After more than 50 years of government service, the nation’s leading infectious disease expert, who became a national figure during the COVID-19 pandemic while also fielding relentless personal attacks, is preparing for his next venture and says he hopes it will include inspiring the next generation to get involved in public service.
Dr. Anthony Fauci, 81, director of the National Institute of Allergy and Infectious Diseases, chief of the NIAID Laboratory of Immunoregulation and chief medical advisor to President Biden, announced last month that he was stepping down from those positions. However, he said explicitly that he is not retiring.
“I would like to look at what I have to offer at this stage in my career and it’s the experience I’ve garnered over the last 54 years as the scientist at NIH and the last 38 years as director of [NIAID] and perhaps inspire some of the younger generation of scientists, and would-be scientists to get them interested in a career in public service, particularly in the arena of public health, involving medicine and science,” Fauci told Government Executive in a recent interview. He advised young federal scientists to “stick with the science, stick with the evidence, stick with the public health issues and stay out of politics.”
The following are highlights from Government Executive’s interview with Fauci that have been edited for length and clarity. The full interview will be on an upcoming episode of our podcast, GovExec Daily.
On his long tenure with the federal government
Well, I came to the NIH 54 years ago, as a 27-year-old physician who [had] just completed his clinical training in medical residency in internal medicine, at the New York Hospital-Cornell Medical Center [now Weill Cornell Medical Center]. I still feel the same of the extraordinary opportunity and excitement and stimulating nature of the environment here at NIH and I’ve had multiple roles. I came in as a fellow then a junior scientist, a senior scientist, then a laboratory chief and then ultimately, the director of the institute. And at each different level, the responsibilities and the opportunities broadened and became even more exciting.
I could stay here forever, but I don’t think that that’s in the cards. You have to step down some time. And there are a few things that I would want to do outside of the realm of the federal government while I still have the energy and the motivation and the good health to do that. But I love everything about the NIH. I’m walking away from it [with] a bittersweet feeling that my life has been the NIH. I don’t think there are very many people who have spent almost 60 years in a single place. I still feel as strongly in a positive way now, if not more than I felt at that time.
On what has most changed and stayed the same at NIH and the federal government
Well, the consistency has been the integrity of the process of scientific investigation. The advancements in science have been breathtaking. So, if you want to say what has changed, it’s the expansion of our knowledge, technically and conceptually about biomedical research. But what has changed is the rapid expansion of this foundation of knowledge and the source of knowledge. It’s gotten much more complicated. Science has been much more of a team effort now because there are so many complicated aspects of it that the day of the individual scientist in a lab alone with their technician is – although it hasn’t disappeared completely – it’s much more of a rarity.
On leaving the government as a national celebrity and a target of criticism
I don’t even think that was even in the fringes of my imagination that that would happen because I was just focusing on learning infectious diseases and learning immunology. And then as I learned it, I was interested in pursuing research projects…I got involved in HIV/AIDS from the very first day in 1981 and I had the privilege of being the personal adviser to seven presidents. That’s an unusual situation for an institute director to be in, but it was the nature of the diseases for which I was responsible that put me in a position regarding policy and public health. That was very public. So, I gradually, with HIV, with the anthrax attacks, with pandemic flu, with Ebola, with Zika became much more and more of a public figure. When COVID came that magnified that multifocal because of the extraordinary impact that COVID has had on the world.
On advice for young scientists or others who are considering working for the federal government
If you have any kind of tendency or propensity to wanting to go into public health, particularly in the arena of public service, but it doesn’t always have to be public service, you could do it in the private sector, but public health is an extraordinary field because the impact that you can have in a very positive way, among the lives of so many people, is extraordinary, an opportunity that not many professions have. So, I would encourage young people to realize that this is something, if you feel you’re interested in it, you should seriously pursue it because it can be extraordinarily gratifying and fulfilling. That would be the advice I would give them. And once there, I would say, stick with the science, stick with the evidence, stick with the public health issues and stay out of politics.
On what the personal attacks from Republicans and the former president mean for the future of the federal government’s public health responses and the next generation of public health scientists in the government
We should not be deterred by those kinds of attacks because there is an anti-science feeling among some in this country, certainly not everyone. That’s manifested, for example, by anti-vax feelings, when you have a vaccine that’s safe, highly effective, and has already saved the lives of many, many millions of people and you still have pushback against the utilization and the implementation. That is an unfortunate situation in our society. So, I would encourage young people interested in getting involved in the field to not be pushed back by that but to realize that the positive aspects of a career in public health greatly override and overshadow the negative issues that we’ve experienced with COVID.
On what the federal government might have done differently in its response to monkeypox
That’s a question, the answer has to be always, you can always do better. No one is perfect. No one should even imagine that they’re perfect. If you look at what the complaint is among some of the constituents with some justification, but also maybe a little bit over-determined, is that the federal government, particularly the [Centers for Disease Control and Prevention], did not come forth quickly with the distribution of the countermeasures that were available. But in fairness to the CDC, they did correct that pretty quickly with regard to the availability of vaccines, with regard to the availability of testing, with regard to the availability of antivirals in the form of TPOXX. So, I think that all in all, they did a good job. But one can understand some of the concern that if it could have been done better, perhaps it could have done better in getting interventions to people more quickly than were available in the beginning.
On whether NIH and/or NIAID should undergo an internal review
We do that all the time. We review ourselves consistently. I’m very pleased to see and I admire the fact that the CDC has decided to do an internal review to see if they could somehow improve the culture at the CDC and make it more public health oriented as opposed to academic oriented. The NIH is a bit different than that because we do biomedical research and we continually have that peer reviewed. Everything we do is peer reviewed. So, we get outside input in everything we do.
On whether or not NIAID/NIH has been correctly applying lessons learned from the pandemic to the monkeypox response
Well, not only the lessons learned from COVID, but also the lessons learned from HIV and that’s even more important than the lessons learned from COVID. Because if you look at the demography of the afflicted population with HIV in the very early years, it was predominantly an affliction of men who have sex with men. That’s exactly what we’re seeing with monkeypox. And the lesson that we’ve learned and hopefully we’ll continue to be aware of is we’ve got to keep stigma out of this equation because the enemy of public health is stigmatization.
On what’s next
Well, I have not pursued anything specific because the rules of government ethics are clear that you’ve got to make sure you stick with the job that you’re doing and to avoid any conflict of interest, you don’t engage in any specific discussions about opportunities after or else you have to recuse yourself from many of the things you want to do. And I don’t want to do that, I want to give all of my effort to my last four months in the job. But as I mentioned publicly, I would like to look at what I have to offer at this stage in my career and it’s the experience I’ve garnered over the last 54 years as the scientist at NIH and the last 38 years as director of [NIAID] and perhaps inspire some of the younger generation of scientists, and would be scientists to get them interested in a career in public service, particularly in the arena of public health, involving medicine and science.
Final thoughts on his time in government
To me, government service, which is public service, is, in my mind, a very, very high calling. I don’t want to say it’s the most high quality because there are many other things that other people do with their lives that don’t involve government service that are very laudable. But there’s no doubt that people, regardless of what level you’re in in government service, you are serving the people of the United States. And that’s something that no matter whether you’re at the lowest level of the ring, or the highest, you’re part of the team that is serving the United States public and that’s something that all government workers should be proud of.