Charlotte Ashton-Khan, Director of External A airs OHE, examines the role of prevention and wellness in healthcare
Preventive healthcare is one of the most powerful tools in our possession for improving lives and minimising the strain on health systems worldwide. By focussing on keeping people healthy, through reducing the incidence of diseases, early detection, and effective management of chronic conditions, prevention not only benefits individuals but also delivers wider gains for society, including reduced inequalities and increased productivity.
Yet, despite overwhelming evidence that prevention pays off, it remains chronically underfunded. Globally, health systems o en prioritise acute care, responding to illness rather than investing in measures that stop disease before it starts. This “prevention paradox”, where the success of prevention is delivered in the longer-term and is challenging to measure, means that avoided ill health rarely make headlines, even though the economic and social returns are substantial. For instance, analysis of vaccines by the Offlce of Health Economics (OHE) shows that when you account for all the benefits, reduced illness, increased productivity, and broader social gains, adult immunisations can have a return on investment as high as 19 to 1.
So why aren’t we investing more? The barriers are complex: short-term political priorities, misaligned incentives between sectors, challenges in attributing benefits to specific investments and funding structures that favour immediate results over long-term gains. Notably, traditional funding models, designed for acute care, o en struggle to support prevention’s unique needs.
At OHE, we are tackling these challenges head-on. Our research highlights the need for innovative funding solutions, such as ring-fenced prevention budgets to protect funding, and outcome-based financing like social impact bonds to grow investments in prevention. We also advocate for greater collaboration between public and private sectors, including employers, to unlock new resources for preventative health. To support this activity we have also developed tools, such as a workplace “cost calculator” for respiratory infections funded by Pfizer, to help employers understand the value of investing in employee health.
Countries around the world are experimenting with new financing approaches. In Finland, long-term investment in community-based prevention led to an 80 per cent reduction in cardiovascular mortality over four decades. In Canada, “prevention-first” budget mandates ensure that public health spending rises alongside acute care. These examples show that with sustained commitment and creative financing, prevention can transform population health.
OHE’s work demonstrates that prevention is not just a moral imperative, it’s a financial one. However, to realise these benefits at scale, we need to rethink how prevention is funded. This means protecting prevention budgets from being squeezed during economic downturns, and mobilising private capital through mechanisms like social impact bonds. It also means building partnerships across sectors, governments, businesses, and communities, to share both the costs and the rewards of a healthier society.
Ultimately, prevention is the smartest investment for sustainable, resilient health systems everywhere. By reimagining how we finance and value prevention, we can build healthier, more prosperous societies for all.
CONTACT INFORMATION
www.ohe.org
cashton@ohe.org