Anthony Fauci’s announcement this week that he plans to retire from government service after nearly a half-century has unleashed a new wave of vitriol on the right. “Someone needs to grab that little elf and chuck him across the Potomac,” said Florida Gov. Ron DeSantis on Wednesday.
Fauci’s decision to step down in December marks the end of an era in more ways than one. He is part of a generation of public health and medical researchers molded by the rise of HIV — a virus that morphed from a certain death sentence to a chronic condition thanks to advances in drug development shaped by activists and scientists alike. The covid pandemic has brought another wave of scientific advances, but it has come amid a broad embrace of pseudoscience, conspiracy thinking and animosity toward basic public health measures.
In some ways, the nation’s capacity to respond to public health threats through collective action is weaker than when Fauci began his career. “The operating environment for public health has changed dramatically,” said Georges Benjamin, executive director of the American Public Health Association.
Fauci, who has become the face of the federal response to the coronavirus, is no stranger to harsh public criticism. The beginning of his tenure leading the National Institute of Allergy and Infectious Diseases dovetailed with the start of the HIV pandemic. Back then, prominent gay activists accused him of profiting from inadequate pharmaceutical responses to the virus while hundreds of thousands of people died. “I call the decisions you are making acts of murder,” the famed playwright and activist Larry Kramer wrote in a 1988 open letter.
But while the scientist eventually won over Kramer and many of his fiercest critics from the HIV era, it’s difficult to imagine politicians like DeSantis, anti-vaccine groups or QAnon adherents changing their tune. That shift reflects the strong hold anti-science and conspiracy thinking has taken in the U.S., especially on the right, health and misinformation experts said. Whereas AIDS activists were imploring the federal government to do more to save their lives, today’s anti-Fauci activism wants the government to do less.
It’s primarily motivated by weaponized anti-science politics, said Peter Hotez, a vaccine researcher at Baylor College of Medicine.
“In this time of covid, opposition to science-driven interventions has been full-on adopted by the far right, adopted by the House Freedom Caucus and amplified nightly on Fox News and given an academic cover by a recruited cadre of contrarian intellectuals,” Hotez said. “It’s an anti-science political ecosystem that has shaped the far right.”
Experience during the AIDS crisis
Fauci began studying HIV and AIDS in the early 1980s, before the illness then primarily affecting gay men had a name. In 1983, his lab at the National Institutes of Health was the first to show that immune cells in patients with HIV became hyperactive. He spent the next several years continuing to plug away at the scientific problem of understanding this mysterious disease, both from his own lab and from NIAID, which he began leading in 1984.
Fauci became the face of the federal government’s response to AIDS, as he appeared regularly on television and in newspapers. In his now-familiar calm-yet-authoritative style, he laid out what was known and unknown about the virus and emerging treatments, emphasizing that science had to progress at its own, steady pace.
But that slow scientific work frustrated and enraged activists, many of whom came from the LGBTQ community. “These activists were impatient because their friends were dying,” said James Curran, an epidemiologist at Emory University who led the AIDS response team for the Centers for Disease Control and Prevention. “People like Tony and I were part of that criticism because we were the most visible people,” he said. “Reagan didn’t say a word in public [about AIDS] until 1987, so they had to go after the people who are out there.”
“AIDS activists were frustrated and confrontational because, quite frankly, the government and resource allocators weren’t paying attention,” said Benjamin. Activists wanted easier access to drugs that hadn’t yet made it through the Food and Drug Administration’s lengthy approval process. As head of NIAID, Fauci wasn’t in charge of drug regulation.
But instead of blocking out the protests, he listened.
“He took their advocacy and joined with them and invited them in versus putting up walls to try to keep them out,” Benjamin said. Fauci worked to get activists directly involved in the clinical trial-planning process. He also strongly advocated for making drugs in ongoing clinical trials available once they were demonstrated to be safe.
“He taught us all to listen more than talk, to find out what people’s concerns are and find ways to address them in a collaborative manner,” Benjamin said. In no small part because of Fauci’s leadership, community-based participatory research has become the norm now, he added: “That doesn’t mean we do it well all the time, but communities expect us to engage them.”
Fauci’s experience during the AIDS crisis helped shape his future leadership. “I think undeniably Tony learned from the AIDS crisis hugely,” said Ezekiel Emanuel, a bioethicist at the University of Pennsylvania. “For lots of people, the AIDS crisis would have been the end of their career, but Tony was able to navigate that and learned how to address complicated, controversial situations and listen to people.”
A rise in conspiracy thinking and politicization around public health
Some of Fauci’s most vocal critics during the AIDS crisis ultimately changed their minds about him. Longtime AIDS activist Kramer once labeled him the “central focus of evil in the world” but reportedly later called him “the only true and great hero” in government during the AIDS crisis. It’s difficult to imagine Fauci’s current critics changing their tune so drastically. That’s not because Fauci has changed, Hotez said, but because the culture has.
“It’s trite to say that [public health] has become politicized,” Hotez said. “You have a whole anti-science empire as a full-on component of the political right. Proud Boys and Oathkeepers are marching at anti-vaccine rallies,” he said. “That’s what’s new.”
At 81, Fauci lives with private security. Politicians, protesters and right-wing media figures accused him of corruption, called for his arrest and compared him to fascist dictators. Far-right Rep. Lauren Boebert (R-Colo.) received raucous cheers at the Conservative Political Action Conference on Aug. 6 when she called for him to be investigated and prosecuted.
On Monday, the day Fauci announced his intention to retire, Fox News’ Tucker Carlson alleged, falsely, that Fauci “apparently engineered the single most devastating event in modern American history.”
Conspiracy theories about Fauci and the role he played were part of a broader “infodemic” that accompanied the pandemic. According to the Cornell Alliance for Science, attacks on Fauci spread alongside phony “miracle cures” and false allegations that the pandemic was a hoax, a planned attack by the deep state or a Chinese bioweapon.
QAnon adherents have linked Fauci to some or all of those related theories. They blamed Fauci for a so-called plandemic and insisted that masks, used to hamper transmission, were actually a tool to disguise child sex trafficking. Some corners of that community believe Fauci personally unleashed not only covid but AIDS and certain cancers and will one day be brought before a Nuremberg-style investigative commission.
There’s a clear difference between these generations of anti-Fauci sentiment, Steve Sternberg, a public health investigative journalist who covered AIDS and Fauci for decades, told Grid in an email.
During the height of the AIDS crisis, Sternberg recalled, activists blamed Fauci for the deaths of their loved ones. But eventually they saw in him a partner in drawing attention to the virus’ devastating effects. This led to “what I think was a unique collaboration between science, government, civil society and the news media,” in the form of international conferences to share research into the medical, social and cultural dimensions of AIDS, said Sternberg.
By contrast, Sternberg said, many politicians today continue to deny covid’s ravages, and no such global covid summit exists.
In some ways, the covid pandemic inverted the demands of AIDS activists — the loudest voices politicizing the science behind covid are those demanding the government do less, not more. “People tied their allegiance to this thing by not getting vaccinated, or believing that covid-19 was either, first, a hoax or genetically engineered by Dr. Fauci and others,” Hotez said.
Attacks on Fauci have trickled down to assaults against public health officials across the country. Nearly 60 percent of local health departments experienced harassment during the first 10 months of the pandemic, including harassment online and over the phone, death threats, vandalism and doxing, according to a recent study in the American Journal of Public Health. Over 250 officials left their jobs in that time period, and nearly half of public health workers are considering quitting in the next five years.
Sternberg said those types of attacks aren’t comparable to the intense scrutiny placed on health officials during the AIDS crisis.
“Government agencies should be scrutinized. Taxpayers deserve to know how their money is spent,” he said. “Character assassination is not scrutiny; unfounded accusations are not scrutiny. They’re the opposite of scrutiny. Scrutiny yields, or should yield, facts. I’ve never seen this much hate and vitriol directed at public servants who are trying to do their jobs.”
It’s not unusual for medical conspiracies to become integrated with other, political, conspiracies, said Mike Caulfield, a research scientist at the University of Washington’s Center for an Informed Public. Covid provided a convenient tool with which to push election-related conspiracy theories, for example, with Fauci as the face of this all-powerful hoax.
“In that thread of American history, there’s always been this integration between medical conspiracy — believed to be an institution of control — and political conspiracy, in connecting these things together,” he said.
But those conspiratorial threads — such as panic over water fluoridation during the Red Scare — were often found on the political fringes. In recent years, those connected streams of misinformation also moved toward the political mainstream.
Leveraging covid misinformation offered a political mainstream among far-right elected officials, said Hotez. Fauci offered them a convenient scapegoat: a public enemy through which some political and media figures could “cultivate allegiance in a group.”
Some of those same politicians have said that, after he leaves office, they’ll investigate him. It remains to be seen whether public interest — or political opportunity — will remain on Fauci after he’s no longer in the spotlight. But the experts who have watched Fauci’s four-decade career as the face of public health responses don’t think that his departure will end the anti-science climate that marked his final years on the job. Public health officials still face harassment. Scientific institutions are discredited and defunded.
“We need to start figuring out a way to uncouple anti-science from the GOP and far-right extremism,” Hotez said. Part of that may be training a more diverse set of scientists to be better communicators and connect with different communities, including on the far right, he said.
“Because if we don’t,” he said, “it’s not only going to have public health consequences, but our ability to be a great nation is going to suffer as well.”
Thanks to Lillian Barkley for copy editing this article.