Richard M. Krause, a microbiologist and immunologist who steered the National Institute of Allergy and Infectious Diseases through the early, tumultuous years of the AIDS epidemic, died Jan. 6 at a hospital in Washington. He was 90.
Dr. Krause (pronounced KRAU-zee) focused much of his scientific career on the genetic factors that affect the body’s immune system. He rose to the rank of professor at Rockefeller University in New York, then served as NIAID director in Bethesda from 1975 to 1984, followed by five years as dean of the Emory University medical school in Atlanta.
At NIAID, Dr. Krause fretted over his comparably small budget as federal research dollars flowed toward other NIH departments that studied cancer, strokes, heart disease and degenerative conditions. He struggled against a widely held belief that because of vaccines, the flu and other infectious diseases no longer constituted serious public health threats.
“Is it any wonder, therefore, that the National Institute of Allergy and Infectious Diseases is sometimes not taken seriously?” he told the New York Times in 1982. “It has a credibility problem. With all else there is to do, why on earth should we have an institute for sneezes and colds, flu and fluxes, itches and blotches?”
He cautioned that many infectious diseases were becoming resistent to antibiotics. More worrisome, he said, the flu, with its evolving molecular structure, continued to kill hundreds and perhaps thousands of Americans each year.
His lectures on these subjects were published in 1981 as “The Restless Tide: The Persistent Challenge of the Microbial World.”
“Richard was among the first scientists in the modern era to sound a clarion call about the persistent threat of infectious diseases, and during his leadership he kept scientists and policymakers focused on the concepts of emerging and reemerging infectious diseases,” Anthony S. Fauci, who succeeded Dr. Krause as NIAID director, said in a statement.
But that clarion call was not widely heard, said Jack Whitescarver, a top assistant to Dr. Krause at NIAID who is now director of NIH’s Office of AIDS Research. After Dr. Krause’s departure, NIAID’s budget increased significantly following the death of actor Rock Hudson from AIDS complications in 1985 and later because of an influx of counterterrorism funding, Whitescarver said.
Dr. Krause presided over the institute at a time when AIDS, marginalized at first by many in the medical establishment as a “gay disease,” began to emerge as a national epidemic.
In 1981, the Morbidity and Mortality Weekly Report, a federal medical bulletin, published some of the first scientific accounts of what would soon become the AIDS crisis. In later interviews, Dr. Krause said it was initially unclear whether AIDS was a cancer — and therefore under the bailiwick of the National Cancer Institute — or a sexually transmitted disease and thus a matter for NIAID.
Once it became clear that the NIAID had a role to play in responding to the disease, he organized high-level conferences to explore its possible causes, including one chaired by polio vaccine developer Albert Sabin.
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Over the years, AIDS activist Larry Kramer singled out Dr. Krause and other leading science administrators as a target for his ire, saying they “crucified” the gay population for not addressing the crisis with single-minded urgency.
Dr. Krause said he understood the hostility and frustration. He accepted a degree of criticism for his agency’s — and the larger federal bureaucracy’s — slowness to understand the scope and importance of the virus.
"One of the things that I have been criticized for is that when we were asked whether we had enough money, I did not immediately ask for a lot more money," he said in a 1988 NIH oral history on AIDS research. "I guess this caution was from my early concern about running too fast after a few cases. It does not mean that we were not concerned about those individuals because they were gay. . . . Our budget requests were written in the context of numerous things that had to be done."
One of Dr. Krause’s most important and far-reaching decisions developed from a 1983 encounter with Peter Piot, the Belgian microbiologist who had earlier discovered the Ebola virus in the African country then known as Zaire (later the Democratic Republic of the Congo). The two met at an international medical conference in Vienna and decided to collaborate on AIDS research in Zaire, where Piot had seen a substantial outbreak of the disease.
“Dick basically wrote a check there,” Piot said. “And being the director of NIAID, he could do that without having to go through I don’t know what kind of applications.”
NIAID funding — and later a huge influx of money from the U.S. Centers for Disease Control and Prevention — set up Projet SIDA (French for AIDS Project). Projet SIDA made breakthrough discoveries about AIDS infection, among them that the virus could be transmitted through heterosexual sex.
The findings were printed in the British medical journal Lancet in 1984. The Times reported that an editor at the New England Journal of Medicine initially declined the paper, citing an expert who said, “It is a well known fact that AIDS cannot be transmitted from women to men.”
By the early 1990s, Projet SIDA fell apart amid bureaucratic infighting and a burgeoning conflict in Zaire. A few years later, Piot helped start the United Nations agency on HIV and served as its executive director until 2008.
Dr. Krause left for Emory in 1984 and tried to set up one of the first AIDS clinical trial groups there, said Whitescarver, who also worked at the university during that era. Top administrators resisted his initiatives, fearing that housing AIDS patients would make other patients in the community seek treatment elsewhere.
“It was a struggle,” Whitescarver said. “He had vision, but he was never able to see it through.”
Richard Michael Krause was born Jan. 4, 1925, in Marietta, Ohio, where his father taught chemistry at Marietta College. After Army service in World War II, he graduated in 1947 from Marietta College and in 1952 from what became Case Western Reserve University medical school in Cleveland.
Dr. Krause returned to the National Institutes of Health in 1989 and remained a senior scientific adviser until his death. He was elected to the National Academy of Sciences in 1977.
He had no immediate survivors.
