A warrior in the AIDS fight never rests

(CNN) -- During the early years of the AIDS scourge, activists took to the streets, protesting what they felt was the U.S. government's inaction in the face of the deadly epidemic.

Among the targets of gay health groups and the AIDS Coalition to Unleash Power (ACT UP) was Dr. Anthony Fauci, the nation's lead scientist in the AIDS/HIV fight. These groups frequently called Fauci and other researchers "murderers" for responding too slowly and even burned effigies of them.

"You have to remember that for the first six years, no one paid much attention to AIDS in Washington," said Larry Kramer, an ACT UP co-founder and playwright, who once called Fauci a "monster" and an "incompetent idiot."

Now 20 years into the AIDS battle, Fauci has the grudging respect of Kramer and other activists, a testament to both his scientific and political skills.

Fauci was able to turn them around by seeking their input. When protesters demonstrated at his office at the National Institutes of Health (NIH) in Bethesda, Maryland, in the late 1980s, he invited them up to talk. "If you got beyond the theatrics and listened to what they were saying, a lot of what they were saying made sense," Fauci said.

Still, it was difficult for his family not to take the attacks personally, admits his wife, Christine Grady. "I thought they were unfair because I knew how hard he worked and how dedicated he was," said Grady, a former nurse and a bioethicist who also works at the NIH. "And some of the accusations were: 'He doesn't care about this; he's not doing enough; he's a killer.' "

Fauci's strategy of bringing advocates into the decision-making process worked, Kramer said, and won him the support of AIDS activists. "Letting the patients in, so to speak, was one of the smartest things anyone could have done, or else there would have been revolution, havoc," Kramer said.

Several months after Fauci first met with protesters, he unexpectedly ran into Kramer at an AIDS conference in Montreal, Canada, in 1989, and the two men began to discuss their differences. "We had a nice talk, like two old warriors," Kramer said, laughing.

These discussions eventually led the NIH to begin a plan to speed up the introduction of new AIDS treatments. The practice, called "parallel track," allows AIDS patients -- who have exhausted all other limited treatments -- unprecedented access to experimental medications not yet approved by the U.S. Food and Drug Administration.

Reflecting back on the evolution of their relationship, Kramer said, "We've been in this together for over 20 years, and we've both aged 20 years and matured and grown to respect each other's positions a lot more, which have changed a lot."

Preparing for the epidemic

As director of the NIH's National Institute of Allergy and Infectious Diseases (NIAID) since 1984, Fauci has been at the forefront in the national effort to conquer AIDS. Under his leadership, the NIAID has grown from the sixth-largest to the third-largest NIH institute, with a $2.4 billion annual budget.

"The all-around multidimensional component of his work in the disease is not surpassed by anyone," said Dr. Robert Gallo, another well-known AIDS researcher and co-discoverer of HIV.

Hard work, organizational skills and discipline have served Fauci well in his 33-year career. He prides himself on excellence and gives credit to the Jesuits who taught him in his youth.

"I often talk about the fact that I've been trained for many years by the Jesuits," Fauci said. "And they're very, very well-recognized for the kinds of qualities they try to impart upon the people they teach -- you know, things about economy of expression, precision of thought, knowing what you're doing, what is the question you're asking."

Anthony Stephen Fauci was born December 24, 1940, in Brooklyn, New York. He grew up in the Bensonhurt section of the borough, where his father, Stephen, was a pharmacist and his mother, Eugenia, a homemaker. As a teen, Fauci commuted to Manhattan, where he attended Regis High School, excelling academically and playing on the basketball team.

He won a full scholarship to the College of the Holy Cross in Worcester, Massachusetts, and majored in Greek, Latin and philosophy, earning a bachelor's degree in 1962.

He received his medical degree from Cornell University Medical College in Ithaca, New York, in 1966 and then completed an internship and residency at the New York Hospital-Cornell Medical Center in New York City.

In 1968, he joined the National Institutes of Health, the focal point of medical research in the United States, as a clinical associate in the Laboratory of Clinical Investigation at the NIAID.

His work was excellent preparation for his eventual role in the AIDS fight. He rose through the ranks, studying the effects of infectious diseases on the regulation of the human immune system. By 1980, he had become chief of the NIAID's Laboratory of Immunoregulation, a position he still holds.

He helped pioneer therapies for formerly fatal diseases such as Wegener's granulomatosis, which is characterized by inflammation of blood vessel walls; polyarteritis nodosa, an autoimmune illness that affects arteries; and lymphomatoid granulomatosis, which causes the deterioration of the veins and arteries.

Having 'the absolutely perfect job'

However, Fauci found his calling in June 1981 after reading an article in the CDC's Morbidity and Mortality Weekly Report on cases of a strange infectious disease affecting gay men. The report would change his life. By the year's end, he was turning his lab into a research center for the disease that would become known as AIDS.

"Every once in a while, one is privileged to meet somebody who you know is in the absolutely perfect job at the time for his particular skills," said C. Everett Koop, U.S. surgeon general from 1981 to 1989.

Fauci and his colleagues were among the first to recognize that the body's own activated immune system is the engine that drives HIV, the virus that causes AIDS.

But his most notable contribution to scientific literature appeared in the journal Nature in 1993, when he reported that HIV infection is never latent in the body but always lurking in the lymph nodes.

"If you look at the lymph node of HIV-infected individuals, those people have virus that's alive, well and replicating even during the period of what we were calling the clinically latent period," Fauci said.

The finding was significant, Gallo said, because it meant "there's no time to relax."

"I think it unified thinking that therapy should be given throughout the period, even when people are feeling well," Gallo said. "And it pointed to the lymph nodes as a terrific site of virus replication and focused some research direction toward the tissue as opposed to simply looking at the blood."

Fauci's contributions have helped to change the course of HIV/AIDS research. As a result, scientists no longer think in terms of eradicating the virus but instead focus on the long-term control of HIV. And research continues on a way to block transmission of the virus via a vaccine.

In addition to his research and administrative roles, the physician-scientist also displays the skills of a savvy politician. Fauci regularly testifies before Congress seeking funding for the NIAID and educating lawmakers about the HIV/AIDS epidemic.

"I've never seen a time," said U.S. Rep. Nancy Pelosi, D-California, a member of the House Appropriations Committee, "when Dr. Fauci came before a committee of Congress where he has not left the panel better informed and impressed by his credentials and his commitment to finding an end to this terrible scourge."

Taking time out for family

A medical doctor by training, Fauci still makes rounds, seeing patients at least once a week at the NIH's Warren Magnuson Clinical Center. He also is the main editor of Harrison's Principles of Internal Medicine, a widely read medical textbook. And he is credited as the author, co-author or editor of more than 1,000 scientific articles.

An admitted workaholic, he arrives at the office before 7 a.m. Fauci frequently puts in an 80-hour week, including working on Saturdays. His myriad professional duties have cut in to the amount of time he spends with his family.

"I would not like to be his wife," Kramer said, laughing. "A woman of great patience."

Not surprisingly, he met his wife, Christine Grady, at the bedside of a patient. Able to speak Portuguese, Grady was the interpreter for an HIV patient from Brazil. She assured Fauci that the patient would follow the doctor's strict orders to rest, but the patient actually said he was planning an outing to a Brazilian beach.

"A day or two later, Dr. Fauci came to me and said, 'I'd like to see you in my office at the end of your shift,' " Grady recalled. "And I thought, 'Oh my God, he knows what happened!' "

But Fauci didn't reprimand her; instead, he asked her out on a date.

Now married for 16 years, the couple have three daughters, ranging in age from 15 to 9. Fauci picks the girls up from gymnastics in the evening when he leaves work, and the family eats dinner together at around 9:30 p.m.

"We're ordinary people, trying to raise a family," Fauci said, "and we happen to be caught up, both of us, professionally in one of the most historically significant epidemics in the history of mankind."

At 60, Fauci shows no signs of slowing down.

"I think any other person might have contributed the service that he has done and then said, 'OK, I burned out, now I'm moving on,' " Pelosi said. "But he seems to be growing -- rather than growing tired of it."

And his peers see a continued strong role for Fauci.

"He's got more history yet to make, and he will," Gallo said. "At this point in time, I certainly think he's the greatest science administrator, combining both scientific leadership as well as science, that I have ever seen."

But Fauci's achievements don't seem to faze him.

"It's tough to get impressed with what you do," he said, "when you're in the middle of an engagement, a war, if you want to use that metaphor, in which this foe or enemy that you're fighting is galloping uncontrolled throughout most of the world."