Public Health

Dr. Fauci stood up for science when it counted. What’s next?

Len Strazewski , Contributing News Writer

Anthony Fauci, MD, director of the National Institute of Allergies and Infectious Diseases (NIAID) and President Joe Biden’s chief medical adviser, rocked the medical and scientific community by announcing his impending retirement—but he’s not disappearing from public service yet.

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The leader of the national response to the COVID-19 pandemic and HIV research before that will be stepping down from government service to teach and speak on medical issues and uphold the principles of scientific research, he said in a recent video interview with JAMA®.

“It’s not retiring—more like rewiring,” Dr. Fauci said, quoting his wife when discussing his past and future career in the video interview with JAMA Editor-in-Chief Kirsten Bibbins-Domingo, MD, PhD, MAS.

In a statement issued when Dr. Fauci announced his upcoming departure from federal government service, AMA President Jack Resneck Jr., MD, said that “for more than 50 years, Dr. Anthony Fauci has been a strong and steady voice for science—and data-driven responses to some of the biggest public health challenges of our time.

“Through the HIV/AIDS crisis, Ebola, Zika, and nearly three years of the COVID-19 global pandemic, Dr. Fauci has not only provided sage advice and counsel to presidents of both parties, but he smartly leveraged modern media to deliver clear and direct guidance and information to the American people,” added Dr. Resneck.

In his interview with JAMA, Dr. Fauci said that upon leaving NIAID he intends to become even more of a public communicator and crusader for scientific values and medical research. The need to stand up for what science teaches is part of his educational history and personal makeup.

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While initially drawn to the idea of being a practicing physician, after a three-year fellowship with the NIAID he was offered a permanent position at the institute.

“I wanted to use that as a personal experiment to see would I like research—both basic and clinical—and was I any good at it?” he said. The result was a commitment to “the nexus between clinical medicine and research.”

Dr. Fauci’s best advice for medical students and public health officials is to try to develop precision of thought and economy of expression, as he was trained to do during his Jesuit high school and undergraduate education.

After he steps down in December, one of the challenges Dr. Fauci will take on is the anti-science attitude that has arisen amid the COVID-19 pandemic as people looked for answers during difficult times. The interest in hydroxychloroquine as a treatment for COVID-19, for example, spread worldwide before scientists attacked the lack of facts and research supporting it.

There are some “people who have complete disregard for facts or distort facts or distort reality or deny data and make statements that are not at all backed up by scientific information and scientific data,” Dr. Fauci said. “What scientists have to do is just stick with the science and stick with the data. It is very frustrating when you are dealing with individuals or groups that actually deny the reality.

“You can’t get rattled by that which sometimes people do. Just make sure you stick with the science and do that consistently,” he said.

Learn more from Peter Hotez, MD, PhD, about the “anti-science aggression” that is feeding vaccine refusal.

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Dr. Fauci recalled needing to disagree publicly with the previous U.S. president on the use of hydroxychloroquine to treat COVID-19. It was necessary, he said, “to maintain my integrity and fulfill my obligation to the American public, which is where my obligation lies.”

But standing up for the facts of research comes at a cost, he noted. During the pandemic and his public role communicating scientific research, Dr. Fauci and his family were threatened and harassed, creating a need for security provided by federal agents. (Learn about AMA policy, adopted in 2020, on protecting physicians and other health professionals.)

At the same time, Dr. Fauci noted, flexibility is essential. Health communicators must be ready to respond to new information and communicate that clearly and effectively to their audience.

“Changing when change is warranted is important,” he said. “When you talk to the public, you’ve got to continue to emphasize that you are dealing with a dynamic situation and you will have to change as new data and new evidence comes about.”

To learn more about health policy, medical research and clinical care news from Dr. Bibbins-Domingo, watch her recent interview as part of “AMA Update.”