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Vol. LXIII, No. 13
June 24, 2011
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Fauci Provides Perspective on 30-Year Fight Against HIV/AIDS

On the front page...

NIAID director Dr. Anthony Fauci

NIAID director Dr. Anthony Fauci

Marking the 30th anniversary of the first published reports June 5, 1981, of a mysterious ailment that would later be called HIV/AIDS, NIAID director Dr. Anthony Fauci, NIH’s—and arguably the nation’s—chief medical spokesman on the disease, offered a uniquely personal perspective of the fight against the worldwide pandemic. Fauci presented a 50-minute talk before a packed Masur Auditorium on May 31.

In often-humorous, often-poignant reflections, he described his personal journey: How “a medical curiosity I thought would go away” transformed a scientific research career, launching it onto the pages of history.

Continued...

Dr. Cliff Lane (l) and Dr. Henry Masur (second from l) were two key recruits in the early fight against AIDS at NIH. Fauci recounts highlights of the past 3 decades of AIDS research; on the screen behind him is a scene from a demonstration at FDA by ACT UP in May 1990.

Dr. Cliff Lane (l) and Dr. Henry Masur (second from l) were two key recruits in the early fight against AIDS at NIH.

Fauci recounts highlights of the past 3 decades of AIDS research; on the screen behind him is a scene from a demonstration at FDA by ACT UP in May 1990.

Some highlights:

  • Summer 1981—Fauci decides to “walk away from” the successful work on Wegener’s granulomatosis that his NIAID Laboratory of Immunoregulation was pursuing to redirect all efforts toward this newly discovered infection affecting a rapidly growing population of people. He engages another scientist in his lab, Dr. Cliff Lane, and recruits from Cornell Medical School Dr. Henry Masur, who form the core of the critical care team that will begin admitting AIDS patients to the Clinical Center.
  • Early 1980’s—The self-described “dark days” of Fauci’s career, when the median survival time for AIDS patients was 6 to 8 months. “We can now mathematically model that a 20-year-old HIV-infected patient can live an additional 50 years on appropriate therapy,” Fauci proclaimed at the lecture.
  • 1987—AZT, the first treatment for AIDS, is approved; it was developed by NCI’s Dr. Samuel Broder and colleagues. Fauci said the triumph was short-lived, as “we quickly realized that one drug was not enough.” Today, more than 30 anti-retrovirals have been approved to fight HIV/AIDS.
  • 1987—NIH, led by Lane, conducts the first-ever AIDS vaccine clinical trial. More than 2 decades later, in October 2009, the New England Journal of Medicine publishes “the first good news” about an HIV vaccine that shows “a modest effect” on preventing the disease.
  • June 1988—Fauci is called an “incompetent idiot” in a San Francisco Examiner open letter by AIDS activist Larry Kramer, founder of ACT UP and the Gay Men’s Health Crisis who later became one of Fauci’s closest friends and allies.
  • June 26, 1989—Fauci mentions at a small meeting of AIDS activists that he endorses so-called parallel track: Offering to AIDS patients some anti-HIV therapies that—while at the same time going through the FDA-approval process —are not yet officially blessed. The New York Times makes his comment a headline. The FDA is not amused. An inter-HHS agency brouhaha brews. “For the first time, I think I’m going to get fired,” Fauci quipped, looking back decades later. Fortunately, then-President George H.W. Bush intervenes, backing Fauci. So begins the parallel track mechanism for AIDS drugs.
  • December 2003—President George W. Bush announces a “game changer” in Africa. PEPFAR (President’s Emergency Plan For AIDS Relief)—a $15 billion effort over 5 years—is born. “One of the things I am most proud to have been involved in,” Fauci noted.
Fauci and his wife, Dr. Christine Grady

Fauci and his wife, Dr. Christine Grady, who was a nurse at the Clinical Center when AIDS broke out in the U.S.

Photos: Bill Branson

Funding has been extraordinary overall, Fauci said. NIH has invested about $45 billion in HIV research over the last 30 years.

His journey as well has been phenomenal, he said.

In July 2010, he and colleague Greg Folkers wrote in JAMA words Fauci said no one ever dreamed would be possible 3 decades ago, “Controlling and Ultimately Ending the HIV/AIDS Pandemic: A Feasible Goal.” Fauci ended his talk by reiterating a statement he made on last World AIDS Day, Dec. 1, 2010:

“I hope that in the not too distant future, World AIDS Day will be a commemoration of something that happened in the past as opposed to a challenge that we still face today.”

To see the full lecture, visit Past Events online at http://videocast.nih.gov/. NIHRecord Icon


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