We all understand on an intuitive level that prevention is better than cure, and that’s especially true in the field of public health.Not only is it better for patients never to have had a disease than to have suffered through it and eventually been cured, as a public health policy it’s more efficient.Printing a leaflet encouraging people to eat more healthily is cheaper than providing costly heart surgery for an obese population. In spite of the benefits of a preventative strategy, however, it’s often the purview of governments, rather than charities. Philanthropists can channel their high net worth towards beating a disease – just look at Bill Gates’ work on tackling polio. Indeed, our work here at the Tej Kohli Cornea Insitute wouldn’t be possible without the generous support of our philanthropist founder and tech billionaire, Tej Kohli (net worth: £4.5 billion), who continues to direct his wealth towards beating disease and making the world a better place.But despite philanthropists’ work fighting disease, addressing broader behaviour – convincing people to quit smoking, for example – tends to fall under the remit of governments rather than individual philanthropists. Here’s why philanthropists should be focusing on prevention, not curing diseases alone.
Why Prevention is Essential to a Public Health Strategy
75% of American healthcare spending goes towards chronic diseases. That includes heart disease, cancer, diabetes, obesity and respiratory diseases. Those are all diseases which can be significantly reduced by changing behaviour (though there are also genetic elements, and behaviour alone can’t prevent them entirely). For example, the leading cause of cancer death is lung cancer, and 80% of lung cancers have smoking as a contributing cause. Minimising the percentage of the population who smoke would therefore have a major impact on one of the most significant public health problems of the day. Obesity, similarly, can be tackled by improved diet and greater exercise.
The American Centre for Disease Control (CDC) identifies four key areas where adjustments to behaviour can have a sizeable impact on the prevalence of many chronic diseases: physical activity, nutrition, smoking, and alcohol consumption.Tackling issues in these sectors as early as possible will have an enormous downstream effect on public health. So why aren’t these areas getting more attention?
What Philanthropists Can Do to Help Disease Prevention
In the US, 3% of health spending is funnelled towards preventative care. Given that three quarters of diseases are preventable, that looks like a clear misallocation of resources. A similar story can be told in the field of private philanthropy. Of course, generous philanthropists do direct resources towards preventing diseases, as our founder Tej Kohli does. But the emphasis seems to be overwhelmingly on curing a disease rather than on preventing it from developing at all. Philanthropists will give admirably large donations to, say, finding a cure for cancer, but encouraging people to smoke less gets far less attention.
Instead, philanthropists should consider working closely with governments to develop a robust preventative care strategy. Free provision of devices to quit smoking, healthy cookery classes, and free access to sports facilities and exercise groups are all simple ways to have a big impact on public health. Governments make efforts in these areas already, but just think of what kind of effect a high-profile philanthropist would have if they put all their efforts into this field. Bill Gates, for example, has so far spent $1.8 billion on polio eradication – a sum which would have an enormous impact if used for preventative care. With governments already spread so thin, philanthropists should consider directing their extraordinary work towards prevention.
Preventative care is a crucial part of a public health policy, but it hasn’t yet received the attention it deserves. It might seem a less dramatic prospect than, say, ‘curing all diseases’, as Mark Zuckerberg has set out to do – but in the end, it’s likely to have more of an impact.