Wafaa Al-Sadr: Public health is everywhere and at all times

Wafaa Al-Sadr: Public health is everywhere and at all times

For more than four decades, Wafaa Al-Sadr, MD from Columbia University, MSc in Public Health, and the Mediterranean Reserve, has advocated for families and communities most affected by health challenges. Her pioneering work in global HIV research, prevention, treatment, and care was honored on November 8 by the American Public Health Association with the Sedgwick Memorial Medal for Distinguished Service in Public Health.

Wafaa Al-Sadr

Al-Sadr began her career as an infectious disease physician in Harlem when the HIV epidemic hit the United States in the early 1980s. I learned the lessons I learned in a required public health course at medical school in Egypt a decade ago to develop successful and innovative models of care to respond to HIV/AIDS in the community. In 2003, she founded ICAP at Columbia University’s Mailman School of Public Health to provide life-saving treatments for HIV to resource-constrained communities in sub-Saharan Africa. Since then, it has expanded the institute’s work to more than 40 countries around the world, addressing some of the most important health challenges we face today.

We spoke with Al-Sadr about her start in public health and what people should know about public health.

You were an infectious disease doctor before entering public health. What first sparked your interest in public health?

When I was in medical school in Cairo, Egypt, one of our required courses was the public health course. As part of the course, I was assigned with another student to a family in the countryside. I vividly remember that once a week we used to go by bus to a very small village and visit with our particular family in their very modest house.

I think this was eye-opening for me in terms of thinking about what happens to people outside of their encounters with us in a clinic or in a hospital and looking at people’s lives outside of health care structures. .

It was a great experience, because I learned a lot by sitting with them in their house, talking to them, observing them and their children, evaluating their performance, identifying their needs, seeing what they are doing right and what they need some guidance on. I vividly remember thinking there was so much they needed and how complicated it was for them on their own to navigate the health system.

When I was a young infectious disease doctor in Harlem at the beginning of the HIV epidemic, I was thinking about those old experiences in rural Egypt. This led me to wonder what forces affected the lives of my patients? What were they testing outside the clinic? How did they act despite the enormous difficulties they faced? What do they really need from us in return for what we give them?

I think this was the beginning, the beginning of a journey to connect public health with healthcare.

How has public health changed since you entered the field? What should today’s students know?

I tell my students that public health has expanded and evolved over the past decades. When you delve into what public health practitioners and researchers do today, you’ll find them working in laboratories, developing new diagnostic tests. You will find them working on mathematical modeling of diseases to guide our work. You will find public health researchers who are behavioral scientists, seeking to understand what motivates people to adopt certain behaviors. You’ll see those working with specific populations and conditions, promoting maternal and child health, HIV prevention and care, environmental health, and treating emerging infections and chronic diseases. Then there are those who are involved in the basics of public health, surveillance, epidemiology, community outreach and engagement as well as in disease prevention and health promotion.

Basically, public health workers are everywhere, and they are all around us, working to secure our health today and the health of future generations.

A woman standing and talking to a group of seated people
Wafaa Al-Sadr discusses health system strengthening at a planning meeting for the new ICAP project to support the recovery of health systems in Ukraine. Photo: ICAP.

What would you tell the average person on the street about public health?

I think people should appreciate that public health is all around them.

The work of public health is what ensures that the air we breathe is clean, that the water we drink is safe, and that our children are protected from deadly infectious diseases. Public health makes sure that we are prepared for whatever health threats come in, whether it’s epidemics or climate disasters.

I tell people that public health at its best is like a well-equipped machine buzzing in the background, indispensable, but barely perceptible. This is part of the challenge to public health: When all is well, it means that public health is working hard behind the scenes.

Despite this, I realized that COVID-19 was a wake-up call. I am confident that many people today have a deeper understanding of what public health does, how it really affects every minute of their lives, and that supporting public health is critical to our collective well-being.

What motivates you to do the work you do?

I feel driven by a passion for achieving healthy people, empowered societies, and thriving societies. How can we work best to achieve – in partnership with others of course – healthy people, empowered societies, and thriving societies? In every sense of these words.

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