What is the gain of applying health promoting and disease prevention measures?

By Derek Yach

Twenty-five years ago while at the Medical Research Council in South Africa, I completed a study that asked: what would be the potential gain in lives saved if known and available health promoting and disease prevention measures were fully applied in the country?

Not surprisingly the numbers were very big—and even bigger when we asked what the impact of such measures would be on people in the future. The biggest impact then would have come from better investments in water, sanitation, management of the sick child. The same priorities would have been seen in most developing countries. Improving the basic conditions to live a decent life are powerful promoters of health now and then everywhere. When prevention quietly works we take it for granted and undervalue it—until we suffer the consequences of a drop in vigilance when epidemics and hunger re-emerge.

Today the major causes of death and disease have changed. But the power of prevention and of health promotion remains a priority. In South Africa, China, the United Kingdom and the US we see a remarkable convergence of the major risks to health that are amenable to prevention: tobacco, unhealthy diets, excess alcohol and a lack of physical activity top the list, only varying in their order among countries and being beaten in South Africa by unsafe sex.

When I was at the World Health Organization, I was part of a team that pushed hard to tackle tobacco through the use of powerful regulatory policies. We partly succeeded and have seen declines of 10% over the last decade in smoking prevalence in developed countries but an 18% increase in developing countries. We raised the flag on obesity, unhealthy diets and physical activity without raising the finance nor mobilizing the research needed to make a difference in trends. Obesity continues to relentlessly increase in most countries.

Today I am part of an innovative team which asks the same question every day: if so much ill health is preventable, how can we develop smarter and more sustainable ways to prevent? Clues to what will work are coming from South Africa, where the Vitality program—based as it is on sound behavioral economic theory and innovative delivery approaches—activates people on a daily basis and steers them to healthy choices.

That success drew me to the challenge offered to me by Adrian Gore, CEO of Discovery: build an Institute that will activate a global debate about the power of prevention and the desire of all to live the healthiest most fulfilling lives they can. Bring together others from all sectors of society who share this passion and develop solutions that can be tested and scaled up across Vitality’s global businesses and adapted more widely. Take advantage of the exciting and innovative advances underway in science and technology that will lead to more personalized approaches to health promotion and disease prevention. Do this in concert with governments, NGOs, academics and the media. And start this work from the day of our launch.

Today we take up that challenge and signal to all readers that our success demands your active engagement. We announced at the Institute launch May 21 that the Vitality Institute has initiated a Commission on the prevention of chronic diseases and risks in the US. The Commissioners reflect the diversity of disciplines and sectors required for success. Most have never worked together. Each represents a constituency with knowledge, resources and commitment to work together to improve the health of this nation. We reach out to you to provide us with insights, guidance and views about how we need to change the debate on health and put prevention and health promotion at its core.

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