Biden Owens opened the dialogue by asking something everyone in the audience was wondering: What is it like to advise a sitting president? The interactions, he said, were always determined by the public health issue faced by that presidential administration. 

With Ronald Reagan and George H.W. Bush, there were the early years of HIV. For George W. Bush, there were the anthrax attacks that followed Sept. 11. In between, President Bill Clinton oversaw years when HIV went from a death sentence to something more treatable with medication. Barack Obama was in the White House for three viral outbreaks: the 2009 swine flu, Ebola and Zika. Then there was the COVID-19 pandemic, which straddled the presidencies of Donald Trump and Joe Biden.

No matter the crisis, for Fauci, the job remained the same: to always tell the truth.

The first call to come to the White House to speak to a president came during the Reagan Administration. 

“A very wise person who was a conservative Republican who served in the Nixon White House told me, ‘Whenever you walk into a White House to advise a president or the president’s staff, tell yourself this might be the last time I walk into this building,’” Fauci recalled. “Because if you go in there thinking this is heady, you might slip and tell that person something you think they might want to hear, as opposed to an inconvenient truth that they may not like.”

So, what is a trusted scientific leader to do in these circumstances?

“I’ve had to deliver sometimes inconvenient messages, sometimes messages of hope and understanding,” Fauci said. “As it turns out, when you do that, you gain the respect in Washington that you’re going to tell the truth.” 

Today’s challenges include the mis- and disinformation that pervades our daily information. Misinformation happens when someone gets it wrong — humans are fallible, after all, and we sometimes make mistakes. Disinformation is far more nefarious, intentionally false or designed to mislead.

Social media platforms make circulating this type of information easy — and fast — creating a space where the “outlandish becomes accepted” as truth quite readily. As for artificial intelligence, well, that’s just an opportunity for “disinformation on steroids,” Fauci said.

As society moves forward alongside COVID-19 and many other viruses and diseases, Biden Owens wondered, “What’s coming on the horizon?” 

“I don’t know [when the next one] is going to occur, but I know what we need to do,” he said. “We need to be very careful in pandemic preparedness, both from a scientific and a public health standpoint, and put in place measures to recognize it and to respond rapidly. What we need to do better is to have a public health infrastructure that is more attuned to surveillance.”

Transparency, particularly globally, will be key. A sensitivity to global equity and access to life-saving countermeasures is also important. The COVID-19 virus is still evolving and changing. Globally, about 20 million people have died from COVID-19. In the U.S., about 1.8 million Americans have died.

It’s a message that hit home for the audience.

The discussion, held May 3 at Clayton Hall on UD’s Newark campus by the Biden Institute, was among the events held in recognition of the Disaster Research Center’s 60th anniversary. According to co-director Tricia Wachtendorf, the DRC was the first center in the world of its kind. 

“DRC’s long legacy of research is the foundation of much of what we know about disasters, how to respond to them, how to recover from them and how to mitigate them,” Wachtendorf said.

A larger “celebratory workshop” brought together practitioners, scholars and students from across the world, many of whom were in the audience, to consider, as noted by DRC co-director James Kendra, disaster management challenges confronting the world and the solutions needed to address them. DRC advances innovative disaster research and educates tomorrow’s scholars and emergency management practitioners. 

Additionally, the Biden School of Public Policy and Administration at UD serves as a living lab where traditional education meets hands-on engagement to equip students with the tools to navigate challenging times and develop solutions to make the world a better place.

“We count among our ranks contributors to academia, politics, government, law, policy, activism, nonprofits and the private sector,” said Joe Trainor, interim dean of the Biden School and a DRC core faculty member. 

Tomorrow’s problem-solvers

Students at the event had several questions for Fauci, too. 

Roxanne Evande, a doctoral student in the College of Health Sciences, was curious whether Fauci had any suggestions for explaining serious scientific matters to a non-expert audience without sacrificing technical accuracy or overexplaining.

He offered four concise tips:

• Know your audience.

• Make one or two points, no more.

• Focus on whether people understand what you are saying, not on what they think about you.

• Don’t give up when people don’t do what you suggest. 

Additionally, he reminded the audience that it is a public health practitioner’s job to tell people when the science evolves based on data and evidence.

“This is science correcting itself,” Fauci said.

Guadalupe Guevara, a senior sociology and global studies double major, noted that marginalized communities can sometimes be deprioritized in a disaster or public health response. She questioned what public health practitioners can do to ensure all sectors of the community are cared for, even when time or resources are short. 

Fauci acknowledged that epidemics do a great job of showing where the gaps are and illuminating the social determinants of health, factors that are non-medical that influence health outcomes like someone’s age or where they live or work. 

One silver lining, Fauci said, is that access can neutralize these social determinants of health, though it can take decades to realize these benefits. Another critical point to proper response in a public health disaster is listening to people from all sectors.

“You’ve got to make the investment of time and listen to people from multiple avenues or sectors. There is always a kernel that will help you in your response,” he said.

Giuseppe Lelow, a visiting doctoral student in the Disaster Research Center from Italy, recalled the severe impacts faced by his country in the early days of the pandemic. 

“Disasters do not recognize national boundaries,” Lelow said, before asking what challenges need to be addressed so we are ready to confront the next global public health crisis. After 54 years of service at the NIH across the tenure of seven different sitting presidents, Fauci’s reply was simple.

“We need to act like a global community,” he said.

Medal of Distinction

In closing, Dr. Joan Coker, a member of the University of Delaware Board of Trustees, joined President Assanis on stage to present Fauci with the University’s Medal of Distinction. One of the University’s highest honors, the medal is awarded to individuals who have made humanitarian, cultural or intellectual contributions to society, have achieved noteworthy success or served the community in a significant way.

Coker, who is a physician in private practice, began with an emotional message, thanking Fauci for his leadership and dedication during the pandemic and throughout his inspirational research career, which has literally saved millions of lives.

“It’s been tough on the front line, but when you’ve got a leader who gets it and speaks truth to power, you can make it,” Coker said. “On behalf of the Board of Trustees — and every front-line worker all over the world — I cannot express to you how grateful we are … Your decades of expertise and guidance on global health issues to the country’s executive leadership, including during the COVID-19 pandemic, has been crucial to the health and well-being of Americans and for communities around the world.”