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Anthony Fauci addresses past, present, future issue of emerging, reemerging infectious diseases at ACP
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SAN DIEGO — While addressing the ACP membership during the Internal Medicine Meeting’s opening ceremony, Anthony S. Fauci, MD, MACP, director of the NIH’s National Institute of Allergy and Infectious Diseases, discussed the importance of treating and preventing emerging and reemerging infectious diseases.
Fauci noted that President Donald J. Trump’s staff called upon him and others to brief the incoming cabinet on a possible unexpected emergence of an infectious disease that they may face while in office.
“The point I wanted to make to the appropriators, senators and congressmen is that we are seeing now an evolution in our history of emerging and reemerging infectious diseases,” he said.
There are so many newly emerging infectious diseases that it is difficult to discern between them, he said.
The opening days of the HIV/AIDS epidemic is a classic example of a newly emerging infectious disease and is “historically one of the worst we’ve ever faced,” he said. While there have been major investments in a variety of areas, treatment has had the most dramatic impact in benefitting mankind and shows the connection between investment and fundamental basic research, he said. When HIV/AIDS first emerged 35 years ago, life expectancy was between 8 to 15 months.
“The investment in biomedical research and the partnership with industry for drug development led to the point where now we have 30 drugs which, when used in the combination of three, have completely transformed the life of an HIV-infected individual,” Fauci said. If patients take their medications and don’t have other complicating diseases, they can lead a normal life span by adding 50 or more years to their life, he said. This is possible due to biomedical research translated into interventions and therapeutics, he said.
“The same can be said for prevention,” he added. “We now have a whole host of combination prevention modalities, so that even before we develop a vaccine –and I believe we ultimately will be able to do that, although it will be very difficult because [HIV/AIDS] is a very unusual virus – we now have, in our grasp, the ability to turn around the trajectory of the epidemic.”
“We have no more excuses,” he added. “We have the drugs. We have the prevention capabilities. Now it transitions from a research question to an implementation question. It’s going to take political and other will to change the trajectory of that epidemic.”
How the research and public health community responded to the HIV/AIDS epidemic should be used as a model for how to address future real and potential outbreaks of serious diseases, he said.
In the last few decades, multiple political administrations have also faced the issue of reemerging infections, such as dengue, West Nile virus, chikungunya, Ebola and Zika, Fauci said.
He announced that he will be conducting a phase 2 trial of a vaccine in the United States and Puerto Rico on what seems to be “a very promising candidate for Zika.”
“If history has taught us anything, it’s that we will likely experience at least one infectious disease crisis of some significance and we just need to be prepared,” Fauci said.
There is no doubt that Trump’s administration will be faced with similar infectious disease outbreaks as those that have challenged previous presidential administration, he said.
Previous pandemics have taught us that we need global surveillance, transparency and communication, infrastructure and capacity building, coordinated and collaborative basic and clinical research, adaptable platform technologies for vaccines, diagnostics and therapeutics and a stable funding mechanism, such as a “Public Health Emergency Fund,” he said.
“When you think about emerging and reemerging infectious diseases, they have always been with us, they are clearly with us now and will we certainly be seeing them in the future in an absolute predictable way,” Fauci concluded. It is a “perpetual challenge.” – by Alaina Tedesco
Reference:
Fauci AS. Opening Ceremony. Presented at: ACP Internal Medicine Annual Meeting; March 29-April 1, 2017; San Diego.
Disclosure: Fauci reports no relevant financial disclosures.