Wafaa El-Sadr: Public health is everywhere, all the time

Wafaa El-Sadr: Public health is everywhere, all the time

For more than four decades, Wafaa El-Sadr, MD, MPH, MPA, of Columbia, has been an advocate for families and communities most affected by health issues. His groundbreaking work in global HIV research, prevention, treatment and care was honored Nov. 8 by the American Public Health Association with the association’s Sedgwick Memorial Medal for Distinguished Service in Public Health.

Wafaa El-Sadr, MD, MPH
Wafaa El-Sadr

El-Sadr began her career as an infectious disease physician in Harlem when the HIV epidemic took hold in the United States in the early 1980s. She learned the lessons she learned in a course compulsory public health in medical school in Egypt a decade earlier to develop effective and innovative models of care to respond to HIV/AIDS in the community. In 2003, she founded ICAP at Columbia University Mailman School of Public Health to bring life-saving HIV treatments to resource-constrained communities in sub-Saharan Africa. Since then, she has expanded ICAP’s work to more than 40 countries around the world, tackling some of the most critical health challenges we face today.

We spoke with El-Sadr about his early days in public health and what people should know about public health.

You were a physician specializing in infectious diseases before entering public health. What first interested you in public health?

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

I think it’s been an eye opener 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 getting a glimpse of people’s lives outside of the structures of Health care. .

And it was a wonderful experience, because I learned so much from sitting with them in their home, talking to them, observing them and their children, assessing how they were doing, identifying their needs and seeing what they were doing well and what advice they needed. I vividly remember thinking there was so much more they needed and how complicated it was for them to navigate the healthcare system on their own.

When I was a young infectious disease doctor in Harlem at the start of the HIV epidemic, I thought back to those experiences long ago in rural Egypt. This led me to ask questions about the forces that have influenced the lives of my patients? What were they going through outside the clinic? How did they cope despite the enormous difficulties they faced? What did they really need from us compared to what we give them?

I think that was the beginning, the start of a journey to link public health with health care.

How has public health evolved since you entered the field? What do today’s students need to know?

I tell my students that public health has expanded and evolved over the past few decades. When you dig deeper into what public health practitioners and researchers are doing today, you’ll find them working in labs, developing new diagnostic tests. You will find them working on the mathematical modeling of diseases to guide our actions. You will find public health researchers who are behavioral scientists, seeking to understand what motivates people to engage in certain behaviors. You’ll see those working with specific populations and conditions, advancing maternal and child health, HIV prevention and care, environmental health, and addressing emerging infections and chronic diseases. Then there are those committed to the fundamentals of public health, surveillance, epidemiology, community outreach and engagement, and disease prevention and health promotion. .

Essentially, public health workers are everywhere, they are all around us, working to ensure our health today and the health of generations to come.

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

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

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

Public health work is what ensures that the air we breathe is clean, the water we drink is safe, our children are protected from deadly infectious diseases. Public health ensures that we are prepared for all health threats that arise, whether epidemics or climatic disasters.

I tell people that public health at its best is like a well-oiled machine humming in the background, indispensable but barely noticeable. This is part of the challenge for public health: when everything is going well, it means that public health is working very hard behind the scenes.

I perceive, however, that COVID-19 was a wake-up call. I am convinced that many more people today have a deeper understanding of what public health does, of its real impact on every minute of their lives, and that supporting public health is essential to our well-being. collective.

What motivates you to do the work you do?

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

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