This month brings the end to the remarkable federal tenure of Anthony Stephen Fauci, MD. Tony, as we’ve all come to know him, is one of our nation’s most accomplished physician scientists. His 54 years as a clinician and scientist at the NIH was marked by an extraordinary research career coupled with leadership positions in which he served as a member of the commission corps of the public health service rising to the rank of rear admiral, trusted advisor to NIH directors, several secretaries of health, and seven U.S. presidents. As he departs his official duties this month, there will be countless accolades about his many substantial scientific and leadership accomplishments, and I suspect even a comment or two from a few critics.
However, his most enduring accomplishment is his assiduous capacity to explain complicated science to both policymakers and the general public. Fauci has a way of taking complex scientific material and making it understandable, becoming the go-to guy whenever complicated public science communication was required. This will be his true legacy.
I first met Tony in 1990 when I was appointed commissioner of public health for the District of Columbia. This position threw me right in the middle of the HIV/AIDS epidemic where, like many of my public health colleagues, I was struggling to communicate effectively to the public and policy makers as we learned about this virus and the disease it caused, which eventually became known as acquired immunodeficiency syndrome (AIDS). Because it impacted the body’s immune system, complications from other infectious diseases and HIV-associated cancers were a rapidly growing area of knowledge. We were often challenged by the fact that what we knew and articulated one month would change a few months later as we learned more. Like many people, Tony was an expert and reliable voice for the scientific community’s efforts to diagnose, treat, and prevent transmission of this pandemic disease. He also was excellent in explaining what had changed and why based on new knowledge. To this end, he had a reliable partner in the nation’s Surgeon General C. Everett Koop, MD, who was then the most trusted name in public health communication. Over the years, I have relied on Fauci’s public communication for examples of how best to articulate complicated scientific principles about infectious diseases in my own work.
Since then, Fauci has continued in the tradition as a trusted health communicator. He has been amongst the most frequently visible public communicators of complicated science, particularly around infectious disease outbreaks. Infectious diseases of national concern such as the anthrax letters, SARS, H1N1, H5N1, MERS, Ebola, Zika, and Mpox, just to name a few. Each time, he served as the explainer of all things infectious and complicated.
His biggest communication challenge may very well have been the ongoing COVID-19 pandemic, which to date, has resulted worldwide in over 650 million known cases and 6.6 million deaths. In the U.S. alone, we have had over 99.9 million known cases and 1.08 million deaths. COVID-19 occurred in an environment of evolving knowledge about the SARS-CoV-2 virus, the clinical impact of the disease, rampant misinformation and disinformation spread through robust social media tools, and an extremely polarized political environment. Adding to the challenge, the lack of communication alignment amongst public figures at the federal, state, and local levels made it easier for false information about the pandemic to spread. This false information resulted in increased morbidity and mortality in communities where disinformation was most prevalent and opposition to proven public health measures like masking or social distancing were resisted. This was particularly a challenge because of his position as a chief health advisor to President Trump, who was often a major purveyor of misinformation. Fauci’s role as a trusted communicator of complicated science was challenged when the public response and backlash in some quarters became threatening to him and his family. Despite this, he remained steadfast in his advice both to the President and the public.
Fauci also gave sound advice to his public health colleagues, including me. He was awarded the Presidential Citation of the American Public Health Association in fall 2020. That year we had an all-virtual meeting because of COVID-19. In his prerecorded remarks, he humbly accepted the award and then acknowledged the hard work of the public health community for their resilience and dedication in addressing the pandemic. His message was one of his strong commitments to science, ensuring equity in our response, his belief that we would have at least one effective COVID-19 vaccine, and his resolute view that public health measures would successfully address the pandemic.
There will be many accolades in the coming days about Tony’s scientific achievements as an immunologist and director of the National Institute of Allergy and Infectious Disease (NIAID). He was central to many discoveries about HIV/AIDS and helped create the President’s Emergency Plan for AIDS Relief. Of course, we all know of his most recent accomplishment as a prime force behind Operation Warp Speed, which delivered, in record time, a safe and effective mRNA vaccine for SARS-CoV-2 infection. He has certainly received a plethora of scientific recognition for this work. There will also be accolades for his role as a physician advocate and his extraordinary ability to engage and partner with community advocates to ensure they have a seat at the research table. This is an approach many of us have tried to emulate in general public health practice.
Tony is indeed stepping down this month from his national role as President Biden’s chief medical advisor, and his 38-year role as NIAID director and clinician. He says he is not retiring, and I suspect like many public health practitioners he will take a well-deserved and needed rest before embarking on the next chapter of his professional life. However, if there is one thing COVID has taught us about infectious diseases, it is that they are here to stay, and we will always need an extraordinary communicator on all things complex and infectious. Tony, don’t turn off your cellphone.
Georges C. Benjamin, MD, is executive director of the American Public Health Association.
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