The politics of pandemics: The legacy of Dr Fauci in context

Recently Dr Fauci announced his plan to resign this December. Dr Anthony Fauci served presidents from both of the major US parties in his nearly thirty-year career as Director of the National Institute of Allergy and Infectious Diseases (NIAID): Republican Ronald Reagan, Republican George Bush Sr, Democrat Bill Clinton, Republican George Bush Jr, Democrat Barack Obama, Republican Donald Trump, and Democrat Joe Biden.

Although he became a polarising figure with the development of the coronavirus pandemic, growing to be much loved by the neo-liberal, centre-right Democrats and much hated by the neo-conservative, far-right Republicans, Dr Fauci has been a prominent bi-partisan civil servant for the overwhelming majority of his career.

Throughout the coronavirus pandemic in the US, far-right media seethed idealist anti-mask propaganda while centre-right liberal media regularly ridiculed anti-maskers, idealistically blaming the spread of the contagion on the anti-maskers' individual moral failing of stupidity and calling on people to obey the technocratic experts. Still, the confusion of the anti-maskers and their distrust of the so-called experts was created in the first place by a technocratic expert much beloved by the centre-right liberal media, namely Dr Fauci.

On 8 March 2020, Dr Fauci dissuaded the US public from wearing masks, claiming that masks are ineffective in the middle of outbreaks and that they may even increase the spread of disease when "people keep fiddling with the mask and they keep touching their face." On 3 April 2020, the White House reversed its position and informed the public to wear masks. Dr Fauci was absent from the White House press briefing where the reversal was announced.

When asked about his anti-mask statement on 15 July 2020, Dr Fauci remorselessly admitted that he deliberately lied, claiming that "In the context of the time in which I said it, it was correct." Dr Fauci justified his anti-mask lie by claiming that the deception was necessary because there was a shortage of personal protective equipment among health care providers; it was not known at the time that cloth masks could be as effective as masks from a medical supply store and that it was not known at the time that Covid-19 could be spread by asymptomatic carriers.

There was nothing scientifically or morally correct about Dr Fauci's injunction to forego wearing masks early in the pandemic in the context of the time in which he uttered it. The dire personal protective equipment shortage in the US continued unabated throughout the first year of the pandemic. On 31 January 2020 and 4 February 2020, Fauci himself acknowledged that asymptomatic transmission of Covid-19 was a medical certainty. Moreover, it has been certain medical knowledge that cloth masks are relatively effective at preventing the spread of infectious respiratory diseases from the beginning of the 20th century up to the present day.

After desperately gasping for air for days or weeks on end isolated in an ICU, lungs ablaze with stinging pain, tubes and needles penetrating their flesh and connecting them to innumerable machines to sustain their mere survival, perhaps wishing to die just to end the unbearable torture, perhaps delirious with nightmarish fever dreams, over 10,47,000 people died of Covid-19 so far in the US in the still ongoing coronavirus pandemic. As of the moment of writing this, more than 13,000 people died of Covid-19 in the US in the last 28 days alone. In context, Dr Fauci's anti-mask deception was a premeditated negligent failure to render proper medical care to the US public as well as to the international public, negligence that caused and continues to cause injury and death on a mass scale.

Dr Fauci's shifting goal post of herd immunity for Covid-19 also caused and continues to cause controversy, lending fuel to unscientific vaccine scepticism in the US as well as in other nations. A population achieves herd immunity to a given disease during a given outbreak when enough of the population becomes immune to infection by the agent of the disease, either through vaccination or infection, to put an end to the outbreak.

Initially, Dr Fauci followed the World Health Organisation and most researchers in estimating that around 60-70% of the population would need to develop immunity to Covid-19 in order for the population to achieve herd immunity. In winter 2020, Dr Fauci changed his herd immunity estimate to "70 -75%," then again to "75, 80, 85%" and "75 to 80-plus %," then yet again to "70 to 90%[but] I'm not going to say 90%."

According to the New York Times, Fauci "Acknowledged that he had slowly but deliberately been moving the goalposts" and that he did so "Partly based on new science, and partly on his gut feeling that the country is finally ready to hear what he really thinks." Fauci also said that he made his earlier estimate with the alleged aim of getting more people in the US to take the vaccine amid widespread vaccine scepticism. Thus, Fauci once again deliberately deceived the US public, paternalistically deciding when people are "finally ready to hear what he really thinks," a strategy that may be excusable for a politician but qualifies as medical malpractice in the case of a medical professional.

In a July 2022 interview for Politico, Dr Fauci completely rejected the possibility of ending the coronavirus pandemic by achieving herd immunity. Fauci said, "We're in a pattern now. If somebody says, 'You'll leave when we don't have Covid anymore,' then I will be 105. I think we're going to be living with this." In this interview, Fauci made no mention of whether this is what he really thinks or whether his earlier statement on herd immunity is what he really thought or whether there is information he is withholding from the public because he thinks they are not prepared to hear it.

Moreover, beginning on 19 February 2021, Dr Fauci was criticised by Palestinians around the world for explicitly supporting Israel's Covid-19 vaccination program, which just so happened to deny Covid-19 vaccines to Palestinians. When Dr Fauci was explicitly asked whether Israel should "Help vaccinate neighbouring Palestinians, Dr Fauci responded, "You're asking me a political question, and I don't want to go there. That only gets me into trouble." However, the question of whether an entire ethnic group ought to be vaccinated during a global pandemic is primarily and essentially a medical question. Moreover, denying an entire ethnic group a vaccine during a pandemic can only result in disproportionate deaths and injuries from the contagion.

Let us turn our attention to another pandemic, the AIDS pandemic. Fauci assumed the office of Director of the NIAID on 2 November, 1984. AIDS was first diagnosed in the US in January 1981, just as Reagan assumed the presidency. Still, Reagan would not even publicly acknowledge the existence of AIDS until 1987, by which time AIDS was documented to have infected more than 36,000 people and to have killed more than 20,000 people in the US. AIDS was and continues to be an especially pertinent medical problem for the gay community. Although AIDS' impact was not and is not limited to the gay community, discrimination against homosexuals was the main driving force behind the US government's inaction.

In the 1980s, Dr Fauci's response to the AIDS pandemic received widespread criticism from the gay community and their supporters. As Director of the NIAID, Dr Fauci was responsible for supervising the US government's AIDS treatment research programmes. Fauci was a special target of the AIDS Coalition to Unleash Power (ACT UP), a protest group formed in 1987 that used direct action in order to draw attention to the US government's inaction on the AIDS pandemic.

In an open letter to Dr Fauci in 1988, playwright and ACT UP activist Larry Kramer criticised Dr Fauci, as well as the NIAID and its mother organisation, the National Institutes of Health, for refusing to test drugs that the gay community, in the absence of a government response, had been experimenting with on themselves in order to combat AIDS. Kramer wrote, "The gay community has, for five years, told the NIH which drugs to test because we know and hear first what is working on some of us somewhere. You couldn't care less about what we say." Kramer went on to accuse Dr Fauci as well as the US government more broadly of genocide against the gay community, an accusation repeatedly made by ACT UP as well as other activists.

The efforts of ACT UP and other activists finally bore fruit in 1990 when Fauci shifted strategies and advocated for allowing infected patients to access experimental drugs before the FDA fully approved them. In 2008, then president Bush Jr, a Republican, awarded Dr Fauci the Presidential Medal of Freedom specifically for Dr Fauci's response to the AIDS pandemic. In his award speech, Bush Jr said, "Three decades ago, a mysterious and terrifying plague began to take the lives of people across the world. Before this malady even had a name, it had a fierce opponent in Dr Anthony Fauci. As the Director of the National Institute of Allergy and Infectious Diseases for more than 23 years, Tony Fauci has led the fight against HIV and AIDS."

Although Fauci did end up responding to the AIDS pandemic, it took sustained activism and direct action, most prominently by ACT UP, to provoke his response. Bush Jr's claim that Dr Fauci was a fierce opponent of HIV/AIDS "before this malady even had a name" is demonstrably false. Although the accusation of genocide hurled at Dr Fauci by Kramer and other ACT UP activists may strike observers outside the gay community as exaggerated, it does, at the very least, exemplify the gay community's dissatisfaction with Fauci's initial non-response to the AIDS pandemic.

In his July 2022 Politico interview, Dr Fauci said that he wants his legacy to be his response to the AIDS pandemic, not his response to the coronavirus pandemic. Dr Fauci's response to the AIDS pandemic should in fact be remembered, not from the one-dimensional saviour myth propagated by himself and Bush Jr, but from the perspective of the communities most impacted by the AIDS pandemic. Moreover, the controversies surrounding Dr Fauci's handling of the coronavirus pandemic also deserve to be included in Dr Fauci's legacy, regardless of what Dr Fauci may think the public is ready to hear.

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.