3.A. Round table: Making the case for prevention: tackling challenges in quantifying disease prevention impact

Abstract While the value of prevention and health promotion is widely acknowledged in public health, quantifying their full impact remains a persistent challenge. Health Impact Assessment (HIA) is a promising tool to evaluate the broader effects of policies, programmes, and interventions on population health. However, its application to prevention-especially in areas like behavioural risk reduction, upstream determinants, and community-level interventions-faces several methodological and practical constraints. Quantifying the effects of preventive actions often requires long time horizons, indirect causal pathways, and measuring intangible outcomes such as improved quality of life or reduced health inequalities. Moreover, estimating the return on investment (ROI) or cost-effectiveness of prevention is complicated by fragmented data, the influence of social and environmental contexts, and challenges in translating evidence into actionable policy. As a result, prevention remains underfunded and undervalued compared to treatment-focused interventions. Today, the question of how to effectively measure and justify investments in prevention is an active area of research and policy debate. The urgency of this issue is underscored by the pressing need to prevent a “healthcare infarction”-a situation where health systems become overwhelmed due to insufficient preventive measures. This concern is being addressed at both international and national levels. Internationally, organizations like the OECD and the European Observatory on Health Systems and Policies are actively engaging in efforts to strengthen health system resilience, with a particular focus on preventive care. At the national level, the Netherlands has set a leading example via its ‘Investment Model for Prevention’, which aims to quantify and guide investments in preventive health measures. These efforts highlight the critical importance of integrating prevention into health policy and the need for robust frameworks to evaluate its impact. As health systems worldwide face increasing pressures, emphasizing prevention is not merely a theoretical ideal, but an urgent and practical necessity for ensuring sustainable and effective healthcare delivery. In this roundtable, we will bring together the latest insights and developments in the research and policy discussions surrounding the value of prevention and health promotion. Building on international and national frameworks, we will engage in a focused policy debate on how to better integrate prevention into health systems. Participants will have the opportunity to discuss the challenges of measuring and demonstrating the impact of preventive measures. We will also examine the pros and cons of current approaches, addressing the practical and methodological obstacles that hinder their widespread adoption. Together, we will identify concrete actions to ensure that prevention takes a more prominent role in shaping the future of health policy. Key messages • Integrating prevention into health systems is crucial for long-term sustainability, but challenges in measuring impact and return on investment remain a barrier to broader adoption. • Active research and policy discussions are exploring how to overcome methodological obstacles and ensure prevention plays a central role in future health systems.