Wafaa El-Sadr: Public Health is All Around, All the Time

November 9, 2022

For more than four decades, Columbia’s Wafaa El-Sadr, MD, MPH, MPA, has advocated for families and communities most impacted by health challenges. Her 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 as the HIV epidemic took hold in the United States in the early 80s. She took the lessons she learned in a required public health course in medical school in Egypt a decade earlier to develop successful and innovative models of care for responding to HIV/AIDS in the community. In 2003, she founded ICAP at Columbia University Mailman School of Public Health to bring lifesaving HIV treatments to resource-challenged 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 her start in public health and what people should know about public health.

You were an infectious disease physician before entering public health. What first interested you about 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 distinctly that we would go once a week by bus to a very small village and visit with our assigned family in their very modest home.

I think that was an eye-opener for me in terms of thinking about what happens to people outside their encounters with us in a clinic or in a hospital and getting a glimpse into people’s lives outside the health care structures. .

And it was a wonderful experience, because I learned so much by 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 right and what they needed some guidance on. I vividly recall thinking that there was so much more that they needed and how complicated it was for them on their own to navigate the health system.

When I was a young infectious disease physician in Harlem at the beginning of the HIV epidemic, I would think back to those long-ago experiences in rural Egypt. This led me to ask about the forces that influenced my patients’ lives? What were they experiencing outside the clinic? How were they managing despite enormous hardships they faced? What did they really need from us versus what we're giving them?

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

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 dig deeper into what public health practitioners and researchers do today, you will find them working in laboratories, developing new diagnostic tests. You will find them working on 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 adopt certain behaviors. You will see those who work with specific populations and conditions, advancing maternal child health, HIV prevention and care, and environmental health, and tackling emerging infections and chronic diseases. Then there are those who are engaged in the fundamentals of public health, surveillance, epidemiology, community outreach and engagement as well as in disease prevention and health promotion.

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

woman standing and speaking to a group of seated people
Wafaa El-Sadr discusses health system strengthening at a planning meeting for a 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, that our children are protected against deadly infectious diseases. Public health makes sure that we are ready for any health threats that come along, whether they be epidemics, or climate disasters.

I tell people that public health at its best is like a well-oiled machine humming in the background, indispensable, but barely perceptible. That's part of the challenge for public health: When all is well, that means public health is working very hard behind the scenes.

I do perceive, though, that COVID-19 was a wake-up call. I trust that many more people today have a deeper understanding of what public health does, how it really impacts every minute of their lives, and that support for public health is critical to our collective well-being.

What motivates you to do the work you’re doing?

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


Wafaa El-Sadr, MD, MPH, MPA, is University Professor in the Departments of Epidemiology and Medicine; executive vice president, Columbia Global; and the Dr. Mathilde Krim-amfAR Chair in Global Health.