Strengthening Risk Prevention Policies
The two previous chapters have quantified the relative importance of various risk factors in different populations around the world and have proposed intervention strategies for some of them. Without doubt, information on the magnitude of disease and injury burden, and on the availability, effectiveness and cost-effectiveness of interventions is essential for prioritizing policy responses to reduce risks and improve overall levels of population health. Rapid health gains can only be achieved with focused interventions that reach large segments of the populations concerned. However, such strategies must take into account the broader framework of risk management considerations, some of which are highlighted in this chapter. It places the risks and intervention strategies outlined in Chapters Four and Five in the context of other considerations that need to be kept in mind when deciding on measures to reduce risk. A key issue is getting the right balance between efforts targeted on primary, secondary or subsequent prevention; another is the management of uncertain risks. The ethical implications of various programme strategies, including their impact on inequities in population health, must also be taken into account. This chapter argues that governments, in their stewardship role for better health, need to invest heavily in risk prevention, in order to contribute substantially to future avoidable mortality. It then shows how policy-relevant choices can be made and which risks should receive priority, particularly for middle and low income countries.