On 7 November 1987, doctors attending to President Bourguiba filed an official medical report declaring him medically incapacitated and unable to fulfill the duties of the presidency.
Ben Ali, as the next in line to the presidency, removed Bourguiba from office and assumed the presidency himself.
The day of his accession to power was celebrated annually in Tunisia as New Era Day.
Two of the names given to Ben Ali's rise to the presidency include "the medical coup d'état" and the "Tunisian revolution".
Ben Ali favoured the latter.
In conformity with Article 57 of the Tunisian Constitution, the peaceful transition occurred.
The country had faced 10% inflation, external debt accounting for 46% of GDP and a debt service ratio of 21% of GDP.

In 1999 Fulvio Martini, former head of Italian military secret service SISMI, declared to a parliamentary committee that "In 1985 to 1987 we organized a kind of golpe in Tunisia, putting president Ben Ali as head of state, replacing Burghiba (the Italian spelling of the name) who wanted to flee".
Bourguiba, although a symbol of anti-colonial resistance, was considered incapable of leading his country any longer, and his reaction to the rising Islamic integrism was deemed "a bit too energetic" by Martini; Bourguiba's threat to execute the suspects might have generated strong negative responses in neighbouring countries.
Acting under directives from Bettino Craxi, Italian Prime Minister, and foreign minister Giulio Andreotti, Martini claims to have brokered the accord that led to the peaceful transition of powers.

Bettino Craxi had visited Algiers in November 1984, and was warned by president Chadli Benjedid that Algeria was ready to invade that region of Tunisia that was crossed by the pipeline towards Italy, if Bourguiba was not able to guarantee the stability of his own country.
Algeria was trying to diversify its foreign policy, feeling isolated by Spain and French President François Mitterrand's accord with Morocco and Libya over Chad.
For two years, according to Martini, Italian and Algerian secret services worked together in order, on one hand, to avoid the growing destabilisation of Tunisia spilling over into Algeria, and on the other hand to control pro-Palestinian activities in Italy.
Finally, Ben Ali was singled out as possible replacement for Bourguiba: as chief of the Tunisian secret services and as Minister of the Interior, he had opposed plans to execute Islamic fundamentalists.
SISMI's action did not have the consent of René Imbot, head of the French secret service, and the USA allegedly was not informed.

According to Martini, the SISMI did not have an operational role in Ben Ali's rise to power, but organised a move to support his new government politically and economically, preventing Tunisia from falling into an open confrontation with fundamentalists, as happened in Algeria in the following years.
On 7 November 1987, doctors attending to President Bourguiba filed an official medical report declaring him medically incapacitated and unable to fulfill the duties of the presidency. Ben Ali, as the next in line to the presidency, removed Bourguiba from office and assumed the presidency himself. The day of his accession to power was celebrated annually in Tunisia as New Era Day. Two of the names given to Ben Ali's rise to the presidency include "the medical coup d'état" and the "Tunisian revolution". Ben Ali favoured the latter. In conformity with Article 57 of the Tunisian Constitution, the peaceful transition occurred. The country had faced 10% inflation, external debt accounting for 46% of GDP and a debt service ratio of 21% of GDP.
In 1999 Fulvio Martini, former head of Italian military secret service SISMI, declared to a parliamentary committee that "In 1985 to 1987 we organized a kind of golpe in Tunisia, putting president Ben Ali as head of state, replacing Burghiba (the Italian spelling of the name) who wanted to flee". Bourguiba, although a symbol of anti-colonial resistance, was considered incapable of leading his country any longer, and his reaction to the rising Islamic integrism was deemed "a bit too energetic" by Martini; Bourguiba's threat to execute the suspects might have generated strong negative responses in neighbouring countries. Acting under directives from Bettino Craxi, Italian Prime Minister, and foreign minister Giulio Andreotti, Martini claims to have brokered the accord that led to the peaceful transition of powers.
Bettino Craxi had visited Algiers in November 1984, and was warned by president Chadli Benjedid that Algeria was ready to invade that region of Tunisia that was crossed by the pipeline towards Italy, if Bourguiba was not able to guarantee the stability of his own country. Algeria was trying to diversify its foreign policy, feeling isolated by Spain and French President François Mitterrand's accord with Morocco and Libya over Chad. For two years, according to Martini, Italian and Algerian secret services worked together in order, on one hand, to avoid the growing destabilisation of Tunisia spilling over into Algeria, and on the other hand to control pro-Palestinian activities in Italy. Finally, Ben Ali was singled out as possible replacement for Bourguiba: as chief of the Tunisian secret services and as Minister of the Interior, he had opposed plans to execute Islamic fundamentalists. SISMI's action did not have the consent of René Imbot, head of the French secret service, and the USA allegedly was not informed.
According to Martini, the SISMI did not have an operational role in Ben Ali's rise to power, but organised a move to support his new government politically and economically, preventing Tunisia from falling into an open confrontation with fundamentalists, as happened in Algeria in the following years.
Zine El Abidine Ben Ali