Candidates nominated for top WHO post: Profile of Prof. Ismail Sallam
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Dear Sir,
First of all, I would like to congratulate you for the publications
and the articles which are well presented in the AFRO-NETS.
Referral to my (Dr. Ismail Sallam) nomination as a candidate for the
Post of the Director General of the World Health Organization, I ap-
preciate if you publish my profile and vision.
With my best regards,
Ismail Sallam
Former Minister of Health and Population
Egypt
mailto:isalam@idsc.net.eg
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Professor Ismail Sallam, M.D., Ph.D., FRCS
Qualification for the Post of Director General of the World Health
Organization
Professor Ismail Sallam's professional career is distinguished by a
longtime involvement in international health and development-related
issues. He served his country as Egypt's Minister of Health and Popu-
lation from 1996 until 2002. His experience in the health-policy
arena at the national and international levels allowed him to acquire
a precise view of the health-related challenges and problems facing,
not only Egypt, but also many other countries. Internationally, his
active involvement in the World Health Organization (WHO) Governing
Bodies, the Arab League, the Organization for African Unity (OAU) and
South-to-South Partners, has familiarized him with both the strengths
and the weaknesses in the structure and performance of the WHO, as
well as the global health community.
1. Technical and Public Health Background and Experience in Interna-
tional Health
Dr. Sallam had a distinguished career where he was assigned high
level administrative duties in addition to educational, and research-
related responsibilities. He took several leading roles for health
planning and policy formation in Egypt. He supervised many projects
related to medical education reform, establishment of community medi-
cine and projects for heart diseases prevention and control. Specifi-
cally he led an extensive work on the prevention of rheumatic heart
diseases in rural areas.
Dr. Sallam�s commitment to community and public health began during
the 60�s. As a leading figure in the University�s Student Union, he
enlisted the participation of local communities in immunization cam-
paigns and in other preventive national health programs.
Dr. Sallam devoted a large part of his professional career to aca-
demic and applied research both in medicine and public health. He
contributed to 104 scientific publications, along with 150 publica-
tions released by the Ministry of Health and Population under his
leadership. Among these studies, there has been leading work on in-
fection control, antibiotic abuse, hepatitis, blood hemolysis, repro-
ductive health and health strategies. He supervised 176 theses for
Masters, M.D. and Ph.D. degrees.
As early as 1980, he chaired three NGOs that collectively worked on
raising health and social conditions in remote Egyptian areas. In his
capacity as chairman, he played a leading role in creating an effi-
cient blood donation system for Cairo in 1985. In 1998 these efforts
formulated the basis for a major joint Swiss- Egyptian Project cover-
ing the whole of Egypt. Additionally, his efforts in another NGO
amounted to the introduction of Family Doctor Primary Health Care in
his own village. A third NGO was formed in 1989 to initiate holistic
women development utilizing reproductive health, family planning, and
illiteracy programs. These early contributions comprised an important
part of the vision for the health strategy undertaken by Egypt in
1996.
On the regional and international fronts, Dr. Sallam was highly ac-
tive. Between 1996 and 2002, he chaired: the Executive Board of Arab
Minister of Health, the South to South Initiative for Population and
Development for four years; and the 1999 Sixth Conference of African
Ministers of Health.
Over the last 20 years, Dr. Sallam was able to establish strong chan-
nels of healthcare finance from national and international donors and
collaborators. He was able to attract several donors and partners,
whose joint efforts contributed greatly to Egypt�s Health Reform pol-
icy.
A sustainable program of Gambia mosquito control has been in action
in bilateral cooperation between Egypt and Sudan.
2. Competency in Organizational Management
Throughout his career, Dr. Sallam showed exceptional managerial
skills, assuming several leading positions in various organizations
including: University, Health Institutes, National Democratic Party,
as well as numerous institutions within the Egyptian private sector
and civil society. Dr. Sallam established a professional training
program for health care and he played a key role in the introduction
of several medical technologies to the Middle East. He helped in the
creation of Kuwait Medical School. Dr. Sallam gained a rich experi-
ence through his involvement in the planning and the management of
many projects in developing countries. Dr. Sallam has been a member
of the Upper House of the Egyptian Parliament for 15 years. He served
as the Majority Leader before his appointment as the Minster of
Health and Population in 1996.
In his capacity as Minister of Health and Population, Dr. Sallam suc-
ceeded in:
(1) Creating a coherent applicable vision that serves all Egyptians;
(2) Developing a management information system that allowed for im-
provement in the ministry�s system of planning, monitoring and
evaluation. The introduction of new technologies gave room for more
effective policy-making support inside the public healthcare estab-
lishment;
(3) An effective human resources development program was established
encompassing the training of existing staff and recruitment of well
trained highly qualified personnel. The program also featured an ad-
vanced performance-based system for evaluation and incentive setting;
(4) Quality management was introduced with a system of accreditation
and certification;
(5) Dr. Sallam overcame serious budgetary constraints by creating new
international as well as domestic channels for health care finance;
(6) He introduced new management and financial concepts to health in-
stitutes to promote independence, create economic autonomy and allow
cost recovery;
(7) Dr. Sallam established the board for medical ethics, research,
and for the introduction of new therapeutic and technical modalities;
(8) Inside the Ministry of Health and Population, he consolidated the
role of women within the sphere of leadership and decision-making;
(9) He solidified the Egyptian government�s commitment to interna-
tional cooperation on the medical and healthcare tracks.
3. Proven Historical Evidence for Public Health Leadership
During his 6-year term as Minister of Health and Population (1996
2002), Dr. Sallam changed the image of public Egyptian health care
system. On the political front, he succeeded in prioritizing his
healthcare reform strategy on the national agenda, which addressed
the alleviation of disparities in health in a holistic approach. He
increased the yearly spending on public health by 10-15% compared to
curative care. An efficiently distributed network of facilities for
primary health care, public health, and laboratories were established
especially in remote and deprived areas. He instituted proper sur-
veillance and monitoring system and developed professional human re-
sources programs and certification. Some of the major achievements
included:
(1) Nearly 100% accessibility of the Egyptian population to quality
primary healthcare services after the introduction of mobile clinics
program which served slums and remote areas;
(2) Rise of immunization coverage from 79% in 1995 to 98% in 2002;
(3) Successful containment of epidemics (typhoid, meningitis and sum-
mer diarrhea) that jeopardized the health of the Egyptian people
prior to 1996;
(4) Increased life expectancy and improvement of all vital health
statistics;
(5) Nutritional Supplements were taken in consideration in areas
showing deficiencies;
(6) 50% drop occurred in the number of children with stunted growth
between 1995 and 2000;
(7) National program for disability control was widely implemented.
The program included control of mental retardation in newly born by
testing of thyroid hormone deficiency;
(8) 55% fall in maternal mortality rate within seven years;
(9) Marked reduction of most of infectious and endemic diseases, such
as elimination of whooping cough, Diphtheria, Anchylestoma; reduction
of incidence of Bilharziasis from 15% (1995) to 3.5% (2001);
(10) Launching of several disease control programs including Filaria-
sis and Trachoma, (Collaboration between WHO, Industrials and NGOs).
The significant improvements in key health indicators allowed Egypt
to rank 43rd position on the international index of health perform-
ance. The index reports how efficiently health systems translate ex-
penditure into health as measured by disability-adjusted life expec-
tancy (WHO, 2000).
Dr. Sallam led major successful inter-sectorial cooperation as he co-
ordinated the efforts of various governmental institutions on the in-
ternational and local levels, in order to improve water and food
safety and to limit environmental pollution. In this context, the Na-
tional Water Developmental Program was founded allowing for continu-
ous surveillance of the public health water supplies. Another major
achievement that was attained through this same inter-sectoral coop-
eration and community mobilization was control of Malaria in Egypt
in1998.
Dr. Sallam managed to incorporate all neonates and preschool children
under the umbrella of the National Health Insurance System (NHI) be-
ginning 1997. He assigned NHI new tasks pertaining to preventive pub-
lic health such as: early detection of diseases; continuous monitor-
ing of children growth, nutritional status, vaccination, and disease
surveillance; and public health services for schools and their sur-
rounding environments. He launched the Healthy Egyptians 2010 Initia-
tive, a comprehensive agenda for health promotion, and disease pre-
vention for the 21st Century. The scope of the agenda covered: smok-
ing, obstacles to a healthy life style, accidents and environmental
health problems. Dr. Sallam established two T.V. Channels, one for
public health education and another for healthcare and medical pro-
fessionals. Internet networks were made available in every healthcare
facility all over the country. In collaboration with local and inter-
national institutions, he promoted numerous research studies address-
ing Egypt�s public health problems and challenges.
4. Sensitiveness to Cultural, Social and Political Differences
Dr. Sallam birth in rural area, his upbringing in Cairo, completing
his training in Britain and USA as well as working in several devel-
oping countries exposed him to a variety of cultures and societies.
This allowed him to acquire a unique ability to manage and overcome
cultural, social, religious and political differences. His major in-
volvement in the civil society attracted them as strong partners. As
a parliamentarian, he easily grasped the public�s confidence as he
worked to fulfill their demands, being able to skillfully manage po-
litical and cultural differences. Dr. Sallam instituted a high com-
mittee for mass communication that was able to establish a strategy
for utilization of media to address health and population sensitive
issues.
Dr. Sallam is a strong advocate for arts and sports as part of health
promotion. He has been a member of the Board of the Opera House for
the last 15 years. He developed sporting clubs for health employees
and introduced sports and music in the rehabilitation programs of the
mental hospitals. He supported art exhibitions and national prizes
for adolescents as part of health education programs for youth. This
encouraged them to share in community health education.
Dr. Sallam was determined to tackle gender-inequality inside under-
privileged groups. In this regard, he took important and crucial de-
cisions, including the issuing of a historical ministerial decree
banning Female Genital Mutilation (FGM). He was able to establish
credibility to his decisions through cooperating with civil society;
a consortium of NGOs was formed in every governorate and training
programs were established for both Muslim and Christian religious
leaders on health and population issues.
In a unique initiative, he was able to establish humanitarian aid, at
the international and domestic levels, a systematic, continuous com-
ponent of the ministry's long-term activities. This policy was based
on Dr. Sallam�s strong belief that patent humanitarian channels could
relieve many political or cultural disagreements.
Dr. Sallam received many awards in recognition of his achievements
which include:
(1) Award of the American Academy of Emergency Medicine, 2001;
(2) The United States Surgeon General�s Medallion, USA, September
2000, for leadership in developing a National Disease Prevention and
Health Promotion Agenda for Egypt;
(3) United Nations Population Award for the Year 2000 (on personal
basis);
(4) Award of the United Arab Emirates Foundation Prize, WHO for the
year 1999;
(5) The Order of Merit from the Libya Jamahiriya, 1999;
(6) WHO commemorative medal and certificate on the occasion of �World
No Tobacco Day�, Brazil, 1998;
(7) International Achievement Prize form the Arab Women Organization,
1997;
(8) Honorary Fellowship of Royal College of Surgeons and Physicians,
Glasgow 1997;
(9) Golden Medal of the Egyptian Medical Association, 1985.
5. A Strong Commitment to the Work of the WHO
Dr. Sallam vision and policies, whether in formulation or implementa-
tion, were all in accordance with the objectives of the WHO as
spelled out by its constitution. He believes these objectives are as
valid today as they were when the WHO was created. There may be a de-
mand for new tools and technologies, yet our commitment to these
original objectives must not be compromised. 'Health for All' was
taken seriously by Dr. Sallam as he became the Minister of Health and
Population of Egypt.
Dr. Sallam has actively contributed to the World Health Organization
activities over many years. His input includes the following:
In 1994, he participated in the Commission on Women�s Health.
He chaired the second meeting of the Directors General�s Task Force
on Malaria Prevention and Control in Cairo in October 1997. He sup-
ported the efforts of the African Ministers of Health in tackling ma-
laria through the mobilization of all resources toward a common goal.
He was a member of the Executive Board of World Health Organization
during the period from 1996 till 1999 and from January 2002, he was
selected for membership in the Auditing Committee. He led many of the
discussions on vital health issues.
In November 2001, he presented his vision on the issue of the acces-
sibility of pharmaceuticals during the World Health Organization, Ex-
ecutive Board Retreat in Florence, Italy.
He was elected Chairman of the Board of Partners in Population and
Development in November 1998. This organization utilized a South-to-
South approach as well as North to South Cooperation. It included 14
countries, which shared and exchanged information and experiences.
Ismail Sallam was born in July, 1941 in Menofia, Egypt. He is married
to Wafia Eteiba, herself a professor of cardiology, and they have
three sons.
Dr. Sallam obtained his M.D. with Honors in 1964 from Ain Shams Uni-
versity, Cairo. He earned his PhD in Medicine from University of
Glasgow in 1973.
He was appointed as a lecturer in the University of Glasgow in 1970,
Associate Professor in Kuwait University in 1975, Professor in Ain
Shams University since 1980. From 1985 to 1992, Dr. Sallam chaired
the Health, Population and Environment Committee both at the National
Democratic Party and the Upper Chamber of the Egyptian Parliament. In
1992, he was chosen as the Majority Leader in the Parliament. From
1996 to 2002, he was appointed as the Minister of Health and Popula-
tion.
Challenges, vision and approach for the WHO
Challenges
In spite of all the major progress and breakthroughs in health care,
the world is facing formidable challenges that must be carefully ad-
dressed by the WHO. To this moment a considerable portion of the
world�s population have little or no access to health care services.
The growing gap between the rich and the poor, gender related ine-
qualities, educational and geographical disparities together have
added significantly to ill health and hence to world misery. The
marked deficiencies and inequalities in public health and primary
health care services in many parts of the world have undermined the
potential for sustainable development. Such a problem is compounded
by the occurrence of demographic, epidemiological and nutritional
transitions, in addition to resource deficiencies and the rising cost
of public health services.
Today we are faced with a reality in which HIV/AIDS, Malaria and
T.B., unfinished agenda of communicable diseases along with the
emerging communicable and non-communicable diseases, all present a
strong threat to a huge portion of the world�s population, eroding
the prospects for any conceivable growth or progress. Maternal and
child mortalities embody an equally menacing hazard in many parts of
the world. Accidents, smoking, illicit drug use, unhealthy lifestyles
and all self-inflicted harms represent virulent challenges to health
and life.
Vision
Dr. Sallam will base his leadership of the WHO on the premise that
health is the basis for any sustainable development, human rights and
human security. In a world full of diversities and differences,
health could be the center in bringing us together and a way to help
mend a fractured world. Dr. Sallam believes that the benevolent po-
tentials of health in realizing welfare in our world have never been
utilized to the fullest. Health could be the bridge that crosses po-
litical differences and cultural barriers to alleviate poverty and to
overcome gender inequalities. �Health for All� has been a long time a
WHO goal. Although much has been done in this regard, there still re-
main many constraints hindering the fulfillment of this noble, yet
essential, obligation. Diseases prevention, health promotion and Mil-
lennium Development Goals (MDGs) demand new strategies from solidi-
fied WHO and all partners. This necessitates serious collective ef-
forts on the part of the global community along with the WHO. Rich or
poor countries, local or international organizations and institutes
should all join together to develop a Global Health System that could
enable the fulfillment of our international health goals. The WHO
should strengthen its position towards health ethical issues, inter-
national health regulations and legislations.
Approach
I. Role of WHO in Global Health:
1- Leadership and Advocacy: The significant changes on the world
stage, whether political, economic or social, provide a demand for a
WHO that could assert a strong leadership in promoting health in or-
der to:
Prioritize health on a complex and highly politicized global agenda.
Maximize the unexplored potentials of the Global Health System in al-
leviating poverty, cultural and gender disparities.
Utilize health as a strong channel for peace and human security.
2- Strengthen Partnership at Global Level:
WHO should provide a Forum for Global Health, inviting all interna-
tional partners to reach a consensus on how to promote and maximize
the benefits for vulnerable groups around the world.
Development of a Global Health System that could:
(1) Respond promptly and effectively to priorities such as combating
HIV/AIDS, Malaria, T.B. etc.;
(2) Fulfill MDGs; and
(3) Provide an insightful guide for effective monitoring, evaluation
and modernization at global and state levels.
Instituting an effective and timely mechanism for responding to emer-
gencies, natural hazards and disasters that may compromise the qual-
ity of global health.
In a cooperative partnership with all the relevant actors and insti-
tutions, WHO must monitor, predict and work on preventive measures
for all potential hazards that may generate ill health or disease
proliferation.
3- Development of strong evidence base. This could be utilized all
over the world for policy makers and governing bodies and other part-
ners in planning health system development, resources mobilization,
allocation, and to improve managerial process. The information base
should ensure two ways utilization, effective surveillance and moni-
toring, consultation on health problems with effective communication
and Tele-Health.
4- Setting the standards and norms improves the technical excellence
to support the health program at country, regional and global levels.
5- Health Research: WHO should energize stronger collaboration be-
tween various academic and health institutions to formulate a valid
agenda for Global Health Research. There is an imperative need to en-
hance the problem-solving capacity on the global and country levels,
which requires effective strategies. Twining approaches between vari-
ous research institutions that link developed and developing coun-
tries should be promoted to cover the needed research on social and
orphan drugs issues.
II- Effective and Integrated WHO:
1- Governing bodies: Active participation of countries and regions
within the organization in a collective manner to optimize the reach
and the effectiveness of the WHO global health policies and recommen-
dations. WHO should address the concerns and aspirations of its dif-
ferent members in a democratic manner, maximizing the utilized input
and effort of every member state.
2- Reshaping the WHO managerial structure:
(1) Collective management and active participation at the regional
and state levels;
(2) Improved management and decision making based on sound informa-
tion system;
(3) Ensuring greater transparency through improved planning, trans-
parent allocations and proper financial management including internal
and external auditing;
(4) Regular reporting on recruitment and technical reports on program
implementation;
(5) Investment and promotion of leadership structures, setting the
standards, norms and guidelines for all divisions. The performance of
WHO personnel cannot be expected to reach a level of excellence
unless they are provided with an insightful supportive leadership, a
suitable working atmosphere as well as performance-based incentives.
III- Strengthening the role of countries:
(1) Support for political commitments with evidences and reasons;
(2) To ensure the priority of establishment of quality public health
and primary healthcare services and to maintain the necessary support
for such development;
(3) Child and maternal health should be well addressed;
(4) Comprehensive women health care should be an important component
of primary health care;
(5) Facilitate and provide technical support for projects in collabo-
ration with international donors in the formulation or in implementa-
tion and resources mobilization;
(6) Give greater attention to human resources development;
(7) Support inter-sectoral, private and community participation;
(8) Support bilateral or multilateral cooperation between countries
sharing similar health problems.
Priorities of the new WHO Director General:
It is important to differentiate between the Organization�s priori-
ties, as set by the Organization�s governing bodies, (Health Assem-
bly, Executive Board and Regional Committees), and the DG�s priori-
ties as head of the WHO Secretariat. The WHO Director General should
build up on the achievements of predecessors.
His priorities must feature a commitment to equity and alleviation of
disparities. Public health and primary health care systems should be
the corner stone at the state and global levels. The DG should focus
on:
* Strengthening WHO�s leadership in promoting global health as an in-
tegral component of a global system for human development and secu-
rity.
* Promoting political commitment and partnerships for health at na-
tional, regional and global levels.
* Developing a strong evidence base to enable policy-makers and gov-
erning bodies to make sound decisions on health system development,
and resource mobilization and allocation, and to enable them to im-
prove managerial processes.
* Developing a global system that can respond efficiently to the vast
range of international health challenges, from emergency and disaster
management through to recent advances in technology development, for
example.
* Providing strong technical support to the health programs identi-
fied by countries and governing bodies as priorities, such as
HIV/AIDS, Malaria, Tuberculosis, vaccine-preventable diseases, child
health and essential medicines.
I wish to emphasize once more that the above would be my priorities
as head of the WHO secretariat. My strategies would include:
* Collective management of the Organization with active participation
of Regional Directors and Countries.
* Strengthening partnership at the global level. WHO should provide a
forum for global discussion to reach consensus on how the various
partners can best promote global health, especially the health of
vulnerable groups.
* Improved management processes within the Organization based on
sound information systems and transparent financial management.
* Improved technical support to health programs at country, regional
and global levels. This should be based on strong presence at country
level and efficient technical support systems. Implementation should
also include a shift in resources, both financial and human, from HQ
to regional and state country levels.
Prof. Ismail Sallam
Osman Towers
Roxy, Heliopolis
Cairo, Egypt
Tel: +20-2-451-7777 - +20-2-792-7777
Fax: +20-2-450-5353 - +20-2-792-8888
mailto:isalam@idsc.net.eg
or
mailto:iasallam@hotmail.com
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