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CNN Live Sunday
Interview With Anthony Fauci
Aired March 03, 2002 - 18:14 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JEANNE MESERVE, CNN ANCHOR: Turning now to the issue of AIDS. Former South African President Nelson Mandela says he supports his country's AIDS policies but also says South Africans should be granted access to anti-AIDS drugs as soon as possible. South Africa has been reluctant to issue the drugs until it has completed a thorough study. One in nine South Africans are affected by the disease.
A few days ago, new figures were released here in the United States. It's estimated that now about one million Americans are living with HIV. Joining me now to talk about what is going on is Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases. Thanks for coming in.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Good to be here.
MESERVE: This is good news. In the early years of the epidemic, many people would have died.
FAUCI: Paradoxically, it looks like bad news but it's actually good news because if you look at the number of deaths per year from the time that the anti-retroviral drugs that has had a major positive impact on HIV infected individuals came into wide use in like 1995, 1996, the number of deaths have gone down.
And so, if the number of deaths go down, the number of individuals who are living with HIV goes up and that number, as you mentioned correctly, is very close to one million people.
MESERVE: Is there concern that the people living with HIV may be spreading it?
FAUCI: There's always the concern of that, and that's the reason why we have to be very aggressive on our educational and behavioral modification. The numbers of the one million also are a little bit tricky, because of that group, 25 percent at least do not know that they're infected and another 25 or 30 percent know about it but are not in adequate healthcare delivery systems.
So you're talking about 50 percent of people either don't know they're infected or are not being properly taken care of by healthcare providers, and that's the group that you really need to target with regard to telling them what they need to do to prevent the spread of infection. MESERVE: Those who are taking the therapeutic drugs, you're finding this is not a perfect solution?
FAUCI: Well it certainly is not. It is a major advance, if you compare what it was like prior to drugs for HIV and now, the morbidity and mortality have decreased extraordinarily so.
MESERVE: But there are side effects.
FAUCI: However, there are side effects that in some respects can be prohibitive. There are side effects over a long period of time in which people can not tolerate the drug, and then after a while, they just get worn down and don't want to take the drug anymore. We have to be very careful. That's the reason why we need to get new and better drugs with less toxicities.
MESERVE: A vaccine is, of course, what everybody is hoping for.
FAUCI: Right.
MESERVE: Mixed news on that front this week.
FAUCI: Well, yes. The mixed news, actually I think in aggregate it was good news, but the mixed news is that a trial that had been going on for years in the phase in which the decision had to be made. Well we're going to do it, give it to thousands of people as opposed to hundreds of people to determine if it worked or not, the benchmarks or the things that we were looking for that would be the indicators of success were so low in the Phase 2 trial that we felt it was not really worthwhile to go ahead with the Phase 3 trial.
But at the same time, as that decision was made, there is going to be a Phase 3 trial in collaboration between the National Institutes of Health and the Department of Defense. There was also a study from the Merck Company, which was really quite, I think, good news if you want to put it that way. A relatively small number of individuals, but the intensity of the response that was elicited in them with the vaccine would indicate that we're dealing with a candidate that has some promise.
And again, we've been here before so you don't want to say "that's it. We have the answer." We don't have the answer, but the strength of the immunological response with that product was really quite impressive.
MESERVE: And we always ask you what's the outlook, what's the time frame? We must be closer, certainly?
FAUCI: You can't give a time frame. We're certainly moving along with some products now, going through the different phases of study. And I think that's the thing the American public really needs to appreciate, that you might do very well at one phase and then you got to go to the next phase. Now in the phase that we're in now, the Phase 1, 2, things look good for several candidates. Let's keep our fingers crossed that it holds true as we go to larger numbers of people who are being tested. MESERVE: Now I can't let you sneak out of here without asking you about smallpox vaccine. NIH was studying whether it would work in a diluted fashion.
FAUCI: Yes.
MESERVE: I know those studies must be just about done.
FAUCI: Yes, they are. They're just about done and the data are being finally analyzed now. But I can say with some certainty that it's been a successful experiment. The precise details of how the dilution will work and what the immune response was, I can't say right now because I don't want to preempt the people who are analyzing. But if you look at the data in the aggregate, it's what we would have hoped.
MESERVE: Everything you would have hoped?
FAUCI: You never get -
MESERVE: In different dilutions or no?
FAUCI: Yes, I think both dilutions are looking good. Yes.
MESERVE: OK, terrific. Dr. Fauci thanks a lot for joining us.
FAUCI: You're welcome.
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