Governments should recognize that major savings in health care costs will be realized by the avoidance of mass behaviours such as smoking, and by achieving positive changes in food consumption patterns. Primordial prevention that is, preventing risk factors from appearing in the first place, is likely to be highly cost-effective.

In both the developing and the industrialized world, economic constraints limit the governments' ability to provide state-of-the-art treatment and prevention programmes to all who might benefit.

Governments must accept responsibility for the influence of their policies on public health. To improve nutrition, promote physical activity and reduce smoking, coordinated approaches, involving all sectors, are needed.

Now that we have been able to study many of the disease related genes, we may soon be able to engineer them to prevent disease in those susceptible. We may also be able to identify individuals with the ‘bad’ genes to be targeted for primordial prevention of disease, long before primary and secondary prevention begin to give any benefit to mankind.