I am writing as a Professor of Community Medicine who recognizes the importance of giving attention to health promotion, primary health care and community oriented programs and who witnessed an excellent model of transformation from ideas to vision to actions in reality. It is crucial to have the leadership that can transform ideas into reality. This is actually what I recognized in Prof. Ismail Sallam, Former Minister of Health (1996-2002). I knew him for more than 20 years and I worked closely with him for 6 years as Director of the Technical Support Office at the Ministry (1996-2002).

Prof. Sallam was born in a rural area of Menofia Governate in Egypt, where he was exposed to underserved populations and developed a deep understanding of their culture. He went on to complete his medical education in Cairo, Egypt where he was exposed to medical and public health issues in large urban and metropolitan areas. Prof. Sallam went on to complete his advanced medical training in the United Kingdom and the United States. His training provided him with more than superb clinical skills and academic training, his diverse training offered an understanding of different health care systems and instruction in solving public health issues. This experience propelled Prof. Sallam to be asked to join as a major contributor to creating the health care in system in Kuwait. 

Prof. Sallam returned to Egypt to implement his philosophy on health, which is a holistic approach to medicine. He recognizes that health doesn’t exist in isolation from other environmental factors and any health care policy must be combined with concomitant measures to improve social, economic and cultural challenges.  These include measures such as building schools, initiating adult literacy programs, vocational training and increasing job opportunities. In addition he emphasized programs promoting public health outside of the hospital or clinic setting, for instance creating programs for health education in the community and encouraging safe recreational activities among children and youth.

In recognition for his novel approach and relentless effort in tackling public health issues, Prof. Sallam was elected to head the Committee on Health and Environment in Egypt’s ruling National Democratic Party. He utilized his position to recruit the efforts of different organizations to further Egyptian Health Care. Prof Sallam is credited with combining the efforts of private health institutions and Non-Government Organizations with those of government institutions. This facilitated programs that capitalized on NGOs familiarity with community needs and rapport in providing services in the community. This included outreach projects that facilitated and sponsored state-employed and private physicians to provide regular care in underprivileged areas of Egypt. It was around that time that I began observing Prof. Sallam’s approach to implementing ideas that brought together often dueling political partners, but more importantly brought about meaningful change and results.

When he became a Minister of Health and Population, I had the privilege of being involved in the most of the process of health sector reform in Egypt from planning to the start of implementation. I was watching his way of developing the ideas from all his experiences and from the proper assessment of the needs of the community. Prof. Sallam continued to engage more partners in improving Egypt’s health care and challenged the trend by involving young minds to solve problems and implement change.

Prof. Sallam used available technical and financial resources to transform his vision to a master plan to start actions in every direction. He was innovative in creating new sources of funding, by involving both governmental and non-governmental partners.  Due to many challenges facing his optimistic plans and willingness to improve health, he put a short-term plan to target high risk areas and hot spots. At the same time, he was following scientific methods to a long term plan targeting comprehensive health sector reform and alleviation of disparities (gender, socioeconomic and geographical).

He believed that primary health care is the main carrier for all the existing vertical programs. He was successful in integrating family planning program, schistosomiasis control programs, maternal and child health services in the family doctor approach. This vision helped to markedly reduce health mortality indicators in the country. A model for this approach included the historically high maternal mortality rate in Upper Egypt. After implementing of the above strategy with a tailored cultural approach to the region, the maternal mortality declined in subsequent years. 

I was amazed not only by the cooperation he instilled between different institutions and his method of implementing programs, but also by the speed at which these program produced results and made an impact on society. The creation of centralized blood banks and cancer referral centers provided those living in rural and underserved areas with equal access to services previously limited to major cities. Prof. Sallam was the first to implement projects targeting health insurance reform and quality improvement programs to monitor and improve the care delivered nationally. In addition, he founded a national medical record system to improve patient care and monitoring of health and quality indicators. Prof Sallam was a staunch supporter of utilizing information technology for use in health care and health education. He oversaw the development of distant learning programs, utilizing mass media to further public understanding of health issues, and creation of two T.V. channels targeting health care professionals for continuing medical education.

He did not limit his efforts and contribution to Egypt but expand to other countries in Africa and Arab countries. He was a leader in the South to South initiative and led many humanitarian missions to several countries.

Realizing the importance of partnership between governmental and non-governmental agencies in targeting women advancement in rural health facilities. A training program was established for the NGOs and the natural leaders to explore the unutilized potentials in the community.  Plans were drawn to create a program that aimed to advance women’s health

Women's clubs were established in affiliation with hospitals and clinics nationwide. They offer social, educational and vocational services to help raise health awareness, economic standards, and promote environmental issues in Egyptian villages. The project was the first step in multiple projects that came out from the MOHP to create a new potential for the advancing women’s health issues, alleviation of socioeconomic and geographical disparities. These programs were the catalyst that motivated female community leaders to rise and become more involved politically. Those leaders became innovators of their own, creating programs to address areas of need for women in their community. Nationally they also became partners in advancing causes of reproductive health issues both by directly engaging in their community and exposure in mass media.

Prof. Sallam was able to overcome many cultural, social and political differences that constrained the health policy establishment through a unique approach that dealt with sensitive and controversial issue. He was highly determined to tackle gender-inequality issues in underprivileged populations. He took important and crucial decisions, which surpassed most of his predecessors’ policies in weight and boldness. In 1996, Prof. Sallam bravely issued a historical Ministerial Decree abolishing Female Genital Mutilation (FGM). The sensitivity and delicacy of this controversial issue discouraged all former health officials from approaching this problem. He took on legal challengers until his decision was finally upheld by the High Constitutional Court in recognition of the legitimate demand of every Egyptian woman. Furthermore, all major health projects were reshaped with a holistic approach in order to take into consideration critical women’s health-related issues.

All of the above added to the achievement made by the Ministry of Health and Population under the leadership of Dr. Ismail Sallam. There were dramatic changes in general health indicators and women’s health; such as maternal mortality that dropped by 55%. In recognition of his efforts, Prof. Sallam was the recipient of 2000 UNFPA prize in women advancement and alleviation of gender disparities

I was honored to work with Prof. Sallam in accomplishing many of these achievements, which not only improved health care for Egyptians but also served as a model for improving the well being of underprivileged and underserved groups worldwide.