Given the disease burden of stroke, Prevention (medical) is an important public health concern.

We are not arguing that there is zero change in disease burden.

Most of this money is needed in Africa, where the countries are among the poorest and the disease burden is the highest.

Dengue is thought to have a disease burden of about 1600 disability-adjusted life years per million population.

The relationship between disease burden and disease spending is clearly disproportionate.

Finally it is very well established that life style changes reduce the disease burden of chronic diseases.

Life style changes including work place wellness programs should be encouraged to reduce the disease burden in this population.

By far the important cause is cigarette smoking, which contributes to approximately half of the disease burden.

In the countries where the disease burden is highest, however, the vaccine is still too expensive.

Given the disease burden of strokes, prevention is an important public health concern.