Setting priorities in prevention

In the last few years prevention has again become the focus of attention because of various international developments such as the WHO strategy for Health for All by the year 2000. When resources are scarce, it is all the more important to set priorities. This applies to prevention as well as to curative care. In this paper, we describe a method for comparing prevention programmes with one another, using efficiency as the final parameter. To determine efficiency it is necessary to collect facts about a number of aspects of the health problems to be prevented: size of the health problem, degree of preventability, monetary and other costs involved and the probability that the prevention programme will cause changes in the overall pattern of morbidity and/or mortality. These aspects are discussed and some examples given.