OUR preventionis known to save lives. But it also saves a lot of money. Much more, in fact, when prevention is not limited to checkups, vaccines, and the treatment of unhealthy behaviors, but also extends to control of the broader determinants of health associated with the physical and social environment.

In the late 20th century, it was estimated that for every dollar spent on disease prevention, $4 was saved by treating them. More recent studies, in terms of his contemporary field healthcare (which includes, in addition to prevention, health protection and health promotion), report that for every dollar invested in public health, the return is $14.

The benefits become even more impressive when you take into account the costs of treating the ten most common diseases. In the EU, their direct costs for 2013 are estimated at $11.7 billion, while the indirect costs associated with the subsequent decline in productivity are $3.8 billion.

In developed countries, the cost of treating cardiovascular, oncological, chronic respiratory diseases, diabetes mellitus and mental disorders is estimated to increase in the period 2011-2030. up to 25.5 trillion. dollars, of which 35% will relate to mental disorders. But on top of the high cost of care, 45% of the cost of cardiovascular disease and 59% of the cost of depression are due to lost productivity due to absenteeism and early retirement.

In the late 20th century, it was estimated that for every dollar spent on disease prevention, $4 was saved by treating them.

In particular, the cost of breast cancer treatment in the US is 14% of the total cost of cancer treatment, while mammography every two years in women aged 50-74 reduces breast cancer mortality by 26%. Early diagnosis of cervical cancer with a Pap smear increases life expectancy by more than five years in 90% of cases. 88% of people with colon cancer diagnosed early by colonoscopy every five years live equivalent life years in men and women over 50, while 88% of people diagnosed early also gain more than five years of life expectancy. compared with those diagnosed late. As for the cost of caring for the sick, it corresponds to 12.6% of the total cost of caring for cancer patients in the United States. In the same country, treatment costs for diabetic patients account for 25% of total treatment costs.

All of these diseases, like many others, are largely preventable, as they are often caused by smoking, poor diet, sedentary lifestyle, obesity, and excessive alcohol consumption. Globally, approximately 20% of deaths are related to smoking, and the cost of health care and loss of productivity due to smoking is 1.4 trillion. dollars annually. The health consequences of malnutrition cost $3.5 trillion. dollars, and lack of exercise 67.5 billion dollars.

Environmental and social factors are also largely responsible for the emergence of modern morbidity. The number one cause of death in the world is poverty. 29% of the world’s population faces food insecurity, 42% are unable to eat healthy food, 22% lack basic sanitation, 26% drink faecal-contaminated water, and 99% breathe unhealthy outdoor air resulting in exposure to air pollution health costs 8.1 trillion. dollars. Billions of people don’t have time or space to exercise, and billions work in toxic jobs. At the same time, obesity is becoming the new big epidemic of our time.

But the new wave of epidemics over the past 40 years or so, culminating in the COVID-19 pandemic that has cost millions of lives and billions of dollars, is driven in large part by ecosystem disruption and, in particular, dietary changes due to rapid demand growth. animal protein consumption worldwide.

On the other hand, OECD countries allocate only 2.4-5.4% of total health spending to prevention. In Greece, spending on the public health sector as a whole is 2.8% of total health spending, while the corresponding figure for health care is about 90%. However, spending on prevention is expected to increase in the near future due to the launch of new related programs.

More generally, however, the therapeutic hospital-based model of health systems that dominates the Western world results in prevention taking a very low place in the choice of the state, in the practice of doctors and in the minds of citizens. of which we lose an average of 10 years of life expectancy.

The health impact of the lack of effective prevention, as well as the need to contain the ever-increasing costs of treatment that threaten the sustainability of health systems at the international level, make the development of prevention and the wider public health sector an urgent political challenge. priority, along with its development First aid.

Mr. Yannis Tundas is EKPA Distinguished Professor of Medicine, Director of the Institute of Social and Preventive Medicine.