WASHINGTON - The prized photos in the office of Dr. Anthony
Fauci, one of the nation's top scientific warriors against
AIDS, highlight a small irony.
There he is - the director of the federal agency that oversees
about half of the government's AIDS research in framed
snapshots with such famous battlers against the deadly disease
as Elizabeth Taylor and Mother Teresa. But for a long time
Fauci was public enemy No. 1 to the activists in gay health
groups and the outspoken AIDS Coalition To Unleash Power.
In fact, in 1988 Larry Kramer, a New York playwright and ACT UP
founding member, called Fauci "an incompetent idiot" and a
"monster." Kramer even wrote a play in which someone labeled
the Fauci character a "scientific fraud."
How Fauci - one of the first government scientists to launch an
all-out federal attack on HIV turned around the irate activists
and made them his allies is the story of a man with infinite
patience and consummate political skills.
When the disease first erupted in America in 1981, he was
directing a lab dealing with the immune system at the National
Institute of Allergy and Infectious Diseases, which is part of
the huge National Institutes of Health (NIH) in the Washington
suburb of Bethesda, Md. In 1984 Fauci became head of the
infectious diseases institute.
As the number of AIDS victims grew and the death toll rose, ACT
UP and other groups complained that the Ronald Reagan
administration in general and Fauci in particular weren't
responsive to the terrible plague.
"We battled Dr. Fauci down to the wire," said Barbara Hughes,
president of the Treatment Action Group, a New York-based AIDS
advocacy organization. "He started out as one of our chief
While he was under attack, Fauci was trying to unlock the
cellular mysteries of the immune system and the deadly virus.
For instance, researchers originally thought that after the
virus enters the body, it lies dormant for years. But Fauci and
others discovered that instead, it is quietly invading
disease-fighting cells and turning them into virus-making
"Tony was among the first to show that HIV continued to be
actively replicating during what was believed to be a dormant
phase," said Dr. William Paul, an immunologist and former
director of NIH's Office of AIDS Research.
But Fauci, as a federal administrator, began to see that the
government and the AIDS activists had to work together if the
raging disease was ever going to be brought under control.
When protesters held a demonstration at the NIH in 1988, he
invited several of them to his office for discussions.
In 1989, at a Montreal AIDS conference, he unexpectedly ran
into Kramer, and the two discussed their differences. Soon
afterward, Fauci aggressively sought the advice of activists.
He was the first high-ranking government health official to do
"Tony came to community groups and asked, "What do you guys
think we ought to do?' " recalls Spencer Cox, a New York AIDS
activist. "It seems like a small thing now, but it was a huge
For his part, Fauci says the activists "were off base on a few
things but, son of gun, a lot of what they were saying made
For example, Fauci agreed with complaints that the sluggish
government was not equipped to deal with the spiraling epidemic
and that bureaucrats had stymied drug development by
pharmaceutical companies with excessive regulations. He agreed
that the bureaucratic red tape was discouraging AIDS patients
from taking part in trials of possible new treatments.
Based on input from the activists and prodding from Fauci, the
NIH instituted a plan in 1989 to speed the introduction of new
AIDS treatments. The strategy, now standard practice, is called
"parallel track," and it lets researchers conduct a clinical
trial of a new treatment while at the same time allowing sick
people to receive it.
Ever since, Fauci's ties to AIDS groups have remained strong,
and he regularly appoints activists to advisory committees that
shape research efforts.
He's also a top advisor to presidents and lawmakers on AIDS
strategy. President Clinton relied on his expertise last year
when the administration laid out an ambitious goal of
discovering within the next decade a vaccine to prevent the
virus from attacking the body. On another front, Fauci's
laboratory published a study earlier this month showing that
Interleukin-2, a drug that stimulates the immune system, may,
along with other drugs, help the body fight HIV.
Besides his scientific duties, Fauci makes rounds twice a week
to see AIDS patients, conducts laboratory meetings and manages
an annual budget of $1.57 billion - $810 million of which is
dedicated to AIDS research.
"He's a lobbyist for AIDS research, an administrator, and he
keeps an active lab going - I don't think he gets much sleep,"
says Dr. Jay Levy, an AIDS expert and virologist at UC-San
Francisco medical school.
Kramer, who is HIV-positive, regularly calls Fauci for advice
on treatments. And when the playwright is in the Washington
area, Fauci usually springs for dinner at an Italian