Long before hashtags and coronavirus, back in the decade when Donald Trump owned a USFL football team, Dr. Anthony Fauci was learning his first lessons in threading political needles.

On one side, he would cautiously correct misinformation caused by a 1980s presidential administration that appeared to be bungling a national medical crisis. On the other, hard-line activists called him a Nazi and a murderer at growing protests.

And then, in February 1989, he met Terry Sutton. The San Francisco teacher was facing the terrifying choice of dying or taking a drug that would make him blind — when there was another drug, stuck behind a wall of government regulations, that might save his sight and his life.

“He made absolute perfect sense,” Fauci told Chronicle reporter Randy Shilts in 1989. “Here was this intelligent and articulate guy who wasn’t confrontational, who didn’t shove a banner in my face, but had this terrible dilemma. You can’t be a human being without having that move you.”

Despite his coronavirus leadership and the regular speculation that he will be fired from President Trump’s White House Coronavirus Task Force for disagreeing with the president, Fauci was never a household name before 2020. For most Americans, the scientist and his easy-to-digest, blunt approach to explaining our shifting pandemic seemingly came out of nowhere.

But activists and journalists covering the AIDS crisis in the 1980s witnessed Fauci’s emergence firsthand. In a short period — including a pivotal 1990 AIDS conference in San Francisco — Fauci took bold steps to become a more compassionate and inclusionary scientist, lessons that echo as he negotiates the coronavirus crisis as a White House task force member in 2020.

Fauci was based in Maryland, but he became a frequent voice for Bay Area residents following the AIDS crisis, even before he became director of the National Institute of Allergy and Infectious Diseases in 1984.

At the time, President Ronald Reagan wouldn’t acknowledge the disease by name in speeches and there was misinformation coursing through the public. Fauci’s first quote in The Chronicle was published in 1983, stressing that the disease couldn’t be transmitted by casual contact.

“If you work with someone who has AIDS, you don’t have to worry about catching it because you hang around the water cooler with that person,” he said. “The chances of that kind of transmission are virtually zero.”

But even as he emerged as a voice of reason to a scared public, and would open his door at the National Institute of Health to activists who were attacking him publicly, Fauci was blamed for outdated drug testing and distribution systems that he initially did little to change.

David Tuller, who protested in New York during the ’80s as a member of AIDS Coalition to Unleash Power (ACT UP) before getting hired by The Chronicle in 1988 as a health reporter, said Fauci was viewed as an obstacle to getting drugs out quickly.

“The system wasn’t set up for an epidemic,” said Tuller, now a senior fellow with the School of Public Health at UC Berkeley. “There were drugs in the pipeline that were going to be too slow to come out. So people were protesting. ‘If we’re going to die, we want the right to take drugs.’ ”

Back to Gallery Decades before coronavirus, a San Francisco AIDS... 5 1 of 5 Photo: Doug Mills / New York Times 2 of 5 Photo: Alex Wong / Getty Images 2005 3 of 5 Photo: J. Scott Applewhite / Associated Press 2003 4 of 5 Photo: Alex Wong / Getty Images 2008 5 of 5 Photo: Gerald Herbert / Associated Press 2003









But even as the protests were gaining more attention, and ACT UP became more organized and politically formidable in New York and San Francisco, Fauci was meeting with activists in increasingly casual situations.

Former ACT UP leader and San Francisco native Mark Harrington, now the executive director of the HIV research and policy think tank Treatment Action Group in New York, said the first meeting with Fauci was at the scientist’s office in Maryland. For the second meeting, Fauci came to a gay and lesbian community center in New York, followed by hamburgers at “some semi-crappy diner place on Seventh Avenue.”

“I think he slowly began to realize that it would be to his benefit to begin working with activists,” Harrington said during a phone interview with The Chronicle.

But protests continued. For ACT UP member Peter Staley, a chaotic protest of the NIH building where the director worked led to one of his fondest, and most surreal, memories of Fauci and the AIDS crisis. After scaling the building and being torn down by protestors — an event captured in David France’s 2012 documentary “How to Survive a Plague” — Staley, a Sacramento native, was taken through the NIH building by police with his hands bound by plastic ties.

“Walking towards us was Tony, in his white lab coat,” Staley remembered. “He squints and goes, ‘Peter?’ And I said ‘Tony!’ And he said, ‘Are you OK?’ and I said, ‘Just doing my job, how about you?’

“That moment kind of encapsulated the very strange relationship that the activists had with Fauci, where we were getting arrested in front of this building at the same time that we had already fallen in love with the guy and respected him. It was a complicated relationship.”

The NIAID director showed a willingness to change in the late 1980s, breaking ranks with the Food and Drug Administration to speed up testing and approval for drugs that treat life-threatening diseases.

“When the history of AIDS in 1989 is written, the transformation of Anthony Fauci may well emerge as one of the most dramatic — and consequential — of human interest stories,” Shilts wrote for The Chronicle in 1989, telling the story of Fauci’s and Sutton’s relationship. Shilts died of AIDS-related illness in 1994.

But Fauci’s transformational moment was still to come, when the International Conference on AIDS arrived in San Francisco in 1990. Hard-line activists were calling for riots, while the national TV news set up cameras to broadcast the conflict. ACT UP member Peter Staley was set to give a speech to thousands of assembled scientists, politicians and activists. But Staley said while he was waiting, he was sternly warned that police would intervene if protestors took the stage.

“I’m behind (the stage) with the mayor and all these people, and we’re all wide-eyed, because we’re pinned between the curtain and 200 San Francisco cops in full riot gear,” Staley said. “Nobody in the audience knew there was a gigantic police force right behind the curtain. ... Helmets, clubs, all of it.”

Staley’s speech started with a protest vibe, calling out President George H.W. Bush, but he pivoted to something more personal, stressing that the activists and scientists share the same goals. The activists were surprised later that day, when Fauci came up and gave them almost everything they were demanding — including a seat at the NIH table.

“Fauci came up to me after one of the panel discussions that we had been on, and he told me he had basically ordered investigators to allow activists and people with AIDS to be part of the research effort.” Harrington said. “Ever since then, people with AIDS and their advocates have been part of the structures of the research effort in the U.S. and around the world. That was a historic change in research that had tremendous benefit.”

It was, for everyone involved, a stunning piece of diplomacy that altered not just the AIDS crisis, but the future of government medical research, including that conducted for the coronavirus. Scientists struggled to find treatments to save HIV patients’ lives through the first half of the 1990s, before a breakthrough in 1996 using combinations of drugs to prolong many HIV sufferers’ lives indefinitely.

Fauci was also central to the President’s Early Plan for AIDS Relief , a foreign policy instrument launched by George W. Bush in 2003, which is credited with saving millions of lives around the world, and considered a positive lasting legacy for President Bush.

Attempts by The Chronicle to interview Fauci for this article about his work on the AIDS crisis were not successful. But activists and journalists who lived through that crisis say the rise of the coronavirus pandemic and the slow response of the U.S. has a triggering effect. Fauci’s involvement is, for the most part, extremely reassuring for them. The scientist, now 79, has spent nearly half a lifetime negotiating political complications as he pursues the needs of his patients.

“I was incredibly thankful he was there. I can’t imagine anyone else being able to fill that role,” Staley said. “The first time I met him, it’s this guy with a Brooklyn accent who you realize is the smartest guy on the street corner who you’d want to hang out with, but he doesn’t make you feel like an idiot. Trump is another opinionated New Yorker. I think, at least until this past week, they might have had some bonding over that approach.”

Staley is referring to Trump’s Sunday social media retweet of a follower who called on the president to fire Fauci, posted after the scientist said that morning on CNN that more could have been done to stop the spread of coronavirus.

Fauci seemed to walk back the comments during a Monday news conference, calling them a “poor choice of words.” But the scientist sparked more controversy on Tuesday, asked about Trump’s hopes to open the country before May 1, and telling the Associated Press, “we’re not there yet.”

Tuller co-wrote in a Chronicle opinion piece last week that it’s not Fauci’s role to stand by quietly while misinformation is spread.

While some have praised Fauci’s ability to negotiate the difficult balance between science and Trump’s shifting narratives, Tuller says remaining silent while the president makes factual errors is “beyond the role that Fauci is supposed to be playing.”

“In terms of the medical scientific side, he’s ready for the crisis,” Tuller said. “But basically I think it’s untenable to have a situation where the main medical person has to also somehow not be protesting when the president is blatantly lying while (Fauci is) sitting there. And explicitly invoking (Fauci’s) name, when (Trump is) making these claims about how incredible his response was.”

Staley is forgiving of perceived stumbles by Fauci, because he’s seen the doctor play the long game before. And he believes the unique set of assets Fauci has been honing for 40 years — compassion and bold thinking along with political survival skills — will save thousands of lives.

“If Tony does survive this, he’ll do something that most generals and secretaries of state have not been able to do,” Staley said. “I am disgusted by the game he had to play (Monday), but I want him in that room as April 30 approaches and this country is faced with a very hard choice about how quickly to reopen and how to do that.”

Peter Hartlaub is The San Francisco Chronicle’s pop culture critic. Email: phartlaub@sfchronicle.com Twitter: @PeterHartlaub