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  • At the October 13, 1988 Presidential Debate, Michael Dukakis and George HW Bush were asked

  • Who are the heroes who are there in American life today, who are the ones that you would

  • point out to young Americans as figures who should inspire this country?”

  • Jaime Escalante.”

  • Valladares” “Those people that took us back into space

  • again.”

  • Sports heroes.”

  • Vice President Bush eventually responded with: “I think of Dr. Fauci, probably never heard

  • of him.

  • You did.

  • Ann heard of him.

  • He's a very fine researcher, top doctor at National Institute of Health, working hard

  • doing something about research on this disease of AIDS.”

  • Today, Dr. Anthony S. Fauci is best known because of his position in the Coronavirus

  • task force and for his many media appearances.

  • In the U.S., he's one of the most recognizable faces in the current crisis.

  • How did this doctor go from his research lab in Bethesda, Maryland to becoming one of the

  • most visible medical experts on the pandemic today?

  • Dr. Fauci.”

  • Dr. Fauci thanks so much for taking the time.”

  • Dr. Fauci.”

  • Dr. Anthony Fauci.”

  • The June 5, 1981 weekly report by the Centers for Disease Control was a notable one.

  • It recorded 5 unusual cases of pneumonia.

  • These cases would become known as some of the earliest reports of AIDS.

  • The next year, Dr. Anthony Fauci wrote an early paper about the disease, which had increased

  • to “290 recognized casesand had become “a public health problem of essentially

  • epidemic proportions.”

  • Fauci worked at the National Institute of Allergy and Infectious Diseases, NIAID, heading

  • up a lab that studied immune system response.

  • NIAID conducts research on diseases to help understand, treat and prevent them.

  • It falls under the National Institutes of Health or NIH -- the medical research agency

  • part of the Department of Health and Human Services.

  • In the early '80s, the NIH had 15 institutes - with NIAID and National Cancer Institute

  • leading investigation of the new virus and disease that would become known as HIV/AIDS.

  • Fauci made that investigation the focus of his career.

  • Today we're going to be listening to Dr. Anthony Fauci, he's going to be talking

  • about AIDS.”

  • “I'm working directly on AIDS, both clinically and on a basic science standpoint.

  • It really is one of the few, or actually one of the only subjects...where you really have

  • to change your lecture every month.”

  • Fauci was named director of NIAID in 1984, and the then Director of Health and Human

  • Services highlighted Fauci's background inimmunology and infectious diseases

  • as a main reason for his appointment.

  • “A major effort was directed at determining if a variant of this virus could actually

  • cause depletion of lymphocytes, or Acquired Immunodeficiency Syndrome.

  • And as it turned out, a variant of that virus in fact caused the syndrome.”

  • Fauci's leading early research helped define NIAID as the central NIH institute for AIDS.

  • And he made it a point to be the person communicating key findings to the public and media.

  • The scientific data is overwhelming that in fact AIDS cannot be transmitted by casual

  • contact.”

  • But it was a later political test that shows how Fauci navigated the AIDS crisis and secured

  • his career.

  • In the summer of 1988, playwright Larry Kramer wrote an open letter to Anthony Fauci, calling

  • him anincompetent idiot”, and a “murderer.”

  • His opinion was broadly reflective of activists, most notably the organization Kramer inspired,

  • the AIDS Coalition to Unleash Power, or ACT UP.

  • In 1986, Fauci had reinforced his position as the leading scientist for the Federal AIDS

  • effort.

  • He created a new division to focus on the disease and earned other significant NIH posts.

  • But progress was slow, especially for a disease as deadly as AIDS, where patients died, on

  • average, 15 months after diagnosis.

  • Fauci and NIAID were responsible for starting trials for new drugs, which the

  • FDA, required for approval.

  • In June 1986, NIAID created a network of clinical trial centers around the country, though they

  • were criticized as ineffective.

  • Activists argued that the NIH, the FDA, and leadership up to President Reagan had failed

  • to take the crisis seriously.

  • This photo from an October 1988 protest shows the key complaints.

  • At the time, the FDA's lengthy drug approvals required strict scientific clinical trials.

  • It was textbook science, but the disease killed at a faster pace than the FDA's process.

  • If you entered a trial, a certain percentage of patients got the drug, and a certain percentage

  • got a placebo.

  • This helped test if the drugs were safe and if they really workedthat was important,

  • because many AIDS drugs didn't pan out.

  • But with AIDS, getting a placebo was a death sentence.

  • And that meant fewer volunteers for clinical trials.

  • The epidemic needed a radical approach.

  • But experimental approaches like aerosolized pentamidine weren't being approved.

  • The drug helped treat one of the most common infections caused by AIDS.

  • Yet, trials had been delayed by NIAID, which Fauci blamed on insufficient staff.

  • Under pressure, he acknowledged the approval problem in 1988, testifying in Congress that

  • he wouldgo for what is available on the streetif he were a patient — a blunt

  • rebuke to FDA policy keeping these new approaches out of reach.

  • Fauci also went on to admit that it took them a “long timeto start trials of Dextran

  • Sulfate, a drug that had early enthusiasm among AIDS patients.

  • For the few approved options, like the then-promising drug AZT, activists criticized the high prices

  • charged by maker Burroughs Wellcome.

  • All these issues had spawned large networks of Buyers ClubsAIDS patients who pooled

  • their resources to import non-FDA approved drugs.

  • In 1990, activists staged another major protest - this time at the NIH in Bethesda, Maryland,

  • where Fauci worked.

  • It was a turning point.

  • In two key ways, Fauci incorporated the sharp activist criticisms and ideas into the government

  • response.

  • In 1990, NIAID invited activist representatives into the administrative committees for every

  • AIDS Clinical Trial Group.

  • This allowed for the government response to include on-the-ground knowledge.

  • Starting in 1989, Fauci had also voiced support for a new program called parallel track, forcing

  • the FDA to consider it.

  • In it, patients who couldn't participate in clinical trials could still get unapproved

  • drugs, once they'd been tested for basic safety.

  • Even if some drugs didn't work, at least they would be available to try.

  • The day ACTUP stormed the NIH, in May 1990, the Federal Register published the FDA's

  • plans to adopt a parallel track plan.

  • “I'm Doctor Anthony Fauci.”

  • 19 years before Brad Pitt played Anthony Fauci on Saturday Night Live, SNL castmember Chris

  • Kattan played him in 2001— “Thank you.”

  • during an anthrax scare.

  • Two decades ago, Fauci was already the face of public health response to unusual diseases.

  • That included everything from Anthrax and flu updates to running the US Government's

  • massive AIDS treatment program in Africa under President George W. Bush.

  • All that's helped his relationship with activistsFauci called Larry Kramer “a

  • dear friend who was a long time nemesis….

  • I remember he wanted to get my attention by writing an open letter to 'that incompetent

  • idiot' Dr. Tony Fauci.

  • He needed to stir the pot.”

  • By staying in the same role at NIAID since 1984, Fauci became a fixture across five NIH

  • directors, eight Centers for disease control directors, and eight surgeons general.

  • They're appointed by the President - and Fauci's been around for 6 of them.

  • As the Director of NIAID, he's insulated from that political element.

  • The AIDS response in particular illustrates how Fauci manages stakeholders - from inside

  • and outside the government, and from above and below his position.

  • That and his scientific expertise, has made him a constant during a new crisis too.

  • Our recent advances of being able to isolate, identify, and characterize the agent together

  • with the advances in understanding the history and pathophysiology of this disease will allow

  • us over the next year to come back to you to tell you that we not only have hope and

  • hypothesis, but that we have real prevention and indeed a real cure.

  • Thank you.”

At the October 13, 1988 Presidential Debate, Michael Dukakis and George HW Bush were asked

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Anthony Fauci博士解釋說 (Dr. Anthony Fauci, explained)

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    林宜悉 發佈於 2021 年 01 月 14 日
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