On June 5, 1981, Mortality and Morbidity Weekly Report, a newsletter that the U.S. Centers for Disease Control uses to convey noteworthy public-health news, featured a short article about five gay men in Los Angeles who had been diagnosed with Pneumocystis carinii pneumonia, an infection usually seen only in severely immune-compromised cancer patients.
As a researcher studying the impact of infectious disease on the immune system, Anthony Fauci was intrigued; when a second MMWR report was published two weeks later about 26 gay men in San Francisco and New York with Kaposi's sarcoma, a rare form of cancer usually seen in elderly men, he was gobsmacked.
"I literally had goosebumps. I said to myself, 'This is a new disease,' " Dr. Fauci recalls.
He decided that day to drop everything else and dedicate himself to studying the unknown disease that would soon be dubbed the "gay plague," and then named AIDS – acquired immune deficiency syndrome. It was a decision his mentors warned him was foolish, and career suicide.
Thirty-five years later, Dr. Fauci, the world's foremost AIDS researcher, is being honoured with the John Dirks Canada Gairdner Global Health Award for "his many pioneering contributions to our understanding of HIV infections and his extraordinary leadership in bringing successful treatment to the developing world."
His achievements – in the laboratory, the policy field and the political arena – are legend.
Dr. Fauci's research unravelled how the human immunodeficiency virus attacks the immune system, which was essential to develop treatments; as director of the National Institute of Allergy and Infectious Diseases of the U.S. National Institutes of Health, he lobbied ferociously for increasing funding for AIDS research, and on his watch it went from zero to $3-billion annually; and he was the architect of the President's Emergency Plan for AIDS Relief (PEPFAR), an international aid program that has saved millions of lives, mostly in Africa.
But Dr. Fauci cautions that the fight against AIDS – one of the worst plagues to afflict humanity, with 70 million infected and 37 million dead to date – is not over. "We've made dizzying advances, but now is the time to keep our foot on the gas pedal, not the brake."
"Outstanding leadership in medicine"
In 1981, when the iconic MMWR article was published, Frank Plummer had just moved from Winnipeg to Nairobi to begin studying why some Kenyan sex workers seemed to be immune to gonorrhea.
That project would soon reveal that two-thirds of the women were infected with HIV, a finding that dramatically changed the world's perception of AIDS. (At the time, conventional wisdom was that the infection was confined to gay men and hemophiliacs, who were infected by contaminated blood products.)
Dr. Plummer's research also helped to demonstrate that HIV could be transmitted by breast milk, that bacterial infections such as tuberculosis greatly increased the risk of infection and that circumcision could reduce the risk of spreading HIV, findings that altered the public-health approach to AIDS prevention.
The Kenyan sex workers – 10 per cent of who have never become infected despite frequent exposure to the AIDS virus – have also been studied extensively because many scientists believe that understanding their immunity is key to developing a vaccine. "If I could figure that out, I'd be going to Sweden [for a Nobel Prize]," Dr. Plummer says with a laugh.
Aside from his AIDS work, he was the founding director of the National Microbiology Laboratory, where he conducted groundbreaking research on SARS, the H1N1 pandemic influenza and Ebola, among other things.
For "demonstrating outstanding leadership in medicine and medical science throughout his career," Dr. Plummer is being awarded the Canada Gairdner Wightman Award.
Public service "a privilege"
Aside from serendipitous detours that made them pioneers of AIDS research, the careers of both Dr. Fauci and Dr. Plummer are notable for a dedication to the largely neglected area of global health and to public service.
Dr. Plummer eschewed the limelight to remain working in Kenya (where he spent 17 years) under the auspices of the University of Manitoba and Dr. Fauci, who could have written his own ticket at any research institute in the world, chose to stay at the NIH for his whole career.
"It's a privilege to be devoted to public service, to work for the people of the world," Dr. Fauci says. "I have no regrets."