Has emerged at this moment as a trusted source. For four decades to make he has exemplified the role of scientist and public servant. During the early years of the aids crisis in the 1980s, dr. Found she was among the first toentists to collaborate advance treatment. He advised president s of both parties in the following decades on every pandemic the world has seen from sars to the asian flu to the ebola. Era, hethe cove it continues to provide the best information to policymakers and the public. A, dr. Couch05 as he revealed the three Guiding Principles of his life. To seek and learn every day. To strive for excellence and to serve mankind. We are profoundly grateful that he has so assiduously followed all three of those goals. Our world is better for it and healthier for it. Please join me in welcoming dr. Anthony franchi. Thank you very much. It is a pleasure to be here with you and im looking forward to our discussion. This is an extraordinarily important topic that we are dealing with. This is a historic pandemic, the likes of which we have not seen in our civilization for 102 years, since the very historic and memorable 1918 spanish flu. I look forward to the dialogue we will have in discussing various aspects of this i believe are already thats i believe our audience aspect of this i believe our audience will be interested in. Ive been interested in what youre telling the public in your messages so clear. That message is about Public Health. It is that we all need to Pay Attention and follow the simplest of Public Health measures so we can better control the spread of the virus and get our communities and countries on track. We thank you for your unwavering commitment to protecting the Publics Health by always speaking truth to power. Dr. Fauci thank you. Let me just come from a personal perspective. I am very pleased to have the opportunity to host this conversation, and one of my First Official duties as dean was back in 2018 when i presided over the school organized with the Smithsonian Organization to discuss responses to the 1918 pandemic. You were our keynote speaker. In response to the symposiums topline question, are you prepared for the next pandemic for when the next pandemic hits, the answer from our audience was no. It was acknowledged we may no progress. Here we are together again today, facing the reality painting for us that afternoon almost three years ago. [inaudible] since that 1918 influenza pandemic when we first admitted our first flu. We continue to translate the research into Public Policies that make a difference in peoples lives. On behalf of my colleagues and legion of alumni around the world who are no will be who i know will be watching this broadcast, i want to thank you for your tremendous leadership and sharing your perspective, not only during this unprecedented time of Public Health, but on the intersection between science and policy. With that, let me begin, and perhaps i can start by reflecting on your nearly fourdecade career leading the National Institute of allergy and infectious diseases. You have led the United States in the response to hiv, aids, and emerging diseases including ebola and zika. What strives you to continue this work and do you see the federal sponsor involved in any way . Dr. Fauci the thing that drives me is my commitment to this whole concept that the John Hopkins School of Public Health stands for, namely Public Health of not only our nation but the world. I am a physician but also a scientist. When i got involved as the director of the institute, i had been an aids researcher before that, fundamentally a chief of a laboratory at the nih, doing Clinical Research on hiv. When i became the director of the National Institute of allergy and infectious diseases. It became so clear to me that there were so many problems throughout the world that could be addressed both by science, science application, and good Public Health measures. I became totally committed to that. When you say what drives me, what is the driving force, it is the realization not only of the normative the problem that the fact we can do something about it. It is not an unsolvable series of problems. It is something we can do something about. The second part of your question, the role of government. Government at its best cant be responsible for things that individual, private sector components would not be willing to take up. For example, in the United States, and it is not just confined to the United States, we have the realization that there are the need to develop interventions in the forms of vaccines and therapeutics for diseases that may not be the kind of commercially viable interventions, but the world needs them. We have seen that with many of the things weve done with malaria, tuberculosis, and diseases that are not particularly germane to the people of a given country. But because it is a Global Health problem, if you look at what we have done through the nih, cdc, through other agencies of the federal government, it has been critical to the viability of a good public and Global Health effort. I know is something you do, dean mckenzie, something that i love, something that is a task i wake up every morning feeling that there is a chore ahead and something we can do about it. The stakes are enormous. You are talking about peoples lives and health. I dont want to put down any other profession, but it is a need and you can get much better than that. If that is what you are suited for and that is what you want to do. Dean mackenzie absolutely, and we are so happy you have that drive and commitment to that mission. You mentioned your early years in fighting hiv and aids. Can you reflect on how the experience in those early years has informed your response to the current pandemic . Dr. Fauci there are some similarities and stark differences. Back then, it was perceived as a restrictive problem. I remember i wrote an article in 1981 the cup published in 1982 that says anyone that thinks this disease will stay restricted does not know much about these issue, because chances are it will be a global issue. Unfortunately, that was prophetic. We had difficulty getting people globalized to realize the potential impacts of this, because it did not universally affect people in a uniformed way. It was a behaviorally related disease, whether the behavior was something people could not avoid or was part of the culture, what have you, it was behavior related. What we are dealing with now is a very complicated issue, i must say, dean mckenzie. It is complicated because it is having a global, serious impact, but there is difficulty in relating to the people how serious it is. Because there are so many people who get infected and have no serious consequences. How do you mobilize a uniform message and effort that this is something that is serious, that we need to take seriously, and all you need to do is look the numbers 215,000 at si 200 15 deaths in the United States. Over one Million Deaths worldwide. Understandably, there are people that look at this disease and say if im a young, healthy person, chances are nothing will bother me. So they do not participate in the control of an outbreak that, for some people, the vulnerable people, the elderly, with underlying conditions, disproportionately hit minorities, for those people, this is a very serious threat. I find thats, in both cases, we had messaging difficulty, messaging of getting people to understand what hiv, aids was and what it ultimately would turn out to be. I find we are having the same messaging difficulty right now. Those are the similarities, and those are the differences. Dean mackenzie do you think we will ever learn the general public will ever learn thats message, that it is not just taking care of yourself but of a community . Dr. Fauci i hope so. That is at the essence of Global Health. If you are interested only in individual health, youre putting yourself in somewhat of a vacuum, which means if it affects me, and flicks me, bothers me, i worry about it. If it doesnt, who cares. That is the antithesis of someone who is aware of and connected to the concept of public and Global Health. Its what i say when we talk about covid19, its the same theme i mentioned a moment ago, that if a person gets infected and says to themselves, chances are im not going to have a deleterious consequence, it doesnt matter to me, ill do whatever i want to do, practice misbehavior, go to bars, be crowded, not wear a mask. That would be fine if your infection doesnt ultimately impact other people. But youve got to get the message, people, that if you get infected, even if you dont have a single symptom, you are propagating a pandemic. By getting infected, you are keeping the pandemic alive, so that even without symptoms, you may inadvertently and even use the word innocently affect someone else who will affect someone else, and then you might have someone who is really vulnerable, someones grandparent. A woman who has Breast Cancer and on chemotherapy, someones beloved wife, child with immune deficiency, an africanamerican person with sickle cell disease. Those are the people who will be at high risk of serious consequence. If you think by getting infected and saying poopooing remote pension youre becoming a problem if you are you are becoming the problem while trying to become a solution. Dean mackenzie we need to talk about how to get the message out. At the root of things, it is so important. Im hoping this pandemic will change the discourse, but we will see. You have been at niad for years. What would you say about the relationship between bias and politics . Dr. Fauci i would get them to understand there is a difference between politics and policy. That means science and evidencebased facts that you bring out. Going with the data, going with the science, and being flexible enough when you are dealing with an evolving situation, which we are in the middle of right now. We still do not know everything we need to know from a Public Health, from a clinical, or from a scientific standpoint about covid19. So when youre talking about policy, making policy, what should we doing we should be doing in a Public Health measure . How do we prevent the spread . What do we do about School Opening or not . About business opening or not . Thats based on scientific facts. Politics are different thing. When you do with politics, you have people who, understandably, because politics are good, how countries are run, people have agendas. They may not necessarily coincide with you as a Public Health person with what you as a Public Health person sees as using the evidence and facts to guide your policy. My advice to people, unless you want to be a politician, stay away from the politics and let science and good data and good evidence guide your policy. Dean mackenzie and youve done an excellent job on that. I know its not easy all the time. As someone who has had a strong connection to academic edison and ill medical research, what you see is the role of universities on the policymaking process, and how has this role evolved over time, and what july universities to do, what role would you like them to play in the current pandemic . Dr. Fauci the universities, including very much your own, is really the home of such extraordinary academic talents of people who come in with an inquisitiveness to learn, to get down to the facts, which to me is an indispensable of any effort of science or Global Health. The government itself, the nih, for example, of which i am a member of one of the institutes, has been historically a great supporter of what goes on at universities and schools of Public Health. I think you need to synergize and partner with each other. I do not think the federal government do this by themselves. I do not think the Academic Community would have the support to be able to do it by themselves. And then we want to bring in another component, which is as important as the other, the pharmaceutical companies. You have a partnership between the pure academics of the university with the mandate that a government has, particularly for Public Health and health of the nation and the world, to develop interventions that are going to get us to that goal, bringing in the pharmaceutical companies. I think the academic institutions, the universities, medical centers, the schools of Public Health, schools of medicine are extremely important to any effort we are going to make an Public Health for our own nation as well as globally. Dean mackenzie so we need to partner more . Dr. Fauci absolutely. You cannot silo at all. Dean mackenzie heres a question our faculty are particularly interested in asking you. Especially our early career faculty are whites worried about the effects of the pandemic, related research delays, and looting reluctant nations to enroll in studies, covid studies, and other issues. While we are grateful the nih allows investigators to draw their grants draw on their grants, we need to backfill those funds. I guess the question is, especially in the relation to our young investigators, which we worry about more than ever during the pandemic. Dr. Fauci you bring up such an important point that is very troublesome to us. Prior to covid19, we were concerned about the lack of consistency of funding for the nih and young investigators who rely on funding for Institution Managers institutions like the nih does not know what will happen two to three years from now, particularly when they see their mentors being insecure about getting a grant. We have been fortunate enough that congress, over the last several years, not counting this past year because it has been money into special products special projects for covid19, they have been generous with us, the congress has been extraordinary with their generosity to the nih. Led by heroes on both sides of the aisle in the senate and house. But now, when you have this interaction in the hiatus, the only thing i can say to encourage the young people, so please hang in there and dont give up on what could be a to please hang in there and dont give up on what could be a success at the nih, to go and get resources to backfill on the lost time and experiments. I can tell you, in my own self and laboratory at nih, where you have cohorts you are following and you cant bring them into the hospital. And we have Clinical Trials that are two your Clinical Trials that all of a sudden have to stop and pause, and i do my best to encourage the young faculty to just hang in there, its going to get better, i promise you. Dont give up. Dont give up. [laughter] the day will come, i assure you. Dean mackenzie well thats a great message, and i hope our faculty, especially young faculty are you listening faculty, are listening. We reached out to our students and asked if they have questions for you. We got a few. One question submitted by a [inaudible] related back to what you are talking about. And the difficulty in enrolling patients to trials and cohort studies and how it might be getting more difficult. The question from the student is, what advice would you have for students concerned about erosion of the general Publics Trust in science, to try to gain that trust back in the future line of work . That is something, as investigators and scientists, we are quite concerned about. Dr. Fauci yes. I think that being strained and stressed right now, what we are going through with covid19, and we are already seeing expression of reluctance in not trusting the scientific establishment, to free themselves of political influence about whether a vaccine is safe or effective. So what we in the scientific community, the young people, people at intermediate levels, and people at my levels, been here for decades, continues to abide strictly by the tenets of science, the honesty, the transparency, the flexibility, the humility of knowing that we dont know everything at any given time. I think when the general public sees that in the scientific community, this we admit we dont know everything and that science is evolving. One of the things i think we need to do a better job at is to get across the concept that science is in so many were spout is in so many respects selfcorrecting, meaning as things evolved, you do an experiment where you gain scientific knowledge, and it might be absolutely true for what the situation is at that given time. But as more data and more knowledge evolves in the situation, you might have to say, you know, we thought it was say, you know, we thought it was this way back then, but we have to know that Scientific Data says it is different than we thought. So it is just pure honesty and transparency that i think will get us out of any skepticism about our motivations and about the scientific community. Dean mackenzie and you think that will translate into the publics acceptance of vaccines, once we have a vaccine . [inaudible] dr. Fauci yeah, but we have to do it correctly. We have to make sure we stick by and insist on the scientific standards that we put forth before we make a decision about whether something is safe and effective. We cant compromise. The public is trusting us, and if we really want to get into a problem of dissolution of trust, it would be to veer from sticking strictly to the Scientific Data and scientific information. Dean mackenzie so lets take a deeper dive into the current pandemic. The u. S. Is seeing over, by last co