Dr. Anthony Fauci: A Conversation on Where We Are and What’s Coming Next

Dr. Anthony Fauci

[Music]
Moderator : Welcome to Conversations on Health Care with Mark Masselli
and Margaret Flinter, a show where we speak to the top
thought leaders in health innovation, health policy, care
delivery, global health, and the great minds who are shaping
the hea lthcare of the future.

This week, M ark and Margaret speak with Dr. Anthony Fauci ,
Chief Medical Advisor to the Biden Administration’s COVID
team and Director of the National Institute for Allergy and
Infectious Diseases at the NIH. Dr. Fauci, talks of t he
remarkable science behind the mRNA vaccines, efforts by the
U.S. and G7 to distribute a billion vaccines around the world
and the threat of the Delta Variant, causing surges in the UK,
Germany and the U.S.

FactCheck.org’s Managing Editor, Lori Robertson checks in,
look ing at misstatements spoken about health policy in the
public domain, separating the fake from the facts. And w e end
with a bright idea that ’ s improving health and well being in
everyday lives.

If you have comments, pleas e email us at [email protected]
or find us on Facebook, Twitter, or wherever you listen to
podcast. Now stay tune for interview with Dr. Anthony Fauci
here on Conversations on Health Care.

Mark Masselli: We're speaking today with Dr. Anthony Fauci , Chief Medical
Advisor for the Biden Administration’s COVID - 19 team and
Director of the National Institute for Allergy and Infectious
Disease at the National Institute of Health which he has lead
since 1984.

Margaret Flinter: Dr. Fauci has d irected research on HIV AIDS, on SARS, Ebola,
Zika and now COVID - 19. His team has been researching the
science behind the mRNA vaccine for years. Dr. Fauci,
welcome back to Conversations on Health Care.

Dr. Anthony Fauci : My pleasure, good to be with you .
th
Mark Masselli: You know we’re just a few weeks away from July 4 President
Biden has set really a great goal of 70% of Americans receiving
at least one dose of the vaccine by that date. And I think it’s
fair to say we are on the 10 yard line or it seems l ike we’re
pretty close. I wonder if you could talk about the collective
effort that made this possible. And also it seems to me without
the mRNA vaccine what this remarkable and elegant science
has put together, we may not be where we are today.

Dr. Anthony Fauci

Dr. Anthon y Fauci : Thank you very much Mark. Well I think certainly with regard
to the latter question Mark, it’s true. We have been very
fortunate that the investment that has been made in basic and
clinical biomedical research both in the platform technology
namel y mRNA among others, as well as the proper
configuration of the immunogen, the spike protein and it’s
right confirmation to be high ly imm u n o genic has lead to
spectacular success with vaccines in the sense of high, high
degree of efficacy in the clinical tr ial and effectiveness in the
real world setting. So that’s you ’ re absolutely correct, if we did
not have that successful investment that went back decades,
we would not where we are right now, that’s for sure.

With regard to the implementation of the vacci ne plan,
President Biden has made this a very, very high priority,
literary from the very first day and even before he was
inaugurated. And it has to do with mobilizing all of our assets
to get people the convenience of being vaccinated.
Community vaccine centers, federally qualified health centers,
40,000 pharmacies no longer needing a computer to sign - up,
just go in and get vaccinated; mobile units to go out. But also
creating what’s called the C ommunity Corps , which is the
cor ps of individuals who will b e trusted messengers to get out
into the community, a greater degree of outreach to the
Brown and Black community. I mean I myself have probably
spent I mean dozens and dozens of interviews like this with
leaders of the Black clergy, the Black community, t he Black
business community, Black sports figures just to make sure
that we get Black and Hispanic people there, understanding
why it’s important to get vaccinated.

So this success that we’re seeing where we have 50% of the
adult population already vaccina ted, 64% of the adult
population receiving at least one dose, is not an accident. It
happened by a lot of effort.

Margaret Flinter: Well, you know Dr. Fauci , I don’t know that we as a country as
a people have ever learned so much, so fast, put into action so
many things and pivoted to make it work, couldn’t agree with
you more and we couldn’t have done it without th e science
that led up there. So we’re very excited about how successful
all of our vaccination efforts have been here in the United
States. But with the window on the world, it is such a, just
huge tragedy to see how difficult this is, in so many parts of
the world. The G7 Summit leaders announced a donation of
870 million vaccine to the world’s poorest countries and that
came right after the Bide n Administration donation of 500
million.

Dr. Anthony Fauci

But tell us about this effort to get vaccines to billions of people
around the world who are in greatest need. Is there a chance
that that will be effective on a global scale, the way it’s been
able to effective on a national scale? Is there an infrastructure
there to take those vaccines and get it into the arms of the
people in those countries?

Dr. Anthony Fauci : Well, Margaret, that’s a good question, because there are two
elements to getting the global response. One is the doses
themselves is to scale up particularly in those companies that
have the capability of scaling up by putting a major
investment. I think we can do that. I believe that we can get
billions and billions of doses in the next year or two. We wa nt
to do it as quickly as a we possibly can.

I think what President Biden’s first step towards that was
really a very, very important move because as he said when he
landed at the Air Force base in the UK that America is back.
And that means back in our le adership role. So when we do
something like 500 million doses , the rest of the world follows
up, because we’re not going to be able to do it alone. The
United States is not going to be able to take care of the rest of
the world, alone, but we can be an imp ortant leader in doing
that.

The second part of the point you’re making is a very good one.
What about the capacity, the absorptive capacity of these
countries? And you know let’s look at the history of what
we’ve done globally with vaccines with polio, wi th small pox,
with measles. What we’ve done with PEPFAR and the global
fund with drugs, to individuals in developing countries
particularly in Southern Africa has been very successful. So
although one might think well, many of these poorer countries
don’t have the capacity , you’d surprised what they can put
together. So I’ve faith that if we get them the doses they will
be able to implement the program.

M ark Masselli: You know you had said to us before that the coronavirus
expect mutations out of it, we see the Delta variant is leading
to spikes in hospitalizations in the UK and Germany and
elsewhere, but the good news in Paris is that the vaccines have
shown some promising protective nature about at least that
variant. Trying to connect at least for our aud ience, the
importance of what we just talked about in terms of this policy
to make sure that we’re addressing the global pandemic,
because when people aren’t vaccinated these variants will
continue to mutate. What do you worry about in terms of
variants in the population that’s unvaccinated around the

Dr. Anthony Fauci

globe a nd how that impacts the United States?

Dr. Anthony Fauci : Well, Mark, a couple of very important issues you bring up. I
think the first one that we’re fortunate and that the vaccines
that we have availa ble right now work quite well against the
variants, including the 617, because we know now from the
study from the Pfizer drug at least that it’s about 88%
effective. So we’re in good shape with regard to the vaccines
that we have.

Getting back to the issu e, is that a global pandemic requires a
global response, is really important, because as you’re
correctly saying, if we get the level of infection very low and
we get the overwhelming majority of the population
vaccinated in the United States, and a large proportion of the
rest of the world particularly in the lower and middle income
countries are not vaccinated, that is a sure fire way to
generated additional new variants. And we may not be so
lucky the next time around that the variant that emerges is
one that our vaccine is able to cover. It may be that it eludes
the protection of the vaccine. So we’ve been fortunate thus far
but we can’t count on being so fortunate forever, which
means we’ve got to get the rest of the world vaccinated.

Margaret Flinter: Well, on the front of getting everybody vaccinated we’re
excited to move down to the 17 and old group and then the 15
years old, we’re vaccinating the 12 and up kids now, very
exciting. And know that the trials are going on to look at
approving children as young as 5 and that might come as soon
as September, I understand. What kind of data are you seeing
in terms of safety and efficacy for young children? And also
number of doses, are we, do we have any reason to think that
kids will need boosters, that adu lts will need boosters . W hat
do you think we’ll see?

Dr. Anthony Fauci : Well, a couple of questions there, first with regard to
adolescence the 12 to 15, we have clear cut data on that that
it works really very well. And the original Pfizer study had
essen tially a 100% efficacy in that group of adolescence from
12 to 15, it’s really, really good. Thus far the safety profile
looks really quite good. You’ll always have a very rare adverse
event but if you look at the risk benefit of adverse events
compared to the benefit of the vaccines overwhelmingly in
favor of the vaccine.

With regard to boosters, you know we will likely need a
booster shot for durability of protection not necessarily for the
higher protection, because these vaccines work very well. But
unl ike measles vaccine which is essentially lifelong protection,

Dr. Anthony Fauci

we probably are not going to see that. So a likely after a year
or so we don’t know what that’s going to be Margaret,
whether it’s going to be a year or a year and a half. So we
likely will need a boost. Whether it’s going to be a regular
boost or just maybe once every few years, we don’t know.
We’re doing the studies now to determine what the need
would be #1 and what the right boost approach is.

Mark Masselli: Dr. Fauci, I’m wondering if you ca n give some advice to health
care organizations like ourselves that are trying to address our
staff’s concerns and also to deal with the science. Many of us
are laying out standards that require people like we do with
the Influenza shot to be vaccinated ex cept for religious or
medical exemptions. Do you have some advice to health care
organizations all across America on the standards they should
employ?

Dr. Anthony Fauci : Well, you know that is as you probably well know Mark, it’s
going to lead a lot of con troversy because the idea about
mandating vaccines it’s not going to be done centrally, by the
Federal Government. But I’ll guarantee you that there are
going to be organizations maybe universities and colleges,
maybe airliners, maybe cruise ships and cert ainly certain
healthcare organizations might in fact mandate that you’ve to
be vaccinated. In fact there was a recent lawsuit that you
know where they tried to prevent a mandate of vaccines and it
turns out the lawsuit was lost and people really had to get
vaccinated if the institution that you’re associated with
requires it. I think it’s going to vary greatly from state to state,
because already some Governors are trying to get laws
through that says you can’t mandate vaccinations.

Margaret Flinter: Well D r. Fauci , I wonder if I can get you to comment on
another area that I know has been of great interest and
concern to you and that’s minority representation and
research over the years. Certainly we’ve seen the impact on
minorities during the COVID pandemic , but we also want to
make sure that there is minority participation in the COVID
vaccine trials. And I know that that has been somewhat
successful. But I understand that you’re seeking a much
broader role for communities of color at the NIH with the All
o f Us Research Program. And we wonder if you could just take
a minute to talk about what’s going on there and why that’s so
important?

Dr. Anthony Fauci : Oh yeah, I mean the NIH has made a major commitment you
know not only for minority representation among us but for
minority health. An equit y you know we have an institute, the

Dr. Anthony Fauci

National Institute of Minority Health Disparities which in fact is
devoted completely to guaranteeing that we have the
wherewithal to make sure that all disparities that are
addresse d right upfront in a very serious manner. So the NIH is
taking this really very seriously, from the Director right down
to the people in the trenches.

Mark Masselli: That’s great. Talking about public health you know we’re in the
midst of doing mass vaccin ations and those are starting to roll
down now, we’re doing more door - to - door, but talk about the
infrastructure that we need to have in place. We have a
childhood vaccination distribution program in America, we
don’t have one for adults, wondering what yo ur thoughts are
about, how we learn from this gap that we had in terms of the
investments that we need to make in our public health
departments and our public health departments?

Dr. Anthony Fauci : Well, you just hit something that is very, very important.
You’re absolutely right, the infrastructure for childhood
vaccines is infinitely better than any infrastructure. So we’ve
got to integrate the idea of adult vaccines right into the
healthcare system. You know many physicians are doing that
right now, by m aking sure in encouraging their patients, but
that’s their patients, you’ve got to have an infrastructure that
goes beyond requiring a physician. You’ve got to be there
available to be able to give vaccines for people who don’t
necessarily have the accessi bility of a physician that they could
call up. So we have a ways to go Mark, because we haven’t
solved that issue yet, of a structure to get vaccines like COVID -
19 vaccines and Pneumococcus and Zoster and all the others
that we need to adults to get.

Marga ret Flinter: Dr. Fauci, I know we don’t have much remaining time with
you. But I have to say it’s been 40 years since HIV AIDS was
declared a health threat, we’ve been on that journey with you
over these last 40 years since the beginning. And I think that
you’ve predicted a cure is possible within 10 years and you
pointed the dramatic scientific collaboration around COVID as
proof of what can be accomplished. What say you, about this,
do you think this is possible 10 years?

Dr. Anthony Fauci: Well you know I think there are two issues with regard to HIV
AIDS, one is the vaccine. And I think what we have learned
from the extraordinary technologies that have allowed us to
succeed with COVID - 19 vaccines are going to be readily
applicable to HIV. I think HIV vac cine work and attempts is
going to get a very positive shot in the arm from the work
that’s been done with COVID - 19. It’s going to be a little bit

Dr. Anthony Fauci

more problematic with the cure, I mean we have spectacularly
effective drugs against HIV, one pill a day and you can
suppress virus to below detectable levels, something we
wouldn’t have imagined you know in the beginning of the
outbreak. But to actually eradicate it from a person I think it’s
doable but it’s not going to be easy, but we’ll continue to try.

Marg aret Flinter: We 've been speaking today with Dr. Anthony Fauci , Director of
the National Institute for Allergy and Infectious Disease at the
NIH and a Chief Medical Advisor for the Biden Administration’s
COVID - 19 team. You can learn more about his vitally
important work by going to www.niaid.nih.gov or follow him
on twitter @ NIAIDnews .

Dr. Fauci , thank you for your life long dedication to eradicating
infectious disease for your heroic work in the face of this
pandemi c and for joining us again on Conversations on Health
Care .

Dr. Anthony Fauci : Thank you very much Mark, thank you Margaret.

Mark Masselli: Well Margaret, we are so fortunate to have Dr. Fauci on again,
th
third time around the virus. He joined us back in Feb ruary 20
of 2020 which is a long time ago.

Margaret Flinter: Long time.

Mark Masselli: And I think one thing that stuck out in my mind is when he
reminded us of the number of travelers from China to the
United States, this is just before all heck broke l oose in the
United States, but he said, there were 20,000 people a day
who came. We knew the virus was going to hit all over the
country and it did.

Margaret Flinter: Yeah, I’d say he was something of a prophet. And a prophet
who spoke in about as clear vo ice as anyone we had ever
heard in science who really understands that people need to
know, they need to hear the science, it needs to be
understandable and that there is course of action to take. And
he has really been with us every step of the way throug hout
this pandemic.

Mark Masselli: And I think one of the things that remarkable in addition to all
of his work in the science that he brings, what a humanitarian
he is. He makes the point that he has spent an enormous
amount of time with the Black and Bro wn populations leaders
in this country to make sure that every citizen, citizens that we
care so much about here at our community health center are
reached by this vaccine. And make sure their voices are heard
by leaders within their own community.

Dr. Anthony Fauci

Margare t Flinter: That’s right and not just here in the U.S. but I really
appreciated him when we asked about what’s happening
globally and even if we give 500 million doses from the U.S.
and 850 from the G7 summit. Can people deliver this vaccine
into the arms? And I really appreciated his clear respect for the
developing and under resource countries that they have
figured out how to deal with measles and small pox and polio .
A nd that they really, we would be surprised I think is what he
said, we would be surpris ed just how much talent there is
there for getting done a job that just has to be done.

Mark Masselli: Right we hope you all join us for another episode of
Conversations on Health Care. Peace and Health.

[Music]

Mark Masselli: At Conversations on Health C are , we want our audience to be
truly in the know when it comes to the facts about healthcare
reform and policy. Lori Robertson is an award winning
journalist and Managing Editor of FactCheck.org, a
nonpartisan, nonprofit consumer advocate for voters that aim
to reduce the level of deception in U . S . politics. Lori, what
have you got for us this week?

Lori Robertson: When President Joe Biden announced plans to reduce U.S.
greenhouse emissions by 50% by the end of the decade, he
provided a few examples, but n o detailed plan about how that
would be achieved. Nonetheless, speculation by a British
tabloid that it could include reducing beef consumption lead
to a wave of outrage from Republican Officials and
Conservative media. Republican Representative Lauren
Boe bert tweeted that Biden’s plan included “cutting 90% of
red meat from our diets by 2030.” She added “W hy doesn’t
Joe stay out of my kitchen? ” But there is no such plan.
Agriculture Secretary Tom Vilsack said there was no plan by
the administration to reduc e beef consumption.
nd
On April 22 during remarks at the virtual Leaders Summit on
Climate, Biden said, some of his infrastructure plan will help
the U.S. cut greenhouse gases in half by 2030. That’s
compared with emission levels in 2005. Biden talked about
infrastructure for clean technology, capping abandoned oil and
gas wells , reclaiming abandoned coal mine, stopping methane
leaks and auto workers building electrical vehicles. He didn’t
mention beef or cattle ranching which does account for some
greenhous e gas emissions.

But a story in the Daily Mail speculated that Americans might
have to cut back on eating red meat by 90% citing a Michigan

Dr. Anthony Fauci

University study. The study considered diet scenarios that
would reduce greenhouse gas emissions including one in
wh ich 90% of beef consumed in the U.S. were replaced with
plant based alternatives. But two of the authors of the study
told Yahoo News that they didn’t know of any connection
between their study and Biden’s climate plan.

While Republicans and social media u sers piled on with posts
about not being able to eat hardly any burgers, it was all a fake
controversy. It is true that livestock operations particularly
cattle farming contribute a significant amount to greenhouse
gas emissions. The UN estimates that glob ally 14.5% of all
human caused greenhouse gas emissions are due to livestock
and cattle represent the majority of that.

A 2019 UN climate change report concluded that reducing red
meat consumption would lower greenhouse gas emissions and
promote better hea lth. But Agriculture Secretary Vilsack said
there is no effort to limit beef consumption on the part of the
White House or the USDA. And that’s my fact check for this
week. I’m Lori Robertson , Managing Editor of FactCheck .org.

Margaret Flinter: FactCheck .o rg is committed to factual accuracy from the
country’s major political players and is a project of the
Annenberg Public Policy Center at the University of
Pennsylvania. If you have a fact that you’ d like check ed , email
us at www.chcradio.com , w e’ll have FactCheck .org’s Lori
Robertson check it out for you here on Conversations on
Health Care.

[Music]

Margaret Flinter: Each week Conversation highlights a bright idea about how to
make wellness a part of our communities and everyday lives.
When Venture Capitalist and Shark Tank co - host Mark Cuban
decides to sink a couple of hundred thousands of dollars into
your business idea taking a very small percentage of the
company in return, you are probably onto something. And
tha t’s what happened to Olivier Noel , a medical student and
young geneticist at the University of Pennsylvania when he
appeared on the popular ABC show.

Through his research and studies Noel learned that no matter
how many resources a clinical study has it is still extremely
difficult to get a large sample of participants to join in studies.
There are many barriers to getting a good cross section of
study participants especially ethnic diversity. So he thought,
what if you could simplify the process, eliminate the barriers
to research participation and build up a rich DNA database for

Dr. Anthony Fauci

future research all at the same time. And he created
DNAsimple, because he wanted to make it well simple.

Olivier Simple : I think the idea came about right around my second year o f my
PhD. I was actually working at the Institute of Personalized
Medicine in Hershey. And one of the key problems that I saw
there is that you know the re was the proper infrastructure,
there was sequencing ability, there was enough funding for
really amaz ing research projects but it ended up being a little
bit of a chasing game where we couldn’t build enough, strong
enough cohort at first, to be able to do some of the studies we
wanted. Some of the patients we were looking for , it was
taking a very long ti me for them to come. And every day we’d
be going down and talking to the you know the counselors and
asking did we have patients from this background today. How
many patients for that particular genetic background that we
had this month?

And so I ended up going to a genetics conference at Penn
actually and the keynote speaker there was alluding to a
similar problem. And one of the ways they were able to
contact patients was through Facebook. And so from Fackbook
they were able to connect with a number of pa tients all the
way in India and organized logistics to be able to get the
sample.

So the joke at the time, at the conference was that you know
Facebook is the new way of doing genetics. And really that
stuck with me and really one of the, sort of the light bulb went
on. And I realized that that’s something that we could use and
leverage to be able to recruit patients differently.

So I wanted to sort of leverage DNA and particularly leverage
social media to be able to build a national database where
somebody did not need to be a patient or go to the same
hospital or be in the same region to be able to participate in
the research study and properly provide samples for research.

Margaret Flinter: All the participants have to do is to take a simple swab of the
i nside of the mouth, send it in and wait to see if your specific
DNA is of interest to researchers. Noel says that the company
will make their DNA and disease data available to researchers
studying specific diseases offering those researchers a much
broader spectrum of study participants.

Ke tki K a ranam: So one of the things we really wanted to do at DNAsimple is to
allow for the possibility of doing longitudinal study so that you
keep track, you could continue keeping contact anonymously
obviously with a par ticular donor. And so if you’re doing a

Dr. Anthony Fauci

study for example and you have the ability to collect samples
now, collect samples in three months, collect samples in six
months and see how that varies, which is very difficult to do if
you’re going to be in contac t with the patient once. And so
that was another key factor that we --

Margaret Flinter: And the study participants themselves receive an extra
something for choosing to participate , a cash stipend for
offering up their DNA to research.

Ke tki K a ranam: So w e ultimately provide a minimum of $50 every time
somebody provides a saliva sample, which they could keep for
themselves or donate it to a charity of their choice.

Margaret Flinter: DNAsimple has gotten a big boost from the Shark Tank win
and they are scal ing up the infrastructure to expand their DNA
database to represent as broad a demographic spectrum as
possible. DNAsimple a vetted database linking researchers
with a broad array of participants to enhance lab research by
eliminating the barriers to findi ng participant , n ow that’s a
bright idea.

[ Music ]

Mark Masselli: You've been listening to Conversations on Health Care. I'm
Mark Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health .

[Music]

Moderator : Conversations on Heal th Care is recorded at WESU at
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