Dr. Fauci stands at a podium in the White House press room with the American flag over his shoulder

A future pandemic is ‘almost guaranteed,’ Fauci says

Dr. Anthony Fauci says a pandemic preparedness plan is being fine-tuned in anticipation of the next one. “We’re working on universal corona vaccine,” Fauci told The World’s host Carol Hills.

The World

As the world continues to fight the COVID-19 pandemic for a second year, situations vary from country to country. European countries are starting to reopen to tourism, while India is grappling with the worst outbreak yet.

Related: EU takes big step toward relaxing travel for vaccinated

Within the US, California will no longer require social distancing, and will allow full capacity for businesses, once the state reopens on June 15, according to state health director Dr. Mark Ghaly. He said that dramatically lower virus cases and increasing vaccinations mean that it’s safe for the state to remove nearly all restrictions next month.

Related: The Galápagos Islands needs tourism. Can herd immunity revive it?

Meanwhile, there’s been an idea to create an international treaty to help the world prepare for a future pandemic. But US and Russian officials have opposed it, pushing to stay focused on the current pandemic crisis.

A global health summit held in Rome highlighted the growing disparity between rich and poor countries. Pharmaceutical companies pledged to deliver more than 1.3 billion doses of COVID-19 vaccines to low- and middle-income countries this year.

Dr. Anthony Fauci, the United States’ top infectious disease specialist who directs the National Institute of Allergy and Infectious Diseases, has helped lead the nation’s response to COVID-19. He spoke with The World’s Carol Hills about the latest updates on the pandemic around the globe.

Carol Hills: What is the current state of the pandemic?

Dr. Anthony Fauci: It’s a mixed bag globally. For the most part, developed nations like the United States and the UK are progressively doing better and better. But as you alluded to, there are other countries that are in very difficult straits, including India, a large country of about 1.4 billion people, where they only have about 2% to 3% of their population that are fully vaccinated, and about 10% to 11% that have received partial vaccinations. So, we have a long way to go. It’s a big planet. There are countries that are very diverse in their resources and their capability of responding to this outbreak. So, we have a long way to go before we get the equity that’s important throughout the world to get this under control from a global standpoint, not just an individual country standpoint.

I wonder if you worry that Americans, with all our optimism for a fresh start, that we may be missing the big global picture.

As long as there’s disease elsewhere in other countries where you have viral dynamics that continue to allow transmission at a high degree in different countries, there’s always, not only the difficult time for the countries in question, but also the generation of variants, which can then come back. And even in a country that has the outbreak under very good control, it can actually set you back if you do get a variant that’s not really covered very well by a vaccine. Thank goodness for us, and we’re very fortunate in that the vaccines that we are now distributing in the United States and in the UK and in other developed nations, handle the variants really quite well. For example, the B.1.1.7, which is dominant in the United States right now, is handled very well by the antibodies that are induced by the vaccines that we use. But that’s not a guarantee that all the variants that might potentially arise are going to be handled as well.

And, of course, to the point you’re making, is that as long as the rest of the globe isn’t vaccinated at a high rate, we run the risk of variants.

That is true.

And the hope that any subsequent vaccine is also robust enough to not be affected by that variant.

That’s true.

Let’s look at the global need for vaccines. President Biden has promised to send a total of 80 million vaccine doses abroad, so far. But meanwhile, the vaccine manufacturer in India, that much of the world was relying on, has said it’s stopping exports until the end of the year. Is the US doing enough to meet the need in poorer countries?

Well, we’re doing a lot. There’s always [more that can be done]. We would like to see other countries chipping in. As you know, we are part of the COVAX consortium. We have either given or promised $4 billion. We’ve given to India a considerable amount of supplies in the form of oxygen, oxygen generators, PPEs, antiviral drugs, sending advisers from the CDC to India. We are going to be giving, by the end of June, the beginning of July, a total of 80 million doses. Obviously, there are other ways of getting even more done. And that is by discussing with and partnering with the pharmaceutical companies to see if we can get them to scale up their manufacturing so that they could supply billions of doses to the rest of the world, particularly those countries that don’t have the resources to do so. But also, to get involved in what’s called transfer of technology to allow the developing world, certain countries such as those in Africa, South America or in certain countries in Asia, to be able to produce vaccines that are made by the larger pharmaceutical companies that have already developed successful vaccines. So there [are] a lot of ways to approach this, and we certainly feel a commitment to help out on the global problem.

You mentioned conversations with pharmaceuticals to ramp up production. Are those conversations going on, and is there any timetable for a real accelerated production of vaccines to get around the world?

Discussions are certainly going on, as a matter of fact, and that’s the whole purpose of it. To see if we can really scale up the manufacture of enough doses to the tunes of several billions of doses. We know from the pharmaceutical companies, Moderna and Pfizer, that have already said that they’d be able to do that in at least a couple of years to get up to a few billion doses. That’s a very good start, together with all the other things that we’re talking about.

I want to go back to variants for a second. India was swamped by a variant it couldn’t control despite improving vaccination rates. Couldn’t that happen here?

Theoretically, it could. But we are really quite fortunate in that the vaccines that we’ve used, particularly the mRNA vaccines, but also the [Johnson & Johnson] vaccine, are really good enough that they seem to cover the variants really quite well. If not for actual infection, certainly for the prevention of severe disease. So, although theoretically, it could always be a case where you get a really problematic variant, but thank goodness, thus far, that has not happened.

But a virus’s job is to stay alive and to replicate, and that means to mutate. That means there’s really no relaxing. Right?

Well, the easiest way to relax is to stop the virus from replicating. There’s a very firm tenet in virology that viruses don’t mutate unless they’re allowed to replicate. So, if you can suppress, to a great degree, the virus replication throughout the planet, you would give the virus a very, very small chance of mutating, and within that scope, an even smaller chance of mutating to a variant that’s problematic.

So, that means vaccine, vaccine, vaccine?

That’s exactly my point.

What do you think of the potential global pandemic treaty?

Well, I’d like to see the details of it. I mean, I’m not sure exactly what they’re talking about, an international pandemic treaty. You’re saying that the United States and Russia do not want to be part of it. I’d like to see what’s in that and why we don’t want to, before I would comment on it.

Looking back at the Trump administration, it restructured, and in some cases dismantled, our pandemic preparedness. Are you confident in the pandemic preparedness plan the US has in place now?

We have a plan that’s in place and we’re fine tuning that plan, literally in real-time, as we go on, because even though we’re still in the midst of fighting this pandemic, we’re acutely aware that this may not be the last one we see. In fact, it’s almost guaranteed. We can’t say when, whether it’ll be a year from now or 50 years from now or 100 years from now. So, you’ve got to be prepared, even though you do not know when the next one will occur.

What is in place in that pandemic preparedness that would happen the next time a pandemic occurs, that didn’t happen this time? What are some of the concrete literal things that are in place?

One of the things is to do what’s called a prototype pathogen approach, where you pick out 10-20 families of pathogens that likely would be within the scope of where a pandemic would arise. And you start doing things in preparation by looking at developing vaccine platforms that would be suited to those families, making a pilot lot of a vaccine that could be universal. For example, we’re working on a universal corona vaccine, namely a vaccine that would protect against all coronaviruses, because we’ve already had three pandemics of coronaviruses since 2002, starting with SARS, then MERS, and now SARS-CoV-2. We want to do that with other families of pathogens that might have the potential of breaking out into a pandemic. So, that’s something that’s going to cost a considerable amount of money. But we’ve already started in the planning process for that.

Americans are itching to travel internationally. Europe is opening up to tourists. Is it too early?

You know, you can’t answer a yes or no to that. It’s going to depend on what country you’re going to and whether or not you’re vaccinated. There’s a lot of negotiation going on right now as we get more and more people vaccinated. Other countries are looking at the possibility of opening up their travel borders to us. And I think as we get into the fall, and into the summer — and [in] the fall more and more people will be vaccinated — you’ll see more and more opening up of travel possibilities. But, I don’t think you can answer yes or no. Is it too early? It depends on a lot of other factors.

This interview was split into two parts. The second part can be heard here, below. 

This interview has been lightly edited and condensed for clarity. The Associated Press contributed to this report.

Tell us about your experience accessing The World

We want to hear your feedback so we can keep improving our website, theworld.org. Please fill out this quick survey and let us know your thoughts (your answers will be anonymous). Thanks for your time!