Fauci: ‘No doubt’ Trump will face surprise infectious disease outbreak
by Gerard Gallagher, published on Healio infectious disease news, on January 11, 2017
Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said there is “no doubt” Donald J. Trump will be confronted with a surprise infectious disease outbreak during his presidency.
Fauci has led the NIAID for more than 3 decades, advising the past five United States presidents on global health threats from the early days of the AIDS epidemic in the 1980s through to the current Zika virus outbreak.
During a forum on pandemic preparedness at Georgetown University, Fauci said the Trump administration will not only be challenged by ongoing global health threats such as influenza and HIV, but also a surprise disease outbreak.
“The history of the last 32 years that I have been the director of the NIAID will tell the next administration that there is no doubt they will be faced with the challenges their predecessors were faced with,” he said.
While observers have speculated since his election about how Trump will respond to such challenges, Fauci and other health experts said Tuesday that preventing disease pandemics often starts overseas and that a proper response means collaboration between not only the U.S. and other countries, but also the public and private health sectors.
“We will definitely get surprised in the next few years,” he said.
‘Risks have never been higher’
Trump, the real estate developer-turned-Republican politician, has worried some infectious disease experts with controversial and sometimes unclear views on certain health issues.
Ronald Klain, who coordinated the U.S.’s Ebola response for the Obama administration, said Trump’s virtual silence about the Zika outbreak and harsh comments about American volunteers infected during the West African Ebola outbreak is “not the kind of leadership we need in our next president.”
“It’s hard to think of a more important time to show a willingness to speak out in the public health community and the global health community than it is right now on the eve of Donald Trump becoming our next president,” Klain said. “The risks have never been higher, and the question of his perspective on these issues has never been more dubious than it is with Donald Trump.”
Fauci and others noted some of the disease outbreaks that recent administrations have faced, including current President Barack Obama, whose administration was tested early on with an H1N1 influenza pandemic in 2009. More recently, the administration was forced to repurpose almost $600 million in federal funds set aside for the Ebola outbreak when Republicans rejected Obama’s request for $1.9 billion to fund the nation’s Zika response.
Current Deputy Homeland Security Advisor Amy Pope, JD, said it was “typical” of the U.S. government that money meant for the Ebola epidemic was appropriated for Zika because of the proclivity of populations to worry about what is currently threatening them.
“We shouldn’t ask the American public to make those choices in the future,” she said. “It doesn’t keep them safe.”
Klain said pandemic preparedness should be approached from a nonpartisan angle. A Democrat, he referenced Republican President George W. Bush founding the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and said Republican Senators Mitch McConnell and Lindsey Graham collaborated with the Obama administration on the Ebola response.
“The mosquitoes don’t know if they’re biting Democrats or Republicans,” Klain said. “They don’t know what party you are.”
According to some of the experts who spoke on Tuesday, preparing the U.S. for pandemics requires proper funding and starts by battling disease outbreaks overseas. This is not just the right thing to do, but the best way to keep Americans safe, Klain said.
“There is no safety for us and our populace when infectious diseases rage,” he said. “The only way the American people can have safety and security in their lives is to promote safety and security around the world.”
Some other highlights from the forum:
- Hamid Jafari, MD, acting director of the Division of Global Health Protection at the CDC, said the CDC has been productive during past presidential transitions and expects the same will be true as control of the White House passes from Obama to Trump: “We have room for optimism that there will be continuing support,” he said.
- Pope said there is no playbook for fighting emerging infectious diseases: “We never know what’s going to hit us, so we need to be prepared as possible,” she said.
- According to Pope, some in the health community are wary about working with the security community because they think it will be detrimental to their work, when the opposite is true: “Marrying these communities actually leads to more resources and more attention,” she said.
- Bill Steiger, PhD, chief program officer of Pink Ribbon Red Ribbon and former director of the HHS Office of Global Health Affairs, said his first piece of advice for the incoming administration would be to budget time for HHS to focus on things other than domestic health issues, because a larger problem is inevitable: “Some international global health crisis will happen that will divert that attention. It has happened over and over again,” he said.
- Steiger said the global health agenda, including programs like PEPFAR, is an “easy win” for the new administration: “Expand the funding if available, but at a minimum keep it going,” he said.
- Fauci said he is in favor of a public health emergency fund that would be used to combat outbreaks like those involving Ebola and Zika: “It’s tough to get it … but we need it. What we had to go through with Zika was very, very painful when the president asked for $1.9 billion in February and we didn’t get [funding] until September.”
Near the end, Fauci speculated about the possibility that there will be a resurgence of Zika this summer. The virus has caused many travel-related cases in the U.S. and some locally acquired cases in Florida and Texas. Fauci said other concerns for the Trump administration include the potential for a new influenza pandemic and outbreaks of diseases that are not yet on anyone’s radar.
“What about the things we are not even thinking about?” he said. “No matter what, history has told us definitively that [outbreaks] will happen because [facing] infectious diseases is a perpetual challenge. It is not going to go away. The thing we’re extraordinarily confident about is that we’re going to see this in the next few years.” – by Gerard Gallagher
Disclosures: Fauci, Jafari and Pope report no relevant financial disclosures. Infectious Disease News was unable to confirm relevant financial disclosures for Klain and Steiger at the time of publication.