Leading the government’s charge on infectious disease

August 22, 2013

Dr. Anthony S. Fauci has been the director of the National Institute of Allergy and Infectious Diseases since 1984, overseeing an extensive research portfolio to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. He spoke with Tom Fox, a guest writer for On Leadership and vice president for leadership and innovation at the nonprofit Partnership for Public Service. Fox also heads up their Center for Government Leadership.

Q. What motivated you to follow a career path in public service?

NIAID/Rhoda Baer
NIAID/Rhoda Baer

A. It was a gradual, cumulative motivation that started in my teenage years. The whole idea of serving the public was something that was just naturally part of my family’s discussions. My parents talked about the importance of serving others and the gratification that you get from doing so. It was a theme that was catalyzed for me at Regis High School and then at the College of the Holy Cross, both Jesuit institutions. That is where the idea of service for others really became an important part of what I wanted to do.

What is the best leadership advice you have received during your career?

Lead by example and set a vision that people can understand if you want them to follow and help you to fulfill your mission. Do not be afraid to hire the best people and, once you get them, do not micromanage them. Give them a vision and a mandate and get out of their way. Never stop listening and learning no matter how high you get in the food chain. Always be fair and consistent in the principles that guide your decisions, because there will be people who disagree. If you are consistent, they will at least respect you when you make your decisions.

When have your leadership skills been truly tested?

My leadership skills have been tested when new ideas have needed to be implemented in settings where there was inertia or significant opposition. For example, I recognized very early in the HIV/AIDS pandemic in the early 1980s that we needed to make a major effort on research, even before it had ballooned into a pandemic. Some of my own colleagues pushed back rather strongly. I saw this disease as an exploding problem. But others felt this initiative took resources away from other important areas of research because they did not fully realize the potential impact of what was going on. I really had to exert leadership to convince my colleagues.

Have there been other situations?

Another example is when I was asked by President George W. Bush in 2002 to go to Africa to design what became the President’s Emergency Plan for AIDS Relief (PEPFAR).  It was a real test of leadership--many people believed PEPFAR could never be achieved in Africa because of the enormity of the resources that were required. I felt strongly that it was a moral imperative.

In this and other cases, I carefully considered the validity of the issue, researched it thoroughly, sought outside advice and then led by example. I respected the people who objected. I tried in good faith to convince them of the importance of the initiatives. Some came on board and those who did not, I gently asked to get out of my way because we were going to do it anyway.

What are some of your goals?

One of my goals is to hopefully begin to see major turnaround of the trajectory of AIDS. I would also like to work with industry and other partners to develop a safe, effective and durable malaria vaccine, and to contribute technologies and advances regarding vaccines and other therapeutics in the arena of emerging and reemerging infectious diseases. We also need to develop a universal influenza vaccine that is effective against all seasonal flu as well as pandemic flu threats.

How are you managing in the current budgetary environment?

I remind others that we are privileged to be working in an arena aimed at the good of our nation. It is important to inspire employees and to strive for excellence despite the constraints. It is also important to analyze, scrutinize and to prioritize, and not whine about what you cannot do. Everybody wants more resources, and cutting biomedical research is terribly ill advised. However, much can and will be accomplished with what we have.

What are the obstacles to attracting young scientists to public service?

Some of the major obstacles are the real and the perceived obstructive elements of bureaucracy in government, such as hiring people in a timely fashion and the unreasonable restrictions on travel. Travel is an important part of learning, networking, and information exchange for scientists. Cutting or freezing resources and looking at federal workers as expendable is demoralizing. I try to inspire young scientists by articulating the advantages of serving our country in the area of biomedical research and pointing out that, even when there are fiscal constraints, we still have significant resources. I tell them their impact can be substantial.

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