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A recent clinical trial compared the efficacy of the
new monoclonal in combination with cyclosporine A (standard immunosuppressive
treatment for transplant patients) versus cyclosporine A alone in preventing
early kidney graft rejection episodes.
There was a statistically significant
reduction in early kidney graft rejection episodes in the group receiving the
History has taught us that new and re-emerging microbes are a constant
threat to the survival of our species.
AIDS offers the most striking example
in recent times of the potentially catastrophic impact of a new infectious
Worldwide, an estimated 10 million people are infected with the
human immunodeficiency virus (HIV).
In the United States, more than 1 million
people are infected, and as of January 1 there have been 160,000 cumulative
cases of AIDS and 100,000 deaths.
AIDS is now the second leading cause of
death for young men ages 25 to 44 in the United States, surpassing heart
disease, cancer, and suicide.
The pattern of AIDS in the United States, however, is changing
Increasingly, AIDS is becoming a disease of heterosexuals,
infants and children, women, and minorities.
By the end of 1988, AIDS had
become the fifth leading cause of death in the United States among Black women
ages 25 to 44; by the end of this year, it is expected to be among the five
leading causes of death among all women of reproductive age.
We have taken several steps to identify research needs associated with HIV
infection in women, including establishment of a women's health committee
within the NIAID AIDS clinical Trials Group, to ensure that the issues
involving HIV-infected women are fully integrated into the NIAID research
In December 1990, NIAID coordinated the first national Public Health
Service-sponsored conference on women and HIV infection.
highlighted how the complex roles of women in the family and society compound
not only their own suffering but also their ability to participate in clinical
NIAID has also focused on improving participation of minority constituents
and health professionals in our research programs.
To help recruit minorities
into clinical trials, we have provided supplemental grants to AIDS Clinical
In addition, we have recently awarded funds to three
institutions that primarily serve minority populations to help them build the
infrastructure necessary to conduct clinical trials.
This past year has yielded benefits from prior Investments in basic and
clinical research in AIDS.
One of the major advances in prolonging the lives
of people infected with HIV has been the use of zidovudine (AZT) and
prophylaxis for Pneumocystis carinli pneumonia (PCP). Preliminary evidence
indicates that in people with low T4 cell counts, appropriate therapy doubles
their expected survival time after diagnosis from 12 to 24 months.
AZT, however, is an imperfect drug, and hence we are actively searching
for new drugs to treat HIV infection.
Preliminary studies suggest that the
combination of AZT and dideoxycytidine (ddC), given in alternating doses, has
the same benefit but is less toxic than continuous therapy with AZT.
promising drug. dideoxyinosine (ddl), is being studied in Phase II clinical
trials in parallel with expanded distribution to patients not eligible to
enroll in the controlled trials.
Several studies of interferon alpha, either
alone or in combination with AZT, have been conducted in persons with early
These studies have shown that interferon alpha appears to both
slow virus production and reduce the risk of developing AIDS-related
opportunistic infections when administered to asymptomatic HIV-infected
We have also made major strides in treating AIDS-related opportunistic
As a result of a large multicenter clinical trial, the drug
fluconazole has replaced an effective but more toxic drug as maintenance
therapy to prevent recurrences of cryptococcal meningitis, a life-threatening
infection of the brain and nervous system.
Studies conducted by NIAID and the
National Eye Institute also showed foscarnet to be effective in delaying
progression of cytomegalovirus retinitis, a sight-threatening eye infection
affecting many people with AIDS.
There have been encouraging results from AIDS vaccine research studies
this past year.
Studies in monkeys using whole killed simian immunodeficiency
virus (a monkey AIDS virus) vaccination followed by live virus challenge show
promising indications of protection.
Other developments included the entry of
several new AIDS vaccines into Phase I clinical trials.
We are now confident
that a candidate vaccine for large-scale testing in uninfected volunteers will
be identified within the next few years.
From the unexplored mysteries of the immune system to the threat of new
and re-emerging microbes, NIAID faces important challenges in the decade of
Our commitment to basic research in immunology and microbiology
has in the past positioned us well to meet such challenges. Our renewed
commitment to this approach will surely allow us to turn these challenges into opportunities to alleviate and hopefully prevent suffering and death caused by
infectious diseases and disorders of the immune system.
Mr. Chairman, the FY 1992 budget request for this Institute is
$976,711,000. I will be pleased to answer any questions you may have.
1966-1967, Intern, Department of Medicine, New York Hospital-Cornell Medical
Board Certification and Military Service:
American Board of Internal Medicine-June 21, 1972. American Board of Allergy and Immunology-March 1, 1974. American Board of Infectious Diseases - October 15, 1974. U.S. Public Health Service, July 1968-June 1970; July 1972-Present.
American Federation for Clinical Research, American Association for the
Medical Association, Fellow of the American Academy of Allergy, Infectious Diseases Society of America, American Society for clinical Investigation, Fellow of The American College of Physicians, Association of American Physicians, Collegium Internationale Allergologicum, Charter Member of the clinical Immunology Society. The Institute of Medicine of the National Academy of Sciences (USA).
Councillor, Eastern Section, American Federation for clinical Research (AFCR). 1977. National Councillor, AFCR, 1978-1979. President, AFCR, 1980-1981, Recorder, Association of American Physicians, 1988-present.
Advisory Boards and Committees:
Chairman, Allergy and Imunology Committee, MKSAP V, American College of
Research Programs on the Acquired Immunodeficiency Syndrome of the Ministry of
Dr. Fauci has been or is on the Editorial Board of 27 scientific Journals in the field of immunology, allergy and Infectious diseases. These include: The Journal of Clinical Investigation, The Journal of Immunology, Journal of Infectious Diseases, Journal of Clinical Immunology. Dr. Fauci is also the Editor of one of the major textbooks of medicine in the world, "Harrison's Principles of Internal Medicine. "
Awards and Honors:
Alpha Omega Alpha. Kileen Prize for Excellence in Chemistry (College of the Holy Cross). John Metcalfe Polk Prize for General Efficiency (Cornell University Medical College). Alfred Mortitz Michaelis Prize for Efficiency in General Medicine (Cornell University Medical College). U.S. Public Health Service Meritorious Service Award, 1979. Arthur s. Flemming Award, 1979 Given to the 10 outstanding employees in the U.S. Federal Government. Squibb Award of the Infectious Diseases Society of America, 1983. U.S. Public Health Service Distinguished Service Medal, 1984. Food and Drug Administration Commissioner's Special Citation, 1984. 1985 Citation Classics (Current Contents) for article A.S. Fauci, D.C. Dale, and J.E. Balow: Glucocorticosteroid therapy: mechanisms of action and clinical considerations. Ann. Intern. Med. 84: 304 -315, 1976. Who's Who in America, 44th Edition. Who's Who in Science and Technology, 2nd Edition. 1985 Stanford University Center Survey of the American Rheumatism Association membership ranked the work of Dr. Anthony s. Fauci on the treatment of polyarteritis nodosa and Wegener's granulomatosis as one of the most important advances in patient management in rheumatology over the past 20 years. The Clemens von Pirquet Award of Georgetown University Medical Center, 1986. Doctor of Science, Honoris Causa, College of the Holy Cross, Worcester, MA May 29, 1987. The Kober Lecture Award of the Association of American Physicians, 1988. Public Health Leader of the Year Award of the Commissioned officers Association of the U.S. Public Health Service, 1988. The National Institutes of Health clinical Center Annual Distinguished clinical Educator Award, 1988. 1988 Citation Classics (Current Contents) for article · A. S. Fauci, B. F. Haynes, P. Katz: The spectrum of vasculitis. Ann. Intern Med. 89: 660-676, 1978. The Leadership Award of the Columbus Citizens Foundation, Inc., for "Inspired Leadership and Outstanding Achievement in the field of Medical Research, " New York, NY October 8, 1988. American Association for the Advancement of Science/Westinghouse Award for Public Understanding of Science and Technology, 1988. The National Hemophilia Foundation Special Award for Research in AIDS, 1989. The Lee P. Brown National Public Service Award of 1989 presented by the National Academy of Public Administration and the National Society for Public Administration. The Duke University Award for Rheumatologic and Immunologic Research, 1989. The William Beaumont Award of the American Medical Association, 1989. The academic Excellence Award from Children's Hospital National Medical Center, Washington, DC, 1989. The Surgeon General's Exemplary Service Medal, 1989. The Surgeon General's Medallion, 1989. The 1989 Achievement Award of the American Association of Physicians for Human Rights. The 1989 National Medical Research Award of the National Health Council. The Flame of Hope Award of the Terri Gotthelf Lupus Research Institute, November 2, 1989. The 1989 Maxwell Finland Award in Infectious Disease presented by the National Foundation for Infectious Diseases. The 1989 Helen Hayes Award for Medical Research. The Excellence in Public Service Award of the Committee for the Support of Public Service, May 9, 1990. The 1990 Lifetime Science Award of the Institute for Advanced Studies in Immunology and Aging, Washington, DC. Doctor of Science, Honoris Causa, Mount Sinai School of Medicine, New York, NY, May 18, 1990. Doctor of Science, Honoris Causa, Neumann College, Aston, PA, May 19, 1990. Doctor of Science, Honoris Causa, Georgetown University School of Medicine, Washington, DC, May 26, 1990. Doctor of Science, Honoris Causa, Hahnemann University