2023-12-05 18:54:29
Anthony Fauci, at the White House, in Washington, November 22, 2022. PATRICK SEMANSKY/AP
The whole world knows Anthony Fauci. Director of the National Institute of Allergy and Infectious Diseases within the US National Institutes of Health (NIH) from 1984 to 2022, he served as chief public health advisor to seven presidents. successive states of the United States, from Ronald Reagan to Joe Biden. But it was his positions during the Covid-19 crisis, sometimes in opposition to his boss Donald Trump, which made him famous. Coming to Paris on the occasion of the conference on the 40th anniversary of the discovery of AIDS, which was held at the Pasteur Institute, from Thursday November 29 to Saturday December 1, the very recent retiree returns, at 82 years old, to the two pandemics that marked his life.
What has AIDS changed in the approach to infectious diseases?
Many things, both in the scientific field and in that of public health. On the public health side, from the first years, we were able to see the negative impact of the stigmatization of populations, due to their lifestyle and the risk of infection they ran. This is a major element that we subsequently learned to take into account. Scientifically, HIV has been essential for infectious diseases in general, for virology in particular, notably for the development of antiviral drugs and the development of a better understanding of the regulatory mechanisms of the immune system.
It was such an extraordinary disease that around the world, here at Pasteur, and at my institution, at the NIH, we invested incredible amounts of money. With major results. In 1983, the virus responsible for the infection was discovered here in France, then we developed the first drug, in 1986, with mixed results, then triple therapies, in 1996. We came to the conclusion that a combination of several different drugs could, if not suppress HIV, at least allow a person to live almost normally. So this is an important lesson in infectious diseases: Anytime you have a goal, the means, and a mandate to apply your scientific capabilities, almost anything is possible.
AIDS is also the emergence of patient associations on the health scene…
Yes, and this is another upheaval. AIDS has taught us the importance of considering the contributions of groups affected by the disease, or at risk of contracting it. They made us understand that the very strict protocols established for the clinical trials promised them almost certain death before having a chance to benefit from the drugs. At first, the scientific community wanted nothing to do with these activists. They therefore became very combative, theatrical, iconoclastic. Until someone – me in particular – paid them real attention. And when I listened to what they were saying, it became clear to me: they were right. And, if I were in their place, I would have done the same. The scientific community came to understand that, even if they were not scientists, they had important information and perspective to provide on the design of clinical trials, on the importance of flexibility in the regulatory approach medication. This lesson has been put to good use, well beyond HIV, for many diseases.
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