Create Exchange 2003 server side rule without logging in as user
Using CDO and VBScript, you can interact with a given Exchange mailbox, as long as you have permissions to do so. For example, I have a script that scans a given mailbox for messages with a certain criteria, and then performs an action (run a program, send an alert, Etc). You don't need Outlook installed, just the relevant DLLs, which seem to get installed with the Exchange System Manager.
Some useful links: http://msdn.microsoft.com/en-us/library/ms526914(v=EXCHG.10).aspx and http://gsexdev.blogspot.com/2006/11/creating-server-side-rule-to-move.html.
Essentially, you create a MAPI session, logon, and then interact with the mailbox. For example, I enumerate the message objects in the inbox, examine the subject and from-address and then go from there.