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Framing prevention: response to Fry, Gleeson and Rissel.

In a recent HPJA article, Fry et al. responded to commentary that we had published earlier in this Journal on the role of secondary prevention of diabetes in health promotion. We were encouraged that our paper stimulated constructive debate, and in this spirit we reply. The premise of the Fry et al. paper is to challenge our supposed assertion that health promoters should conduct secondary prevention programs at the expense of primary prevention. Rather, we caution the field not to ignore secondary prevention at a time when prevention has attracted more than a billion dollars of investment through the Council of Australian Governments (COAG). We argue: ?By not engaging, health promoters run the risk of not having a seat at the policy table and ... increase the chance that secondary prevention programs draw resources away from primary prevention?. We do not state that health promoters should divert efforts away from primary prevention, rather that the field should influence the strategic development of secondary prevention to ensure these investments are not wasted through poor design, targeting and rollout.