And now from the Institute of Politics at the University of Chicago and CNN Audio, The Axe Files, with your host, David Axelrod.

Anthony Fauci has been my guest here many times now. He's written a memoir, "On Call," about his life and career in public health. Now, he and I have talked about his story before, but I wanted to chat again, because among the seven presidents with whom he worked are the two nominees for president this year, Joe Biden and Donald Trump. We spoke about his experiences with each and how in his fifth decade of public service, Doctor Fauci suddenly became such a target. Here's that conversation. Doctor Fauci, great to see you again.

Same here, David.

The last time we got together here, you had just left your job of 40 some odd years and the office that was home for you. Probably more home than home, because you probably spent more time there than you did at home.

I did, I did.

And you were starting off on this book project that has now been realized. The book, "On Call: A Doctor's Journey in Public Service." And you poignantly describe leaving your office for the last time. And so I thought that the appropriate place to start would be to ask how you're doing now in your in your new life.

I'm doing real well, David, it's a great relief to have gotten the book out, because when I did walk out of the NIH for that last time, I began in earnest, literally hours and hours a day, working on the book and editing what I had already written and writing the new chapters. But one of the things I did, which I really feel good about because it's turning out really well, is that I am now a distinguished university professor at Georgetown University, with a dual appointment in the School of Medicine in the School of Public Policy. And what's so good about that is that I had spent the 54 years at the NIH dealing with doctors and subspecialists and researchers with very little, some, but very little exposure to students. Now I'm in the middle of the Georgetown campus, and not only do I have exposure to medical students and students in the School of Public Policy, but I have exposure to students in all of the many schools of Georgetown, and it's really wonderful to have that kind of close interaction with very young people and young minds that are willing to learn and excited about things. It's really, you know, I wouldn't say surprising, but an unexpectedly really big plus.

Let me ask you about that, because you're. Part of the book, and one I want to spend some time on, describes the challenges that you had over the years, but certainly over the last several in the clash between public health imperatives and politics and the subversive nature of social media and the internet in that battle, in that clash. And, you know, I don't know whether you walk into class with your security, but. Your security people. But, you know, in some ways you are an icon for people who are concerned about public health, for all the things you've achieved in another. I would imagine you're a bit of a disincentive because of the target that you've become. Do you talk about the challenges in public health that politics presents today?

'You know, I do, David, and it is a very unusual situation now that was not present back then because, you know, back when I first started, you know, as you say, I've been there, director of the Institute, for almost 40 years. It was always political differences. I mean, during the Reagan administration where I started and then George H.W. Bush and George W Bush and then, you know, Clinton and Obama and Biden, there was always in the early years, differences in ideology that were respected with a degree of civility and not really divisiveness. So differences and diversity did never, in my experience, sink into profound divisiveness. So it's a different situation now. So I do have to address that, because when public health, young people who are thinking of going into public health or who are already in public health see what's happening not only to me, because I'm a very visible person, but I'm not the only public health person or scientist who's being maligned and hit with, you know, conspiracy theories and ad hominems. So what I try to tell the young people is that although that's not what we would like to see, that the gratification and the feeling of accomplishment, of contributing to making the world a better place, to contributing to the health and the well-being of people, far outweighs the negative aspects of what we're going through now. And I would hope, and that's how I sort of end the book with the the epilogue, I would hope that it someday we'll get to the point where we start speaking to each other more instead of fighting with each other.

Yeah. Although the epilogue, you know, of your book is also a very much a a cautionary note about what the implications of not doing that are. And, you know, I should say to our listeners that I'm not going to review the sweep of your career in this podcast. First of all, because we did that. We've done that in several conversations right here. And it's a remarkable story. And you earned the Medal of Freedom for your work. And that was before Covid. And, you've only added, in my view, luster to it. And I would, my, my colleague Sanjay Gupta did a podcast with you this week and covered a lot of this, and I commend that to folks. But I really want to talk. I'm concerned about the implications of this sort of movement against science, against experts generally, when it comes to issues like public health. You write at length in this book about how that impacted when it came to combating Covid. So talk a little bit about that. Then let's talk about what the implications are moving forward.

'To me it's a very corrosive effect. And what it is, it it's it's a fundamental anti-science effect that I, I came into full collision with that during my year in the Trump White House because, you know, right in the beginning when I was, among others, part of the coronavirus task force, my relationship with the president was was actually a good relationship. You know, I describe it in the book that it I don't know whether it was two guys from New York who kind of had a feel for each other. One guy from Queens. One guy from Brooklyn. It was fine. You know, he has his own special way of bravado and all that, but everybody knows that. That's not unique with me. And we did get along well until it became clear that he wished very much that the outbreak would sort of disappear the way flu does in March and April. And when it became clear to him that it was not going to do that, he began saying things that were not true. And he had a Greek chorus, you know, echoing what he was saying, first that it would go away like magic. And that's when I had to, in a very uncomfortable but something I felt I had to do, was to contradict him on that. And when it was clear to everybody that it was not going to go away with like magic, then he invoked these magical elixirs like hydroxychloroquine, which there was no scientific data whatsoever. You know, I think he got the idea from Laura Ingraham that she mentioned that on on Fox News. I'm not sure. And that's when things started to get dicey, because I had to essentially say publicly when asked by reporters that, no, that's, not it doesn't work and it really can hurt you. That's when all of a sudden there was a tremendous pushback against me and science in general. Like, clinical trials didn't matter. It depends on who spoke to you last. And the easiest way to essentially put down what a scientist is saying that's contradictory to what you're saying is to just discredit science. And I was put in a situation in the White House, David, that was stunning to me. And I described it in the book where when it became clear that I was saying things that were contradictory to the president's agenda of wanting everybody to think it was going away so we could get back to the election cycle, it was the opposite. I've never heard this before. Opposition research against somebody on your own team. And, you know, people like Peter Navarro were writing, you know, editorials in USA today saying I didn't know what I was talking about. When you get that kind of conflict, the public.

We should point out Peter Navarro is an economist. He's not a scientist, a medical scientist. And, so his standing to, to to make these judgments is a little bit doubtful. But yeah.

Yeah, yeah. But the end result was that with the social media spreading anything and everything that's unedited, including things that are frankly untrue, the general public gets confused, particularly when you put on the air, you could always find someone with scientific credentials who will say something absolutely preposterous. So you have social media with information, disinformation and misinformation, and you compound that with finding somebody somewhere who's going to say something preposterous, and the general public who's going about their daily business trying to earn a living and and raise their family come to the conclusion that we don't have any idea what's true. So maybe, you know, the scientists don't know what they're talking about. And that really becomes corrosive, because when you live in an arena of the normalization of untruths, and that's the terminology I use, it becomes normalized. There's so much misinformation and disinformation that people throw up their hands and say, we don't have any idea what's true, so we can't believe anything. And that is, I think, corrosive, David, not only to the system of public health, I think it's corrosive to the social order and our own democracy.

Yeah. You point out in the book that, you know, the great disparity, which I think has been written, about 40 to 50 times more likely to have been a victim of Covid if you hadn't been vaccinated than vaccinate. But so there are real, tangible implications of this. If masking, if the vaccines, if public health measures are discredited, there are lives are at stake.

Well, absolutely. In fact, if you look at the clear, unequivocal data, particularly early on, the difference in hospitalizations and deaths of vaccinated people versus unvaccinated people, it is multifold differences of a higher incidence of hospitalization and death among unvaccinated. And when you do it by region, David, it's stunning that when you look at red states versus blue states, the fact that you are someone of a political ideology which leads you to not accept vaccination, means you are at a greater risk of dying. Now, I'm not a political person. You know that. You've known me for years. But as as a physician and a scientist, it pains me to see that people are making a choice that will influence whether or not they get ill or their family gets ill based on a political ideology. That should never, ever happen.

You just had the honor of appearing before a House committee again recently. But you write about one, these, some of these hearings that you attended during this period when, when you were still in the job and one struck me, which was Congressman Jordan, now Chairman Jordan, assailing you and saying, when, when will the American people get their liberty and freedoms back? And it struck me, you know, the Declaration of Independence talks about life, liberty and the pursuit of happiness as rights of people. But they don't say you should choose between them. It seems like life is an important part of this.

Yes.

Yeah. And a lot, a lot of lives were cost. But here's the question I want to ask you. Part of what drove this was, in fact, people were being asked to make a lot of sacrifices, and either the public was going to blame the politicians for that, or they were going to blame, or the politicians were going to blame the scientists. Right. And in an election year, I think increasingly what happened was the politicians blamed the scientists, but there were legitimate sacrifices that people were making that were really difficult. Do you think you, as a policymaker, or as an advisor in the public health establishment, was sensitive enough to that?

Yeah. Well, first of all, David, we were not perfect in our response. But you have to go back, turn back the clock. And well, first of all, look at look at the summation of the data. We've lost 1.2 million people in the United States, more than almost any other country, even the low and middle income countries. At the time, decisions were made to make recommendations. You know, and, you know, it was very interesting that I was the spokesperson for the coronavirus task force often, because I was asked to be in the media. That for some reason or other, understandably, I'm not blaming, people thought that I solely made these decisions myself, which was absolutely not the case, and that could never have been. But I accepted responsibility as part of the team who did make those decisions. Those decisions were made in a situation. The context. We were having 3 to 4000 deaths per day, where the freezer trucks were lined up in front of Elmhurst Hospital in New York Hospital because there weren't enough of enough room in the morgue. You had to do something desperate, shut things down the 15 day bend and flatten the curve, followed by an additional 30 days. That was the right decision. What we need to reexamine is how long that was kept up. How long the schools were closed.

Yeah. That in particular.

Yeah. I for one, if you go back and look at the record, very quickly was saying let's do whatever we can to quickly and safely get the schools open. But there was a great degree of disparity, within the country, depending upon where you were with the schools were closed for a long time, for a moderate amount of time, for a little bit of time. Whatever it is, we need to go back in a careful, non accusatory way and reexamine lessons learned about what the collateral effects of the kind of restrictions, were they things that on balance saved more lives, that was worth the negative effect, or was the negative effect so profound that we need to reexamine? That's the way to do it. When you look at the thing you referred to a moment ago, David, the tenure of the hearing at the House a few weeks ago, there was nothing there that was looking about doing anything better. It was all ad hominem and vitriol. That's not the way you do lessons learned. So it gets back to what you said a moment ago. It became attack the scientists for trying to save lives, which is what we were trying to do.

I mean, we see variations of that on other issues. Climate is one example of that where, you know, people don't want to be directed, they don't want to be told what they have to do, what they must do. I mean, I find it sort of crazy that we're in we're in the sort of meteorological environment we're in right now where every single day there's extreme weather all over the country that is taking a larger and larger toll. And yet we're still assailing the climate scientists who've been warning about this for decades. But that's a that's a separate issue. On the school issue, you know, I think there is ample evidence now that the absence of in class participation had a really deleterious effect to kids. I mean, they fell way behind and it completely enraged parents. Why was. I mean, you were there in both the Trump and the Biden administration. Why wasn't there a clearer directive? I remember, you know, and Jen Psaki was here talking about this. They announced, well, we're going to try and get schools open one day a week, which went over like a lead balloon. Was it pressure from the teachers unions?

You know, I think it was a complicated issue, David. I don't know exactly what the major driving force, but I, I realized early on that we needed to do something. And I kept on saying, you know, one of the sayings that I was quoted for was, you know, close the bars, open the schools. Is to get the kids back to school as quickly and safely as possible. There was a lot of pushback at that. There was pushback sometimes.

Probably from a lot of drunks who wanted to be in the bars. But anyway, go ahead.

Well, maybe. But, you know, sometimes local authorities, the mayors, governors would want to, you know, because of the concern of the spread of the virus in their community. The teachers unions had a lot to do with that. I mean, you can't have the school open if the teachers are not going to go to school. So I don't think there was one thing that was the cause of this prolonged. But I was very uncomfortable and still am. And will we go back and look at it in a civil way about how we can do better? I think we need to get some people who are unbiased with any political agendas to try and figure out what the cost benefit ratio of that in lives saved versus the deleterious effects on the children. You've got to look at it in an open way, as opposed to essentially attacking everyone that has done something that you don't agree with.

In this environment, to find someone who is trusted, who is under biased and has no political agenda is a task. I was going to joke that I know that guy. Let's find that guy. We're going to take a short break and we'll be right back with more of the Axe Files. And now back to the show. How? In the book. I noticed you spent several pages. There's a lot in this book, but you devoted several pages to the question of how this virus began. And the reason was obvious, because, and I think that's still came up in these hearings, that there is this intimation that somehow you were covering for yourself and the Chinese because the NIH had funded part of the lab in Wuhan, and the accusation of the president was that that's where the virus began. You had that discussion with him, I'm sure.

Well, no, he just came out when someone told him that we were actually funding some research, he came out and says, cancel that grant, which you actually can't do. You know, legally, but. Well, the president, I guess, can do whatever he wants to do, which you really can't do that.

He would say so.

'Yeah. Yeah, he would say so. But once he did that, then everything started about, it absolutely started from that lab. When we don't know where it started from. And if you look at the the details of the virology that was done, the viruses that was studied under the NIH grant. And the trouble with that, David, it is complicated, and when you try and explain it, you get into a lot of somewhat arcane virology. But the simple way is that it certainly could have come from a lab in China. I keep a completely open mind. The data from evolutionary virologists that don't seem to have any any skin in the game, people from Australia, from Canada, from the European Union, from the UK, from the United States feel that it's much, much more likely that it came from the wet market because of an animal reservoir jumping. That doesn't mean definitive, and they themselves are honest enough to say it isn't definitive, but the evidence for that is much, much more strong than a, quote, lab leak. Now, what people then do with that? They say, ah, you funded a lab in China, so that must have been where it came from. Well, if you look at the viruses that were studied. In order to get, first of all, all the intelligence agencies uniformly agree this was not a manufactured virus for bioterror. It must have been some sort of an accident. Even the ones who think it came from a lab say that. So then if you look at the virus, in order to get a virus to do with SARS-CoV-2 is doing, you have to have a precursor virus that's close enough to the virus that you're dealing with to be able to say it came from them. But if you look at the viruses that were studied under the NIH grant, they were evolutionarily so far removed as the precursor that they could not possibly have turned into SARS-CoV-2 even if they tried to. Now, having said that, does that mean that there isn't a lab somewhere in China that we don't know about, that were doing things that led to this? Absolutely. That's the reason why I keep an open mind that it's one or the other, even though I feel based on scientific evidence, that it's more likely a natural occurrence.

But this whole debate must strike a nerve with you, because you do spend a lot of time talking about it in the book. And it's one of these things that has been weaponized in the campaign against you.

'Yeah. Well. Well, David, the reason I. And I tried to put it in language that the person who's not a scientist can understand. The reason I devoted several pages to that, because the social media go crazy, you know, with accusations that are completely preposterous. And then when you have a senator of the United States of America saying publicly on C-Span that you're running away from the responsibility of the death of 4 million people. I mean, come on, folks. I mean, that was really you know, I don't even want to say any more about that, David.

Now, this was this Rand Paul or.

Yes. Yes.

Yeah, yeah, yeah. You've had your clashes with him. One of them was early on over masking, which he said had no scientific basis. Talk a little bit about that.

Yeah. He's wrong. I did I don't want to get into any details. I have no. I don't have any antipathy towards nor do I have anything against Senator Paul, though he obviously.

Really? You should. I mean, I can.

Well, you know, I try to keep personal things out of it and just do my job. He clearly doesn't like me, that's for sure. You know, but, you know, it is what it is. But he says things that that, you know, he cherry picks things and comes up to conclusions that I think of just incorrect.

Yeah, yeah. But I guess the bigger question is looking forward. The campaign against vaccines. The campaign against masks. The campaign against scientists. Are you worried that there's a foundation that's been laid that is going to make it more difficult to subdue the next?

Yes.

The next pandemic. And there will be others?

Yeah.

What were the lasting impacts of the politicization of these issues?

Well, David, you've touched on something that's extremely important. I am more concerned about that phenomenon that I am about these off the wall attacks on me as a person. Because if this disincentivizes young people, young, bright people from getting into public health and public service, then we're going to have an attenuation of our army of defense against the next pandemic, which we will inevitably have. We don't know when that's going to be, and maybe next year, maybe 50 years from now. But the idea that you essentially lead to an erosion of trust in science will mean that when scientists, based on solid information, say we should be doing this for the preservation of our health, and you have a substantial number of people who don't believe or listening to that, that's going to be detrimental to the health of the entire country. And a good example of that, David, is what I mentioned to you a moment ago, that red states have more deaths and hospitalizations from Covid than do blue states, simply because they don't get vaccinated. And you know, when when the president got up after the CDC said we should be wearing masks indoors, he said, well, that's a recommendation. But myself personally, I'm not going to do that. You know, he has tens of millions of followers. So all of a sudden masks became a political issue. And, you know that, you wear a mask, you know, you're against the president, you don't wear a mask, you're with the president. That's ridiculous. It should have nothing to do with what your political ideology is. It should have to do with what the safety is and the effect of an intervention to protect you. So that's very disturbing.

You say you're you're more concerned about that and the long term impacts than the personal attacks on you, but the personal attacks on you have been significant. And, they've changed your life and they've impacted on your family. And they continue. In fact, you're now back on the circuit because of this book. Probably raises the threat level against you all over again. Talk to me about that. We talked about last time we were here. But, you know, now you've written about it, and I know you became but somewhat uncharacteristically emotional, at that house hearing about this issue. Tell me about your talk to me about your wife and particularly your kids and how this has affected them.

Well, you know, it has. And it's disrupted. Because with all of the ability to get personal information on on people, you have these trolls out there. I don't know whether they're real people or they're bots or they're a combination of both, you know, who do things that are very intimidating to my children, my three daughters saying, just a simple sentence, we know where you live. Now just put yourself in the place of a young woman who's in a city alone with their friends, and somebody who is making threats against your entire family and says something like that. You know, I, I try to stay, you know, calm and collected about threats against me, because I made the decision to do what I did when I made the decision that I had to speak up against the president of the United States with his tens of millions of followers, some of whom stormed the Capitol, some of whom done things that just astonished me. I can handle that. But what angers me is the cowardice of people that attack innocent people like, you know, try to intimidate my wife and my and my children. You know, Christine, my wife, who I believe you met, is a is a very free spirit. She just likes to do things spontaneously. She's just a wonderful person. She she refreshes my life by that capability of spontaneously wanting to do things. The spontaneity of things is gone. When you have to have protection, you just can't decide you're going to go out for a walk, go up to the bar and have a drink. It just, you just can't do that. And that has been disruptive to our lives.

You you describe in the book several incidents that were more than just idle words or threats. You've got what was feared was an anthrax scare. In your office, you describe. I don't want to dwell on the image of you standing there naked, because you had to take all your clothes off after you got this letter. That was too much for me. But. But, I mean, you know, there was a time when you, and, you know, you had to alert your family, had to wait, await the results of lab tests to know exactly what you were dealing with. So these were, you know, these things happened. And as you point out, there have been acts of political violence in this country in recent years that were, appalling and and frightening. I will accept that you have taken this on as your mission. But when you take this on as your mission, it does impact on your family and not just their worrying about themselves, but how about them worrying about you?

Well, you as usual, you hit on, you hit on the right button, David. Because when when I had that experience and I was with my daughter, one of my daughters happened to have been home during that waiting period when we were waiting for the results from the FBI, whether it was ricin or anthrax or just plain old powder. That really traumatized my children. They were so worried about me, they kept on asking me, calling me up. Are you okay? Do you feel well? They were, you know, expecting that all of a sudden I was going to start feeling sick. And they were really, I mean, to me that that that combination, you know, hurt me but infuriated me to see how frightened my children were that I was going to die in the next couple of days because of that powder.

Well, the fact that you have, you know, persistent round the clock security is probably a reminder all the time to them. Let's leave the politics aside for a second. I want to get back to the presidents in a second. But what did you learn about the public health system through this crisis, beyond this challenge of social media and politics, about the weaknesses in the system? And are you satisfied that we're addressing them?

I learned a lot about the weaknesses.

You wrote about that as well.

'I did. I wrote about it, and and so let me very briefly and succinctly explain. I look at it in two separate categories or buckets. One is the scientific preparedness and response, and the other is the public health preparedness and response. When you talk about the scientific preparedness and response, we get an A+ because the investment over decades, bipartisan investment, in basic and clinical research led to our capability of being able to get a vaccine in in an unimaginably short period of time, 11 months.

We should explain that the foundation, the basic science foundation, put this these researchers working on this particular project way ahead of the game because the years and years of of government funded research.

Exactly. And, you know, I remember that I describe in the book is that the the sequence of the virus was on a public database on January 10th. And my team, my vaccine team that developed what we call the immunogen or the business end of the vaccine, whereas others developed the mRNA. But that was also with government funded research. They said, just get me the sequence and we'll start a vaccine. In a few days. We'll start working on it. And we did. And that, together with the enormous amount of money that was invested in Operation Warp Speed, had us do something that literally saved, not only saved millions of lives for those who received the vaccine, but just think of what would have happened if it had taken five years to develop the vaccine, how many deaths there would have been worldwide. So we did well there. Where we did not do .

Let me just interrupt to say we should point out, in fairness, that for all of the disruptive efforts of the president, who was worried about his reelection and wanted to will the virus away and propagated all kinds of strange theories about how to deal with it before the vaccine came, this happened under his administration. He did greenlight this.

And he deserves all the credit for that, that he did. The problem is he doesn't want to even admit it anymore now, because once you mentioned the vaccine at a rally and he got booed.

Yeah, I saw, yeah.

'And I think that was the last time he mentioned anything about vaccine, which is unfortunate. But anyway, getting back to the other bucket, the public health bucket, we really have a long way to go on that. And thank goodness, the CDC, but which is, you know, staffed by really terrific people, they have a system there that, in their interaction with the local public health, is somewhat fragmented. Unlike other countries where the public health system is very intimately linked with the primary care system so, you know in real time what's going on with a disease. It goes into a computer, and you know tomorrow what happens today. Whereas in our system, the states can give information or not to the CDC, on time or not. And when the CDC did a self-examination, they made a bunch of recommendations, which I hope get adhered too, because we need to do a better job of that if we want to respond better. So the public health arena needs some significant improvement.

Yeah. I mean, that seems every time I speak to public health experts, they point to the fragmentation of the system as a real failing. You know, you mentioned earlier the value of research. That's another concern I have is that funding continue for such research and that our investment in these things continue. Are you confident of that, given all the other budgetary pressures in politics?

No, I'm not confident of that because, you know, we're already talking. Yeah, I'm hearing not rumors, but statements that they want to cut, or limit the funding of NIH. They want to put more constraints on research, which I understand if they're reasonable things. I mean, I, I'm not against accountability at all. And I think some of the suggestions are good suggestions, but you don't want to have a situation where you hamper the conduct of research that has led to those discoveries, which we know now as a fact, looking back, has resulted in the saving of millions and millions of lives.

Yeah. I also, I worry about the folks around President Trump have suggest that if he is returned to office, they want to centralize control over all agencies more tightly under the president, not just the Department of Justice, but all regulatory agencies. And that would include the FDA. That would include the CDC. I trust that has to be a source of concern to you if political people are making judgments, based not on the science, but on the politics.

That, David, is the beauty of the extraordinary accomplishments of the CDC, the NIH, and the FDA over decades and decades is the fact that they're free of political interference, and it's people coming into science and coming into the regulatory arena knowing that they can do the right thing and make a decision based on the best science, not looking over their shoulder knowing if they happen to disturb somebody by a decision, they could immediately be kicked out. And that was one of the reasons why this idea of doing away with the civil service, so that if you don't like someone for any reason, including political reasons, you can get rid of them. I think that's going to be a major, I hope that never happens, but I think that will be a major disincentive for the best and the brightest to come into those organizations that we need. We need an NIH, we need a CDC, we need an FDA, but we need it with the best possible people. We don't need it with politically appointed people.

The best possible people who, as you say, feel free to give the most unfettered advice as to how we should proceed. We're going to take a short break and we'll be right back with more of the Axe Files. And now back to the show. You worked for these two presidents. You've worked with seven, famously. But I want to focus on this, because they're running against each other now. One of them will be the president on January 20th of 2025. Talk about the governing styles of Trump and Biden as you experienced them.

You know, David, the one thing I want to make clear to, to our listeners is, is that when I say I'm an adviser to presidents, which I was, I wasn't an adviser on everything the president did. So I was only an adviser in the arena of when it came into my lane of public health and science and medicine. So I already explained, and I explained in the book, that when I was dealing with, with, with president Trump, it was very, very clear that he wanted so badly for the outbreak to go away that he started to say things that were not true. And that was when I, put me in conflict with him and his team, when I when the president when President Biden asked me to be his chief medical adviser very, very soon after he was elected, I obviously took the job. I had known President Biden for the eight years that he was vice president, because he was in a lot of those situation room discussions about Ebola and Zika and pandemic flu with President Obama. So I got to know him and his style better. And what became clear that nothing changed, that he is driven, you know, by integrity and by empathy. And when we talk about what's going on in a pandemic. And remember, I'm talking only about health, not talking about any other political issues. He cares very much about the effects of this outbreak on people, even though there are other considerations. The primary consideration is the really the health of the people. That was clear to me.

I guess implicit in that is that that is a differentiator in your mind in your conversations with President Trump, because the reason you're an important person to talk to about this is you were dealing with the same crisis under two different presidents, right? So that gives you an apples to apples comparison. How much did Trump inquire about the impact on people and how much empathy did you see in his judgments about that virus?

Yeah, again, I'm going to say this with the caveat that this is not a political statement, because I keep telling people, and it's the truth, that I stay away from politics. But I can only tell you about the facts. And the facts were that there was more concerned about what impact this was going to have on the economy and what was going to have, you know, on the election cycle. And to me, the facts and what rolled out proved it, because once I started to disagree with what he was saying, the entire White House team, not necessarily him. I mean, he you know, we didn't do too badly, but, you know, to have the comms team do opposition research on you, prevent you from getting on television even though all of the shows on Sunday, including shows you were on, we're asking you to come on. They wouldn't let me go on, because they didn't want me to say anything that was contradictory. Whereas when I was in the in, in the Biden White House, I mean, the first thing Jen Psaki did was throw me in front of the, the, the podium and said, it's yours. You know, do it, say whatever you want to say. I mean, that's a big difference.

I guess if a Trump supporter were here, they'd say, well, worrying about the economy is worrying about people too, isn't it? I mean, of course, the ability for people to make a living, the ability for people to pay their bills and so on. So you have to balance those interests.

I do, and that's the reason why I have, and I mean this sincerely, I have no antipathy towards President Trump. In fact, if you look at the last conversation I had with him when he said, you know one of the last, I don't think it was the the actual last, he said, you know, you got to do your thing and I'm going to do my thing. So he was essentially saying, you know, you're going to be talking about health, but I'm doing other things, you know, and I understand that obviously the economy is important, but, you know, yes, it's important. But also saving lives is important.

Without question. And saving lives obviously has an impact on the economy as well. I mean, it's and I'm sure President Biden would say this, it's a balancing act that you constantly have to weigh and consider you've worked with both Trump and Biden. They're both older. Trump is 78. Biden's 82. You're 83. I guess she'll turn 84 in December. Is that right?

That's correct.

I think anybody who's listening to this can make a judgment as to your mental acuity, including your ability to avoid questions that are that might get you into political hot water. But, you know, there are these concerns that particularly about Biden, but also about Trump, about putting someone in that position in an advanced age. And what is your sense of that and asking you really as a medical professional? You also know the job, too, of the president.

The only thing that I can say is that in my interaction with President Biden, he was actually sharp, because he would ask probing questions that were very relevant to the subject matter. The thing about him from, with, what the public sees, that he walks, you know, in a, in a somewhat stiff way, in a careful way, because I think he has some of the old, you know, aches and pains of the bones that that we all have. But as far as his mental status, I think it's fine. I haven't had any indication in my mind that that he's slipping.

'You dealt with another person who is a candidate for president in this race, and that's, Robert F Kennedy Jr, who, has been one of the leading advancers of conspiracy theories surrounding vaccines generally, vaccinations generally. And you had a meeting with him at the urging of the White House and the president's son-in-law, who called you and and asked you to meet with Kennedy. Talk about that.

Yeah. Well, you know, as soon as Trump got elected, Bobby Kennedy Jr. made a statement that was unsubstantiated by the Trump people that he was going to be the head of a commission on vaccines. And I think that was the first that the Trump people heard about it. So they wanted to figure out what to do. So Jared Kushner asked me and Francis Collins, who was the director of the NIH to sit down and listen to what Bobby Kennedy Junior has to say. So we brought him in a team of people with him to the White House, and he came into the room and he had been saying things that we were all disagreeing with. I mean, they just had no basis in facts or reality. Totally disproven. So he came in and the first thing he said was, I never get a chance to fully explain, you know, what it is that I'm trying to say. So I'm going to make a presentation and I don't want to be interrupted until the end, and then we'll talk about questions. So I said, well, that's not the rules that we do here, but okay, you know, we'll cut you some slack. So he got up and the first slide I remember he showed is that it has been shown that vaccinations are responsible for the following diseases. And you get every disease in the world rheumatoid arthritis, schizophrenia, epilepsy, lupus.

And famously autism.

Yeah. Autism. Well autism was right on the top of it, but everything else. So I raised my hand and I said, excuse me, Bobby, but, I don't really mean to interrupt you, but there isn't a bit of evidence at all of anything that's on this slide. And he looked, he says, there you go again, you know, not allowing me to give my pitch. So for the next 40 minutes or so, he showed slide after slide after slide that, David, made no sense at all. It was not founded. Not only was it not founded in data, it was definitively disproven as per the autism situation. So at the end of it, you know, all we could say was, you know, Bobby, I'm sorry, but, you know, we don't really agree with you. And one thing I'm not even sure I, I put it in the book or else we, we cut it out because of space. As we were walking out of the room at the NIH, I went over to and I said, Bobby, I believe you care about children and you care that you don't want to hurt them. But you got to realize that from a scientific standpoint, what you're saying does make no sense. And this issue about autism with, with, with Wakefield in England was completely disproven as being fabricated data that led to the loss of the guy's medical license. And he looked at me, and I don't know whether he heard me or not. And then all of a sudden, fast forward, he writes a book, "The Real Anthony Fauci," and talks about how I was responsible for killing so many people with vaccines. So, you know, I don't know what's going on in his head, but it's not good. And his.

Well, a worm, apparently, was one of the things.

You know, he's he's steeped, David, in conspiracy theories. I mean he is just he's seething with conspiracy theories.

Yeah. Which, by the way, have a market today. This goes back to our previous discussion, conspiracy theories. You know, I've talked about this often. Social media, the model of social media is to keep people online. And what they've found is that out of anger, outrage, resentment, conspiracy theories are magnets to keep people online.

Yeah.

And so if you're a purveyor of conspiracy theories, there's a ready made market for you somewhere.

'Yeah, I think you brought that up really well--I listen to all your podcasts-- when you had Frank Bruni on about "The Age of Grievances."

Yes. Yeah. I mean, it's very dangerous not just to our public health but to our democracy. And that's something that you, that you write in your book, about your concern about the larger, democracy and conspiracy theories, which are, you know, you talk about epidemics. They're epidemic in our communications today. Let me ask you again. I said I wasn't going to talk about the sweep of your career, but you've been involved in all the major public health crises in some form or fashion, you know, of an epidemiological. There, I said it. Yeah, I said it, for this is why the show is an hour, Tony, because sometimes it takes me a while to pronounce these words. So, but, you've been exposed to a lot of death and a lot of suffering going, you know, back to your significant essential involvement in the HIV Aids crisis. Tell me what the psychological impact of that is.

'You know, David, when you're dealing as a physician with serious diseases, there's the high of doing something to cure it or to put it into remission, as we did ultimately in the later years, from 1996 on with HIV. And then there's the pain of when you don't have an adequate intervention of seeing people who you develop relations with die. I refer in the book to the years from 1981, when I turned around the direction of my career and began devoting it almost completely to persons with HIV, who at that time were almost exclusively young, otherwise previously healthy gay men who were really dealt with a terrible disease that was devastating their community. When you deal with death day after day after day with people that you can relate to, that you develop relationships with, in order to function you have to suppress that so that you can go on and be the best physician you possibly can be. When I found that is done to me and has done that to many of my colleagues, particularly the ones early on, the young people who are getting involved in HIV now, we have such great drugs, they rarely see somebody who really gets into trouble. Only occasionally someone will slip through the cracks. But when you spend 1981, 2, 3, 4, 5, 6, 7 taking care of individuals, almost all of who died, you do develop a degree of post-traumatic stress. You know, I didn't even know what that was until all of a sudden, you know, 30 years later, when you think back about a flash of a person in your mind, and I describe one of them in detail in the book about. I still think about that time on rounds when one that I went around and he got blind right in front of me. That was really traumatic.

Was writing this book. You tell about PTSD. You know, I found when I wrote my memoir and there were some painful episodes in my life that I found it very emotional to write about it, honestly. Was it hard for you to go back and reflect on some of those times?

Oh, absolutely. I mean, in some respects it was painful. But the other thing, it was a bit cathartic, too, because when I put it down on paper and sort of distanced myself from it, it was, I think, helpful. When you write it down, you look at it, you read it, you edit it, and then it just becomes something you accept. As something that you've always suppressed. Because one of the things about PTSD is that you suppress things. And then it comes out. So when you come out in a most explicit way by writing about it, I think that kind of, it is cathartic.

You know, my wife Susan and the story of my family and my daughter's epilepsy. And Susan started a research foundation, now a mature research foundation, called Cure Epilepsy to raise research money to find cures for epilepsy, not just palliatives. And I remember her very. She's very shy, but she overcame that because of out of love, really, and grief. Speaking to 4000 neuroscientists, researchers at a epilepsy conference in Rome, and in this enormous setting and telling the story of our daughter's struggles. And I look to the left and right. I mean, I saw people in tears and and several of them came up to me afterwards and said, when you're in the lab, you're so removed from the experience of people. And this really ties it together. And, you know, it seems to me that's a challenge. You know, you, you, you can deal with these things that sort of intellectual exercises, but they're life and death for people on the receiving end.

Absolutely. You know, that's one of the reasons, David, why I've always stayed connected to the patient and have always been seeing patients until literally the last day that I walked out of the NIH in December of 2022, because it really anchors you into the reality of what you're dealing with. And it's a great source of inspiration to go back to the lab and go back to the clinical trial and try and get meaningful answers, because you know what the impact is going to be, because you were just at the bedside of somebody who would be gaining from that, or who might die if you didn't happen.

Yeah. It's just so important. I remember when President Obama was in office, he would ask each day for ten letters that the public had sent. He'd get 50,000 letters a day. But there was a group of people that culled through them to find ones that were really representative of what people were going through, particularly in the middle of that economic crisis. And he would read them and he would respond to them, and he would talk to us about them. Sometimes he would call the people who sent the letter. And the whole purpose was to stay connected to people's lives, because it's so easy to lose that focus, especially in that town, by the way, in Washington, D.C.. My colleague David Plouffe once said, working the White House was like looking at the world through a telescope. You know. Yeah. You have you have to avoid that. Well, listen, I highly recommend this book, "On Call: A Doctor's Journey in Public Service." And more than anything, I want to thank you for the millions of lives that you've saved and impacted through your work. The phrase, a life well spent has never been more apt than in your case. And we all owe you a great debt of gratitude.

Thank you so much, David. I really appreciate. That means a lot to me coming from you. Thank you.

Doctor Fauci. Always good to be with you. Hope to see you down the line.

Yes, indeed. Thanks an awful lot. Take care.

Thank you for listening to the Axe Files, brought to you by the Institute of Politics at the University of Chicago and CNN Audio. The executive producer of the show is Miriam Finder Annenberg. The show is also produced by Saralena Berry, Jeff Fox, and Hannah Grace McDonald. And special thanks to our partners at CNN, including Steve Licktieg and Haley Thomas. For more programing from the IOP, visit politics dot uChicago dot edu.