I first met, heard and came to admire Tony Fauci several months ago at the Aspen Health Forum. Dr. Fauci heads the National Institute of Health’s National Institute of Allergy and Infectious Diseases. In addition to his spectacular medical contributions, he is, equally importantly, a passionate and wonderfully articulate explainer of the importance of infectious disease and global health to common people. Unfortunately, I was called unexpectedly out of the meeting for a call, but here are my notes on his comments. They provide a clear view of the value of his work.
Plagues and epidemics have shaped societies since the beginning of civilization. Gradually, though, and with progress in hygiene and the management of disease, the dangers from infectious diseases to ordinary people have been significantly lessened, though the idea that we’re home free is seductive and illusory. In 1967, Surgeon General William Stewart testified a little prematurely that “the war on infectious disease has been won.”
Still, 26 percent of deaths worldwide today result from infectious disease. This occurs in two major patterns. The Matrix of Infectious Disease represent a relatively stable number of deaths that occur each year. Emerging and Re-Emerging diseases – AIDS, SARS, and others – are much more variable and represent significant potential for unprecedented devastation.
The war between microbes and humans is ferocious, and depends on our mutual strengths. Microbes that cause infectious disease have extraordinary capabilities to mutate and replicate to persist, emerge and re-emerge. Humans can plan and implement strategies and tactics.
Over time, it has become clear that global health exerts enormous influence on nations’ economic development and stability. As a result, interest in global health has galvanized within major organizations like the UN, the G-8, the US Government, major philanthropies (like the Gates and Clinton Foundations), NGOs and so on. The topic has achieved visibility in the mainstream media, giving it credibility and a spot in the popular consciousness.
AIDS is currently the most frightening and pervasive infectious disease, with 90 percent of cases in low- and middle-income developing countries, and 2/3 of the cases in Africa. The US has spent more than $210 million on global attention to this disease over the last several years, mostly stemming from The President’s Emergency Plan For AIDS Relief, or PEPFAR.
Most governments act in their own interests, but as our understanding of what constitutes and impacts those interests matures, so does our appreciation of how we must respond. The US has undertaken a major, strategic role in global health precisely because it appreciates the role that disease plays in the stability of international relations and regional development.
Dr. Fauci’s contributions and perspective are refreshing because they clarify the role that health activism plays in economic prosperity and peace. Here in the US, we are so often turned inward, and focused on issues within our own system. By leveraging our science, wealth, and the tremendous variety of other resources we have accumulated here in our nation, Dr. Fauci and his colleagues are engaged not only in a vast humanitarian enterprise that seeks to reduce misery throughout the developing world, but he is one of our most effective international diplomats, conveying that we want to share what we’ve learned in helping improve the world’s health, financial stability and political stability.