At a supermarket checkout, a child spots a chocolate bar and asks a parent to buy it. An adult waiting to pay may also reach for sweets or crisps they had not planned to purchase. Now imagine fresh fruit and healthier snacks taking their place at the checkout, while sweets and other less healthy options are moved further away, requiring shoppers to make an extra effort to find them.
The products have not been banned, and shoppers remain free to choose what they want. But by changing where food is displayed, the shopping environment can encourage healthier choices while making impulse purchases of less healthy options less likely.
It is a small change, but one that illustrates a bigger idea that preventing illness does not always require expensive medical equipment or new hospitals. Sometimes, it starts with changing the environments in which people live, move and work.
Rispah Walumbe, the Head of Strategy and Policy at Amref Health Africa, shared the example. This non-governmental organization works to improve people’s health, during a media workshop on health investment in Africa organized by the United Nations Economic Commission for Africa (UNECA) in Nairobi from October 28 to 30.
Walumbe described initiatives in Abu Dhabi that approach prevention through three areas of daily life, including how people live, how they move, and how they work.
The approach offers a different way of thinking about health spending: rather than directing most attention to treating illness after it develops, governments can also consider how schools, workplaces, businesses and urban planning can help prevent it in the long term.
In Abu Dhabi, Walumbe explained, schools are required to provide children with 30 minutes of age-appropriate physical activity each day, in addition to a weekly 90-minute physical education lesson. Designed to move a regular part of the school day, rather than leaving physical activity entirely to children and their families to organize.
The same emphasis on building healthier habits extends to workplaces, where Abu Dhabi’s broader Healthy Living strategy requires government entities to ensure that at least 70 percent of the food and beverages they provide meet approved nutritional standards.
By making healthier options more readily available, the policy seeks to encourage better eating habits beyond the home and school, as part of wider efforts to prevent lifestyle-related diseases.
Walumbe said none of these measures eliminate personal responsibility, and their effectiveness depends on how they are implemented. But they show how policy can make healthier behavior easier without relying only on health campaigns telling people what to do.
The examples come against a growing health challenge where non-communicable diseases (NCDs), including cardiovascular diseases, diabetes and chronic respiratory conditions, account for a substantial share of deaths.
Rwanda’s Vital Statistics Report 2024 found that NCDs accounted for 47.7 percent of deaths with defined causes recorded in health facilities, up from 46 percent in 2023.
Yet NCDs that include heart disease, stroke, cancer and diabetes account for about 74 percent of all deaths worldwide, according to the World Health Organization (WHO). The burden is particularly significant in low- and middle-income countries, which account for nearly three-quarters of global NCD deaths.
Walumbe said the wider issue is how governments balance urgent health needs with investments whose benefits may take years to emerge.
“African governments must finance existing health services while also meeting debt obligations, responding to outbreaks and funding other public priorities. Under such pressure, preventive programs can compete with immediate demands for medicines, health workers and hospital services,” she said.
This debate is also reflected in continental efforts to strengthen health financing. On April 1, 2026, African ministers met in Tangier, Morocco, for discussions on sustainable health financing during the 58th session of the Conference of African Ministers of Finance, Planning and Economic Development.
The discussions highlighted the need to strengthen domestic financing and reduce the vulnerability of health systems to declining and unpredictable external assistance.
Walumbe said primary care extends beyond treatment at health facilities to include community-based initiatives, support for community health workers, digital health solutions and efforts to help people access appropriate care earlier.
“Such services can help identify health needs before they become more serious and improve access for communities that face barriers to care. Their effectiveness, however, depends on how they are designed, funded and delivered.”
Walumbe stressed that programs should be developed with communities rather than imposed on them.
“People’s health is shaped by the circumstances in which they live, including their ability to earn an income, afford nutritious food and manage other daily responsibilities. And the same principle applies to government decisions outside the health sector.”
Agricultural policies influence the availability of food. Transport and urban planning affect opportunities for walking and physical activity. Energy and industrial policies can influence exposure to air pollution, which contributes to respiratory and other health problems.
Climate change can add to these pressures through its effects on food production, nutrition and the distribution of diseases such as malaria.
“These links mean that preventing illness cannot be left to health ministries alone. Education, agriculture, trade, transport and environmental authorities also shape the conditions that influence health.”
