Dear HIFA colleagues,
Below are extracts from an interview with Dr Fauci in the current issue of the WHO Bulletin.
CITATION: Bull World Health Organ. 2023 Jan 1; 101(1): 8–9.
Published online 2023 Jan 1. doi: 10.2471/BLT.23.030123
Anthony Fauci: a scientific adviser’s role from HIV to COVID-19
Anthony Fauci talks to Gary Humphreys about his achievements at the National Institute of Allergy and Infectious Diseases (NIAID), his experiences advising seven consecutive United States presidents, and the challenges faced in communicating scientific evidence.
Q: Were all the presidents equally receptive to the truths you delivered?
A: With the exception of President Trump, I would say yes. It was different with him, and that difference crystallized around the COVID-19 response. For the first couple of months, he listened to me, and we had some constructive discussions about what our response should be, but then, unfortunately, he started taking advice from people who were saying things that were demonstrably untrue. For example, that drugs such as hydroxychloroquine were effective treatments for the disease. He was also saying that the virus would disappear like magic. I had to tell him that these things were not true. And not just him, I told the whole country, often openly contradicting what he had said.
Q: How hard was that?
A: It was difficult and there were clearly easier options. I could have stayed in my role and kept quiet, for example, or simply left. But the first option would have made me complicit, and the second would have just meant that the President would bring in some “yes person” to agree with everything he said. In the end I felt that, because of my responsibility to myself as a scientist and to the American public, I had to be honest and open.
Q: Were you ever afraid of what that would expose you to?
A: I was certainly concerned, and not just for myself but for my family. Standing up to the President made me public enemy number one as far as the far-right political elements were concerned. And even to this day I am being attacked viciously by those same elements, which remain completely loyal to him. But I really did not feel I had a choice. The truth is the truth, and the scientific evidence is the evidence. If we lose sight of that, we are all in big trouble.
Q: How hard was it to get across helpful public health messaging about COVID-19 in the face of rapidly evolving evidence regarding the transmissibility of SARS-CoV-2 or, for example, the relative health harms of exposure to the pathogen versus shutting down the economy?
A: It was challenging, especially in the first several months, and even beyond. It is very difficult to get across the idea that messages you shared in January might have to change in March because of new information. Unfortunately, many people interpret that as flip-flopping and lose confidence in the science underpinning the messages, while the politically minded use it to advance whatever their agenda happens to be. The truth is that changing positions or the hypotheses on which they are based is an inherent part of the scientific method. Science is a self-correcting discipline, and this self-correction is one of its greatest strengths. So, yes, it was very difficult to communicate around this issue. I did my best but clearly was not completely successful. Going forward, we scientists, especially in the field of public health where so much of what is said is public facing and open to debate regarding different trade-offs, will have to do better at that.
1. What, if anything, can be done to help ensure that future leaders of the USA and other countries will listen to the science?
2. We have heard previously on HIFA that Dr Fauci has received death threats for promoting scientific evidence. What can be done to increase public awareness of the validity of scientific evidence?
3. Dr Fauci rightly says that 'changing positions or the hypotheses on which they are based is an inherent part of the scientific method'. What can be done to increase public awareness of the fact that scientific evidence evolves?
Dr Neil Pakenham-Walsh, HIFA Coordinator
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