“Prevention is the Best Buy in the Health Sector”

by Eric Zuehlke, editor

Thomas Frieden, director of the Centers for Disease Control and Prevention, talked this week at the Center for Strategic & International Studies about an important and sometimes overlooked area in global health: proven prevention strategies. He went through a laundry list of simple, low-cost interventions that have saved millions of lives worldwide and their policy implications. For example, immunizations are a low-cost intervention that prevent disease and debilitating conditions. Frieden pointed out that over 12 million lives have been saved through measles immunization over past 10 years, and in the case of polio, we are almost at the finish line in terms of eradication (even though the final push remains stubbornly difficult). But, as he says, success is fragile and requires vigilance. Sanitation was another example; it’s so often overlooked, but can save millions of lives. Clean indoor cookstoves, in addition to their environmental benefits, can prevent pnemonia. Addressing neglected tropical diseases through public education (prevention) along with treatment is doubly effective. Reducing the sodium content of processed foods can lower high blood pressure that often lead to heart attacks. There are countless other examples. Each dollar invested pays itself back many times over.

One aspect of the talk worth higlighting is his focus on the Kenya AIDS Indicator Survey (see the PRB Data Sheet on it here) because it conveys how tranformative understanding data can be in prevention strategies. According to Frieden, before this survey, Kenyan policymakers had a vague sense of the scope of the AIDS . The survey showed that the vast majority of HIV-positive people didn’t know their status, and therefore couldn’t change their behavior and prevent the further spread. This finding led to a change in policy.

With all the talk of rising health care costs in the United States, tough public budget austerity in the face of massive deficits, and increasing access to treatements such as antiretrovirals to fight HIV/AIDS in poorer countries, this is an important message. Prevention behaviors and strategies not only allow people to live longer and healthier lives, it saves money in the long run.

There’s a lot more in this dense, fascintating presentation that gives a great birds-eye view of the current state of global health (for example, tobacco is the world’s leading cause of death — more than AIDS, TB, and malaria combined). Highly recommended: http://csis.org/multimedia/video-new-twist-old-concept-prevention-interventions-global-health

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