The basis of health care is that it is much better for the individual member of society to be healthy and well than to be ill or deceased (1). To assist the individual in staying alive and well the health care system provides a broad range of services aimed at cure or control of disease. These services are available when someone becomes ill.
A different approach to preservation of good health and longevity is the prevention of disease. Prevention may take many forms. This may vary from legislation on food declaration via public campaigns on the importance of physical exercise to neonatal screening programmes. The intervention may be directed at decreasing the risk for disease in healthy subjects (primary prevention). A common variation is prevention of the severe consequences of disease by early detection of subclinical disease by screening or case-finding (secondary prevention). Other variants are prevention of complications of disease (tertiary prevention) or prevention of recurrence of disease by secondary intervention.
Often the costs of classic clinical care and prevention are compared in a way suggesting that the primary advantage of prevention is that it saves money. This conclusion may be correct in some areas of prevention such as in iodine deficiency disorders. It is, however, far too simple when it comes to many other areas such as prevention of complications in elderly patients with diabetes mellitus (1). The major appeal of prevention is that it is a most effective and often also a cost-effective way of reducing the burden of disease.