So we're about at the five year mark of when COVID-19 really exploded onto the scene.

So my Big Question for you is, are we on the verge of yet another pandemic?

I'm Insoo Hyun, a bioethicist and the Director of the Center for Life Sciences at the Museum of Science.

Today, my co-host, Vardit Ravitsky, and I sat down with Doctor Anthony Fauci, former Director of the National Institute of Allergy and Infectious Diseases and Medical Advisor to the President.

We talked about pandemics, the COVID-19 experience, and public mistrust in science.

Are we on the verge of yet another pandemic?

Well, the the word "verge of" implies that there's going to be another pandemic in six months or a year.

I would phrase it a little bit differently.

So if I could rephrase your question, I say, "Are we in danger of another pandemic?"

And the answer is "Absolutely yes."

And the reason for that is, if you look historically, from before recorded history through the earliest years of recorded history, until the last 100 years, we inevitably have had pandemics.

They're not evenly spaced.

They're somewhat unpredictable.

But there are a number of factors that go into the likelihood that there would be a pandemic.

Those factors in many respects, have not gone away, and some of them have intensified.

Things like travel, things like encroachment on the animal-human interface, because 75% plus of all new infections, are zoonotic.

They start off as an animal reservoir, jump species, adapt themselves to the human environment, and then they can spread.

Not every emerging infection evolves into a pandemic.

But we have, for example, the last 100 plus years, we've had three of the most impactful pandemics known to our civilization.

One was the 1918 influenza pandemic, killed 50 million people, maybe more in a world population that was one third of what it is today.

We've had HIV/AIDS, which still is an endemic threat in some countries, even in the United States, we still have a considerable number.

And then there's the transformative, if I might use that word, experience that we've all had now in in year five of COVID.

So the thought that we won't have another pandemic, I think, is naive at best and just completely unrealistic at worst.

So to rephrase your your question: I'm convinced that there will be another pandemic.

And that's the reason why we have to be perpetually prepared to prevent the terrible impact of a pandemic.

You know, there's a difference between the emergence of a new infection, which there's very little you can do to prevent emergence of new infections.

You can mitigate it a bit by stricter controls of the animal-human interface.

But preparing this in response is to prevent an outbreak from becoming pandemic.

And that's the things that we've got to do better at.

A little bit of a long winded answer to your question.

I could have said, "Yes, we are going to have another pandemic."

I'm not so sure, imminent in the sense of in the next months to a year or so, but the history of pandemics tell us we will have another pandemic.

[DR.

HYUN] Dr.

Fauci.

Tony, if I may.

[DR.

FAUCI] Yeah?

How worried are you about the bird flu?

You know, I'm I'm concerned but somewhat tempered concern.

I first got involved with the H5N1 bird flu in 1997, when there was an outbreak among chickens, a highly pathogenic avian influenza, which was H5N1 in Hong Kong.

And the health authorities in Hong Kong, contained that by essentially killing all the chickens in Hong Kong and preventing import, and that sort of went under the radar screen for a while and then reappeared in 2003, 4 or 5, where it not only was in China but Southeast Asia.

And the difficulty with H5N1 is that particularly the strains that kill chickens are highly pathogenic.

It shows that it can jump from a chicken to a human, and the scary part of that is that, unlike the mortality or the case fatality of run of the mill influenza, which is less than a fraction of a percent when you think of all the people who get infected with flu, even at its very worst, the terrible influenza pandemic of 1918 only had a 1 to 2% mortality.

The bird flu among those humans who get infected back historically in 2003, 4, 5, 6, was really quite disturbing.

You know, 30, 40, 50, 60% mortality.

That was the very concerning news.

The somewhat encouraging news is that it never adapted itself to go from human-to-human.

So it was almost all a one off from a chicken to a human.

However, when viruses evolve to adapt themselves better to humans is when they start infecting other animals, including mammals.

Remember, chickens are not mammals.

They're birds.

But when you start infecting mammals, be they pigs or cows, the way we're having now in the dairy herds that there have been, you know, 900 to 1000 herds have been infected.

It gives the virus the chance to adapt itself to mammals.

And then when you have it on a farm, you can get pigs, get infected, you could get mixing of viruses, simultaneous infection with a flu that is adaptable to a human, with an H5N1 that's not yet adaptable to transmission, they can reach a sort and recombine their genes.

How likely is that to happen?

It's very, very difficult to predict that.

So, you know, the CDC still says the risk in general is low.

I recently they've said sort of low-to-moderate.

They're changing because we know now that the original of the 66 or so cases of H5N1 in 2024 into 2025, mostly non serious disease, except for two cases, you know, one in the United States, in Louisiana, the case died, and one in Canada, and the person became very sick.

Usually it is a disease that is mild in its manifestations, conjunctivitis and some systemic abnormalities.

But the good news is it hasn't yet spread from person-to-person.

So I think we need to take it very seriously.

Even though the CDC says that the risk of it being a pandemic is low, you know, things change and they change very, very quickly.

So I think we need to be very aggressive in serosurveillance of dairy workers, of making sure when you move herds from one place to another, if there's an infection in the herd, you don't move them.

I don't want to get into what USDA should be doing, but it seems to me that even though the risk is sort of categorized as low for a pandemic, we have to take it very seriously.

I think to our own risk, if we just blow it off and say, well, it's been around for such a long time, bird flu, H5N1, there was that situation we had in in Southeast Asia and in China back in 1997, but it's changed now because it's gotten into another group of animals that are mammals.

So it's clear that there will be other pandemics.

And you talked about preparedness.

There's the biological, the clinical preparedness.

But I want to ask you about the ethical social preparedness.

We saw in this country and around the world the tension between individual rights, people wanting to continue their lives the way they always did and the need for public health measures.

And we've learned these painful lessons about this tension.

How should we prepare as a society to launch public health interventions that correctly balance this tension?

Sure.

Well, obviously, you have to have a respect for people's individual choice of what they want to do.

But, you know, there is a responsibility you have to society.

You know, societal responsibilities not only for your own self, for what impact that an action that you may or may not take would have on the broader society that gets impacted by a pandemic?

I think you need to take those things very seriously.

You know, you use the word ethics.

I think more in an ethical situation of the next time we get a pandemic that we have, a greater equity globally about accessibility to interventions, be they drugs or vaccines or what have you.

Yeah.

You know, it was not our finest hour.

When you have vaccines available and the developing world did not get nearly the availability of the accessibility of vaccines and in a timely manner, then they should have.

That's what I think is the more compelling ethical question of what responsibility do we as a global community, have to make sure that there are some form of equity in accessibility, and a person does not have a greater risk of dying from a preventable disease merely because of where they happen to live.

To me, that's the more compelling ethical question.

Allow me to follow up.

The vaccines were, to me, obviously a scientific success.

And you have so many people in this country, rejected this and, you know, put their own life at risk and the lives of others.

What role do you think misinformation played and how should we better prepare?

Well, misinformation is huge in what we're seeing now, about true anti-vax conspiracy theories that years ago, when we didn't have social media would not have taken off the way it has taken off now.

I mean, there's somewhat of a misunderstanding of the scientific process.

I don't mean that in a pejorative way.

How do we address misinformation and disinformation?

It's not easy.

And I look at it on what you can do in the immediate term.

And what's the long game approach to misinformation and disinformation?

In the immediate situation, although it would be difficult to be completely successful, is that the people who spread myths and disinformation, which is totally amplified by the social media, seem to be extremely energetic in what they're doing.

I say, somewhat tongue in cheek, but it is a serious matter.

It's almost as if they don't have a day job that all they're doing is spreading this misinformation.

It gets compounded by bots, it gets compounded by the social media and the general public.

Understandably, some people, many people have so many other stresses in their lives, they're getting this information and after a while they don't know what's true and what's not true.

And that is really a problem, because when you get to the point where there's a normalization of untruths, where people accept that there's so much misinformation, they don't know what's true or not, that's when bad decisions are made.

And when you have divisiveness the way we've had that has permeated the years that we've experienced COVID-19, a profound degree of divisiveness that something occurred that just should never have happened, that people would make decisions that would impact their health in a negative way.

And because of political ideology or divisiveness, don't make use of for themselves or their family a disease, hospitalization and death preventing intervention.

So when you look at the data on vaccines, there's no doubt that if you look at those areas of the country, you know, red states versus blue states, political ideology, the people who fundamentally are red state or Republican were less accepting of the vaccines, and they were more hospitalizations and deaths among those people.

That is very, very tragic.

Forget what your political ideology is.

People should not suffer and die themselves and their family based on this social media- fueled misinformation and disinformation.

We have to do a much, much better job of that.

So I told you my response about how do you address misinformation, since this seems to be a very energetic cohort spreading it?

I think people who are wedded to the scientific process of being critically, thinking of information, analyzing it, they should be spending more time spreading correct evidence- based information.

And most people don't do that because they're very busy with their busy lives.

And you can't be going tit for tat for every bit of misinformation.

Obviously, the way things have rolled out now, there's going to be very few checks on misinformation and disinformation.

We know, recently heard that is not going to be fact- checking on some of the social media.

So rather than trying to prevent somebody from saying something, which you should never do, people should, you know, you can say what you want to say, counter it with correct information.

That's in the immediate.

[DR.

RAVITSKY] And the long term?

[DR.

FAUCI] The long game is to try and get kids in school to understand the scientific process, to be able to do critical thinking.

Not every person needs to be a scientist.

God, you know, goodness gracious, you wouldn't want that.

But we should be doing a better job in our educational process of getting kids as they're going through the educational process, regardless of what their ultimate vocation or way of life is to understand critical thinking.

What is science?

The misunderstanding during COVID was that you were dealing with a moving target.

You know, when it first became clear that we had these strange pneumonias in China, the original information was that it's not really spread very efficiently at all from person-to-person.

And then a week or two later, we found that, well, it is spread pretty efficiently and it spread very efficiently.

And then, it's not like other respiratory infections, because 50 to 60% of the transmissions come from someone with no symptoms, which has a major impact on ventilation, on spacing, on wearing a mask.

So what happened is "science," which is a process to gather information, data and evidence so that you can make a recommendation or a guideline based on the information that you have now.

But if the information changes, that's where the self-correcting aspect of science comes in, where if this is what you had available to you in January of 2020, and then as the months went by and the years went by, and you realize that aerosol spread is prevalent, that asymptomatic people do spread, variants change over time.

I mean, what other respiratory infection in the same outbreak do you have multiple, multiple, multiple variants that don't really get protected from the previous response that you had either to a prior infection or to vaccination?

So the scientific community and all of us were not perfect in our communication, have to do a better job of people understanding that this is a dynamic process.

And when you have a dynamic process, you do the best you can to communicate the information that you happen to have at the time.

If that information changes, proper science in its self-correcting way, tells you that you've got to then communicate that changed information.

Unfortunately, that got interpreted as scientists don't know what you're talking about.

You're flip-flopping.

Yeah, I mean, that's an understandable response on the part of the general public, which is, I think, compounded by scientists, myself included, all of us.

We're not perfect in our communication to the American public.

I loved how you responded to Vardit's question about sort of the long game, the long range strategy of trying to fight misinformation by basically improving better science literacy amongst the population.

[DR.

RAVITSKY] That's what the Museum of Science is-- [DR.

HYUN] That's what the Museum of Science is trying to do.

Our mission is to inspire a lifelong love of science in everyone, and also to ensure the science belongs to each of us for the good of all of us.

These are all kind of like catchphrases and mottos I think would resonate well with you.

I'm curious.

You're absolutely right.

The scientific process is one of ongoing discovery, and you may have to change your mind to be a good scientist, right?

And looking back at the COVID-19 experience and what was being learned along the way, what surprised you the most?

What was it?

What was the pivot that you thought well, the data here were kind of surprising and I have to change my mind.

I think it was the the appreciation that a substantial proportion, you know, different studies give you different numbers, but somewhere between 50 and 60% of all the transmissions came from a person who did not have symptoms at the time.

And that's how we realized how incredibly transmissible this is, that you could be sitting in a room, you would have no symptoms, you would have no symptoms, I would have no symptoms.

We'd be talking, thinking everything is okay.

And as a matter of fact, we could be spreading the infection one-to-another.

That was really one of the most important things that that we had to learn.

And, it impacted everything.

The wearing of masks, the absolute need for better ventilation.

I mean, you know, the WHO was saying well into the outbreak that aerosol transmission doesn't have anything to do with it.

Now we find out that might be the major modality of transmission is through aerosol.

Is that a rare property of the virus, to have asymptomatic transmission?

[DR.

FAUCI] Other respiratory infections have a usually a limited, very limited period of time where someone maybe is mildly symptomatic and they don't appreciate it, and they go out and they're not coughing or sneezing, but they're feeling a little bit under the weather and they don't know they're sick.

You could say they're either truly asymptomatic or not appreciating they have symptoms.

There's always a small window there.

And even with influenza of asymptomatic spread, but not to the extent when when you look at large cohorts where 50 to 60% of the transmissions occur from someone who is not symptomatic.

I mean, that's the reason why we've had many, many, many stories in our five year experience of you go in people in a choir, everybody feels great in the choir.

They're singing, they're enjoying themselves.

And all of a sudden six people come up with COVID.

No one was sick to begin with, and yet there was someone there who had an asymptomatic infection who was spreading it through aerosol.

And we know when you speak softly, little bit, you speak loudly.

More.

When you sing, there's more aerosol.

And that's what actually happened under those circumstances.

You said something that really resonated with me, that the public perception was of us flip-flopping.

Right.

Having worked in the School of Public Health during the pandemic, myself and my colleagues who were doing media work all the time.

You did most of of anyone else.

And the more we spoke to the media to try and encourage the public to follow the public health measures, the more we were seen as, oh, they don't know what they're talking about because what you're saying now is different than what they said a week ago [DR.

FAUCI] Yeah.

[DR.

RAVITSKY] Do you think that we emerged from the COVID pandemic with less public trust than when we started?

Oh yeah.

I don't think there's any doubt about that.

And again, it's a multifaceted deterioration of public trust that is not saying that all of the things being equal, people are not communicating well or they're somehow giving confused messages so we don't trust you.

It's that superimposed and amplified on the the misinformation and disinformation of social media just waiting to get one little thing that they can say, "Oh, look, see, they don't know what they're talking about!"

It really is, it's so unfortunate because lives are at stake with with disinformation and misinformation.

And that's exactly what what happened.

It's happened in other diseases, too.

You know, it's happened back, you know, when some of the misinformation and disinformation that was spread by some people about HIV, that it doesn't really cause AIDS, and it's the medications that do it.

And that led, you know, in South Africa with Thabo Mbeki, the President and his Health Minister, Manto Tshabalala-Msimang, saying, well, if the virus doesn't cause AIDS, then we shouldn't be giving drugs.

It's probably the drugs are toxic.

And there was an estimate that somewhere around 300,000 people unnecessarily died in South Africa because of the misinformation associated with the relationship between the virus, HIV, and the disease AIDS.

You know, and I can tell you that, you know, people do modeling studies about people who didn't take a vaccine because they are listening to information that vaccines for COVID caused more deaths than COVID, you know, and then when you look at the data of the hospitalization and deaths of unvaccinated people versus hospitalizations and deaths, with vaccinated people, it's a tragedy that people themselves don't utilize a highly effective intervention because of misinformation and disinformation.

So you mentioned the AIDS epidemic, and you were director of the National Institute of Allergy and Infectious Diseases for many decades, including during the time of the AIDS epidemic.

[DR.

FAUCI] Yes.

[DR.

HYUN] How did that period impact you?

Well, it is entirely me.

Impacted me physically, socially, emotionally, medically.

Yeah, I mean, I learned a lot.

Then I think one of the things was the frustration and the pain of dealing with a completely mysterious disease.

If you remember, I started taking care of persons with HIV before the disease had a name.

And certainly years before we knew HIV was the cause of it.

And the and the frustration being a physician who was practicing medicine, at the NIH and developing protocols for other types of diseases very successfully, I might add, developing protocols for these autoinflammatory diseases that had a high degree of mortality and developing therapies that put people into remission to then switch the direction of my research from 1981, literally to the present day.

And when I stepped down a year and a half ago, two years ago, from from the NIH, to taking care of individuals who almost invariably died, it taught me the importance of perseverance in the pursuit of scientific, basic, and clinical knowledge because we took a disease where virtually every one of my patients, with few exceptions, who I took care of in the 80s, mid 80s, late 80s, early 90s, died or were seriously ill.

Then when we made the investment in basic and clinical research to develop lifesaving drugs, it was almost a miraculous turnaround with HIV.

Whereas now, if you look at what science has done for HIV with regard to the availability of drugs, both for treatment, both for prevention and, treating a person getting the level of virus to below detectable, you could tell them they could live essentially a normal life.

You could tell them that they will not infect someone else if their viral load is below detectable.

It's called undetectable equals untransmittable.

And now we have long acting injectable drugs that are used for prophylaxis to prevent the acquisition of infection in people who are uninfected.

The results have been spectacular.

So I'm giving you a little bit of a long winded answer.

What it's taught me is the value of the investments in basic and clinical biomedical research, which is already translatable now to COVID, because if you look at the decades and a half of research that my institute, when I was the director put into funding the work that led to the mRNA platform technology and the work that was done on immunogen design, which was original work that started with HIV immunogens, namely, to get the right conformation of the envelope protein.

That same technique of getting the right stable conformation of the spike protein of COVID.

You put those two together, the mRNA technology and immunogen design, and you get a vaccine that was available for people less than 11 months from the time the sequence was available.

I would say that's beyond spectacular.

When you think of how long it usually takes to get a vaccine available, it usually takes seven, eight, nine, ten years.

Here we had a vaccine that was tested in tens of thousands of people and shown to be highly effective in preventing significant disease that has already saved millions of lives, not only in the United States, but many millions of lives globally.

So the lesson that I learned was the importance of the investment in basic and clinical research.

So when I talk about preparedness and response, I tend to put it into two separate buckets: scientific preparedness and response and public health preparedness and response.

If we were to grade how we did with scientific preparedness and response, it would be an A+.

I mean, no one imagined you'd get an effective vaccine or monoclonal antibodies or a drug like Paxlovid in such a short period of time.

If you look at the public health response, that's what we've got to do better.

I mean, we have got to have much more transparency.

We've got to have coordination, we've got to have communication, and we've got to modernize the public health infrastructure that we, you know, in our country, if you look at the public health infrastructure at the local level, that has been really led to attrite a bit, more than a bit, a lot, almost victims of our own success thinking that we have vaccines, we have antibiotics, we have antivirals.

We don't need that local public health infrastructure.

We've got to rebuild that.

I mean, that's part of the preparedness for the next pandemic.

You describe the scientific success, and we think of science as apolitical.

It's not about ideology, whether it's going to save your life or not.

These are facts.

And yet, it was the polarization and the ideological resistance that sort of impeded the implementation of these successes.

How have you been dealing with this frustration, seeing the success of the science itself, not being able to save the lives that it could.

How do you personally even cope with this frustration?

First of all, it's it's painful, but it should not deter you from your efforts to try and communicate to people the importance of utilizing these lifesaving interventions.

I think one of the things you got to be really careful of is just throwing up your hands and say, oh my God, this is this is a hopeless situation.

It's not, it's not.

We've got to continue and we can do better.

You know, public health officials, scientists are not perfect at all.

We've got to do better in communicating.

We've got to be consistent in our communications.

We've got to put a lot of effort in to try and understand some of the concerns that the general public might have and reach out to them and not say, well, they just don't understand.

That's not helpful in any way.

We've got to continue to try and reach out, in public relations, to try to get them to understand that the whole purpose of this is to save lives and mitigate suffering.

That's the reason for what we're doing.

We talked earlier about mistrust and misinformation, but a very large portion of the public trusted you a great deal and and looked to you for guidance and certainty during times of uncertainty.

How did you navigate that kind of responsibility?

Well, I take it very seriously.

And that's the reason why I try very hard to both, you know, in the position I was in, which was, you know, kind of a dual position because I was responsible for the bulk of the science that in collaboration with the pharmaceutical companies, came up with the vaccine, came up with the monoclonal antibodies, came up with the drugs.

There's always that good communication with industry.

But we provided the basic and clinical science.

So to me, I took that responsibility very, very seriously.

The responsibility of communication, I put a lot of effort into always being frank, honest, and transparent with the American public.

You know, when you're speaking, be it on TV or on the radio or in articles that you write, you know, to be be humble about what we don't know, and to try and crisply communicate what we do know at a given time.

That is made much easier when you don't have the divisiveness that we've had to face, where people are just looking to put down what you're saying.

So you have to just continue to put effort into it.

The one thing you don't want to do is to get discouraged and give up on trying to crisply communicate something that can save someone's lives.

That's the whole motivating force of this, is to try and alleviate suffering and save people's lives.

So I have a really tough question for you.

You just said that preventing suffering and death is a shared goal.

And of course, it is the ultimate goal of public health and science.

What if, as a value, it is not shared by all communities?

We saw communities putting economic sustainability above that goal.

Mental health, kids staying in school.

What if we have to come to the recognition that the value of preventing death and suffering is not a shared value, and that some groups, some populations, would design public health with different goals?

How would we tackle that?

Well, you try your best to appreciate the needs that people have, and to try and explain to them the importance of what you're doing from a public health standpoint.

There are a lot of things that could be done better.

I mean, in the beginning when we had that flattening the curve for 15 days and extended to 30, that was absolutely essential to do that because the hospitals were being overrun.

I mean, people have somehow selective amnesia about that when they criticize now.

I mean, there were freezer trucks parked in front of Elmhurst Hospital and other hospitals in New York and in Boston and in other cities.

Because there was so many dead bodies, the morgues couldn't handle it.

The only way to, at least for a while, put a lid on that is to shut things down.

And we didn't shut down completely.

Trust me, compared to other countries, we did not.

So everything was closed.

I think what needs to be reexamined is how long that was put into effect, particularly schools, because you can go back and remember, you know, go to YouTube or whatever and click it.

My saying, "We've got to open the schools as quickly and as safely as possible."

You know, we even using catch words: "Close the bars, open the schools."

Because we were appreciative of what negative collateral effect that would have.

But there was a lot of disparity in some regions, depending on the teachers union or what have you.

Schools stayed closed for a very long period of time.

Those are the lessons learned without pointing fingers at anybody that you've got to, you know, reexamine what the balance of other social issues compared to the pervasive need to prevent suffering and save lives.

That's something that needs to be reexamined in a non-pejorative way, the way it's been handled by these congressional committees that have overlooked it has been, you know, finger pointing, which is not the good way to prepare for the next pandemic.

You're pretty apolitical.

Regardless of what people say about you, you're pretty apolitical.

So you've served under many different presidents.

[DR.

HYUN] Seven.

[DR.

FAUCI] Seven different presidents.

I'm curious, you know, it seems like your relationship with George W. Bush was very effective, in your work.

What was it about George W. Bush that you think made that working relationship so good?

Well, I got to know him a bit because you know, I advised seven presidents.

I had a lot to do with George H.W.

Bush, his father, who was an extraordinary man.

And I think that argues about my being an apolitical person.

I got along as well with George H.W.

Bush as I did with Obama and Biden.

I mean, two completely different ideological bents for those individuals.

But George W. Bush, had a very strong feeling of fairness.

And, I got to know him very well, following the 9/11 attacks and the anthrax attacks, which we thought was Al-Qaeda, which wasn't, it was a homegrown person who had mental difficulties, and essentially was an American who actually did that.

But as part of that, we had this big program of trying to prepare ourselves for terrorist attacks as well as naturally- occurring outbreaks.

And in some of my conversations with President George W. Bush, he became very, very concerned and told me and as well as others.

But I had conversations with him where he said, "I believe we have a moral obligation as a rich country not to allow people to suffer from and die from a preventable and treatable disease merely because to happen where they happen to live."

So I had felt very strongly that way for years because I'd been involved with HIV since 1981, and now we're talking about 2002, when he sent me, and I had been to Africa multiple times, he sent me to Africa specifically to see if we could do a transformative program that was accountable and that was transforming to be able to treat, prevent and care for persons with HIV in the developing world.

Because what people don't appreciate is that we were in a terrible situation before we had drugs.

Then when we had one drug, a combination of drugs, and then around 1996, with the triple combinations with the protease inhibitors, we had an absolutely dramatic turnaround in the prognosis of people living with HIV.

So from 1996 to 2000 or so, 2001, the developed world: the United States, Canada, Australia, countries in the European Union, they were seeing a Lazarus effect with with persons with HIV, that people who normally would be going into hospice were out leading reasonably normal lives on therapy.

Yet in the middle of sub-Saharan Africa, those physicians who I knew well from years of collaboration, they were in the same boat in 2000, 2001, 2002 as Tony Fauci was in 1983, 4 or 5 where there were no drugs and my patients were dying.

Here there were drugs, but they didn't have access to the drug.

So what President Bush asked me to do was to go back and see if we could put together a program that would have a transforming effect.

And he was absolutely wonderful, he just said, "You know, you just go do it."

I came back and said, "You know, it's going to cost a lot of money."

And he said, "Let me worry about the money.

Go put together a program."

And he was committed to that.

And we did.

I mean, I worked with that White House staff from the spring and summer of 2002, all the way through the end of the year, and we put together a program that was originally designed to treat 2 million people, to prevent 7 million infections, and to care for 10 million people, including AIDS orphans.

And I made a proposal that it should be $15 billion over five years, starting off with at first 14 and then 15 countries.

The President absolutely bought that.

He announced at the State of the Union Address, and he saw that it got authorized and appropriated, that Congress, bless them in a positive way, did a very good job of, in a bipartisan way, supporting it.

Fast forward 20 years because it was authorized and appropriated in 2003.

Fast forward 20 years in 2023, we had a meeting right here in Washington, D.C.

with the original team that put together the PEPFAR program.

And by that time, instead of the $15 billion, we had done over $100 billion in 50 countries and saved over 25 million lives.

So to me, that is the President, whether you agree or not with his ideology, who because of his leadership, who, you know, essentially made me the principal architect of it, but it was his leadership.

It would have never happened without President George W. Bush.

And there's no way I would have pulled that off myself.

It never would have happened without him.

So yeah, I had a great relationship with President George W. Bush, and I admired him for what he did.

He used the leadership of the Presidency to now saving over 25 million lives.

So when you speak of that experience and like, your passion and your inspiration just comes through, what are you inspired by and passionate about now?

You know, I have an abiding faith that that we will realize soon, hopefully sooner rather than later in this country that we are much more alike than we are different.

And these kind of rather profound divisivenesses that we're seeing in society we're going to realize that we can do much better if we pull together as a country, because it's just nothing works well when people should have a common enemy, like the common enemy, you know, is disease and pandemics that are killing people.

You don't want to be fighting with each other.

You want to direct all of your energies against the common enemy.

And it didn't seem that that was the case during Covid.

And I would hope that the better angels will prevail.

I mean, people may say, well, you're being naive.

That's not going to happen.

I'm not so sure I'm naive.

I think if we just keep trying to understand each other better, that we got to realize we've got to be sensitive to our differences, you know, differences, nothing wrong with differences.

It's when differences become divisiveness.

That's really the problem.

And I think we've got to realize that that's what's happened.

And I'm not a politician.

I can only speak of what impact that's had on public health.

And it's had a negative impact on public health.

So for our audience watching this conversation and hearing what you have to say about misinformation, what can an everyday person do to try to navigate these waters of misinformation and reliable information?

What advice do you have for them?

Yeah, I think it's to try and not get into a silo where you only hear an echo chamber of something, and to try and look at the broader approach that what is going on, what different people think.

And you don't have to be trained in science, but try to be critical in your thinking.

Don't take things as truth merely because the silo you're in is saying it's true.

Be critical about the information.

Like when someone would say, which is that, and this is an egregious disinformation, that the COVID vaccines killed more people than the actual disease itself.

You could pretty much with a little bit of a research, take you about five minutes, to figure that out, to look at deaths among unvaccinated people versus vaccinated people and just do a little bit of of critical thinking, don't don't just take this siloed approach that we...and sometimes things really are almost on their face value disinformation.

You know, people actually have believed that Bill Gates and I, to certain extent, have put chips into the vaccine.

[DR.

HYUN] You didn't do that?

[DR.

FAUCI] Exactly, that magnetizes you and that can follow you.

And then it sounds almost ludicrous, but you would be surprised how many people.

And the easiest thing to do is, well, they say it magnetizes you.

You go near a refrigerator.

Well, if you get-- [DR.

HYUN] You can try it!

See if you stick.

[DR.

FAUCI] If you get vaccinated, try it, you know, stick your shoulder near the refrigerator and see if you're magnetized.

Tony, you were in the public eye for a long time during very difficult years.

What did you do to maintain your peace, to remain centered.

How are you so resilient in the face of so much pressure?

I think it actually relates to my training as a physician.

I feel very strongly that particularly, I've chosen a field of medicine that patients are usually very sick with life- threatening diseases.

Is to train yourself to focus like a laser beam on what your mission, your goal is that what you're trying to do.

And realize that everything else is noise and it's a distraction.

The unfounded conspiratorial attacks on you is noise.

The undue praise and adoration that some people have is kind of nice, but that's in certain respect noise.

So just focus on what your job is, whether it's taking care of desperately ill patients with HIV before there were drugs, whether it's trying to develop a vaccine in the middle of a pandemic that is historic in nature, namely COVID, is to just continue to focus.

Now, the other thing that I have found important, is that I've gotten good at that about just focusing like a laser on what you're trying to do, and don't get distracted by other things because you have to have some sort of support structure.

I'm very fortunate that I have a family situation, a wife who is just extraordinary at keeping me well-grounded, you know, not, you know, agreeing with everything I do, but seeing when I'm when I'm getting a little bit too frazzled about something to just get me back to reality.

You know who you are.

We know who you are.

You know what your job is.

Don't worry about all that other stuff.

Because sometimes it gets stressful too, when you're trying to save lives.

People attacking you for that, that can wear on you.

But when you have a really good support structure, and my wife Christine Grady, I think she's the best person in the world for that.

Recently you came down with the West Nile virus, and sometimes this may be a good idea for doctors to get pretty sick, to better understand their patients' perspective.

Well, what did you learn from that?

Well, I hope that I would have learned enough about medicine and understanding what people go through without the experience I had with West Nile virus.

That was a horrible experience.

I mean, I think it certainly had an impact on me that I'm still trying to process a bit because I came close to dying.

It was just, you know, at my age, to get a very serious neuroinvasive disease that 1. a substantial proportion of people my age would die from it, and an even greater proportion would have residual neurological defects, you know, difficulties in walking, difficulties in strength, difficulties in speech, etc.. I was just really very, very fortunate that I have no residual from it, but I can't even describe how sick I was.

I mean, it's very difficult to describe.

I've taken care of people with deathly levels of suffering, it was just an extraordinary experience that what it jolted me was less the pain of the disease and the disorientation and the disruption of your life.

But when I came home, and was in my house, and the diagnosis of West Nile was only after I got out of the hospital, they thought I had gram negative sepsis.

They put me on antibiotics, you know, my fever was 103█, 104█.

I was disoriented, I couldn't move.

It was really very bad.

Was when you're lying in bed and you read.

I couldn't read, but people read to me of what it takes to recover from that.

And it says it's measured in months, not days or weeks.

The thing that worried me is that I was lying down on my couch in my living room.

I had to be almost carried upstairs to the to the to the bedroom.

I couldn't put my feet over the side of the of the bed.

I couldn't sit up and I wasn't getting better.

And I got very worried.

My wife, Doctor Grady, was a nurse before she became the chair of the Department of Bioethics at the NIH, and she took over a month, you know, working from home virtually to be with me to to get me not to be discouraged because one day would go by, two days, three days, five days, and there was no improvement.

I mean, you had no strength.

You couldn't move, you know, you're just somewhat disoriented.

And she just stood with me.

And I remember asking her, saying, "You know, what is the end game here?

I'm not getting better.

Am I going to be like this, like forever?"

I didn't know that.

And I've got to tell you, not knowing that for those few days to a week where I didn't improve, I just stayed flat, scared me like I've never been frightened before.

But when I started to get better little by little, sitting up, standing up, walking with a walker, then walking without a walker, and then doing physical therapy to get my strength back, now I am much more appreciative of what it is to be well.

You take being well for granted.

Well, when you walk over to the precipice of almost falling into the black hole, you appreciate what it is to feel well.

So that's what that terrible experience has taught me.

I wish I didn't have to go through that experience, but it was a real horrible experience.

Well, I'm so glad the West Nile virus did not take you out, because that would have been one of the biggest medical and historical ironies.

[DR.

FAUCI] You know, wouldn't that?

[DR.

HYUN] Right.

[DR.

FAUCI] The infectious disease guy gets taken out by West Nile.

You know, it was a very interesting thing.

I got bit by a mosquito right in front of my house in northwest Washington D.C.

[DR.

HYUN] Wow.

[DR.

FAUCI] Just incredible.

[DR.

HYUN] It's been a little while since you retired from the NIH.

What's next for Anthony Fauci?

Well, you know, I wrote my memoir, which occupied at least the first full year of when I stepped down.

I'm now a Distinguished University Professor at Georgetown, a dual appointment in the Department of Medicine and the School of Public Policy.

And I'm enjoying that very much.

You know, I'm writing, I'm lecturing, I'm doing fireside chats.

I'm, you know, mentoring some students.

I have a big lecture to the medical school beginning of next week.

And I've started to make what's called morning report with the residents and the interns and the students at the Georgetown Hospital.

I do that, you know, about three times a week.

I did it this morning.

I did it right before I came here.

Tomorrow we're going to make patient rounds on the ward.

So that's a lot of fun.

Getting back to my roots as a physician.

Tony, thank you so much for sharing your time with us.

On behalf of the Hastings Center and the Museum of Science.

Thank you for your time.

My pleasure.

Thank you for having me.