There is an urgent need for research on sustainable models of disease prevention that can be delivered through primary health care in a variety of resource-poor settings. While much is known about the elements required for effective and safe prevention, little is known about how to deliver these reliably and affordably in new disease epicenters such as India, China and South America. If this could be achieved on a large scale throughout low- and middle-income countries, several million people would be saved each year from death or disability during the most economically productive years of their lives.