Anthony S. Fauci, MD, director of the National National Institute of Allergy and Infectious Diseases, NIH, delivered the 20th Harry A. Feldman Lecture on March 24 at the Bloomberg School. His lecture was part of the 78th annual meeting of the American Epidemiology Society, held March 24 and 25.
During his presentation, Fauci showed a slide of a world map superimposed with the names of all types of infectious diseases and their locations.

“Every year, I add one or two more, sometimes three,” he said. “It’s gotten to the point where I need to remove a few just to read the slide.” In addition to a persistent stable of infectious diseases, new and re-emerging diseases continually bombard us such as SARS, West Nile, E. coli, monkeypox, HIV/AIDS, and multidrug-resistant tuberculosis.

Fauci groups infectious diseases into three categories: emerging, re-emerging, and deliberately re-emerging, such as those used by bioterrorists. Even though more people died of the flu in 2001 than died of anthrax, the fear factor of bioterrorism sparked a big infusion of resources into biodefense. Luckily, the rapidly expanding areas of genomics and proteomics, and the new power to sequence microbes quickly are helping combat the ever-increasing tide of disease agents. What used to take a year now takes a day or two. Last year, the malaria vector and parasite were both sequenced. And just a year after the SARS virus was discovered, the microbe was sequenced, and a vaccine was in development.

“The rapidity with which the public health community mobilized to attack this [disease]… I don’t ever recall seeing anything this rapid,” Fauci said.

Despite these advances, Fauci still feels that it’s going to take a combined effort of basic bench science, disease surveillance, and mobilized and coordinated public health forces to keep up with new and re-emerging infections.

Fauci quoted Nobel Laureate and microbiologist Joshua Lederberg who said, “The future of humanity and microbes likely will unfold as episodes of a suspense thriller that could be titled Our Wits Versus Their Genes.”