This section gathers brief quotations from authors who, directly or indirectly, have explored the central themes of the DARE project: health, prevention, time, care, technology, and the human condition.
These are not mere literary embellishments, but sparks for reflection—inviting us to renew our perspective on the present, finding in the essential nature of the aphorism a key to understanding—and, at times, reimagining—our world.
The passage we offer in this issue of the newsletter is taken from Silvio Garattini, publisher il Mulino, 2023.
With time and the extraordinary advances in medicine, culture has become predominantly oriented towards the treatment of diseases and the care of the sick, developing diagnostics, therapies, and rehabilitation. This has led to the emergence of a vast market: the health market. As with other markets, this too pursues the same objective: an increase in turnover through the growing medicalisation of society. Diagnostic tests, pharmaceuticals, dietary supplements, and medical devices tend to increase in terms of both quantity and cost, often without yielding significant health benefits. In our country in particular, thanks to the National Health Service, the medical market can rely on a flawed mechanism, because the party that pays (the State) neither chooses nor uses the products it purchases; the party that chooses the products (the doctor) neither pays for nor uses them; and, finally, the party that uses the products (the patient) neither chooses nor pays for them. This vast market, which globally amounts to several hundred billion euros in public and private expenditure, has succeeded in concealing its irrationality. It is not, in fact, logical to expend human and economic resources on treating diseases that are ultimately avoidable. Indeed, more than 50% of chronic diseases […] can be prevented; more than 50% of cancers are avoidable, and yet, approximately 180,000 people in Italy die from cancer each year. That which must be done to avoid diseases and cancers has a very specific name, one that is all too seldom spoken of in medicine: ‘prevention’.
Who is the author
Silvio Garattini is a physician and professor of Chemotherapy and Pharmacology. As the founder (in 1961) and Director of the Mario Negri Institute for Pharmacological Research, he has been a member of various bodies, including the Committee for Biology and Medicine of the National Research Council (CNR), the Commission for Italian Research Policy of the Presidency of the Council of Ministers, and the Single Drug Commission (CUF) of the Ministry of Health. He has also held numerous positions at an international level and has received a great many awards and honours. He is the author of hundreds of published scientific papers and numerous books in the field of pharmacology. He is among the most highly cited Italian researchers in international scientific literature.
A necessary change of paradigm
Garattini's reflection brings to light a fundamental contradiction: whilst medicine has concentrated its resources and innovations on treatment, the crucial investment in prevention remains lacking. Shifting the focus from care to health promotion would not only reduce medicalisation and costs, but would, above all, improve the quality and equity of people's lives. This is precisely the perspective of the DARE project, which proposes placing digital prevention at the core of the Health Service's innovation strategies.