Q and A
From humble beginnings in a small village in Uganda to director-general of the Swedish Institute of Public Health, Sarah Wamala now has set her sights on collaborating with IANPHI to strengthen national public health institutes in other parts of the world
IANPHI WORLD recently chatted with Dr. Wamala about her life’s journey and new destinations
Tell us about your journey in public health—where did you grow up and what influenced you to make public health a career?
I grew up in a household of two strong women in Kituntu, a small village in Uganda. I had five brothers and sisters. There was a tradition of education in my family. My grandmother was the village midwife—she could not read or write but she taught mothers about nutrition and hygiene and delivered many children to the world. My mother was a schoolteacher. They wanted me to be a physician, but when I went to visit the government hospital, I was terrified by what I saw. There were no doctors, because the government could not pay them. I told my mother that I could not’t be a doctor because we needed to solve our economic problems first. That is why I studied economics at Makerere University in Uganda and then came to Sweden as a refugee when I was 23 years old and earned a Masters in biostatistics at Stockholm University and a PhD in medicine with a focus on public health sciences from the Karolinska Institute in Sweden.
What's your vision for Sweden's $150,000 collaboration with IANPHI? Why is Sweden involved in this effort?
IANPHI is a great network with a lot of potential. The work that’s been done by IANPHI over the past years is very good, and I think we can partner together on issues such as strategic strong leadership in public health and capacity building. We can solve a lot of challenges through cross-cutting multi-sectoral global partnerships and IANPHI provides a great platform for partnerships. I would especially like to involve young leaders in this work and concentrate on countries that are in great need, such as in Sub-Saharan Africa.
Why is strong and strategic leadership important for the future of public health?
There is a lot of focus on strong corporate leaders, but we need to teach managerial skills and tactics to social leaders as well. We need to think strategically about investments in public health—how we invest and the long-term outcomes of those investments. And the leaders in public health can play a substantial role – balancing science, politics and finances.
For example, in Sweden 30% of young people don’t go to high school because they don’t have good enough grades. That has a social impact on economic development and growth as well as health so it’s important to get those young people into high school or in technical training. Our institute coordinates programs that support a good start in life.
You’ve also endorsed science-based public health as the key to strategic investment in public health and improvement of population health. Why?
Science-based public health decisions prevent suffering and save money.
In Sweden, we’ve shown decision-makers that prevention is as important as treatment. For example, premature deaths from high blood pressure, cardiovascular disease, diabetes and other noncommunicable diseases (NCDs) can be prevented. We have adopted techniques to grade the scientific evidence in public health programs that can minimize risks.
What do you see as key issues in global public health in the 21st century?
In addition to strategic investment, strong leadership in public health, and balancing science and politics, responding to the challenges of NCDs is critical. More people are living longer, and with NCDs outpacing infectious diseases as our population ages, there will be more demands on the healthcare sector. Low-income countries especially face a double burden of both NCDs and communicable disease. We also need to think about how to involve more young people in public health issues. The young are concerned about health, global warming and the environment, so this is a good opportunity for education and capacity building.
What has given you the most satisfaction in your career?
It is very beautiful to me that public health is no longer a left wing issue in Sweden. The people here understand that we must invest in public health. Our institute budget has not been cut since I have been director (five years) because our government has made evidence-based decisions and is attuned to the importance of investing in public health. I am grateful that we have the resources to continue strengthening public health and reaching out to other countries through IANPHI.
Also, my mother died at age 47 in Uganda and life expectancy there is not much better today. In Sweden life expectancy is 80 for men and 84 for women. Statistical prognostic models show that every child born today in Sweden will live until 100 years and we can only imagine the implications of such longer lives. I can just say that public health leaders and workers are doing the right job.
Read more about Dr. Wamala and the Swedish National Institute of Public Health at http://www.fhi.se/en/.