On January 30, Dr. Anthony Fauci, former chief medical advisor and former director of the National Institute of Allergy and Infectious Diseases (NIAID), sat down for a candid conversation moderated by Dr. Robert Klitzman, Program Director of Bioethics at Columbia University.

Hosted by the Columbia University Bioethics Program, this virtual event offered a unique opportunity for attendees to hear firsthand from one of the most recognized figures in global public health. Dr. Fauci’s talk with Dr. Klitzman was more of a conversation where the focus was not just on his extensive career but on the deep intersections of science, politics, and public trust. Fauci, whose career has spanned over four decades, provided invaluable insight into how science drives public health policy. He reflected on the seismic changes he witnessed during his time at NIAID, particularly in the fight against HIV/AIDS, and then during his time advising the presidents, especially during COVID-19. As one of the most trusted voices during the pandemic, Fauci shared his experiences navigating the evolving scientific landscape while managing public health responses—sometimes in direct conflict with political pressures.

The conversation kicked off with a look back at Fauci’s work throughout the HIV/AIDS crisis, which was one of the defining public health challenges of his career. Fauci, who first began studying the disease when it emerged in the 1980s, spoke about how the scientific community initially grappled with the unknowns of HIV. At the time of his initial work with HIV/AIDS, it didn’t even have an official name yet. He stressed that the breakthrough research needed to treat the disease took years of collaboration and trial. “We knew this was going to become a serious problem, and that’s why I decided to focus on it early,” Fauci remarked. While much of his conversation focused on the science behind these efforts, Fauci also addressed the political and social consequences of his work. “The biggest challenge was getting people to listen. Science is always there, but it needs the right political will to be implemented effectively,” he said. 

Fauci also shared personal insights into his career. Reflecting on his journey into immunology, he explained, “It wasn’t always clear to me that I would end up in immunology. I was initially drawn to medicine because I wanted to help people, but it was the early days of HIV research that solidified my path.” He saved millions of lives through his HIV/AIDS work,  where he helped develop antiretroviral drugs and became a principal architect of the President’s Emergency Plan for AIDS Relief (PEPFAR). Fauci acknowledged the challenges of the decision to focus on HIV research, a shift that many of his colleagues called “career-ending.” But he knew that the growing HIV epidemic was a looming public health crisis that demanded attention.

As the conversation shifted toward the COVID-19 pandemic, Dr. Anthony Fauci’s role as the nation’s leading infectious disease expert became the focus. He admitted that the pandemic was “unlike anything I had faced in my career” and discussed the unique challenges of balancing evolving scientific data with widespread misinformation. Klitzman colloquially mentioned that many people misconstrued the evolving science of COVID as Fauci’s opinion changing on a whim, rather than new science being uncovered. “Science changes, but at the moment, the public expects certainty,” he explained. “The truth is, science evolves as we learn more, and that uncertainty can be uncomfortable for people.” He further expressed how the rapid changes in guidelines created difficulty in maintaining clear, consistent communication with the public, often exacerbated by the pressure of immediate media demands.

Fauci didn’t shy away from addressing the political tensions that surfaced during the pandemic. He reflected on his disagreements with the Trump administration and the politicization of public health measures, stating, “It was painful, especially when the facts were clear. People were getting sick and dying, and we were still fighting misinformation and political polarization.” Fauci acknowledged the difficulty of his position, admitting that as someone who considers himself apolitical, “It’s hard when you have so much respect for the president but must publicly disagree.” Still, he emphasized that his commitment to scientific integrity outweighed the political fallout. “You have to stick to what the science tells you, no matter the fallout,” he asserted, even at the risk of being labeled “public enemy number one” by those who felt strongly about the previous administration.

A key theme of the conversation was the rise of misinformation, particularly surrounding vaccines and COVID-19. During a time when many people blamed Fauci for constantly changing his stances on the pandemic, misinformation was spreading like wildfire. Fauci emphasized how this misinformation significantly hindered public health efforts. “Misinformation is the enemy. People need to understand how science works and why trust in experts matters,” he said. He underscored the importance of educating the public and helping them distinguish credible sources of information from the noise of misinformation.

As the conversation turned toward the future, Fauci offered cautious optimism regarding global health preparedness. “We are better prepared for the next pandemic than we were for COVID-19, but we need to continue strengthening our public health infrastructure,” he said. Scientifically, Fauci believes that the world is more capable of handling future pandemics. We were able to show that even under immense pressure with a virus we had very little experience with, we could develop an effective vaccine. But he stressed that the public health response still requires significant improvement. “What we need to do better is public health response,” he noted, explaining that the existing infrastructure was not up to the task during the pandemic.

Fauci also offered advice to aspiring scientists: “Stay curious, be dedicated to the truth, and never underestimate the power of collaboration.” He stressed that working together across disciplines is crucial for tackling the biggest challenges in science. The field goes through constant ups and downs, but it is maintaining a dedication to science that allows it to persist. He concluded with a similar sentiment by encouraging young scientists to stay true to their principles, even in difficult times, “There is so much turmoil right now but stick with your fundamental principles and maintain your integrity. The field will be fine.” Public health continues to face turmoil, but it is maintaining a dedication to science that allows it to persist.

The ending remarks were between Fauci and Klitzman, conversing about the future of public health before the two gave their farewells. They wished students well, whether our goal was to pursue public health or something else. Dr. Fauci’s conversation was more than just a reflection on his career—it was a call to action for the future of public health and scientific inquiry. His emphasis on the need for political will, scientific integrity, and education showed that while the challenges of public health are immense, they are not insurmountable. Fauci’s legacy is one of dedication, truth, and service, reminding us all that while science can be complicated, it remains our best tool for solving the world’s biggest problems.

Image via Bwog Archives