The Great Prevention Pivot workshop in Canberra, June 2026, brought together health leaders, clinicians, policymakers, researchers, and consumers to discuss the current state of prevention and explore initiatives for improving prevention across the full spectrum. The workshop defined prevention across six domains: primordial prevention, social determinants of health, health protection, health promotion, early detection and intervention, and chronic disease management. Participants were asked to invest $100 million across these domains, with social determinants of health leading the way at 63%, followed by early detection and intervention at 48%, and health promotion at 31%.
The workshop highlighted the need for significant focus and investment in groups with the highest modifiable risk factors and burden of chronic disease, such as people in poverty, First Nations communities, those with poor housing, and people with lower levels of education. Australia performs reasonably well at the basics of primordial prevention, but there are still gaps to close, such as access to safe drinking water and social determinants accounting for an estimated 35% of the First Nations health gap. Mass campaigns do not reach many of the people who need preventive assistance, and targeted investment through trusted community relationships, culturally safe services, and place-based models is critical.
Health protection attracted significant debate, with a focus on regulatory levers such as the 'sugar tax', food labelling reform, and restrictions on junk food advertising. Australia has genuine achievements in areas such as adult smoking rate and childhood immunisation coverage, but there are still challenges, such as the 'Red Rooster theory' where unhealthy options are cheaper, faster, and more accessible. The food environment needs regulatory attention, and the current approach of voluntary industry action is not delivering.
Health promotion was a key focus, with the question of how to get people to engage with their health before they are sick. The data suggests that engagement is a serious problem, with one in five Australian men not seeing a GP in the last 12 months and only 17% of Australians aged 45-74 having had a cardiovascular risk assessment. A consensus was that better outcomes may not correlate with a better information campaign, and a shift in design logic may be required, tied to critical moments in life.
Early detection and intervention were discussed, with examples of current performance data illustrating the scale of the gap. Only 55% of women had breast cancer screening, and around 41% of eligible Australians did not complete the bowel cancer screening test. There is a gap in the population not systematically screened, and the recommendation was to explore structured five-year screening focused on key age cohorts.
Chronic disease management was the focus of previous articles, and workshop participants saw the prevalence of chronic diseases as the downstream consequence of the 'upstream prevention system' not working as well as it should. There is a need for improved care coordination, evolving the national eHealth infrastructure, and enabling insights from data. The workshop highlighted the criticality of improved care capabilities, clarifying roles in the ecosystem, and accelerating digitisation across the sector.
The workshop concluded with five clear imperatives for Australia: committing to national leadership with local delivery, investing across the full spectrum of prevention, improving the design for the person, not the system, building the digital and data infrastructure that prevention requires, and providing a more transparent and stronger approach to key measures.
