Which is the more important, to cure disease or to prevent it?
The answer depends on the standpoint of the individual. Should he or she contract a disease, then prevention is too late. The only thing left is, hopefully, a cure. However, a minister of health may take a different view. In any country, he will need to decide on the allocation of his budget, and this, in turn, will depend on the priorities obtained in that country. The main priority may be prevention. This will require the expenditure in fields other than medicine; these are public works, nutrition, and health education. Other ministries will therefore be involved. In the long run, there is little doubt that the prevention of disease is of higher priority than finding cures.
This is particularly true in countries where people become the victims of epidemics, or where certain diseases are endemic. In certain tropical countries, malaria is endemic. The effects of it can be suppressed by drugs and its source, the anopheles mosquito has long been known. However without strict public health regulations, e.g. avoiding standing water, and using mosquito nets in the wet season, malaria will persist, although the mosquito can be destroyed by spraying. Meanwhile, a course of drugs will build up the body’s resistance. Suppression and prevention will ultimately lead to a natural cure.
Discovery of the cause of any disease is crucial. Up to the 17th century, England was ravaged by a series of bubonic plagues which killed off people by the thousand, especially in London. The old theory was that the plague was caused by the stench of rotting refuse. In fact, it came from rat fleas, which infected humans. The prevention procedures were to destroy the rats, which in turn meant providing London with proper drainage, and also to educate people in public hygiene. The plague was eradicated by preventive methods, in a period when finding an actual cure was medically impossible.
The most important preventive measure against disease is inoculation. The means is to vaccinate with enough of the virus concerned to achieve immunity to the actual disease. Certain diseases, some fatal, have now disappeared from the Western world as a result; immunity from poliomyelitis, yellow fever, tetanus, typhoid fever, and some forms of influenza can now be achieved by injection. In the case of childish and non-fatal complaints, it is sometimes thought best to accept them, because where a child’s bodily health is generally good a natural immunity results. In adults, jaundice and hepatitis are far more dangerous, although nowadays hematology saves many lives.
Other preventative measures include eliminating the cause of disease from the environment; e.g. measures to prevent the inhalation of coal dust in the mining industry, and the rejection of asbestos from the building trade. Where the quality of water is suspect, boiling achieves a general level of safety. The strengthening of bodily defenses against disease is of strategic importance. This necessitates a balanced diet, reasonable exercise, warmth in cold climates, good sleep, and favorable housing and working conditions. When a disease has been caught, measures to control it include the use of modern drugs, X-ray therapy in the case of cancer, and at times, surgery.
What is disease? It is the invasion of the body by outside agents, bacteria, viruses, fungi, toxins, or radiation. It can also result from changes in the body and from physical malfunctioning, or from failure to adapt to environmental change. Changes in diet and the invasion of microorganisms can also contribute. In general, people have a built-in immunity to these invasions, though not always.
Unfortunately, it seems that as fast as one disease is eliminated another seems to take its place. This applies less to infectious and contagious disease than to contraction by individuals, though not always. A greatly feared recent illness is AIDS, of which the origin is at present unknown, though its means of spread has become clear. So far, this scourge, which is becoming endemic in certain parts of Africa, is incurable. It can be contained by prophylaxis and avoided altogether by avoiding sexual promiscuity. The prevention of its spread is essential. Its cure remains uncertain.
Meanwhile, there is no means of preventing or curing either the common cold or the various kinds of rheumatic and arthritic complaints. All of them can be lived with if drug suppressants are used, but the facts illustrate the patchy nature of medical advances. The same may be said about cancer. There are treatments, but so far no cure. There are preventive measures, such as not smoking, to avoid lung cancer, although the stated connection between smoking tobacco and lung cancer is opinion and propaganda rather than demonstrable fact.
Certain addictions, including drug addiction, may be classified as disease. In no case is there a cure for the condition. Prevention by abstention is all-important.
Dramatic advances in bodily organ replacement. e.g. heart, lung and kidney surgery, now gives new hope to many sufferers. Cure by skilled surgery may be the only option, since there are no medical treatments. Neither are there any preventative measures.
These examples and others can be cited to prove the topic statement either way, but if one has to generalize for the long term, the balance may be on the side of prevention. However much of the latter remains empirical while the actual causes of serious diseases remain unknown.
