By David Sinclair, Chief Executive, International Longevity Centre UK (ILC) & Laetitia Bigger, Director Vaccines Policy, International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)

As delegates return home after the 78th World Health Assembly in Geneva, they may well feel more resolute and energised despite a context of heightened uncertainty, where global health progress, projects and partnerships face challenges amid shifting political and funding priorities. At a time when multilateralism is being questioned and competing domestic priorities lead to tough decisions about resource allocation, “health” is at risk of being deprioritised. Yet, in the adoption of the pandemic agreement, we are reminded of one crucial truth: diseases do not respect borders.

Whether we are dealing with infectious outbreaks or the slow-burning crisis of non-communicable diseases (NCDs), the case for prevention has never been clearer – nor more urgent. As underscored by the OECD and the Business at OECD (BIAC) 2024 Health Forum, good health is a vital economic and security asset. If we are to secure a stable and prosperous future, we must place the prevention of ill health at the heart of our policies – from global strategy to local service delivery.[1]

Prevention is an economic imperative

Health is not simply a cost – it is a strategic investment. Prevention, with adult immunization as a key pillar, can yield an exceptional return. According to recent data from the Office of Health Economics, every dollar or euro spent on adult immunisation generates a return of up to 19 times the original investment. The BIAC report further illustrates this by showing how value-based care and prevention reduce hospitalisations, cut costs, and improve workforce productivity. Prevention also supports fiscal sustainability, enabling governments to invest more effectively in long-term social infrastructure.

Despite this, prevention remains chronically underfunded. OECD countries typically spend less than 3% of their health budgets on prevention, with EU countries spending less than 0.5% of their health budgets on immunization[2]. ILC research has consistently shown that prevention pays. Increasing prevention spend by even 0.1% of GDP can unlock a 9% rise in annual consumer spending by people aged 60 and over and add 10 hours of volunteering per person annually.[3] Investing in healthy ageing alone could save 150 million lives globally and generate $3.2 trillion in economic returns.[4]

Health security means a safer world

Recent years have shown us that health emergencies are no longer occasional shocks – they are becoming the new normal. From COVID-19 to emerging antimicrobial resistance, from zoonotic outbreaks to climate-related health impacts, our global interconnectedness means that local health threats can quickly escalate into global crises. This is especially true for in low-and lower-middle income countries (LMICs) where health systems are often fragile. However, this also presents an opportunity: to reaffirm how stakeholders in the health and global health space can work together to keep “health” on the top of the agenda – not just for the benefit of patients, but as an economic and security imperative.

The economic argument for support is clear. According to the WHO, scaling up primary health care interventions across low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030.[5] But progress towards UHC in LMICs has stalled and is now at risk of reversal. Without continued investment and support, the goal of achieving UHC by 2030 will slip out of reach – and with it, global stability and prosperity.

The role of community care

If we are to prevent ill health effectively, we must diversify how and where care is delivered. That means democratising access to health services, breaking down silos, and making prevention an everyday part of life – not something that happens only within hospital walls.

We must remove the barriers to preventative interventions, allowing those who need them to access them. Delivering prevention in people’s communities, workplaces and homes is one way of breaking down barriers that relate to poverty, geography, and disability and ill health. Implementing person-centred approaches, delivering value-based, proactive health interventions and targeting tailored services to underserved populations are also critical.

Post-pandemic, accessible points of care like pharmacies have seen an expanded role. In many countries, pharmacists are now being empowered to deliver vaccination programmes, screen for NCDs, provide remote consultations, and support medication adherence.

Yet in many systems, restrictions on prescribing authority, inadequate funding models and poor integration into wider health systems all limit the potential of locally based services. If we are serious about prevention, we must unlock the full power of community-led care.

Prevention across the life course

Our approach to prevention must also be holistic. It must start early, be sustained across the life course, and respond to changing demographic needs.

That includes improving childhood immunisation, which suffered global setbacks during the pandemic – with 67 million children missing out on vaccines, according to UNICEF.[6] It includes prioritising adult and older people’s vaccinations, especially for flu, pneumococcal disease, RSV and shingles, where uptake remains suboptimal.  Despite socio-economic returns far exceeding investment, ILC has shown that adult immunisation is underutilised, underfunded and undervalued in most countries.[7]

Ahead of the 4th High-Level Meeting on Non-Communicable Diseases (NCDs) and Mental Health in September, we call for collective action to harness the power of vaccines to protect people living with NCDs, who are at higher risk of complications from common respiratory infections as well as addressing NCDs through education, early detection, and community-based management.

Beyond immunisation, screening and early intervention can transform lives and reduce long-term healthcare costs. Cancer screening programmes such as the NELSON lung cancer screening trial in Europe[8] have demonstrated high cost-effectiveness, while data-driven tools – from AI risk scores to behavioural science interventions – show how prevention can be personalised and efficient.

Resilience means inclusion

A truly resilient health system is one that works for everyone – including older people, people living in poverty, and those in rural or underserved areas. Yet too often, these groups are excluded from preventive services or face disproportionate out-of-pocket costs.

In ILC’s joint research on UHC in low- and middle-income countries with HelpAge International, older people in Rwanda, Zambia and Mongolia described travelling long distances to reach care or forgoing essential medicines they could not afford. In one account, a doctor questioned the value of treating an older patient’s broken leg because of their age.[9]

This kind of ageism and exclusion is not only unethical – it is economically self-defeating. As societies age, the economic contribution of older people will grow. But only if we ensure they can stay healthy and active for longer. This also means tackling the social determinants of poor health – such as poor housing, unemployment, limited access to green spaces, and social isolation. Public-private partnerships, better data and digital technologies offer unprecedented opportunities for improved population health but only if they are backed by real investment – and underpinned by enabling regulatory environments and a commitment to equity.

Prevention as policy: what governments must do next

We are calling on governments to:

• Commit to investing a greater proportion of health budgets in prevention – for high-income countries the ILC recommends matching Germany which spends 7.8% of its healthcare budget on prevention.[10]
• Expand uptake and ensure fairer access by offering immunisation and NCD services in settings close to where people live and work from supermarkets to places of worship.
• Tackle the wider determinants of health by investing in community-based infrastructure.
• Prioritise vaccinations across the life course
• Make health data systems inclusive of older people and marginalised groups

The pandemic taught us that prevention is not a luxury – it is a necessity. It is the thread that binds together public health, economic resilience, and national security.

Because the next crisis is not a question of if – but when.

This op-ed is published in partnership by the International Longevity Centre (ILC) and the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), in support of a global commitment to prevention following the 2025 World Health Assembly. You can also read this article on the IFPMA insights page here 

[1] FIN-2025-03 Health as an Economic Imperative – Business at OECD (BIAC) Health Forum 2024 Synthesis report.pdf (March 2025)

[2] 40. Faivre P, Benčina G, Campbell R, et al. 2021. Immunization funding across 28 European countries. Expert Rev Vaccines 20(6): 639-47

[3] Health equals wealth: The global longevity dividend (ILC, October 2020)

[4] Unlocking the Power of Healthy Longevity: Demographic Change, Non-communicable Diseases, and Human Capital (World Bank, September 2024)

[5] Countries must invest at least 1% more of GDP on primary health care to eliminate glaring coverage gaps (WHO, 2019)

[6] New data indicates declining confidence in childhood vaccines of up to 44 percentage points in some countries during the COVID-19 pandemic (UNICEF, April 2023)

[7] No health, no wealth: the cost-effectiveness and socioeconomic value of life course immunisation (ILC August 2024)

[8] NELSON: A successful early detection trial shown to reduce lung cancer mortality in (ex) smokers – iDNA

[9] Achieving Universal Health Coverage in low- and middle-income countries: a global policy agenda (ILC February 2025)

[10] Countries can boost life expectancy by up to 3 years by investing more in prevention – ILCUK (May 2025)