Anthony Fauci and the Complicated Legacy of a Life in Public Health
Updated: 3 days ago
Moshe Arditi
There are few Americans whose names evoke such sharply different reactions as Dr. Anthony Fauci.
To some, Dr. Fauci is a symbol of scientific integrity and public service: the physician-scientist who helped lead America through numerous epidemics: AIDS, Ebola, Zika, and COVID-19. To others, he is a symbol of everything they believe went wrong during the COVID-19 pandemic: lockdowns, school closures, mask mandates, vaccine requirements, and an uneasy sense that ordinary citizens were asked to surrender too much of their normal lives in the name of public safety.
Fortunately, there is room for nuance. Jewish tradition does not ask us to pretend that human beings are flawless. It asks us to see human beings as complicated, morally responsible, and deserving of judgment that is tempered by fairness. We can honor great accomplishments without denying mistakes. We can acknowledge harm without assuming harmful intent. That may be the most appropriate way to consider Dr. Fauci’s legacy.
Dr. Fauci spent most of his professional life preparing for and responding to infectious diseases. He became director of the National Institute of Allergy and Infectious Diseases in 1984 and remained in that position for 38 years, serving seven presidents and shaping the national response to HIV/AIDS, Ebola, Zika, influenza, and other emerging infections. He was awarded the Presidential Medal of Freedom, the highest civilian honor in the United States, by President George W. Bush in 2008 for his leadership in the fight against HIV/AIDS and his contributions to the advancement of medical research and public health. The AIDS epidemic, in particular, is essential to understanding Dr. Fauci’s legacy. In the early 1980s, AIDS was a terrifying disease with no effective treatment. People were dying, often young, and in those early years, AIDS activists viewed the medical establishment, including the NIH, as too slow, too bureaucratic, and insufficiently responsive to people who were dying while clinical trials and regulatory procedures moved at their traditional pace.
Dr. Fauci’s response to that pressure set him apart from other leaders in medicine and public health. He listened. He developed a close relationship with activists and became an important bridge between the scientific establishment and people demanding faster access to experimental therapies and a greater voice in research. The NIH leadership has described how Dr. Fauci's engagement with AIDS activists helped bring stronger patient representation into clinical research and decision-making.
Dr. Fauci also helped build the federal infrastructure that accelerated AIDS research. During his tenure, the resources supporting the National Institute of Allergy and Infectious Diseases expanded enormously, and the Division of AIDS was created to coordinate the national research effort. The scientific advances that followed were incredible, transforming HIV infection from an almost universally fatal illness into a manageable chronic disease for people with access to effective treatment.
When the COVID-19 pandemic started, Dr. Fauci held the same institutional position he had in the 1980s, but the world had changed. Society was more deeply polarized, distrustful of authority and elites, and ensnared in an often fact-free social media echo chamber. America was also being led by a President bent on evading truths and minimizing the danger.
His leadership through the AIDS crisis had not prepared Dr. Fauci for his role in this new world. Thanks to social media and the 24-hour news cycle, Dr. Fauci was thrust into the spotlight, suddenly speaking not just to physicians and scientists but to an anxious public of more than 300 million people. That audience wanted certainty, but there simply wasn’t sufficient scientific evidence to allow certainty. Dr. Fauci has come under considerable criticism for the decisions surrounding school and business closures, masking and vaccination recommendations, social-distancing measures, and even questions about the origins of the pandemic itself.
As the SARS-CoV-2 virus spread rapidly across a globalized world, scientists were learning about transmission, asymptomatic spread, immunity, treatments, and risk in real time. Hospitals in some cities were overwhelmed. Physicians and nurses faced a frightening disease for which there was no established treatment and no vaccine. In that environment, public officials were forced to make decisions before the evidence was complete. With hospitals overwhelmed, and older and medically vulnerable people at substantial risk, the recommendations to restrict gatherings and close schools seemed rational.
With the benefit of hindsight, we can now see that in 2020 there were really two pandemics taking place at the same time. There was the biological pandemic caused by the SARS-CoV-2 virus, and there was the social pandemic created by our response to it. The first caused illness and death. The second disrupted education, employment, family life, mental health, and social relationships.
Social isolation affected everyone, but children paid a particularly high price for that second pandemic. When schools closed, there was no coherent plan because scientists and public officials did not know what was coming. But as months turned into a year, many began to ask how much disruption children could reasonably be expected to absorb, and at what point did the harms of keeping them away from school begin to outweigh the benefits?
The evidence that has accumulated since the pandemic shows substantial educational and psychological consequences associated with prolonged school disruption. Major reviews have found learning deficits and deterioration in children's mental health, with the negative effects falling disproportionately on vulnerable and disadvantaged students.
As the nation's most prominent infectious-disease expert, Dr. Fauci helped shape the intellectual climate in which many of these policies were adopted. He gave scientific legitimacy to approaches that, in some cases, remained in place even as more evidence became available about the burdens being imposed on children and families.
But importantly, Dr. Fauci should not be made into a scapegoat for every pandemic policy. He did not set policies; that was up to governors and mayors. Governors ordered lockdowns. School districts made decisions about classrooms. The CDC issued guidance. To attribute every pandemic policy in the United States to one man is historically misleading.
Dr. Fauci was criticized when recommendations changed; the recommendations on masking in particular were confusing and sometimes conflicting. That was unavoidable when the science was changing fast. His defenders have an obvious point: recommendations change when evidence changes. Any scientist who refuses to change their mind in response to new evidence is not practicing good science. Changing one's mind is scientifically responsible, but it is equally important to clearly explain why one has changed one's mind. During the COVID-19 pandemic, many Americans were not given enough sense of the uncertainty behind the recommendations. People sometimes heard scientific judgments presented as if they were settled facts. Later changes therefore felt less like the normal evolution of science and more like reversals. That damaged their trust in the scientific establishment.
Dr. Fauci has also faced criticism over the origins of COVID-19, with some accusing him of concealing a possible laboratory leak in Wuhan, China. Fauci has said he remains open to that possibility, but has emphasized that he follows the available scientific evidence, which he says has not established that the virus originated from a laboratory and is also consistent with a natural animal-to-human transmission. A half-dozen papers in high-profile journals by "highly qualified evolutionary virologists" support the theory that the virus naturally jumped into humans from animals.
Perhaps the saddest aspect of this recent history is the way in which Dr. Fauci has become a symbol onto which Americans projected their broader political anxieties and grievances. To his admirers, criticism of Fauci can appear to be an attack on science itself. To his critics, support for Fauci is evidence of blind faith in government experts.
But Dr. Fauci is neither a saint nor a villain. Jewish history teaches us that human beings are capable of extraordinary courage and extraordinary error, sometimes within the same life. Dr. Fauci should be remembered as a gifted physician, scientist, administrator, and public servant who spent the greater part of his professional life confronting diseases that frightened the public and challenged medicine. He deserves recognition for his decades of scientific leadership, his service to presidents of both political parties, and his willingness to engage with patients and advocates.
During COVID, he faced circumstances that no public-health official could have navigated perfectly. He should be lauded for his work laying the foundation that enabled rapid development and distribution of COVID-19 vaccines. At the same time, Dr. Fauci can be questioned for unclear messaging around those vaccines and for not explaining to the public that officials were erring on the side of caution, with policies based on the best knowledge available, not some universal truth. He can be criticized for promoting policies that underestimated the costs of prolonged restrictions—particularly for children and families.
The principle of pikuach nefesh, the preservation of human life, rightly carries enormous weight in Jewish thought. During COVID, protecting vulnerable people was not an abstract exercise. Families lost parents, grandparents, siblings and friends. Many healthcare workers watched people die without their families beside them. That suffering should never be minimized. But preserving life cannot mean pretending that all other human needs disappear. Children needed schools. Elderly people needed human contact. Families needed one another. The challenge was not choosing between caring about saving lives and caring about preserving society. The challenge was understanding that these are intertwined. In retrospect, I believe that is one of the most important lessons of COVID.
Dr. Fauci himself should ultimately be remembered not as the hero of one political camp or the villain of another, but as a gifted physician who spent more than half a century trying to confront diseases that frightened the world. He was extraordinarily successful in some of those battles. He should also be remembered as a human who—like all of us—was limited by the information, institutions, and assumptions of his time. During COVID, he operated in circumstances in which nobody possessed all the answers, and some of the policies associated with the public-health response imposed unanticipated costs.
Dr. Fauci deserves gratitude for a remarkable career. His accomplishments should be honored, his mistakes acknowledged, and his legacy judged with the fairness and humility we hope to receive ourselves.
The next pandemic will eventually come. When it does, we will need scientists and public-health officials whom we respect and trust. We will also need humility, transparency, and the courage to ask not only, "How do we stop the disease?" but also, "What else are we doing to the people we are trying to protect?" That is a lesson worth carrying forward.
And it is a lesson that allows us to look at Dr. Fauci's long life of service with both gratitude and clear eyes.
Note: An artificial intelligence language tool was used to assist with editing, grammar, and English-language refinement of portions of this article. The author assumes full responsibility for its content.
