Abstract:
Non-communicable disease (NCD) prevention efforts have traditionally targeted high-risk
and high-burden populations. We propose an alteration in prevention efforts to also include
emphasis and focus on low-risk populations, predominantly younger individuals and low prevalence populations. We refer to this approach as “proactive prevention.” This emphasis
is based on the priority to put in place policies, programs, and infrastructure that can disrupt
the epidemiological transition to develop NCDs among these groups, thereby averting future
NCD crises. Proactive prevention strategies can be classified, and their implementation pri oritized, based on a 2-dimensional assessment: impact and feasibility. Thus, potential inter ventions can be categorized into a 2-by-2 matrix: high impact/high feasibility, high impact/
low feasibility, low impact/high feasibility, and low impact/low feasibility. We propose thathigh impact/high feasibility interventions are ready to be implemented (act), while high
impact/low feasibility interventions require efforts to foster buy-in first. Low impact/high feasibility interventions need to be changed to improve their impact while low impact/low feasibility might be best re-designed in the context of limited resources. Using this framework,
policy makers, public health experts, and other stakeholders can more effectively prioritize
and leverage limited resources in an effort to slow or prevent the evolving global NCD crisis.
