`I'm an optimist,' says AIDS pioneer
The tsunami began as a trickle one spring morning 25 years ago.
Dr. Anthony S. Fauci , then a senior researcher at the National Institutes of Health, was at his desk in Bethesda, Md., when a federal disease publication called the Morbidity and Mortality Weekly Report landed. It carried a three-page account chronicling the devastating symptoms that had befallen five gay men in Los Angeles.
Two were already dead from a rare form of pneumonia. The other three were gravely ill.
That report, from June 5, 1981, foreshadowed the arrival of a global epidemic that would change Fauci's life -- and forever alter the world.
``As it turns out, I just let it sit there for a while," Fauci said. ``And then four weeks later almost to the day, on July 4 of 1981, came the . . . cases from New York, from LA, and from San Francisco.
``It was at that point that I started to get the sinking feeling that, `My God, this is something that isn't just an accident. There's something going on here.' "
Fauci, whose Brooklyn upbringing still lingers in his speech, had devoted his career to battling lethal illnesses -- developing treatments for rare diseases that starve organs of blood.
But this germ, HIV, was something different -- and dangerous.
``The more we learned about the virus," Fauci said, ``the more ominous it became."
That was especially true at the dawn of the epidemic. Even as Fauci's stature rose -- in 1984, he began leading the federal government's fight against AIDS -- his ability to help AIDS patients remained slight.
``You knew deep down, unless something very different happened really soon, that this person was going to die," said Fauci, still director of the National Institute of Allergy and Infectious Diseases. ``That is not a good feeling."
So Fauci began a quest to better understand how HIV disarms the body's ability to control disease. He became -- according to a highly regarded review of scientific literature -- the 13th-most-cited researcher in the world from 1983 through 2002.
His agency's research helped lay the groundwork for the more than two dozen drugs that have entered the AIDS medicine cabinet in the last decade, profoundly altering the course of the epidemic. Still, both a cure and a vaccine remain elusive.
``I'm an optimist, and I operate under the assumption that we will be successful," he said. ``But I can't guarantee anybody that we're going to have a safe and effective vaccine that's going to prevent infection in 85, 90 percent of the people who get exposed."
Stephen Smith can be reached at stsmith@globe.com. 