Investments in health promotion and prevention within primary healthcare hold transformative potential for universal health coverage, paving the way for a healthier future for people everywhere.
A central pillar of primary healthcare is health promotion and prevention. Photo: Laura Garcia
In 2015, the United Nations put universal health coverage (UHC) forward as a Sustainable Development Goal (SDG) to prepare the world for a better and healthier future. Delivering UHC, which ensures that everyone, everywhere, has access to health services without financial hardship, contributes significantly to improved health outcomes and greater equity.
However, with five years left until the 2030 deadline, the world is not on track to achieve UHC. In fact, as of last year, only 11% of countries worldwide have adopted a concrete strategy to reach this goal and more than 50% of countries set either zero or less than five measurable UHC targets in their policies.
We know that primary health care (PHC) can deliver 90% of essential health services, potentially saving 60 million lives and increasing the average global life expectancy by 3.7 years by 2030, according to the World Health Organization (WHO). A central pillar of PHC is health promotion and prevention, which efficiently reduces morbidity and mortality, curbs disease transmission, protects individuals, and reduces the burden on healthcare systems.
The case for prevention and health promotion
Investments in prevention and health innovation hold transformative potential for UHC. Prevention and health promotion is no longer seen as an individual responsibility but as a shared societal obligation that governments, communities, and employers must prioritise. A study by McKinsey & Company across 200 countries showed that prevention and health innovation could save 60 million lives and add USD$12 trillion to global GDP in 2040. Health promotion efforts, such as regular screenings, as well as health literacy, promoting urban health, and building health into the environments in which we work and live, amplify the impact of integrated PHC.
Life-course immunisation is also a cornerstone of prevention within PHC and a critical enabler of UHC. Despite its proven benefits, the potential of immunisation—particularly for adults—remains underutilised. Integrating immunisation across all ages into PHC systems reduces healthcare costs, improves productivity, and advances health equity.
For example, data from the Office of Health Economics (OHE) demonstrates that adult immunisation programs can deliver up to 19 times their initial investment, generating substantial societal and economic returns proportional to childhood immunisation programs. To realise these benefits, countries must prioritise the development of robust immunisation infrastructure and monitoring systems to improve coverage rates and ensure equitable access.
A child receiving a vaccine in Mogadishu, Somalia. Photo: US Government
Prevention and health promotion also have enormous potential to address the global burden of non-communicable diseases (NCDs), including cardiovascular diseases (CVD), cancer, diabetes, and chronic respiratory conditions. Almost one quarter of the population—1.7 billion people worldwide—live with at least one underlying condition, most often an NCD. Each year, 17 million people die prematurely from NCDs. NCDs are often chronic and require ongoing care, posing enormous challenges to patients and health systems.
NCD prevention and health promotion offers incredible life- and cost-saving opportunities as part of national UHC benefit packages. The WHO ‘Best Buys’ make this case. Cervical cancer screening, combined with HPV vaccination, is considered one of these best buys because it is both cost-effective and feasible for country implementation at any income level. Organisations like Jhpiego have put this guidance to use, taking an integrated approach to cervical cancer programs that prioritise prevention and screening, especially for vulnerable populations like people living with HIV. These efforts may not only reduce cervical cancer incidence, but also mortality. A recent study suggests the early impact of HPV vaccination on cervical cancer deaths, observing a substantial reduction in mortality—a 62% drop in cervical cancer deaths among women under age 25 in the US over the last decade.
Of the 28 best buys for NCDs, those that would fall under prevention and health promotion also include global tobacco control, policies and practices to sustain healthier diets, and promotion of physical activity. Secondary prevention of rhematic fever and rheumatic heart disease through a patient registry of those receiving prophylactic penicillin is another best buy, together with a number of other highly cost-effective interventions that help to prevent comorbidity, such as blood pressure management for people living with diabetes and drug therapy to control CVD risk.
The role of innovation
At IFPMA, our vision is that scientific progress translates into the next generation of medicines and vaccines that deliver a healthier future for people everywhere. We know the role that pharmaceutical innovation has in preventing, slowing, and stopping illness and advancing UHC.
For example, pre-exposure prophylaxis has transformed HIV prevention, as well as twice-yearly injectables for people living with HIV. In the past two years, the WHO has prequalified two malaria vaccines for the prevention of malaria in children, which holds new promise for tackling this global health challenge. A 2021 economic impact assessment of 120 countries found that reducing tuberculosis (TB) mortality rates to meet the target set in the SDGs would save US$13.1 trillion and avoid 23.8 million deaths. Today, there are 12 TB vaccines undergoing clinical testing.
It is easy to get caught up in the barriers on our path to UHC. Countries are grappling with humanitarian crises, recession, climate change, ageing populations, health worker shortages, and more—all of which play into the social, environmental, and economic determinants of health. An investment in health promotion and prevention as part of PHC will help shield us from these challenges. Better yet, applying a prevention-first mindset to UHC will mean fewer people becoming sick at all, a result which is at the very heart of our collective efforts.
The opinions expressed are those of the author and do not necessarily reflect the position of Re:solve Global Health.
David Reddy joined IFPMA as director general in April 2024. His background is as a scientist, with more than 30 years’ experience in the development and commercialisation of medicines, including 13 years as the head of the Medicines for Malaria Venture (MMV). In his role at MMV and in industry prior to that, Reddy accumulated significant experience interfacing with governments, international organisations, NGOs, and patient advocacy groups around access to medicines for priority diseases.
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