amongst others. Tony Fauci is the best that American Science has to offer. He is a remarkable public servant who runs a research department at the NIAID with over 1,600 members and a budget of several billion dollars. Above all, Dr. Fauci is a decent man of extraordinary humility and humanity. Previous recipients of the Robert Koch Gold Medal were the Nobelist John Enders, Albert Sabin, Jonas Salk and more recently Maurice Hilleman, who probably saved more lives than anyone else through the development of many vaccines. Dr. Anthony Fauci belongs in this Hall of Fame of great scientists and great human beings – Congratulations!!!