The Great Prevention Pivot workshop in Canberra, June 2026, brought together health leaders, clinicians, policymakers, researchers, and consumers to discuss the state of prevention in Australia. The workshop explored six domains of prevention: primordial prevention, social determinants of health, health protection, health promotion, early detection and intervention, and chronic disease management. The participants were asked to prioritize their investment in each domain, with the results revealing a shift in focus over the course of the day. Social determinants of health and early detection and intervention emerged as the top priorities, with health promotion and chronic disease management also gaining ground. The workshop highlighted the need for targeted investment in communities with the highest modifiable risk factors and chronic disease burden, such as people in poverty, First Nations communities, those with poor housing, and people with lower levels of education. Primordial prevention, while important, was seen as less urgent compared to other domains. Health protection attracted significant debate, with a focus on regulatory levers such as the sugar tax, food labeling reform, and urban design. The workshop also emphasized the need for a stronger structural response to health literacy, with a shift towards a design philosophy that considers key personas, stages of life, risk-based and culturally sensitive early intervention, behavioral science, and stronger incentives. Early detection and intervention were identified as areas where Australia is falling short, with low screening rates and a lack of structured five-year screening programs. Chronic disease management was seen as a downstream consequence of the 'upstream prevention system' not working effectively, with a focus on improved care coordination, evolving national eHealth infrastructure, and enabling insights from data. 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. The report highlights the importance of a comprehensive and coordinated approach to prevention in Australia, with a focus on addressing the underlying social determinants of health and improving the effectiveness of the prevention system.
