Since the early 1980s, HIV/AIDS has claimed tens of millions of lives.
The pandemic has touched every corner of the world, affected young and old, rich and poor and men and women of all backgrounds.
It has been one of the worst scourges in human history, Anthony S. Fauci, M.D., a leading HIV/AIDS researcher and director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said Friday (October 23) upon receiving the Centennial C.-E. A. Winslow Medal Award from the Yale School of Public Health.
Fauci, however, was also optimistic that the deadly virus will eventually be defeated. “It’s almost inevitable that it will happen, if we do a few things,” he told hundreds of people gathered in Harkness Auditorium.
The Winslow Medal recognizes leaders in public health research, education and practice and is the school’s highest honor. It is named after Charles-Edward Amory Winslow, who founded public health at Yale in 1915 and today is recognized as a seminal figure in the early American public health movement. He led the school for some 30 years before his retirement in the mid 1940s.
Greeted by a host of old friends and Yale HIV/AIDS research colleagues, Fauci received a standing ovation at the end of his remarks for decades of work in the front lines against a virus that has taken a terrible toll.
An immunologist by training, Fauci has made important contributions to the understanding how HIV attacks the body’s immune system as well as helping to develop therapeutic strategies. He has also authored, co-authored or edited more than 1,270 scientific papers along with several textbooks and is a key adviser to the White House on HIV/AIDS policy, including the PEPFAR program, credited with saving millions of lives around the world.
“There are few people in the field of public health who have had such a profound impact on global health and infectious diseases,” Paul Cleary, dean of the School of Public Health, said in his introduction. “In the spirit of Winslow, [Dr. Fauci’s] work has involved extensive communities of professionals and laypersons, which directly promotes Winslow’s goal of preventing disease and promoting health.”
Fauci began with a grim overview of the devastation wrought by HIV/AIDS over the past 35 years. There have been some 76 million infections and 34 million deaths internationally. Approximately 37 million people currently live with the virus and there were 1.2 million deaths and two million new infections in 2014 alone.
Since the 1980s a host of interventions in the United States and elsewhere, such as needle exchange programs for injection drug users, along with significant investments in biomedical research that have produced a host of effective HIV-AIDS drugs, have slowed the spread of the disease and the death toll for some.
But Fauci argued that much more remains to be done in the area of treatment if the rate of new HIV/AIDS infections is to be further slowed or eliminated. This includes regularly testing people for infection (with some at-risk groups being tested multiple times annually) and immediately providing comprehensive care (such as antiretroviral drugs) for those who are HIV-positive. In the area of viral suppression, Fauci pointed out that Rwanda is currently doing better than the United States.
Treatment as prevention works!
Anthony Fauci, MD
Prevention is equally important, and people at the highest risk for the disease should be offered counseling and provided a “toolbox of prevention,” options that include giving at-risk people antiretroviral drugs (pre-exposure prophylaxis) that lessen their chances of ever becoming infected.
“Treatment as prevention works!” he said.
Fauci closed by touching on efforts to develop a cure for HIV/AIDS, as well as a vaccine. Eradicating the virus has proven to be extremely difficult and a variety of innovative approaches have either failed or are still in early stages of experimentation. If a cure is discovered, it will need to be simple, safe and scalable to treat the millions of people currently infected, he said.
A vaccine, meanwhile, remains necessary if the goal of ending the disease is to be reached and sustained, Fauci said. Any vaccine will have to effective, in the neighborhood of 50 percent to 60 percent, to be worthwhile.
Such a vaccine, in conjunction with non-vaccine preventative efforts, will put a “durable nail” into the coffin of HIV/AIDS, he said.
Since its creation in 1999, the Winslow Award has only been bestowed four other times. Previous recipients are Sir Richard Doll (2000), who is credited with identifying smoking as a leading cause of lung cancer; William H. Foege (2004), who directed the Smallpox Eradication Program at the Centers for Disease Control and Prevention; Sir Iain Chalmers (2010), founder of the Cochrane Collection, a leading creator and repository of systemic reviews of evidence-based health care; and Sir Michael Marmot (2015), a prominent international researcher on health inequities.
Sir Michael was the first of three Winslow Award recipients during the school’s ongoing centennial celebration in 2015. Fauci is the second and the final recipient is Judith Rodin, Ph.D., president of the Rockefeller Foundation, one of the world’s leading philanthropic organizations.
She will receive the award on November 2 at noon at the Yale University Art Gallery at 1111 Chapel St. The event is free and open to the public.
Her talk , “Public Health 2.0: Aligning People and Planet,” can also be followed live on Twitter with the #YSPH100 hashtag.
See the Yale School of Public Health Facebook page for additional photos of Dr. Fauci’s appearance at Yale at www.facebook.com/YaleSPH