It felt like the end of an era on Monday when Anthony Fauci announced that he would be leaving his long-standing perch heading the National Institutes of Health’s (NIH) National Institute of Allergy and Infectious Diseases (NIAID) and its associated leadership positions in the Biden administration. The physician-scientist and public health luminary, whose extensive career spans decades, guided seven different presidential administrations on the best ways to tackle new infectious disease threats ranging from HIV to coronavirus. He also became the ultimate vessel for Americans’ hopes for—and mistrust of—the scientific establishment during the once-in-a-century COVID pandemic. Fauci has couched his departure, not as a retirement, but a way for him to move on to the next stage of an already illustrious career.
But celebrity in science is prone to the same discontents and nuances of celebrity in just about anything. From politics to the ability to communicate to the public when they are at their most fearful, skeptical, or both, a doctor serving in the federal government—and leading a public health campaign which can only be successful with maximal public buy-in—is an open target for both adulation and criticism. And Fauci racked both up in spades, as have so many medical leaders before him trying to shake people into action based on the scientific evidence and despite their baked-in political biases.
In the earlier days of the COVID vaccine campaign in late 2020 and through 2021, COVID shots were often referred to as the “Fauci ouchie,” as Grammy award-winning children’s musician Joanie Leeds highlighted in a catchy kids’ tune just earlier this year when the vaccine was authorized for use in younger children. Fauci himself appeared on PBS’s Sesame Street to inform Elmo and company that he had personally traveled to the North Pole to vaccinate Santa against COVID during the 2020 holiday season—so rest assured, jolly old St. Nick could still deliver presents after a year of lockdown. He may be the only scientific government official (or, really, any government official) to be played by Brad Pitt, in a tribute to Fauci’s leadership and ability to communicate the nature of the coronavirus threat to an anxious nation, on an SNL episode in the earliest days of the pandemic.
Public health requires public persuasion, public knowledge, and public engagement. And the politicization of the COVID response, with a sharp divide that cuts across ideological grounds and manifests itself in the gap between vaccination rates in red and blue states, also made Fauci a veritable boogeyman of government overreach and Big Pharma-fueled nefarious intentions. A cursory glance at “Fauci”-related products on Etsy demonstrates this divide, with “Saint” Fauci prayer candles for sale alongside monstrous caricatures of him splashed on T-shirts demanding the masses, “Obey,” in a consumer version of the storylines popularized by conservative media organizations like Fox News.
But Fauci’s divisive legacy is actually nothing new in the world of infectious disease. When germ theory itself—the literal underpinning that organisms naked to the invisible eye can spread through the air, or by touch—was proposed by Louis Pasteur in the 1860s, the acolytes of alternative medicine and scientific contrarianism slammed him as a quack. Hundreds of years later, that very pseudoscience continues to have a hold on society and is direct fuel for the anti-vaxxer movement, and by extension, a source of consternation for those like Fauci. One prominent germ theory denial Facebook group formed in April 2020, and highlighted by Ars Technica, ballooned from a handful of members to more than 26,000 today.
If a lesson exists, it may be this: Leveraging science for practical and social good requires a type of engagement with the public that is inherently political. And those who become the face of such movements open themselves up to the double-edged sword of public scrutiny. Anthony Fauci certainly did.
Sy Mukherjee has reported on the healthcare industry for a decade. He is a consultant and communications architect at IDEA Pharma.