ACR meeting kicks off with lessons learned from 3 decades of infectious disease outbreaks

Anthony S. Fauci

SAN DIEGO — In the opening lecture and awards ceremony of the American College of Rheumatology Annual Meeting, Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, reflected on the lessons learned from the pandemic threats of the past 3 decades.

“History has taught us that the new administration is likely to experience at least one infectious disease crisis of significance,” he said.

Fauci said that during his time advising five presidents, he has found that an infectious disease outbreak usually happens during the first year of a new administration. This was seen during the Reagan administration with the emergence of HIV and AIDS in the early 1980s. He said that among the lessons learned from this emergence was outbreaks that become important can sneak up, and that not all outbreaks are pandemic in nature.

“Pay attention to emerging infections even when they don’t look explosive at first,” he said.

Among other lessons learned from the last 3 decades is the need for a strategic, international plan, as “the greatest danger will likely be naturally occurring,” he said. The U.S. President’s Emergency Plan for AIDS Relief, which was first proposed by President George W. Bush in January 2003, has made great strides in combating global HIV/AIDS, tuberculosis, and malaria primarily for 13 high-burden countries, he said.

“When you have leadership from the top, you can do good things,” he said.

Another important lesson learned is that good clinical research can be done while an outbreak is occurring, as seen with the Ebola outbreak during the Obama administration. He said Ebola was an example of a “perfect storm” hitting a region with a massive population, no prior experience and a poor health care system.

“You should not give up on trying to answer questions when you are responding to an outbreak,” Fauci said.

Overall, he said the broad lessons that can be learned from the emergence and re-emergence of infectious diseases are the need for global surveillance; transparency and communication; infrastructure and capacity building; coordinated and collaborative care; adaptable platform technology for vaccine, diagnostic and therapeutics; as well as funding mechanisms, such as public Health Emergency Fund. Fauci said emerging infections are a perpetual challenge.

“We have always had emerging infectious diseases. We have emerging infectious diseases now. We will always have emerging diseases. It is incumbent for us to take it seriously and be prepared,” he said.

Fauci said it is unknown what is next, as emerging and re-emerging infectious disease outbreaks are unpredictable situations. He said among the outbreaks the NIH is bracing for is the return of Zika as summer returns to the southern hemisphere.

“We can’t predict what the next one is going to be. That is the lesson to be learned,” he said. – by Kristine Houck, MA, ELS

Reference:
Fauci AS. ACR/ARHP: Opening lecture. Emerging and re-emerging ID: From AIDS to Zika. Presented at: American College of Rheumatology Annual Meeting; Nov. 4-8, 2017; San Diego.

Disclosure: Fauci reports no relevant financial disclosures.