The Prevention Papers

Prevention is essential to what NEF calls the ​‘Great Transition’: moving from where we are today to a sustainable future.

Instead of being beset by widening social inequalities, accelerating climate change, catastrophic waste of natural resources and an economy locked into decline, we want social justice and wellbeing for all, environmental sustainability and an economy that flourishes without wrecking the planet. We can only hope to make this transition if we pay much closer attention to preventing harm.

Just about everyone would agree that our goals are desirable. Where people differ is how to reach them. Some say the markets should be in the driving seat, perhaps with some tweaks to regulation. Others insist that the future lies with voluntary and community- based organisations. Still others argue that government will have to take the lead, as the only institution that can curb the markets and deliver social equity. These competing views have created a kind of impasse, or what we might call the ​‘paradox of prevention’ – everyone agrees that prevention is a good idea, but little is done to make it happen. Considering the depth of the social, environmental and economic crises we face, we must find ways to escape this paradox.

With support from the Big Lottery Fund, NEF has organised a series of papers, presentations and events to examine and develop the case for shifting investment and action ​‘upstream’ to prevent harm. Six key themes have emerged from the work so far, which focus on the need for:

1. a systemic approach to prevention that addresses society, environment and economy and how they interact and depend on each other for a sustainable future;
2. a better understanding of how the idea of preventing harm can be realised in practice;
3. an upstream, positive approach to prevention and an awareness of unintended consequences;
4. new incentives and policy mechanisms to support prevention;
5. new ways of valuing and measuring prevention and its consequences;
6. a broad alliance in favour of upstream investment and early action, to include policymakers and practitioners, communities and citizens.

‘Prevention’ may sound negative. In fact, it is about realising benefits – making better use of public money, better quality of life, less need for heavy-handed state intervention to cope with things that go wrong, and the safety and security of future generations.

However, there are significant barriers. For example, the ​‘rescue principle’ defines much philanthropy, charity and health care. It’s a strong motivation for many organisations, who want to help people who are already needy and give priority to those in greatest need. They may see upstream prevention as a diversion, threatening to reduce funds available for urgent treatment and repair.

Efforts aimed at coping with existing damage are more likely to have immediate, tangible and measurable results. Preventative action is usually longer-term, more complex, less visible, and typically harder to measure. This sets up a political bias against prevention. Some may find there are more headlines, more reputational advantages and even more profits in doing things further ​‘downstream’ – by helping problems become less acute or managing them, once they have occurred.

To help resolve the paradox of prevention and build a broad alliance in favour of ​‘upstream’ intervention, we are building an agenda for further research and action. This agenda is big, broad, complicated and extremely challenging. Nonetheless, in bringing together a diverse range of participants, capturing cutting-edge thinking in prevention and setting out some thoughts for ​‘where next’, we hope to build knowledge about prevention, to help build a broad alliance and to influence policy and practice.