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Photo illustration: Shoshana Gordon/Axios. Photos: Edwin P. Ewing, Jr. /CDC, Anna Moneymaker-Pool/Getty Images

NIAID director Anthony Fauci is aiming to curb another epidemic: 40 years of HIV, a virus that has remained elusive to a vaccine.

Why it matters: About 1.2 million people in America are living with HIV, but Fauci tells Axios the goal of ending the AIDS epidemic by 2030 may be achievable.

Flashback: A good portion of Fauci's long career has been directed at tackling the global AIDS epidemic, which started to appear as a mysterious illness in June 1981.

  • "I'm probably one of the few individuals who was there from the very first day that we realized we were dealing with a new disease," Fauci tells Axios. He says he remembers "very, very clearly" hearing about an unusual pneumonia found in five young gay men who had unusually low white blood cells called CD4.
  • At first he thought it was a fluke. But he quickly realized it was something more significant, when there were reports in July 1981 of 26 cases in L.A., San Francisco and New York City, also in gay men.
  • Those patients "not only had the same pneumocystis pneumonia, but also Kaposi's sarcoma, a strange kind of cancer, again only seen in immunosuppressed people, as well as a number of other opportunistic infections."

Fauci decided to pivot his career and "devote myself to studying this strange disease that did not yet have a name, and certainly did not have an etiology."

  • He pulled together a small team at NIH and began admitting patients seriously ill with the disease.
  • "That began a 40-year journey that I'm still on, because even though it's been sidetracked a fair amount by COVID-19, HIV/AIDS is still one of the most important things."

But, "the first few years were the darkest years of my medical career, because I was working countless hours taking care of desperately ill young men," Fauci says.

  • "To be honest with you, I still have post-traumatic stress about it, " Fauci describes. Part of the issue, he says, is prior to AIDS research, he had enjoyed several successes in curing some unusual and fatal autoimmune diseases.
  • "I was the guy who developed the therapy to save their lives. ... Then I go to HIV in 1981–1985, and to my horror, all of them died and all of them were young men. It was very, very traumatic."
  • When scientists discovered in 1986 the first therapy that gave some temporary help to patients, AZT, "it was like all of a sudden, the clouds moved away and the sun started shining."

However, the virus quickly developed resistance, Fauci says.

  • They began testing combinations of drugs and in 1996 there was a "major, major, major breakthrough in HIV treatments" via a triple-combination drug that started with a protease inhibitor and was able to dramatically diminish the level of virus in a person's blood.
  • Since then, multiple drug treatments have been developed, and researchers were able to whittle the therapy down from 28 separate pills a day to one pill a day, and early treatment began to mean patients "could resume a normal life."
  • Scientists also developed a very effective pre-exposure prophylactic drug for people at risk of HIV called PrEP that can reduce the risk of someone getting HIV from sex by around 99%.

What's next: A vaccine for HIV remains elusive — and it's not for lack of trying, Fauci says. But, "we may get a home run. ... I believe we will get there, but it may not necessarily be with a highly effective vaccine. It may be with a combination of things."

Go deeper: The long drive toward ending HIV/AIDS once and for all

Go deeper

Updated 3 hours ago - Politics & Policy

Omicron dashboard

Illustration: Shoshana Gordon/Axios

  1. Health: Fauci: "Confident" Omicron cases will peak in February.
  2. Vaccines: The shifting definition of fully vaccinated.
  3. Politics: New York Supreme Court strikes down Gov. Hochul's mask mandate for public areas — Sarah Palin tests positive for COVID, delaying defamation trial — Virginia school boards sue Gov. Youngkin for lifting mask mandate.
  4. World: U.K. to lift travel testing requirement for fully vaccinated — Beijing Olympic Committee lowers testing threshold ahead of Games.
  5. Variant tracker
Updated 1 hour ago - World

Pentagon: 8,500 troops on high alert for possible deployment to eastern Europe

Photo: Anna Moneymaker/Getty Images

Defense Secretary Lloyd Austin has placed 8,500 U.S. troops on "heightened preparedness to deploy" to eastern Europe in case NATO activates its rapid-response force over tensions with Russia, the Pentagon announced Monday.

Why it matters: No decisions have been made to actually deploy U.S. forces, but the heightened alert level will allow the military to rapidly shore up NATO's eastern flank in the event that Russia invades Ukraine. The Pentagon warned that Russia has shown "no signs of de-escalating," and continues to amass troops on Ukraine's borders.

Updated 2 hours ago - Politics & Policy

Biden calls Fox News reporter a "stupid son of a b---h" on hot mic

President Biden blasted Fox News' Peter Doocy on Monday after the reporter asked if the nation's soaring inflation is a political liability, saying, "what a stupid son of a b----h."

The latest: The president called Doocy Monday evening, the reporter told Fox's Sean Hannity. "He cleared the air and I appreciated it. We had a nice call," Doocy said when asked whether the president apologized, adding: "I don't need anyone to apologize to me."