The proverbial benefits of prevention over cure are self-evident and yet we are reluctant to invest in staying healthy. Resolution of this age-old dilemma begins with a timeless truth: the benefits of good health come at a cost; prevention is not better than cure at any price. That logic leads to the testable hypothesis that prevention should be favoured when an imminent, high-risk, high-impact hazard can be averted at relatively low cost. Application of this idea helps to explain why cigarette smoking is still common place, why the world was not ready for the COVID-19 pandemic, why billions still do not have access to safe sanitation, and why the response to climate change has been so slow. Much more money and effort are invested in health promotion and prevention today than is commonly thought, but the enormous avoidable burden of illness is reason to seek ways of investing further.
The Great Health Dilemma: Is Prevention Better than Cure? provides a framework for investigating prevention and illustrates the application of principles with practical examples. Chapter 1 discusses the history of prevention and draws on examples over a 5000-year period from neolithic times to the present day. Chapter 2 considers the principles of prevention and the societal conditions that affect how individuals, governments, and countries react to issues linked to public health. Chapters 3 to 8 explore the efficiency of prevention in a variety of settings including financing health services, pandemic preparedness, tuberculosis and hiv/aids control, non-communicable diseases, sanitation and climate change. Drawing together the evidence, chapter 9 provides suggestions for promoting good health and preventing disease in the future.
Publisher: Oxford University Press
ISBN: 9780198853824
Number of pages: 224
Weight: 294 g
Dimensions: 217 x 139 x 13 mm
I strongly recommend The Great Health Dilemma not only to teachers and students of public health but to anyone who is interested in their own health, their children's health and the health of the planet. - Brian Williams, South African Centre for Epidemiological Modelling and Analysis
It may seem self-evident that prevention is better than cure, but we seldom act as if we believed it. In this brilliant work, Christopher Dye describes the many ways prevention is undervalued in comparison to its demonstrable benefits. Everyone who cares about the public's health—and their own—has much to gain from absorbing Dye's lessons. - Harvey V. Fineberg, President, Gordon and Betty Moore Foundation
In a chapter on unlikely disasters, Chris Dye explores pandemic preparedness as a highly topical example of prevention. Invoking principles used throughout the book, he argues that Covid-19 should be seen not as an isolated, once-in-a-lifetime event, but rather as one among hundreds of outbreaks of infectious diseases that are recorded each year. Borrowing ideas from the insurance industry, he suggests pooling all risks and sharing the costs to fund the development of generic "platform" technologies – precursors for diagnostics, therapeutics and vaccines that can be into called into action to combat a wide variety of pathogens as they emerge. This is a book for all who are concerned about the disruption of our planet, and about the increased opportunities that it creates for emergence of infectious pathogens at the animal/human interface. - David L. Heymann, Professor, Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine
By incisively dissecting the dialectical relationship between prevention and treatment of illness, Chris Dye has laid bare one of the great contradictions in health. His razor-sharp analysis unravels the complexity of our values and choices that has seen prevention remaining a poor neglected cousin of treatment. A truly enlightening book - a must-read! - Salim S. Abdool Karim, CAPRISA Professor of Global Health, Department of Epidemiology, Mailman School of Public Health, Columbia University
Using the example of TB, Chris Dye explains that by addressing the underlying risk factors and determinants for the disease, one would in fact be preventing a host of other health conditions and improving wellbeing. While biological and immunological reasons make finding a vaccine for TB challenging, we should also be addressing environmental, economic, and social risk factors for ill health. - Soumya Swaminathan, Chief Scientist, World Health Organization
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