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Brownstone Institute

The Six Major Fails of Anthony Fauci

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When the pandemic hit, America needed someone to turn to for advice. The media and public naturally looked to Dr. Anthony Fauci—the director of the National Institute of Allergy and Infectious Diseases, an esteemed laboratory immunologist and one of President Donald Trump‘s chosen COVID advisers. Unfortunately, Dr. Fauci got major epidemiology and public health questions wrong. Reality and scientific studies have now caught up with him.

Here are six key issues:

1. Natural immunity

By pushing vaccine mandates, Dr. Fauci ignores naturally acquired immunity among the COVID-recovered, of which there are more than 45 million in the United States. Mounting evidence indicates that natural immunity is stronger and longer lasting than vaccine-induced immunity. In a study from Israel, the vaccinated were 27 times more likely to get symptomatic COVID than the unvaccinated who had recovered from a prior infection.

We have known about natural immunity from disease at least since the Athenian Plague in 430 BC. Pilots, truckers and longshoremen know about it, and nurses know it better than anyone. Under Fauci’s mandates, hospitals are firing heroic nurses who recovered from COVID they contracted while caring for patients. With their superior immunity, they can safely care for the oldest and frailest patients with even lower transmission risk than the vaccinated.

2. Protecting the elderly

While anyone can get infected, there is more than a thousand-fold difference in mortality risk between the old and the young. After more than 700,000 reported COVID deaths in America, we now know that lockdowns failed to protect high-risk older people. When confronted with the idea of focused protection of the vulnerable, Dr. Fauci admitted he had no idea how to accomplish it, arguing that it would be impossible. That may be understandable for a lab scientist, but public health scientists have presented many concrete suggestions that would have helped, had Fauci and other officials not ignored them.

What can we do now to minimize COVID mortality? Current vaccination efforts should focus on reaching people over 60 who are neither COVID-recovered nor vaccinated, including hard-to-reach, less-affluent people in rural areas and inner cities. Instead, Dr. Fauci has pushed vaccine mandates for children, students and working-age adults who are already immune—all low-risk populations—causing tremendous disruption to labor markets and hampering the operation of many hospitals.

3. School closures

Schools are major transmission points for influenza, but not for COVID. While children do get infected, their risk for COVID death is minuscule, lower than their already low risk of dying from the flu. Throughout the 2020 spring wave, Sweden kept daycare and schools open for all its 1.8 million children ages 1 to 15, with no masks, testing or social distancing. The result? Zero COVID deaths among children and a COVID risk to teachers lower than the average of other professions. In fall 2020, most European countries followed suit, with similar results. Considering the devastating effects of school closures on children, Dr. Fauci’s advocacy for school closures may be the single biggest mistake of his career.

4. Masks

The gold standard of medical research is randomized trials, and there have now been two on COVID masks for adults. For children, there is no solid scientific evidence that masks work. A Danish studyfound no statistically significant difference between masking and not masking when it came to coronavirus infection. In a study in Bangladesh, the 95 percent confidence interval showed that masks reduced transmission between 0 percent and 18 percent. Hence, masks are either of zero or limited benefit. There are many more critical pandemic measures that Dr. Fauci could have emphasized, such as better ventilation in schools and hiring nursing home staff with natural immunity.

5. Contact tracing

For some infectious diseases, such as Ebola and syphilis, contact tracing is critically important. For a commonly circulating viral infection such as COVID, it was a hopeless waste of valuable public health resources that did not stop the disease.

6. Collateral public health damage

A fundamental public health principle is that health is multidimensional; the control of a single infectious disease is not synonymous with health. As an immunologist, Dr. Fauci failed to properly consider and weigh the disastrous effects lockdowns would have on cancer detection and treatment, cardiovascular disease outcomes, diabetes care, childhood vaccination rates, mental health and opioid overdoses, to name a few. Americans will live with—and die from—this collateral damage for many years to come.

In private conversations, most of our scientific colleagues agree with us on these points. While a fewhave spoken up, why are not more doing so? Well, some tried but failed. Others kept silent when they saw colleagues slandered and smeared in the media or censored by Big Tech.

Some are government employees who are barred from contradicting official policy. Many are afraid of losing positions or research grants, aware that Dr. Fauci sits on top of the largest pile of infectious disease research money in the world. Most scientists are not experts on infectious disease outbreaks. Were we, say, oncologists, physicists or botanists, we would probably also have trusted Dr. Fauci.

The evidence is in. Governors, journalists, scientists, university presidents, hospital administrators and business leaders can continue to follow Dr. Anthony Fauci or open their eyes. After 700,000-plus COVID deaths and the devastating effects of lockdowns, it is time to return to basic principles of public health.

A version of this article originally appeared in Newsweek

Authors

  • Martin Kulldorff, Senior Scholar at Brownstone Institute, is an epidemiologist and biostatistician. He is Professor of Medicine at Harvard University (on leave) and a Fellow at the Academy of Science and Freedom. His research focuses on infectious disease outbreaks and the monitoring of vaccine and drug safety, for which he has developed the free SaTScan, TreeScan, and RSequential software. Co-Author of the Great Barrington Declaration.

  • Jay Bhattacharya, Senior Scholar at Brownstone Institute, is a physician, epidemiologist and health economist. He is Professor at Stanford Medical School, a Research Associate at the National Bureau of Economics Research, a Senior Fellow at the Stanford Institute for Economic Policy Research, a Faculty Member at the Stanford Freeman Spogli Institute, and a Fellow at the Academy of Science and Freedom. His research focuses on the economics of health care around the world with a particular emphasis on the health and well-being of vulnerable populations. Co-Author of the Great Barrington Declaration.

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Brownstone Institute

Bizarre Decisions about Nicotine Pouches Lead to the Wrong Products on Shelves

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From the Brownstone Institute

  Roger Bate  

A walk through a dozen convenience stores in Montgomery County, Pennsylvania, says a lot about how US nicotine policy actually works. Only about one in eight nicotine-pouch products for sale is legal. The rest are unauthorized—but they’re not all the same. Some are brightly branded, with uncertain ingredients, not approved by any Western regulator, and clearly aimed at impulse buyers. Others—like Sweden’s NOAT—are the opposite: muted, well-made, adult-oriented, and already approved for sale in Europe.

Yet in the United States, NOAT has been told to stop selling. In September 2025, the Food and Drug Administration (FDA) issued the company a warning letter for offering nicotine pouches without marketing authorization. That might make sense if the products were dangerous, but they appear to be among the safest on the market: mild flavors, low nicotine levels, and recyclable paper packaging. In Europe, regulators consider them acceptable. In America, they’re banned. The decision looks, at best, strange—and possibly arbitrary.

What the Market Shows

My October 2025 audit was straightforward. I visited twelve stores and recorded every distinct pouch product visible for sale at the counter. If the item matched one of the twenty ZYN products that the FDA authorized in January, it was counted as legal. Everything else was counted as illegal.

Two of the stores told me they had recently received FDA letters and had already removed most illegal stock. The other ten stores were still dominated by unauthorized products—more than 93 percent of what was on display. Across all twelve locations, about 12 percent of products were legal ZYN, and about 88 percent were not.

The illegal share wasn’t uniform. Many of the unauthorized products were clearly high-nicotine imports with flashy names like Loop, Velo, and Zimo. These products may be fine, but some are probably high in contaminants, and a few often with very high nicotine levels. Others were subdued, plainly meant for adult users. NOAT was a good example of that second group: simple packaging, oat-based filler, restrained flavoring, and branding that makes no effort to look “cool.” It’s the kind of product any regulator serious about harm reduction would welcome.

Enforcement Works

To the FDA’s credit, enforcement does make a difference. The two stores that received official letters quickly pulled their illegal stock. That mirrors the agency’s broader efforts this year: new import alerts to detain unauthorized tobacco products at the border (see also Import Alert 98-06), and hundreds of warning letters to retailers, importers, and distributors.

But effective enforcement can’t solve a supply problem. The list of legal nicotine-pouch products is still extremely short—only a narrow range of ZYN items. Adults who want more variety, or stores that want to meet that demand, inevitably turn to gray-market suppliers. The more limited the legal catalog, the more the illegal market thrives.

Why the NOAT Decision Appears Bizarre

The FDA’s own actions make the situation hard to explain. In January 2025, it authorized twenty ZYN products after finding that they contained far fewer harmful chemicals than cigarettes and could help adult smokers switch. That was progress. But nine months later, the FDA has approved nothing else—while sending a warning letter to NOAT, arguably the least youth-oriented pouch line in the world.

The outcome is bad for legal sellers and public health. ZYN is legal; a handful of clearly risky, high-nicotine imports continue to circulate; and a mild, adult-market brand that meets European safety and labeling rules is banned. Officially, NOAT’s problem is procedural—it lacks a marketing order. But in practical terms, the FDA is punishing the very design choices it claims to value: simplicity, low appeal to minors, and clean ingredients.

This approach also ignores the differences in actual risk. Studies consistently show that nicotine pouches have far fewer toxins than cigarettes and far less variability than many vapes. The biggest pouch concerns are uneven nicotine levels and occasional traces of tobacco-specific nitrosamines, depending on manufacturing quality. The serious contamination issues—heavy metals and inconsistent dosage—belong mostly to disposable vapes, particularly the flood of unregulated imports from China. Treating all “unauthorized” products as equally bad blurs those distinctions and undermines proportional enforcement.

My small Montgomery County survey suggests a simple formula for improvement.

First, keep enforcement targeted and focused on suppliers, not just clerks. Warning letters clearly change behavior at the store level, but the biggest impact will come from auditing distributors and importers, and stopping bad shipments before they reach retail shelves.

Second, make compliance easy. A single-page list of authorized nicotine-pouch products—currently the twenty approved ZYN items—should be posted in every store and attached to distributor invoices. Point-of-sale systems can block barcodes for anything not on the list, and retailers could affirm, once a year, that they stock only approved items.

Third, widen the legal lane. The FDA launched a pilot program in September 2025 to speed review of new pouch applications. That program should spell out exactly what evidence is needed—chemical data, toxicology, nicotine release rates, and behavioral studies—and make timely decisions. If products like NOAT meet those standards, they should be authorized quickly. Legal competition among adult-oriented brands will crowd out the sketchy imports far faster than enforcement alone.

The Bottom Line

Enforcement matters, and the data show it works—where it happens. But the legal market is too narrow to protect consumers or encourage innovation. The current regime leaves a few ZYN products as lonely legal islands in a sea of gray-market pouches that range from sensible to reckless.

The FDA’s treatment of NOAT stands out as a case study in inconsistency: a quiet, adult-focused brand approved in Europe yet effectively banned in the US, while flashier and riskier options continue to slip through. That’s not a public-health victory; it’s a missed opportunity.

If the goal is to help adult smokers move to lower-risk products while keeping youth use low, the path forward is clear: enforce smartly, make compliance easy, and give good products a fair shot. Right now, we’re doing the first part well—but failing at the second and third. It’s time to fix that.

Author

Roger Bate

Roger Bate is a Brownstone Fellow, Senior Fellow at the International Center for Law and Economics (Jan 2023-present), Board member of Africa Fighting Malaria (September 2000-present), and Fellow at the Institute of Economic Affairs (January 2000-present).

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Addictions

The War on Commonsense Nicotine Regulation

Published on

From the Brownstone Institute

Roger Bate  Roger Bate 

Cigarettes kill nearly half a million Americans each year. Everyone knows it, including the Food and Drug Administration. Yet while the most lethal nicotine product remains on sale in every gas station, the FDA continues to block or delay far safer alternatives.

Nicotine pouches—small, smokeless packets tucked under the lip—deliver nicotine without burning tobacco. They eliminate the tar, carbon monoxide, and carcinogens that make cigarettes so deadly. The logic of harm reduction couldn’t be clearer: if smokers can get nicotine without smoke, millions of lives could be saved.

Sweden has already proven the point. Through widespread use of snus and nicotine pouches, the country has cut daily smoking to about 5 percent, the lowest rate in Europe. Lung-cancer deaths are less than half the continental average. This “Swedish Experience” shows that when adults are given safer options, they switch voluntarily—no prohibition required.

In the United States, however, the FDA’s tobacco division has turned this logic on its head. Since Congress gave it sweeping authority in 2009, the agency has demanded that every new product undergo a Premarket Tobacco Product Application, or PMTA, proving it is “appropriate for the protection of public health.” That sounds reasonable until you see how the process works.

Manufacturers must spend millions on speculative modeling about how their products might affect every segment of society—smokers, nonsmokers, youth, and future generations—before they can even reach the market. Unsurprisingly, almost all PMTAs have been denied or shelved. Reduced-risk products sit in limbo while Marlboros and Newports remain untouched.

Only this January did the agency relent slightly, authorizing 20 ZYN nicotine-pouch products made by Swedish Match, now owned by Philip Morris. The FDA admitted the obvious: “The data show that these specific products are appropriate for the protection of public health.” The toxic-chemical levels were far lower than in cigarettes, and adult smokers were more likely to switch than teens were to start.

The decision should have been a turning point. Instead, it exposed the double standard. Other pouch makers—especially smaller firms from Sweden and the US, such as NOAT—remain locked out of the legal market even when their products meet the same technical standards.

The FDA’s inaction has created a black market dominated by unregulated imports, many from China. According to my own research, roughly 85 percent of pouches now sold in convenience stores are technically illegal.

The agency claims that this heavy-handed approach protects kids. But youth pouch use in the US remains very low—about 1.5 percent of high-school students according to the latest National Youth Tobacco Survey—while nearly 30 million American adults still smoke. Denying safer products to millions of addicted adults because a tiny fraction of teens might experiment is the opposite of public-health logic.

There’s a better path. The FDA should base its decisions on science, not fear. If a product dramatically reduces exposure to harmful chemicals, meets strict packaging and marketing standards, and enforces Tobacco 21 age verification, it should be allowed on the market. Population-level effects can be monitored afterward through real-world data on switching and youth use. That’s how drug and vaccine regulation already works.

Sweden’s evidence shows the results of a pragmatic approach: a near-smoke-free society achieved through consumer choice, not coercion. The FDA’s own approval of ZYN proves that such products can meet its legal standard for protecting public health. The next step is consistency—apply the same rules to everyone.

Combustion, not nicotine, is the killer. Until the FDA acts on that simple truth, it will keep protecting the cigarette industry it was supposed to regulate.

Author

Roger Bate

Roger Bate is a Brownstone Fellow, Senior Fellow at the International Center for Law and Economics (Jan 2023-present), Board member of Africa Fighting Malaria (September 2000-present), and Fellow at the Institute of Economic Affairs (January 2000-present).

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