William Foege (left) and Anthony Fauci
The two scientists received the award and spoke at a ceremony on October 28 that was attended by Julius Richmond, former U.S. Surgeon General and Harvard emeritus professor, in whose name the award is given.
Fauci has led the National Institute of Allergy and Infectious Diseases for more than 20 years, virtually since the beginning of the AIDS epidemic. As a researcher, Fauci has made major contributions to understanding how HIV undermines the immune defenses, and showed that the virus is never entirely cleared by drugs-a finding that has shaped treatment approaches. In addition to guiding treatment and vaccine development research, Fauci, who won the support of initially skeptical AIDS activists, has tirelessly educated Congress and the public about the need for greater resources for scientific research.
Foege, who holds an MPH degree from the School, was director of the U.S. Centers for Disease Control and Prevention in the 1970s. At a time when a smallpox vaccine shortage in Nigeria was jeopardizing control of the disease, Foege devised a strategy of immediately immunizing close contacts of infected individuals to forestall wider outbreaks. This innovation accelerated the eradication of smallpox by 1979. Foege later was a founder of the Task Force for Child Survival and Development, whose efforts raised the vaccination rate among the world's children from 20 percent to 80 percent. As Executive Director of the Carter Center, he guided efforts to eliminate river blindness in Africa, and currently is a senior advisor to the Bill & Melinda Gates Foundation's Global Health Program.
Dean Barry Bloom, in his introduction, commented that a common theme in the selection of the two scientists was "the importance of public service, the value and power of integrity and leadership."
Fauci's lecture addressed what he called the "crisis mode" of preparations for a global pandemic should the avian influenza now rampant among chickens in Asia jump to humans in a form that can easily spread. While the threat can't be ignored, Fauci said, it's equally important to stiffen global defenses against seasonal flu, which "we do not take as seriously as we should."
Although yearly flu shots have created "background immunity" that limits the toll of seasonal influenza, nevertheless about 500,000 people die globally each year, and the economic toll is in the tens of billions of dollars, said Fauci.
"So if you add up the 500,000 people a year since 1968 (when the last pandemic Hong Kong flu ranged around the world) you would have the equivalent of a major pandemic," Fauci said. "And yet, seasonally, we don't look upon it in that way."
The NIAID director called for higher levels of annual flu immunization, and in response to the avian flu threat, he made several other recommendations. Among them: pursue live-attenuated, rather than killed, vaccines; invest in switching from egg-based to cell-based vaccine production; and work to develop a "universal" vaccine that is active against many more antigens of the flu virus than are current vaccines.
In his lecture, Foege referred to remarkable accomplishments in recent decades as "the Renaissance of global health and public health."
"I sometimes cannot believe what has happened in our lifetime," he added. Who would have imagined, he asked, a U.S. President-Jimmy Carter-working to combat river blindness, or a rich person -Bill Gates-getting interested in global health?
"And if we could have imagined that, would we have ever imagined that it would be the richest person? And that person would get the second richest person (interested in global health)?", referring to Warren Buffett, the billionaire investor and philanthropist. Buffett gave 85 percent of his fortune to the Bill & Melinda Gates Foundation in June 2006. "And then could we have imagined that he [Bill Gates] would decide to quit his day job in order to do [public health] full time?"
Foege recounted some of the most gratifying global health projects of his career, framing them as examples of the Greek historian Polybius' declaration 2,000 years ago that "the world must be seen as an organic whole, where everything affects everything."
In one series of events, a soil sample from a golf course in Japan yielded a much-improved treatment for heartworm in dogs. The sample was analyzed by Merck & Co. scientists in the United States. Subsequently, a researcher from India, who was funded by Merck to test the drug, Mectizan, in Africa, showed that the drug was highly effective in preventing river blindness-and also relieved itching and stopped roundworm infections. Ultimately, Merck gave the CDC the rights to the drug, and the CDC oversaw distribution to millions of people throughout West Africa.
"And there's no superstructure to drain off overhead," noted Foege. "It's held together by a shared objective" and administered by a Mectizan Committee.
In another example of global interconnectedness, a wish expressed by Norman Borlaug, the father of the "Green Revolution," to see amino-acid-enriched maize introduced to West Africa came about through the intervention of Foege and President Carter, who pitched the idea to Jerry Rawlings, former president of Ghana, at a state dinner in 1989.
Foege, observing that Rawlings showed little immediate interest, pointed out that the protein deficiency disease in children, kwashiorkor, was first described in 1933 by Cecily Williams, a Jamaican physician working in Ghana at the time. "I said it would be nice if the solution came from Ghana in the lifetime of Cecily Williams"-who was then 95 years old. Rawlings "sat straight up and said, 'We don't have much time'," recalled Foege. "When Cecily Williams died at the age of 98, this maize was already being sold in markets in Ghana as a weaning food."
In concluding, Foege said of Richmond, who recently turned 90 and was seated in the audience, "It is a source of great joy to know that, as long as people will walk on this earth, the ripple of your work in health and education will continue to enrich their lives, and I thank you for myself, for the people I've worked with, and for those generations yet unborn who will thrive because you acted."
Following the lectures, Richmond took the podium, commenting that he had worked closely with Fauci and Foege during his time in government service. Richmond urged HSPH students to "go forward and emulate the kind of role models they have become. We are deeply in their debt."
—RS
Copyright, 2007, President and Fellows of Harvard College
