166 The World Health Report 2002 EXERCISING STEWARDSHIP MEANS FULFILLING THE GOVERNMENT S RESPONSIBILITY TO PROTECT ITS CITIZENS Although governments rarely can hope to reduce risks to zero, they can aim to lower them to a more acceptable level, and explain, through open communication with the pub- lic, why and how they are doing so. Governments are the stewards of health resources. This stewardship has been defined as"a function of a government responsible for the welfare of the population and concerned about the trust and legitimacy with which its activities are viewed by the citizenry. The careful and responsible management of population well- being is the very essence of good government. With regard to risks to health, therefore, governments must take a long-term view and have the vision to tackle major, common and complex risks, even if they do not have high public appeal. Governments should not re spond disproportionately to risks that are controversial and newsworthy, but rare, yet must ely to highly uncertain or unki RECOMMENDED ACTIONS This report offers a unique opportunity for governments. They can use it to take bold and determined actions against only a relatively few major risks to health, in the knowl- dge that the likely result within the next ten years will be large gains in healthy life expect ancy for their citizens. The potential benefits apply equally to poor countries and rich countries, even if some of the risk factors are different. Bold policies are required. They may, for example, have to focus on increased taxes on tobacco; legislation to reduce the proportion of salt and other unhealthy components in foods; stricter environmental controls and ambitious energy policies; and stronger health promotion and health safety campaigns he same time, governments will need to strengthen the scientific and empirical evidence bases for their policies. They will have to improve public dialogue and commun cations; develop greater levels of trust for risk prevention among all interested parties; and consider carefully a range of ethical and other issues. This is undoubtedly a radical approach. It requires governments to see the value of shifting the main focus from the minority of high-risk individuals to include preventive measures that can be applied to the whole population For many of the main risk factors there is likely to be good agreement between the general public and public health experts on what needs to be done once a dialogue begins In some countries, risk understanding may need to be strengthened amor public, politicians and public health practitioners Recommended actions that governments can take in risk reduction have been tailored to suit high, middle and low income countries, but in general the report recommends the following Governments, especially health ministries, should play a stronger role in formulating risk prevention policies, including more support for scientific research, improved sur- veillance systems and better access to global information Countries should give top priority to developing effective, committed policies for the prevention of large risks to health. The right balance should be struck between popu lation-wide risk reduction and aiming to reduce risk in a smaller number of high-risk individuals. The former has great, often unrealized, potential.166 The World Health Report 2002 EXERCISING STEWARDSHIP MEANS FULFILLING THE GOVERNMENT’S RESPONSIBILITY TO PROTECT ITS CITIZENS Although governments rarely can hope to reduce risks to zero, they can aim to lower them to a more acceptable level, and explain, through open communication with the pub￾lic, why and how they are doing so. Governments are the stewards of health resources. This stewardship has been defined as “a function of a government responsible for the welfare of the population and concerned about the trust and legitimacy with which its activities are viewed by the citizenry”. The careful and responsible management of population well￾being is the very essence of good government. With regard to risks to health, therefore, governments must take a long-term view and have the vision to tackle major, common and complex risks, even if they do not have high public appeal. Governments should not re￾spond disproportionately to risks that are controversial and newsworthy, but rare, yet must still respond appropriately to highly uncertain or unknown risks. RECOMMENDED ACTIONS This report offers a unique opportunity for governments. They can use it to take bold and determined actions against only a relatively few major risks to health, in the knowl￾edge that the likely result within the next ten years will be large gains in healthy life expect￾ancy for their citizens. The potential benefits apply equally to poor countries and rich countries, even if some of the risk factors are different. Bold policies are required. They may, for example, have to focus on increased taxes on tobacco; legislation to reduce the proportion of salt and other unhealthy components in foods; stricter environmental controls and ambitious energy policies; and stronger health promotion and health safety campaigns. At the same time, governments will need to strengthen the scientific and empirical evidence bases for their policies. They will have to improve public dialogue and communi￾cations; develop greater levels of trust for risk prevention among all interested parties; and consider carefully a range of ethical and other issues. This is undoubtedly a radical approach. It requires governments to see the value of shifting the main focus from the minority of high-risk individuals to include preventive measures that can be applied to the whole population. For many of the main risk factors there is likely to be good agreement between the general public and public health experts on what needs to be done once a dialogue begins. In some countries, risk understanding may need to be strengthened among the general public, politicians and public health practitioners. Recommended actions that governments can take in risk reduction have been tailored to suit high, middle and low income countries, but in general the report recommends the following. • Governments, especially health ministries, should play a stronger role in formulating risk prevention policies, including more support for scientific research, improved sur￾veillance systems and better access to global information. • Countries should give top priority to developing effective, committed policies for the prevention of large risks to health. The right balance should be struck between popu￾lation-wide risk reduction and aiming to reduce risk in a smaller number of high-risk individuals. The former has great, often unrealized, potential