Science Friday - Fauci On 40 Years Of HIV/AIDS, Watermelon Origins, Venus Missions. June 4, 2021, Part 1

Episode Date: June 4, 2021

Anthony Fauci Reflects On 40 Years Of HIV/AIDS Research Every week, the Centers for Disease Control and Prevention (CDC) releases its regular report of the latest developments on emerging diseases—a living record documenting decades of medical history, known as the Morbidity and Mortality Weekly Report (MMWR). In May 1981, former MMWR editor Michael B. Gregg got a call about an unusual deadly pneumonia, seen in young gay men in Los Angeles. The tip was from epidemiologist Wayne Shandera, Epidemic Intelligence Service Officer for the Los Angeles County Department of Health. He described the cases of five men, ages 29 to 36, who had developed Pneumocystis carinii, a kind of pneumonia typically seen in cancer and immunosuppressed patients. These men were previously healthy, yet they struggled to fight off the illness with treatment. Two of the patients died. All five were gay. Gregg didn’t know what to make of the cases, but he and CDC experts were compelled to publish the observations in the June 5, 1981 issue of MMWR. Soon after, clinicians around the country began to flag similar cases. The number of infected people rose, as did awareness of the strange collection of symptoms. That summer, the media ran stories about the mysterious disease; the New York Times ran the headline, “Rare Cancer Seen in 41 Homosexuals.” At that time, Ira was a science correspondent for NPR, and was in the thick of covering the nuances of the illness. Today marks 40 years since the first official report on the HIV/AIDS epidemic in the United States, and the beginning of a long-puzzling medical mystery. “I was totally baffled, and did not know what was going on. I thought it was a fluke,” recalls Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during an interview this week with Science Friday. Read more at sciencefriday.com.     Where Did Watermelon Come From? You may think of watermelon as a red, sweet taste of summer. The watermelon itself is ancient—paintings have been found in Egyptian tombs depicting a large green-striped object resembling a watermelon next to grapes and other sweet, refreshing foods. But if you look at many of the melon’s biological cousins, its red, sweet pulp is nowhere to be found—most close relatives of the watermelon have white, often bitter flesh. So how did the modern watermelon become a favorite summer snack? Back in the 1960s, Russian researchers suggested that one sweeter melon species found in south Sudan might have been a close relative of the modern watermelon. Now, a detailed genetic analysis of a handful of wild melon species, and 400 modern varieties of watermelon from around the world, has concluded that the Kordofan melon from Sudan is, in fact, the closest living relative of the watermelon. Susanne Renner, an emeritus professor at the University of Munich and an honorary professor of biology at Washington University in St Louis, explains the work on the origins of the modern melon—and how knowing the history of the watermelon could lead to new varieties. NASA Plans Two New Trips To Venus This week, President Biden announced the U.S. will donate 75% of its unused COVID-19 vaccine doses to foreign countries via the COVAX global vaccine program. The U.S. has promised to promptly send it’s surplus to South and Central America, Asia, and Africa, where countries are experiencing major shortages. Plus on Wednesday, NASA announced plans to launch not one, but two new missions to explore Venus by the end of 2030. It’s the first time the agency has devoted any mission to Venus in 30 years. MIT Technology Review editor Amy Nordrum joins Ira to discuss the biggest science stories of the week.   Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Flato. Later in the hour, we'll reflect on the early days of the HIV-AIDS crisis with Dr. Anthony Fauci. It's been 40 years, believe it or not, since the first CDC report documenting what we know as AIDS. I'm going to also talk with Dr. Fauci about the latest news that the NIH is launching a clinical trial of a universal flu vaccine. We think that this is hopefully going to be a winner, but we don't know if we're going to. sure unless we test it, as you well know. We'll have more on this later in the hour. But first, in other news headlines, President Biden announced the U.S. will donate 75% of its unused COVID-19 vaccine doses to foreign countries via the COVAX Global Vaccine Program. We've talked a lot about

co-vax asking for such donations, and now it appears the U.S. is stepping up. Plus, move over Mars. It's time for Venus to take a turn in the spot. On Wednesday, NASA Chief Bill Nelson announced plans to launch not one but two new missions to explore Venus by the end of 2030. Congratulations to the teams behind NASA's two planetary science missions, Veritas Truth and Da Vinci Plus. These two sister missions both aim to understand how Venus became an inferno-like world capable of melting lead at the surface. It's been over 30 years since the U.S. visited Venus with Magellan launching in 1989. And here to tell us more about the dual missions is MIT Technology Review editor, Amy Nordstrom.

Hi, Amy. Welcome back. Hi, Ira. Thanks for having me. You know, Venus has always been such a mysterious planet, has it not? That's right. Venus is so interesting. It's the second planet from the sun, and it's a lot like Earth in some ways. It's roughly the same size and its orbit is closest to ours. It has mountains and volcanoes just like we do, and it sits in the zone of our solar system that could support life. But it's totally unlivable. The air pressure there is really high, like what you'd find deep in the ocean here on Earth,

and it has these hurricane force winds that just blow constantly in a very thick atmosphere with lots of carbon dioxide and even clouds of toxic sulfuric acid that trap heat. So even though Mercury is closer to the sun, Venus is actually the hottest planet at around. 900 degrees. So we're not going to send probes down to the surface with a rover like we've done on Mars, right? That's right. It's a really difficult planet to send a rover to. There has been spacecraft that have landed on surface before, but because of the heat, the conditions there, the spacecraft didn't last very long, only less than two hours, actually. So we are sending missions to Venus, but yeah, it won't be a rover mission like we did with Mars. Because we're really interested in those mysterious clouds. And there were hints recently that there might be life in there somehow.

Right. We have a lot of questions about Venus's atmosphere and also the surface of Venus. And so these two missions, the first is called Da Vinci, and that's a spacecraft that will parachute down to the surface of Venus and take measurements and images and study the composition of its atmosphere on the way down. There was a publication last year that scientists, in which scientists claimed that they might have found traces of life in the atmosphere around Venus and those results have since been contested. It's not really clear if that's the case, but that study will help us determine, you know, kind of once in fall, whether that's possible. And then the second mission, Veritas, that's an orbiter that's going to move around the

planet and use radar to map the terrain and the elevation of Venus's surface and use infrared to figure out what kind of rocks are down there and whether there's still volcanic activity on Venus. Wow, that's great. There's other cool space news we learned this week that a piece of Space debris hit the International Space Station. Whoa. Chaves up the film Gravity, I hope not. Yes, a piece of space debris struck a robotic arm on the outside of the International Space Station and did cause damage. It put a hole in the insulation of this arm. And we found that out through a post shared this week by the Canadian Space Agency, which developed the arm. And they said the damage was found on May 12. So we don't really know when this happened exactly or what caused it. It was a pretty small hole, and the piece of debris that caused it would have had to

would have been too small for NASA to track, because NASA does track thousands of pieces of space debris. But it could have been manmade or it could have been naturally occurring, something like a rock or a piece of dust. You know, there are tens of thousands of pieces of debris from spacecraft out there. Are any plans for vacuuming up all of this stuff or capturing it somehow? You know, there have been some demonstration missions for spacecraft that could travel up there and help us remove some of this debris. The UK tested one called Remove Debris a few years ago, and it tried out a few different techniques. Like, it tossed a net at a piece of fake debris, and it stuck another one with a harpoon. And right now, there's a company called Astroscale,

testing out another spacecraft that can kind of latch onto dead satellites and move them toward Earth to burn up in the atmosphere. But it's really early for those projects, and it's a big, expensive job to do any of that at scale. And there's really no international effort or agreement around this right now. Moving on to other news, President Biden is suspending all oil and gas leases issued for the Arctic National Wildlife Refuge. I remember when the Trump administration auctioned these off at the very end of his term. What happened to them? Right. That was back in January, right before the administration left office, it auctioned off nine leases that would allow whoever owned them to drill for oil and gas on specific tracks of this national wildlife refuge in Alaska.

But on Tuesday, the Biden administration said it would suspend all of those and review them to decide whether they should be allowed to proceed. And Biden said during the campaign that he opposes drilling in Anwar, this wildlife refuge in Alaska, but these leases were awarded as part of a program approved by Congress back in 2017. So he can't just cancel them because the companies that hold them could sue the administration if he did that. So the suspension is just a temporary measure, and the Interior Department will need to find some kind of legal or environmental reason why these leases shouldn't be allowed to proceed or else reinstate them at some point. So we're not going to have an immediate halt to all the drilling. Right. There hasn't been drilling happening there. They're more for exploration at this stage. So it's not halting any actual equipment happening there, but it would delay and halt any plans that any company may have had to develop there.

Yeah. Next up a story. Boy, I remember this story. from back in the 70s in the early environmental movement days, talking about freshwater lakes are losing oxygen. As I say, we've known about these for years. But now it seems to be like for a different reason, before we were talking about algae and eutrophication, something different happening? Right.

Freshwater lakes, yeah, they're losing oxygen at a far faster rate than oceans. And this is driven primarily now by climate change and warmer air temperatures, which caused the surface water to get warmer and make it harder to absorb oxygen. and for the oxygen that does get in the water to mix all the way down to the bottom. So a new analysis published in nature led by Kevin Rose quantified this loss for the first time. It looked at around 400 freshwater lakes, including some in Maine and Minnesota and New Hampshire and Missouri over a period of about 75 years. And they found a deplying in oxygen of 6% at the surface and 19% in deep water. And so for comparison, oceans have lost about 2% of their oxygen.

So what's happening to fish and other wildlife in the water? Is it dying off? Well, it is a problem because some species do need a minimum amount of oxygen in the water in order to survive. And they didn't find any specific examples of species that had necessarily been impacted. That wasn't the scope of this study. But it certainly could threaten populations if the oxygen in lakes drops down below those minimum levels or even goes to a situation where there's no oxygen, in which case other chemical reactions can also start to happen and there can be phosphorus released in the water and that can actually spur

the growth of algae too. So it could cause the growth of more harmful algae blooms in the future as well. I'm wondering if there's anything you can do about this. If it's due to global warming, I don't know what kind of solution you could come up with except the obvious. Right. I mean, addressing climate change would be the primary priority and certainly monitoring some of these lakes. The situation was worse. It wasn't across the board the same in every lake. So keep an eye on those lakes, especially those that are close to urban areas or agricultural areas where there's a lot of runoff and pollution already happening in them and making sure that those oxygen levels aren't dropping below the levels required for species in those lakes. Let's move on to the controversy at the prestigious

medical journal, JAMA, Journal of the American Medical Association. Yes, this journal has been criticized for months for comments that one of its editors made on a podcast back in February and on a tweet that JAMA published to promote that podcast episode. The episode was about structural racism in healthcare, and a deputy editor who is white essentially said that he didn't think it was constructive to talk about racism and that he and others like him were offended by the suggestion that they might be racist.

And to promote the episode, JAMA posted a tweet saying, no physician is racist, so how can there be structural racism in healthcare? And that editor has since resigned for those comments, and the journal has apologized and deleted the tweet and retracted the episode. But the fallout for the situation continued this week when the American Medical Association

said the editor-in-chief would also be leaving at the end of this month. Amy, do people feel like this is enough of a response? Well, physicians and health care employees for a while have been calling for broader changes, both at JAMA and other medical journals. In particular, physician Raymond Givens of Columbia University's Irving Medical Center has been calling on these journals to diversify their staff because he did a study last year that found that of 49 editors at JAMA, as of last October, only two were black and two were Hispanic. So there's a lot of people like him saying that medical journals need to do

more to hire and promote a more diverse staff and prioritize articles and conversations that address structural racism and the fact that exists in health care and in society and how that affects people's health and well-being. Let's move on to a story we talked about a few weeks ago, and that is the fate of the right whales. This week, there's new research suggesting the whales are getting shorter. What does that mean? Exactly. These right whales, which live in the North Atlantic off the East Coast, are an endangered species. There's actually fewer than 400 of them left in the world. And the new city out

this week in current biology found that the whales are getting shorter and smaller in size. Researchers from NOAA used airplanes and drones to take aerial measurements of more than 100 right whales. On average, they found that the whales born today are about three feet. shorter than those born in 1980. And the main reason for this, they say, is that right whales are getting tangled up in fishing gear. And even though it might not kill them, they're getting caught in nets and fishing lines and dragging that stuff through the water with them. And that just takes so much energy that it's physically stunting their growth and the growth of their calves. This is such a sad story, but there is some good news. The New England aquarium scientists have spotted the 18th right whale

calf of the season in the Bay of Fundy. And while that number is still low, It represents the highest calf count since 2013, Amy. So there's some good news at the end of that trail. Oh, that's fantastic to hear. Thank you, Amy. Always great to have you on the show. Thanks, Ira. Amy Nordrum, editor at MIT Technology Review.

When we come back, Dr. Anthony Fauci reflects on the early days of the HIV-AIDS crisis, what we've learned and what work is left to do. Stay with us. This is Science Friday from WNYC Studios. This is Science Friday. I'm Ira Plato. My best friend died of Carpoise-Sarcoma was the second case of it in New York. I have five, six friends now who have died. And I have four or five other friends who are in chemotherapy.

And these are all guys who are in their 20s and 30s. Voices from a different era, a different illness. I bring up those voices from a story I covered for NPR's All Things Considered 40 years ago. Because Saturday, June 5th, marks the 4th. 40th anniversary of a major medical milestone. On that day in 1981, the CDC published a report of a strange occurrence. Five young, otherwise healthy men in Los Angeles were hospitalized for pneumocystis pneumonia. This pneumonia is an illness that normally strikes seriously ill patients whose immune systems have been compromised. But these young men confounded doctors,

because for all intents and purposes, they should have been able to fight off this. sickness. Two of these five men died, but they all had one thing in common. All five were gay. And this report kicked off a long head-scratching few years where the medical community could not figure out what was happening to mostly gay men who lived in cities. Here's a clip of mine from Morning Edition in 1981, right when this was emerging. Something baffling is going on in major gay communities around the country. It's a medical mystery more difficult to solve than Legionnaires disease. homosexual men are succumbing to fatal diseases that they should normally be immune to. The news first became public last summer when the Center for Disease Control in Atlanta

began keeping track of the outbreak of two diseases, pneumocystine pneumonia and Kaposi sarcoma in young homosexual men in Los Angeles and New York. It was a confounding and fearful time for a lot of people. Medical professionals couldn't figure out what was going on. They didn't know how it originated or spread. Gay communities in big cities were being decimated. The death rate for this mysterious illness was about 30 percent. To think out of a community as big as they are, there are 180 or 90 cases or whatever it is, I know personally about eight of them. It's an incredible when you think about it.

You can't not but be scared by all of that. Over the past 40 years, we've learned a lot more about HIV and AIDS. Treatments are readily available and they work well, and the illness is no longer a death sentence. Joining me to reflect on this time is someone who was there from the beginning, Dr. Anthony Fauci, recipient of the Presidential Medal of Freedom and Director of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland. Welcome back to the show. Good to be with you, as always, Ira. Listening to those clips, hearing that history, it's got to evoke memories for you, Dr. Fauci. Ira, it invokes very painful memories, having lived through that.

that literally from the very first day that the first cases were reported in June of 1981 in MMWR. And I was totally baffled and did not know what was going on. I thought it was a fluke. And then one month later in July of 1981, it was a similar report only now of 26, curiously, very curiously, all young gay men, who now were not only from L.A. but from San Francisco and New York City, who were now very ill not only with numicistus, but some had other opportunistic infections, as well as capesisarcoma. And I made a decision literally when I was reading that horrifying MMWR, because I knew that my entire professional career following my residency. I was about eight or nine years following my chief residency. I was seeing all sorts of

infectious diseases, and I had never seen anything like this in otherwise healthy young people. And I said, I'm going to change the direction of my research, and I'm going to study these young gay men who have this terrible disease that they're presenting with far advanced immunosuppression and opportunistic infections. And the years that I did that before we developed adequate therapy were really personified by the clips that you just played. I mean, those are things that even though they were 40 years ago, 39, 38 years ago, they resonate in my ears because I was there on the ground when it was happening,

desperately, as some of my other colleagues were trying to do, be they in San Francisco, L.A. or New York were desperately trying to find solutions, which were elusive because we didn't even know what the ideology was of this devastating disease among mostly young gay men. But as the weeks and months went by, we found out that it was not only young gay men, it was injection drug users and sexual partners of individuals who were infected. it was a terrible, terrible time, Ira. And at what point did it become apparent that HIV was passed through blood and bodily fluids? Well, it was certainly apparent when very soon, and even before we identified the virus, now known as HIV-1, that it was clear to us from a pure epidemiological standpoint, that it was transmitted by blood, blood products, and to hemophiliacs through plasma derivatives.

Because we were seeing this unusual situation where, wait a minute, we having gay men who clearly were in the middle of the sexual revolution with the bathhouse culture, which is a perfect setup for the spread of a sexually transmitted disease. And then you have people who are transfusion recipients, and then you were having hemophiliacs, and they were all getting infected. I mean, it wasn't very difficult to put two and two together to know what we were dealing with. We just didn't know what the ideological agent was. I recall that a word that was thrown around a lot in those early days was baffling.

Accurate description? Yeah, baffling and painful and dark. The only thing that really got us through was the extraordinary bravery. of the young men who were going through an unprecedented, very frightening experience. A big day in the history of HIV AIDS was when Magic Johnson told the world that he was HIV positive. The following is from the press conference he gave, announcing his status in November of 1991. Because of the HIV virus that I have attained, I will have to retire from the Lakers today.

I just want to make clear, first of all, that I do not have the AIDS disease, because I know a lot of you want to know that, but the HIV virus. I plan on going on living for a long time, bugging you guys like I've always have. I will now become a spokesman for the HIV virus because I want people and young people to realize that they can practice safe sex. and, you know, sometimes you're a little naive about it, and you think it could never happen to you. You only thought it could happen to, you know, other people and so on and all. And it has happened, but I'm going to deal with it, and my life will go on. Do you think this was a turning point for how people looked at other people with HIV? Oh yeah, I think that whenever you get a celebrity who's highly admired almost universally in the community,

certainly Magic Johnson with that infectious smile of his and his exploits on the basketball court had many, many admirers. When you see someone like that who's now living with HIV, the stigma associated with HIV is, I think, markedly diminished because people can identify very closely with someone they've admired for years. Yeah, because if I recall correctly up to that point, a lot of people saw this as, quote, unquote, a gay disease and the community was sometimes vilified for this. I mean, remember there was a point of time when people were referring to AIDS as gay cancer. Right. Or gay related immune deficiency, grid. That was the name that was used, right? And that sort of turned it around when Magic Johnson came out.

Indeed. Indeed, that was important. We talked about HIV on our very first Science Friday show back in 1991 in November. I want to play a comment from a caller from that show who summed that up very well. I think it's react and the media reacts and politicians react like this as brand-new news when something like this happens or, you know, a Rock Hudson or Ryan White. And there's this hidden level, I think, that, you know, this can happen to, quote-unquote, innocent people. The guilty people who are in the millions are right around the corner. Do you think, Dr. Fauci, that people could have done a better job to not villainize the gay community and drug users?

Oh, I mean, obviously. I mean, that was the stigmatization of a community that was disenfranchised from the people. beginning because of the levels in various segments of our society of homophobia. Then you superimpose upon that a mysterious baffling illness and then you associate that well people who have injection drug use get it and commercial sex workers. So what became villainized was instead of the virus was the in many respects the people who were afflicted with the virus. Absolutely.

Was research sidetracked at all by public perception? Well, certainly not those of us, myself and my colleagues who jumped on this from literally the very first day. I believe that, and again, there's a lot of differences of opinion of that, but I believe if, well, President Reagan, with many of his good qualities, if he had used the bully pulpit of the presidency in a more proactive way to call attention to this, there would have been a more resources and with more resources, perhaps we would have done faster, more quickly in some of the development of countermeasures, but also if there is a real show of genuine

empathy on the part of the leadership in the country, that that may have gone a long way to have the rest of the country diminish the stigma associated with this disease. Was there a decision made by you in your office about which direction to take in fighting the illness, whether to develop a vaccine or to develop a treatment first? Well, I think it was both done simultaneously, Ira. And one of the things that was the stumbling block of the development of a vaccine is that the body, does not seem to want to or like to make a good immune response against the virus. So if natural infection itself does not induce an adequate immune response,

one of the tenets of vaccinology is that the best way to get a good vaccine is to mimic natural infection without hurting the host. That's the fundamental strategy. of what vaccines are. The only trouble is natural infection itself does not induce an adequate immune response. Whereas when you look at other really serious diseases like polio or measles or smallpox, as serious as they are for many people, in general, most people recover from this infection, because they develop a very potent immune response that ultimately clears the virus and renders them protected from reinfection with the identical or very similar virus.

That is what's called nature providing you with the proof of concept of what the body can do. Unfortunately, we have no proof of concept that way with HIV vaccine, So we have to do better than what natural infection does. And that's a very, very high bar for a vaccine. Whereas with therapeutics, you have the virus in hand and you do targeted drug development by identifying the vulnerable targets in the HIV replication cycle.

And you develop and target your therapies for those vulnerable targets, Hence, reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, fusion inhibitors. Those are the things that were developed. And ultimately, we developed combinations of drugs that were spectacularly successful in suppressing the level of virus so that people living with HIV can actually think about leading a normal life that's almost with a normal life expectancy. as well as knowing that if they remain undetectable, that undetectable equals untransmitable.

So you're not going to be of danger to anyone else. So there was really a very large dichotomy between what we have done and we're able to do with therapies versus the success with a vaccine for the reasons that I just mentioned. This is Science Friday from WNYC Studios. In case you're just joining us, we're talking to Dr. Anthony Fauci about what we've learned over 40 years of HIV-AIDS research. Did you learn anything that I don't mean you in particular, although it might be you, any lessons from the COVID episodes we're hopefully getting out of

that might be applied to HIV or vice versa. Did we learn anything from HIV that might be applied to combating COVID or future cases of this? Well, right now, that there's no doubt that the types of elegant science that has evolved in an attempt, albeit thus far unsuccessful, to develop an HIV vaccine, are technologies that have paved the way for the spectacularly successful COVID-19 vaccines. It seems a little paradoxical that technologies, structure-based vaccine design, getting the right stable confirmation of a particular immunogen, are all things that originated out of work with HIV that has been applied to developing the right pre-fusion component that's stabilized of the spike protein that is a wonderful immunogen

for COVID-19 and has led to the right. to vaccines with up to 94-95% efficacy and even better in effectiveness in the real world. Yet, that same technology has not delivered for us an HIV vaccine. Now that we have this highly successful MRNA platform technology, there are many HIV vaccinologists who are looking very closely at that platform technology to see if you apply the MRNA approach to HIV,

will we be able to make some giant steps towards a vaccine? So even though it's gone one way, namely HIV helping COVID-19, maybe, and I hope that what we've done with COVID-19 will help HIV. We have to take a quick break, and when we come back, we'll have more with Dr. Anthony Fauci about the 40 years of HIV AIDS. We'll be right back. Stay with us. This is Science Friday from WNIC Studios. This is Science Friday. I'm Ira Flato. We're continuing our conversation with Dr. Anthony Fauci about 40 years of HIV and AIDS in the U.S. How much we've learned, how much is still unknown about the illness that was so frightening four decades ago.

I want to play a clip from another Science Friday show 26 years ago back in 1995. You were on the show with Bob Gallo, who co-discovered that HIV was the virus responsible for AIDS. And in this show, we talked about the latest HIV-AIDS treatments that had been discovered and discussed all the things we still don't know about the virus. This was 26 years ago. And I brought up the point that it seemed like there's a lot we don't know about the human immunity system and how HIV plays into it compared to how much we know about other systems in the body, and that got some pushback from both of you.

Bob Gallo, does this mean we really don't understand the human immunity system that well? Very often, scientists will say we don't know anything, we don't know much, we're just scratching the surface. I feel in a relative scale, we know quite a bit about HIV relative to other viruses, and I think the field of immunology is a rather well-developed field. however you know you can you can make the argument either way if somebody says we know nothing you can argue that's ridiculous you can say we know an awful lot you can say the same thing but being more of the virologist i'd rather punt that right to dr fouchy well you know i take issue i take issue with the with the point that was made that we know everything about all other other systems but we don't

know much about the immune system i disagree strongly with that i mean if you look at the neurological system, of which we know a lot. There are more mysteries in the neurological system than you could even imagine in the endocrine system, a variety of systems. I don't think the immune system is any much further off in the amount we understand or don't understand. I think the point that Bob made is a very good point, and I think that's the reason why there's a lot of confusion. We know an awful lot about HIV. We know how the virus works. We know how the virus destroys the body's immune system, but we don't know everything. And that's the reason why the kinds of discoveries that was made by Bob and others most recently adds more to the store of knowledge.

But to say that we know very, very little about it, I think is over-exaggerating, or to say that we know everything is certainly a naive oversimplification. We're making step-by-step progress as a ways to go, but we do know an awful lot about it. First of all, Dr. Fauci, it's great to be reminded that you've been a straight talker for all of these years and not afraid to speak your mind. In hindsight, did we know a lot about HIV at this time? Yes, we did know an awful lot about it. One of the things that as the years went by Ira, that really was, I would say, a little bit disturbing, if not quite disturbing,

was that the full realization that when you present the antigen and the form of an envelope, trimer or on whatever mechanism you're using in your vaccine platform, that the body doesn't make broadly neutralizing antibody. And when you have a virus that continually mutates and changes because of the pressure of the immune system, that you've got to get antibodies that are broadly neutralizing to all iterations of the virus. When you get a disease like me, measles? Measles doesn't change a heck of a lot over decades, much less within a person over a period of months to years. So that's why you just need antibodies against the appropriate component of the virus to block it. That was the thing that we still don't know yet, Ira,

exactly how to induce broadly neutralizing antibodies against HIV. Are we getting any closer? We are. And I think we're getting closer because we're using very sophisticated technology of structure-based vaccine design, whereby using cryoelectron microscopy and looking at the right confirmation that would, in fact, trigger the B-cell lineage so that you can actually trigger the appropriate lineages to coax it along to get to the point of making broadly neutralizing antibodies. That might require an approach to vaccinology that we've never had to do before is to give sequential immunizations with a modified form of the immunogen to continue

the pathway to broadly neutralizing antibodies. So you're saying just constantly giving people booster shots? Well, yeah, sort of. I mean, a version of a booster shot where you bring it to one point in differentiation and then you bring it to the next so that you get to the point where you really do have broadly neutralizing antibodies. And how far along are you on this? Are there going to be human trials on this soon? I believe so. I mean, there are certainly the only human trials that have gone to phase three are the ones that are not going after broadly neutralizing antibodies that are going after other types of immune responses. But the ones that are going to be going for the broadly neutralizing antibodies are in phase one trial. And hopefully when we get enough information,

we'll proceed to phase two A, two B, and then ultimately to phase three. Compared to 40 years ago, our collective worry about HIV AIDS has largely gone down, of course, but it hasn't gone away. I mean, I want to cite a 2019 report where more than half of new HIV diagnoses in the U.S. happened in southern states. And of those, African-American men made up a disproportionate number of those cases. How did this dramatic demographic shift happen? Well, it happened, I believe, because of the accessibility of counseling, accessibility to prep, accessibility to test, and ultimately adequate treatment if you prove to be infected or living with HIV. Whereas in some areas of the country, particularly in rural areas of the South,

which are demographically overrepresented with African Americans, that the stigma, the lack of access, all of those other factors, have made it very difficult to have that kind of accessibility to all the things that you need to really stop the outbreak, easy testing, lack of stigma, accessibility to care, accessibility to drugs when you need it. There are certain areas of the country where that is not as accessible as in other areas. I just have a few minutes left. I want to just change gears for a second because I could not help but ask you something that I just saw released by your office this week. And And that is concerning.

We're going on with universal flu vaccine clinical trial. Is that correct? That is correct, Ira. And it's a viral, like it's a nanoparticle that has on it at least four separate hemaglutin molecules from various different strains of flu. So what we're doing now, there's a number of ways to do that. You can do it by looking, for example, at the invariant part of a single virus, or you can cluster together on a nanoparticle, the hemaglutin from multiple different ones. We are very, I would say, cautiously optimistic about this because we feel that this type of technology, this type of platform technology, as,

new as it is, as really has a really extraordinary degree of potent immunogenicity of a wide array of responses. So we think that this is hopefully going to be a winner, but we don't know for sure unless we test it, as you well know. Yeah. One last simple question for you. How do you feel about your emails getting leaked? Well, you know, the trouble with that, Ira, is when people look at emails, they then can take anything out of context. They could pull a sentence out without the rest and say that Tony Fauci said this in an email, and it could be a real misconstruing of what the real context of what the email is. But the ones that were published in the Washington Post, I mean, there was nothing, no problem with that. I think it showed me to be an honest,

straightforward person. Yeah, it shows that. You're working very hard. hard. Yeah. Send the emails at 1.30 in the morning. Yeah, you're not getting them seven hours. Well, you don't get that many hours sleep anyhow, I'm sure. No, I don't, Ira. Well, thank you very much for taking time to be with us today. I appreciate that. Thank you. It's good to be with you, as always, Aura. Dr. Anthony Fauci, recipient of the Presidential Medal of Freedom and Director of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland. And hopefully, We'll try this again 10 years from now and see where we stand. Indeed.

Hopefully I'll be here. Me too. If you want to go back in time to learn more about the history of the AIDS epidemic in America, including some of my reporting for NPR back in the 80s, you can check out our Science Friday Rewind Story at sciencefriety.com slash AIDS. You could revisit all kinds of interviews from the archive and sign up to get future Science Friday rewind stories. That's Science Friday.com slash AIDS.

Perhaps no food says summer better than a chilled slice of juicy watermelon. And now researchers have been piecing together genetics, history, and Egyptian two marked to slice into the question of just how the modern watermelon came to be. Charles Berkwist has more. You know the watermelon is a red, sweet taste of summer. But many of its melon relatives have whitish-pals. and they're often bitter. Back in the 1960s, Russian researchers suggested that a sweet melon from South Sudan may have been a close watermelon relation, and now an international

team of researchers has analyzed the DNA of over 400 watermelon varieties from around the world, and they've concluded that cortofan melon from the Sudan may indeed be the closest link to the modern watermelon. Suzanne Renner is an emeritus professor at the University of Munich, and an honorary professor of biology at Washington University in St. Louis. She's one of the authors of a paper on the work published in the Proceedings of the National Academy of Sciences. I asked her just how far back what we think of as a watermelon has existed. It depends on what you define as the watermelon, because there are so many forms of watermelon. In West Africa, people like to snack on the seeds.

They don't eat the pulp, the form with the red sweet. flesh, as we know it today, super sweet and perhaps even without seeds, is a product of the past 50 to 100 years of intensive breeding. But people certainly enjoyed watermelon pulp. I think, or we think, based on our research, by 4,000, 5,000 years ago. This is Science Friday from WNYC Studios. Walk me through how you know about that. Part of it relies on art found in Egyptian tombs? Yes. The tomb art by itself, a painting of a fruit that certainly looks like of sweet fruits in different tombs that certainly look like watermelons to us doesn't prove that their pulp

was eaten raw. You know, it could have been bitter things and people were, as I said, eating the seeds. So the painting as such is not sufficient, although in context with other evidence you say, oh, yes, this fruit is depicted. on a tray next to grapes and other refreshing vegetables, lotus flowers that were also eaten and snake melons. But it's not enough. The painting alone doesn't do it. But knowing from our really solid sampling of all kinds of watermelons that exist in Africa,

we think there are six or seven wild species. So we have high-quality genomic data of well-understood representatives of each wild species, and they all have bitter fruits that have white pulp. And then we have genomes of 400 types of domesticated watermelons from China, from nothing. And in this context, in this large sampling of genetic data, the cordofar melon, which is represented only by genomes from. three plants, comes out as closer to the domestic of watermelon than anybody else. If you were going to start with something like a cordofan and selectively breed it into what we know

as a modern watermelon, how long would that take you? Yes. So it's an annual crop. Okay, every year you get a new generation in principle. It's very hard to say. With modern conscious breeding, you get changes fairly fast. But this modern level breeding, you know, where you understand that there are genetic traits that you want to enhance in the offspring and you need to do self-pollination and things like that, that is a recent thing.

You know, the modern breeding, as I said, in watermelons, it's well documented, started around 1900, precisely 1907. The word gene was coined in 1905, you know, Mendel's laws, where we discovered in 1900, this is all so reason. So how long it took ancient farmers to get desired traits, let's say, sweetness or red-colored, is very hard to know.

I would think hundreds of years. Is there a specific gene for redness or juiciness? Yes, that is, well understood. The redness, the red color has been much researched in red fruits, okay? The genes underlying the red color are well understood. And as you probably know, red is good. So lycopenes and carotinoids are potent antioxidants. It's good to eat red watermelons or red tomatoes.

So that is well understood and one can look if one has high quality data from ancient material, 100 year old, 200 year old, 400 year old material. When you have the relevant part of the genome well sequenced, you can see the mutations that cause the red, presence of red or absence of red. So does knowing the origins of the watermelon get you any closer to being able to improve the modern watermelon? I think so. Currently, for the past hundred years, breeding beta watermelts has focused on bringing in genes from South African material. Now they will have to focus on Sudanese or southern Egyptian populations.

They will be closer. they will have other types of alleles having to do with, let's say, military resistance or drought resistance, because these watermelons are growing in the desert, and really they are drought resistant. What would you like to know next? What's the cutting edge of watermelon for you? Okay, it's getting the ancient genome.

So we have, I can say this, this is a manuscript we are literally working on right now. High-level genomic data from seeds that are 6,000 years old or 4,000 years old. And then you can see if the red color or the sweetness was already, or loss of bitterness, was there and when it came, that's the next step. Ancient DNA. Interesting. Suzanne Renner is an emeritus professor at the University of Munich and an honorary professor of biology at Washington University in St. Louis.

Thank you so much for taking time to talk about this with me today. Thank you, Charles. For Science Friday, I'm Charles Bergquist. And that's about all the time we have. Charles Berkwurst is our director. Our producers are Christy Taylor, Katie Feather, and Kathleen Davis. Senior producer Alexa Lim, contributing editor, John Dan Koski, B.J. Leideman, composed our theme music. Oh, and one more thing before we go.

A big sci-fry welcome to our friends in Maine, listening this week via Maine Public Radio. Glad to have you aboard. Have a great weekend. I'm Ira Flato.