EXPLORE | THE BIG IDEA
PHOTOS, FROM TOP: ANTHONY S. FAUCI ARCHIVE; NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASESFrom top: A 1940s photo shows young Anthony Fauci
with his parents, Eugenia and Stephen, and his sis-
ter, Denise; a 1984 photo shows Fauci working at the
National Institute of Allergy and Infectious Diseases.I was sitting in my little office on the 11th floor of
the NIH Clinical Center on a hot summer day, the
first week in June, when I saw the report. I had been
studying drugs that suppressed the immune system,
and we were seeing Pneumocystis cases. So I said,
“There’s something strange going on here,” and put
it into my desk drawer.
One month later, on the fifth of July of 1981,
another MMWR appears on my desk. This time,
26 men. Amazingly, all gay men. Not only from Los
Angeles, but from San Francisco and New York,
who not only had Pneumocystis pneumonia but had
Kaposi’s sarcoma: a tumor, a cancer seen in people
whose immune system is dramatically damaged.
I remember looking at that and going, Oh my God,
this is a brand-new infectious disease. I actually got
goose bumps. I had no idea what the cause of the
infection was, but I did know it destroys the immune
system. As a physician/scientist trained in infectious
diseases and immunology, if ever there was the dis-
ease that was made for me, it’s this.
I made a decision then that I was going to com-
pletely change the direction of my research. I had
been extremely successful in my career, and my
mentors, the people who recruited me here years
ago, told me I was crazy. They said, “Why are you
throwing away a promising career to go chasing after
a disease that’s a fluke?” I decided that I was going to
do it anyway. I felt obliged to explain it to the world.
Unfortunately, it turned out that I was right. It
exploded into one of the most extraordinary pan-
demics in the history of our civilization.Homophobia was clearly pervasive at the outbreak
of AIDS. Because I was spending most of my time
with sick gay men, I would see homophobia in soci-
ety—and by association as their physician be on the
receiving end of homophobic attacks.
I don’t think I ever had any element of homopho-
bia or even any inkling of that in me. I think it gets
back to my parents and their tolerance for other
people. Empathy was a big component of my growing
up in the family in which I grew up—and again, it was
solidified and underscored in the training, in Jesuit
training in high school and in college.
I have always felt an empathy towards people who
were being treated unfairly, as well as the unfairness
of the prejudice against a person whose sexual per-
suasion is beyond their control. It’s just who they are.
The injustice of that dominated my attitude about
what homophobia was and is. It made me angry to
see people have that attitude. It made me a defender
of someone’s right to be who they are.My optimism is that there are going to be bad actors
and there are going to be better angels. But I think
there are more better angels than bad actors.I’m really not afraid of very many things. But what I’m
most concerned about is not getting the opportunityto finish the things that I started decades ago and
to add the finishing touches. I would like to see the
defining public health challenge of my professional
career, HIV, ended as an epidemiological pandemic.
Everyone thought ... we could cure or eradicate AIDS.
And that turned out to be very difficult and could
actually be impossible. I don’t think we’re going to
eradicate HIV—in fact, I know we’re not—but I think
we can almost eliminate it gradually throughout the
world. First in countries that have more resources,
like the developing countries, but then, ultimately,
in sub-Saharan Africa ... My fear is that I may not
necessarily see that. But I hope I do. And I think I will.Fauci’s work at the NIH made him uniquely prepared
to face the coronavirus pandemic: He had already
worked on treatment and prevention efforts for the Zika
virus, Ebola, anthrax, pandemic flu, HIV, tuberculosis,
and others. But he’s acutely aware of the public’s short
memory. We say we learn from experience, but how
can we make sure that’s really true?
I think when you get further and further away from
a really profoundly defining event, the impact of
that just attenuates. In 1918, during the Spanish flu18