VODI

Prevention is better than cure. It’s cheaper too. In fact, preventing future illnesses and preventing complications from existing conditions, are vital to the future sustainability of health systems. For a vaccine that prevents measles, or a medication that prevents a heart attack, the value is obvious. But what about the value of learning that you are at risk of heart attack? This information could trigger changes in behaviour and lifestyle that reduce the chances of hospitalisation or death. What about the value of regularly monitoring your blood glucose if you have diabetes? This could prevent profoundly negative (not to mention expensive) complications such as blindness, amputation or stroke. And what about the value patients and society gets when a clinician knows whether to use an antibiotic – and which one to choose. Not only does this enhance the patient’s chances of a timely recovery, it supports responsible use of antimicrobials and makes better use of resources. Investing in prevention With many conditions, earlier intervention improves patient outcomes and spares them – and the health system – avoidable illnesses and treatments. The obvious example is cancer: effective treatment of early stage cancers can dramatically improve prognosis. That’s why screening is so important. Screening is also an example of how population-based prevention programmes can deliver for citizens across the social spectrum, regardless of income or health literacy which can otherwise exacerbate inequality of outcome. I realise this is not breaking news. Yet less than 3% of health budgets is devoted to prevention. The rest goes on cure and care. I sometimes think we should refer to healthcare as ‘sick care’ – a system focused on ‘healthcare’ would dedicate itself to preserving good health for as long as possible. As rates of diabetes, heart failure and other chronic conditions continues to rise, and...