Transcripts For CSPAN2 Q A 20150330

From california. To the new york islanders. Saturday at noon eastern on cspan2 book tv and sunday afternoon American History tv. After one dr. Anthony fauci director of the National Institute of allergy and Infectious Disease how many years . Guest 30 after one in those 30 years 30 years have you ever had the feeling that something would get away from us when it came to one of these crises and disease . Guest not that it would get away from us but would be much more serious than anyone anticipated and that started from the beginning of my career as the director of the institute. When i 1st started seeing and taking care of hivinfected individuals in the early 80s, 1981 the fall winter of 81 and 82 as to what would happen. I got involved early on and was concerned that many people in and out of government were considering this just a fluke among gay men some strange disease. The way i saw it involved and following it it was quite scary. Unfortunately my concerns were wellfounded because it turned out to be historically and yesterday one of the most devastating historic pandemics that we have ever experienced, the civilization has ever experienced. Cspan when do you personally recognize this . Guest there was a moment the early summer of 1981, 1981, the cdc, the center for Disease Control and prevention every week puts out something called the morbidity and mortality rate report which is almost a pamphlet which gives you a heads up on diseases or patterns of disease like a flu is coming or an outbreak of this. They reported on their june 5 1981 5 men from los angeles who presented with a very unusual kind of pneumonia that you only see in people who have dramatically suppressed immune systems. I looked at it and said five gay men. Why all gay men and why this strange disease you almost never see in Healthy People . They were supposedly completely healthy otherwise i thought it was a fluke and put it aside. One month later july 4 of 1981 the next in nwr appeared on my desk at nih and they said no 26 men with not only this strange pneumonia but a strange kind of cancer you only see in people that are immunosuppressed. All of them were gay. I. I said something is going on here that is really bad and this is likely a new disease. I had no idea what it was. Was. It looked very much like it was an Infectious Disease. When you look at the pattern it seems to have been spread by sexual contact and command that is when i had a combination of a realization and anxiety where i was saying this was going to be bad and made what i consider the transforming decision in my own career and decided i would stop what i i have been doing rather successfully for the previous nine or ten years and devote myself completely to studying it and what i felt would be an enormously difficult disease. Unfortunately turned out that was the case. Cspan when you look back at that, i that i have read that people were mad at you in your operation. Who got mad at you for what reason that you took a zen and had them involved in the discussion . Guest it was a a combination. In a wellmeaning way, my mentors those red cultivated me in science and academics thought i was being foolish throwing away a promising career in one area of medical research to go after something that they thought was going to disappear, was just a fluke that would go away. Later on away. Later on as i began to take a leadership role in that only the research, but when i became director of the institute of the National Institute of allergy and Infectious Diseases in 1984 there were people that were concerned and i think bordering on being angry with me in that it was clear i wanted to put more research on this. I wanted to get more Government Resources and research into became clear to me that we needed to embrace the gay community, the activists to get a a better feel for what was going on in the trenches. There was a lot of resentment on the part of the scientists because they thought i would diverge resources away from other important areas, other Infectious Diseases. I was arguing out to diverge resources but get knew resources, argue before congress and the president about why we needed more resources for this disease. That was the area of resentment. The idea of activists playing a Important Role in a Research Program was completely foreign and antithetical to many scientists. At the time it was, well, we are. Stick scientists. We will make the decisions and dont need to involve the community. They were the ones that were suffering with unknown diseases, the rigidity of the regulatory process of getting drugs approved quickly that were experimental drugs that showed some efficacy was all a change in paradigm that had not been experienced before. Cspan we will come back to some of this, but we have seen a lot of you over the years. I want to talk about your background and life. When did you make a decision why you would be available to the media . There are 27 institutes at the National Institutes of health and i could name maybe one or two others. You are always available to answer questions. Why . Guest it became clear to me that particularly in the discipline i was dealing with, emerging Infectious Diseases that would generate a lot of concern on the part of the public hivaids, pandemic flu ebola, most recently now with the ebola crisis it became clear that the public needed to be educated to understand just what these issues meant to them personally and to the nation and the world. I was perplexed by seeing scientists who shunned away from trying to explain things in plain english in a way people could understand. There was a culture back then that scientists did not want to be bothered with the press or getting involved or when they did they spoke over people as opposed to trying to get people to understand. I made a decision a long time ago that it was important for the public to understand and if you wanted the to garnish support from the congress and administration he had to be understood and in the public eye. Otherwise it would slip under the radar. That was one of the reasons there was attention paid to it in. Science technically science technically speaking if you look at the executive branch of the federal government obviously the president is the boss. The department i am in is the department of health and Human Services. The secretary is the next level and then there is the nih. Technically speaking that is the boss. When you are in a scientific and Public Health there really is very little of the boss tells someone to do something that you might see in another endeavor. It is more of a collaborative discussion and intellectual deciding what is the best direction to go. Technically someone is administratively your boss but in reality it is more of doing the right thing and best thing and most appropriate thing cspan where are you located . Guest bethesda bethesda, maryland, right off the main campus right there just a little bit north about five and a half miles to washington dc. Cspan the 1st dark in your family was your father a pharmacist. Tell us about him. Where were you born . Guest i was born and raised in brooklyn, new york the bensonhurst section which was back then and maybe even now brooklyn, if you took an aerial photo ethnically divided italianamerican, irish, africanamerican, puerto rican so i so i was in an italianamerican section called bensonhurst, a very family oriented warm and nurturing area to live in. My father is firstgeneration. His father was born in italy and came to the United States at the turn of the 20th, 19 to 20th century my father was raised early on and little italy section of new york in manhattan moved to brooklyn and that our family was raised in brooklyn. He went to Columbia University college of pharmacy, became pharmacy became a pharmacist, and that is what he did for his life. Cspan that is how he got the name dark. Guest they called him dark. A little bit different than it is now. Many people either could not afford to go to a dr. Or did not want to take the time to make an appointment and would go to there neighborhood pharmacy and explain symptoms. My father never overstepped his bounds. Often he would give them the advice that they needed to take care of what minor ailment they had. Cspan moms background . Guest my mother went to Hunter College in new york city and got married at an early age. My mother and father got married right out of high school. My father went through Pharmacy School and my mother went through Hunter College, both married, and as soon as my mother gave birth to my sister three years older than i and then me she became a homemaker. Cspan the jazz it was. Dot you high school. What did it mean to be taught by jesuits . Guest it was a great experience. They combine intense intellectualism with discipline not in discipline, not in the sense of smacking you around but intellectual rigor discipline and how you handle yourself zero as a human being. And they have a general motto and i and i think this had a major influence on me and what i did the issue of service to others that is big it does not mean people who dont go into Public Service are doing anything lesser with their lives but they tend to have a pushing but leaning toward something about what you do is Public Service, either everything you do which turned out what i did or at least a part of your life. So when i went to the Regis High School we took four years of greek four years of latin romance language, ancient history, things like that. When i went to holy cross i took a hybrid premed course almost an oxymoron called a be greek classics premed. Majoring in majoring in the humanities and classics with a lot of philosophy but took a can of science to get into medical school. The idea about what i wanted to become a doctor i like science, discovery, the challenges of science but also liked mankind into the humanities that it was just a natural fit over you put science of people in the same bucket. To me bucket. To me that was medicine. Cspan who was an early mentor . Guest probably some of the very young jesuits in Regis High School. In the jesuit training it is a long long training before you become a priest. Back then they had what were called scholastics people who were not yet priests but dressed in the garb and taught in high school and there were a couple of scholastics who had a major impact on you migrate people, highly intellectual and nurturing. Cspan you did an interview with science magazine. They lead off of this by saying he worked 14 hours a day charge for lunch, eats dinner with his family and continues working until bedtime when he sleeps for about four and a half hours. How much of that is still true . Guest it is still true i do that. I do that. I work a lot of hours, most of the weekend. I do not do it as a drag. I like it and am energized our undoing. We fortunately likely through the creativity and the tolerance of my wife who also works at the nih and is the chair while the departments there we arrange your schedule when the children were growing up even though it is not particularly healthy to eat dinner later at night i preach to people about that. The only way the only way that we could as a family be together everyday was when i would i would come home at quarter to nine, 9 00 oclock, my children got out of school at 3 00 oclock come home, have a snack, and wait for me to come home. We would have dinner together. I would go into my office and continue to work until midnight and go to bed and get up around 5 00 oclock. Cspan how old are those kids now and what are they doing . Guest my eldest is 28 28, a phd student in Clinical Psychology at Boston College graduated from harvard and taught in the innercity minority areas in new york city and washington dc and then went for further graduate training and is now in a phd program. My middle daughter is 25, a firstyear medical student at the university of pennsylvania and my youngest just graduated from stanford as a Computer Scientist working in San Francisco for twitter. She is a computer geek. Cspan please tell us the story of meeting your wife. [laughter] guest well i had been at the nih for about ten years or so. I just happened to have made a trip to china for a meeting for a scientific meeting. While i was away the nih it was the beginning of the hivaids pandemic hired a nurse, a clinical nurse specialist. My wife started off as a nurse before she got her phd in ethics. I did not know she was a new nurse because i was away. One of my patients was a person from brazil who only spoke portuguese. My wife had just come back a few months earlier from two years with project project hope in brazil and was totally fluent in portuguese so as i was talking to the patient, i wanted to tell the patient that the patient had to go home could not do activities, drink, and dolts because he was recuperating. I told him that i needed someone to translate and they said, we said we have a new nurse back from brazil who could translate. I told her he is got to do a, b c and d. She turned round and spoke portuguese and i found out later that he told her to tell the dr. That there is no way the 1st thing im going to do when i get back is go to the copacabana beach, play around have some fish ossa and have a ball. She was horrified, so she turned to me and said, he said fine he will do that. I believe it or. When i. When i looked at her she was just this very attractive young nurse. Very interesting. I went back to my office a few days later and told the head nurse, tell that nurse to come to my office, i office, i wanted to talk to her. She thought she was going to get fired because she thought i had found out she misled me about the patient so she walked into my office petrified and sat there looking nervous. I cannot figure out why. I did not realize you had come here and tell just last week. Would you like to go out to dinner sometime. Of course. We get married a year later. Cspan in the same interview they asked you a question. You attended to jesuit run schools. Are are you a man of faith. Let me read to you what you said. I am not a regular church attender. I have have evolved into less a Roman Catholic religion person to someone who tries to keep a degree of spirituality of upon them. I have faith in the goodness of mankind. Is that still accurate . Guest totally accurate cspan what does that say to the jesuit education . Guest i am less and amit of organized religion than i i am with the principles of humanity and goodness to mankind and doing the best that you can. There are a lot of things about organized religion that are unfortunate, and i tend to stay away from that and think more in terms of the principles that i learned from the jesuits the catholic religion the principles of run my life by the idea about the organization of religion is not something i adhere to very much. Cspan the National Institute of allergy and Infectious Diseases is responsible. What are those 1800 people doing . Guest either the conduct an administration and planning of research and all of Infectious Diseases as well as in certain immune mediated diseases. Cspan what is an Infectious Disease . Guest one caused by a microbe that is transmissible, the ones that you know of that are clear, aids is an Infectious Disease. Influenza, a recurrent problem. Every winter you get an influenza outbreak. Sometimes you get a pandemic malaria tuberculosis childhood diseases respiratory diseases viral diseases sexuallytransmitted diseases diseases caused by a microbe that hopefully you can prevent and or treat. Cspan what is a microbe . Guest an organism that has the capability of replicating being transmitted from one person to another. Bacterias can live more freely. Viruses need to get into a cell to live. Cspan as we look at the world as an outsider and you see the cdc your institutions, the nih, the World Health Organization, who is in charge . Guest no one needs to be in charge. Within the federal government it is relatively easy to explain. Take the department of health and Human Services the three most commonly recognized organizations are the cdc nih and fda. The cdc are the disease detectors. They do surveillance, tracked down disease, recognize outbreaks, track recognize outbreaks, track them and are active with the Ebola Outbreak right now in west africa very active with the flu season or an outbreak of west nile fever. The nih is pure research. When there is a disease what we do in my institute when you are thinking of Infectious Disease is we understand how that disease evolves, develop drugs develop vaccines to my do prevention mentality the research that allows you to intervene. The fda is the Regulatory Agency and they make the regulation of approval or monitoring of drugs or interventions. That is within our own government. When you go globally who is kind of like a global cdc. They sort of coordinate Health Globally throughout the various nations. Cspan leobally throughout the various nations. Cspan let me show you video that you probably have not seen for a long time. Very quick from the debate. George Herbert Walker bush and Michael Dukakis talking about heroes. I agree with the governor on athletics, governor on athletics, and there is nothing corny about having sports heroes, young people that are clean and honorable out there setting the pace. I think of dr. Anthony fauci, probably never heard of him a very Fine Research top dr. At National Institute of health doing research on this disease of aids. Cspan that was 1988. What was the impact on you . Guest i did not know i did not see the debate. I was out of town coming in on a plane. The next morning when i walked in, as i walked in to the lobby people started clapping. I said, what is this all about. What do you mean . The president told you a hero during a National Debate seen by a hundred million people. I was totally surprised. Cspan did you know him . Guest well, very well. I have a great privilege of getting to know president George Hw Bush and the time that he was Vice President. When he was getting ready to run for president he sincerely wanted to know more about this strange disease called aids because quite frankly and disappointingly the Reagan Administration of which he was a part, Vice President president reagan did not i believe use the bully pulpit enough about calling attention to aids. George hw bush felt that this was important. While he was still Vice President he came to the nih and wanted to meet me. I want i want to meet this person i see doing all this. I spent a considerable amount of time with them and reducing them to my patients, talking to him about what hiv is command we struck up a friendship. It it was one of those great honors that falls into your lap. He would invite he would invite me to the Vice President s mansion for lunch and receptions. When he became president it was wonderful because i had a direct input to him. He would call me up or invite me to watches. Even after he left the presidency he would write me notes and sent me a nice letter on my 60th birthday joking around saying, i saying, i cant believe you are 60 years old. Dr. Fauci for the purpose of determining the feasibility of developing a program that might transform hiv aids in the developing word. I got to be close to president george w. Bush reerated to the fact i knew related him from his father but he took a keen interest in global aids and allowed me to be one of the architects of the program that is now transformed hiv globally the president s emergency plan for aids relief. And luckily now that president obama is quite interested and quite amendable to getting involved in solving the problems that i am involved with. So i have had the great privilege of meeting several times at the whitehouse and nih with president obama. I have been lucky that the president s of the units have been amendable to listening to and helping out with the problems we face with research. Cspan 27 institutes in the nih and you are justing one of the them. How many times were you asked to be the director of the nih . Dr. Fauci george h. Bush two or three times and i said no. And he was great. People thought he would get upset with me but he was wonderful and said continue to do what you are doing. When president clinton became president his staff asked if was interested and said they heard i would be good. I explained what i said to George H Bush that this would be an honor i dont want to be asked because i dont want to have to say no. When George W Bush became president he specifically asked me. And i said to his father this is a great honor and position i think i could contribute more to the nation and arena of Biomedical Research by staying in the position i am now. Cspan do you still see patients . Dr. Fauci oh yes. Cspan how often . Dr. Fauci two or three times a week. We make teaching rounds. I am not the primary physician like i was before the director. That would not be fair to the patient but i have other responsibilities. But i make teaching rounds all year long for the last several decades. Cspan what would you say to your fellow doctors about the way they should treat a patient . Dr. Fauci well there are lot of approaches to a patient. One is first with Great Respect because you have have a privilege as a physician of having someone put their health pain, suffering and even their lives in your hands. You have to take it seriously. It is not just another job. I dont want to be mellow dramatic but it is a calling. It gives you a huge amount of responsibility. Listen to the patient also. If you listen to what the patient is telling you you get a head start. Cspan what would you advise a patient to do in relation to his or her doctor . Dr. Fauci it goes back and forth because it depending on what the reaction of the doctor is to the patient. But try to be as open with your doctor and explain everything because it is so important for the doctor to hear from you what it is that is bothering you because there may be things you dont think are important that are very important in the doctors formation about what is wrong with you and needs to be done. Cspan here you are in 1990 at a town hall meeting. Cspan we will see seeing revolutioning of the way we look at treatment of hiv because the end of the 1980s created the concept you will see in the 90s of Early Intervention and treating people early on before they develop full blown disease and keeping them from optimistic infections. Having the goal of the 1990s to convert hiv into a manageable disease where you can council them treat them with drugs so you might have a situation like many other chronic diseases where there is the feasibility of a reasonable comfortable lifespan. Cspan 20 years later here we are. What happened . Dr. Fauci it happened. We are lucky. We have drugs right now that when given to people who are hiv infected i can show you the dichotomy. Half would be dead in eight months that come in. Now i i go back to rounds and someone comes in who is recently infected and i put them on the three drugs i could predict and say if you take the medicine regularly you could live an additional 50 years. So to go from knowing that 50 of the people are going to die in eight months to knowing that if you tack your medicine you could live a normal lifespan just a little less than a normal lifespan. That is a huge advance. Cspan in 1991 a familiar face stood up and said he said aids i am run the video and ask you the impact this had on the discussion. Because of the hiv virus i have obtained i will have to retire from the lakers today. I want to make clear i dont have to aids disease because i know a lot want to know that. But the hiv virus. My wife is fine. She is negative so there is no problem with her. I plan on going on andlove living for a long time and loving you like i always have. Cspan do you notice . What do you notice . Dr. Fauci i have been on panels with imagemagic. He is an example of someone caught. Cspan do you have people call the office and say they want to see you and have you treat them . Dr. Fauci yeah they do it all of the time. We bring them in and i have them seen in the clinic. In order to be seen at the nih you have to fit into a protocol and many people who call do fit and we to take care of them. Cspan the interesting thing about the job you have is the government has decided and i dont think a lot of people know this that you are so important in the work you do that they pay you a lot more money than they way the Vice President of the United States more than the chief justice of the United States last figure was 335,000 a year. How does that happen in this town . Dr. Fauci at the nih when you have positions that are difficult to recruit for people and they can make the salary in the typical range that is not the normal level. They have a system that is flexible because it isnt permanent. They could take it away. For a period of time they will pay you a certain amount and there are several of us at the nih who are in that category where we would make more than if we were in the typical government slot. Cspan and you have a Speakers Bureau . Dr. Fauci no. Absolutely not. Not me. I dont take any money for speaks. Cspan has money every mattered to you . Dr. Fauci not at all. In the federal government, particularly when you have someone as visible as i am i would go to a meeting and the speakers would get thousands of dollars a piece, that is nothing. Cspan in 2003 you testified about another subject. Dr. Fauci how does this cause the affect . The genesis of the pathology and that is what we will be studying now we have the virus. We are not sure if it is the virus itself causing the damage in the lungs of the individual or if it is the virus together with what would be a normal immune response but in some diseases the immune response causes damage. We have infections where a concern type of immune response can make the path logical effect worse. We see that in some cases of measles. So it important to nail this down. The big item is vaccines. Cspan you remember of course you remember sars but do you remember when you talk to a group like this the average person gets lost. Dr. Fauci you have to make sure you are understood. I make it an important goal and you dont want to impress people and razzledazzle them with their knowledge. Cspan what happened to sars . Dr. Fauci it disappeared. It came we started making a vaccine that was successful and then all of the a sudden. It jumps from animals and sometimes it adapts to the human and spreads. That is what it did. But once you suppressed it it essentially stopped because the next one that jumped into humans didnt have the capability of spreading easily from person to person. So we dodged the bullet with sars. We did. Cspan these numbers may be off. You can correct any of them. Since 1978 we have had 400 major electric ships and 31 honerary degrees. Any gone up . Dr. Fauci the degrees are up to 3839. Cspan where do you find time for all of this . Dr. Fauci i dont sleep much. Four and a half hours of sleep no doctor would tell you to do that. Dr. Fauci it is true. It is not the healthiest thing in the world but when you are used to it you are. Cspan when do you find time to speak and such . Dr. Fauci no boon dogging. If someone is saying they are having a meeting and want me to talk i will not do that. If there is a National Meeting where you will impart information to a group of science i may or may not do that. I pick and chose enough so i am not so often away from my office that i would lose effectiveness and i am careful about not over traveling. Cspan you were talking about another issue. Dr. Fauci the virus can jump from chicken to human not very efficiently and it has been real rare, like one or two cases, that have been definitively confirmed it goes human to human. So it is still a virus that has n nhasant been not able to be a real pandemic. And you see the area of the world the birds are in. The bird flu the infections of the birds are not going away. So the conditions that would be amendable to a pandemic are not resolving themselves in fact they are getting worse so that is a reason for the accelerated current activity. Dr. Fauci what happened to bird flu . Cspan what happened to bird flu . Dr. Fauci it went away. There are flips of bird or animal virus that jumps to a human but it doesnt adapt itself to easily go from human to human. So you would see cases of h5n1 and things that are animal viruses that will jump. The thing you have to worry about is if it jumps enough will it by evolution adapt itself to all of sudden seeing i like being in a human and transit more and more. That particular virus didnt do that. It just stayed in a very inefficient way from bird to human and never going from human to human in any way. Cspan this is by denise gradey. A way of making antibiotics might serve as a new help. The lack of antibiotic to replace ones that dont work. I know you know the story. The medicine the lead author is dr. Kim lewis. Did you play a role in this . Dr. Fauci our Institute Funded the research. We do research and most of what we do is give grants to very comp competent scientist who do this. We had finger prints on this. This is an interesting finding because we have a significant problem with antibiotic resistance today in the modern day. If we continue to have a problem with microbes becoming more and more resistant and not the class of antibiotics to meet the challenge we could get in trouble and things that are normally treatable could be untreatable. Whenever you get a situation where you have a new class of antibiotics that could counter the emergence of resistance that is something you want to pursue vigorously which is what we will do. Cspan did you know before the article came out . Dr. Fauci yeah we know about it because when you fund a researcher, when they are getting ready to publish something they write it up submit it gets reviewed revised and published, they let us know when they have a finding. Cspan how much does your institute spend on research . Dr. Fauci the entire 4 and a half billion on antimicrobial several hundred thousands. Cspan what is an antibiotic . Dr. Fauci it is a substance whose main purpose is to suppress or kill a microorganism. A typical one is a microbe called pneumococcus and an antibiotic is a substance that kills that. If i have pneumococcal mona and i am given an antibiotic it will kill it. It is an antidote. Cspan but the point is many are resistant now. Is there a point in someones system where they are resistant to all antibiotic . Dr. Fauci it is not the person who is resistance. We were able to track it down and suppress it but the microbe whether it was in me or you it would be resistant to the antibiotic. Cspan you are 74. How long are you going to work . Frmths dr. Fauci until i am not effective. Right now i believe i am effective as i have ever been. Cspan who determines if you stay . Dr. Fauci you get reviewed by an outside committee every few years and they look at your effectiveness and if you are not the recommendation is you step down. Cspan when there is a new director of the institute and he or she comes in and says tell me what i should look out for. Not talking medicine but politician. As the head of the institution for over 30 years what would ayou say . Dr. Fauci the things i have found when dealing with politics and medicine the things i have found to be effective is be consistent, be totally honest and dont tell people things you think they might want to hear. Tell them the truth that is based on evidence because even though politicians, be it the administration or the congress may not be happy with what you tell them because it disappoints them. They will respect you if after a while it is clear to them you are telling them the truth based on Scientific Evidence. That is the one thing i would emphasis to anyone in that is how you can be successful to get good science to drive policy. Cspan what about dealing with congress . Dr. Fauci be clear. Dont try to razzledazzle them. Dont talk down to them. Dont feel because you are a scientist you are superior and can talk over their heads. The most important thing is for the congress to understand and appreciate what you are to and the importance of your work. So there is a balance between talking down to someone and not talking in such an esoteric way that they dont have a clue what you are talking about. You have to do the balance where you can make the person feel they really understand what you are talking about. They will like that because people like to learn. They will feel good about that. And they will respect you for being able to explain it to them. Cspan there was a time with the media and politicians screaming that we didnt have control over ebola. You were out a lot talking about ebola. How does that look now . Dr. Fauci from the United States standpoint it looks very good. We had a situation where a person came over inadvertently and went to the hospital and infected to nurses. That created concern and panic to a tremendous degree. People took what they saw on the front page of the newspaper with all of the death and suffering in africa that that was going to happen here. And what we tried to do or what i tried to do in front of the National Audiences would say, we are taking this seriously for sure and given our Health Care Structure here and the ability to suppress the spread by identification isolation, and contract tracing, this is not going to happen in the United States the way it is happening in west africa. We may get a case or two, which we did but we will not have this out of control outbreak. If you say it enough and give the good Scientific Evidence for why that is the case people believe it and as it turned out that is exactly what happened. There is no ebola right now. We may get a case that might come in but we will be able to handle it. Cspan the flu. Dr. Fauci yes. Cspan a lot of people i know got the flu shot. People over 65 got a double dose and i know a ton of people that came down with the flu. Lots and lots of money was spent on the flu vaccine and it is not working. Dr. Fauci it is not working optimally because each work you make a calculated guess based on information you gather of what is circulating toward the end of the season of your season and what is going on in the southern hemisphere. Who makes that decision. Cspan the World Health Organization . Dr. Fauci yeah and they have to let us know in february of the prior season because in order to make the vaccine we need six months so it is ready by the summer distribute and it is ready for the winter. At the time of the 2015 season they thought this particular strain of h3n2 would be one type. As soon as they started manufacturing the vaccine a month and a half later it was clear the virus was drifting. And that means mutations and drifting so that by the time you got to the flu season the majority didnt match what was in the vaccine. The comforting news is you get good benefit from vaccines even though they are not a perfect match. There is cross protection. If i am vaccinated with a flu that is not the same one circulating but i could get a degree of protection. Maybe not against getting infected but serious disease. Cspan do you get the flu shot . Dr. Fauci i do. Every year. Cspan have you gotten the flu . Dr. Fauci i got the flu in the mid70s and was sicker than i have ever been. But it seems to work since then. Cspan as you sit at your desk every day what is your number concern way out there . Dr. Fauci my number one concern way out there is the idea of emerging and reuha reemerging infections that are spread through breathing. One of the real priorities we are working on right now is to develop what is called a universal influenza vaccine and it is one you can take once or twice in your life time and it would cover all of the strains of influenza so you dont play the guessing game and change the vaccine every year and keep getting vaccinated every year. If you could get a universal flu vaccine and gave it like you do the measles vaccine and forever be protected that is the thing we need to do. Cspan how close are you . Dr. Fauci it is tough to predict and foolish to see we will have it in xnumber of years. We have made breakthroughs in the last three or four years that encourage me to think within a reasonable amount of time. Cspan the toughest decision you have ever had to make. Dr. Fauci well, one of the tough toughest was when i made a decision during the middle of the aids pandemic to bring the activist community into our liberations because most of the Scientific Community, including my own staff were totally against that. They said they would be disruptive and get in the way of the scientific approach. I got to know the activist very well. Some of them are close to me today. Cspan larry crammer . Dr. Fauci i still talk to larry and the group in the movie with peter stalely and mark harington and greg davis. I insisted we bring them in and i made it knowing there would be a lot of pushback from the Scientific Community and everyone but it was the right the thing to do. People thought i was selling out the activist but absolutely not. They have a lot to offer and it is to against us not to bring them in. Cspan we thank you very much for your time. Dr. Fauci really good to be with you. Have cspan created by 35 years ago and brought to you by your local cable or satellite provider. Host we are at the Las Vegas Conventional Center home of International Ces the annual trade show for consumer technology. This is the largest trade show in the world and we are on location. We will look at new technologies coming out and talk to policymakers. This is the the communicators