Proactive prevention: Act now to disrupt the impending non-communicable disease crisis in low-burden populations

Benson Njuguna, Sara L. Fletcher, Constantine Akwanalo, Kwaku Poku Asante, Ana Baumann, Angela Brown, Victor G. Davila-Roman, Julia Dickhaus, Meredith Fort, Juliet Iwelunmor, Vilma Irazola, Sailesh Mohan, Vincent Mutabazi, Brad Newsome, Olugbenga Ogedegbe, Sonak D. Pastakia, Emmanuel K. Peprah, Jacob Plange-Rhule, Gregory Roth, Archana ShresthaDavid A. Watkins, Rajesh Vedanthan

Research output: Contribution to journalArticlepeer-review


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 prioritized, based on a 2-dimensional assessment: impact and feasibility. Thus, potential interventions 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 that high 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.

Original languageEnglish (US)
Article numbere0243004
JournalPloS one
Issue number12
StatePublished - Dec 2020


  • Cost of Illness
  • Health Priorities
  • Humans
  • Noncommunicable Diseases/economics
  • Policy Making
  • Risk Factors

ASJC Scopus subject areas

  • General


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